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Often I get phone calls and emails from women looking for the “out of the box” type birth experience. The box is going to the hospital for birth classes where you will be taught how to be a good patient. Then going to the hospital when the care provider decides you are ready to give birth, being induced and getting your epidural and hopefully not having a cesarean in the meantime. But since the metro Atlanta area cesarean rates has several hospitals whose cesarean rates are close to or over 40%, you can see this is not happening.

So, if you are looking for something different- here is my recommendations. Have you considered a home birth? The studies show it is just as safe if not even more safe. There is a great link- Georgia Midwifery where you can see information and details on hiring a home birth midwife. As as a doula, I have experience with several of the local midwives and would welcome telling you about my personal experiences with them. A doula is still helpful as the midwife is caring for you medically and her assistant is much like the role of the nurse in the hospital. The local midwives are lucky to have great physician back up available in the case of needing to go to a hospital during the labor or needing to transfer care during your pregnancy.

If you are not ready to step outside the box to a home birth, let me tell you about the local hospitals that offer gentle birth options and where the staff is used to supporting moms who desire a low intervention birth or natural birth. The care is usually the midwifery model of care. Atlanta Medical has two different midwifery practices that offer water births and gentle cesareans when they are needed. And North Fulton has two midwifery practices that share call between the two groups of midwives that offer many of these same options.

This does not mean you can not find a doctor or midwife elsewhere to offer these options, but as a whole, these are the places where we find these options are normal. If you are concerned about the use of midwives vs doctors- read this article.

As a doula who has been doing births for over 22 years- and attended over 600 births, I have to tell you when something great is happening on a regular basis regarding births, we talk about it within our community. And we talk about the horrific things going on as well. I think hands down the talk in town is to consider Intown Midwifery@AMC ,  Providence Womens Healthcare midwives and Nile OBGyn Midwives @ NFR and for the desire to have a doctor practice Dr Joe Tate @ EMTH.

I wrote this initially in 2013 but feel it needs to be back at the top of our blog. So often folks come to our Mingles to meet us and say that they want to avoid a cesarean. Yet they are choosing a hospital where the cesarean rate is over 40%. They do not plan to take classes or they plan for a hospital based class or a one day abbreviated one. Please realize that today with the high levels of intervention, you have to do a lot of things to avoid the interventions that lead you to the OR. There are lots of ingredients that go into making a gentle birth pie:

  1. Provider
    1. Your gynecologist may not be the best one for your pregnancy care- well woman care vs pregnancy and birth care
    2. Communication goes both ways- can you discuss things and be heard and feel listened to now?
    3. Back up is important- who covers what- do they share call- will you get to meet them beforehand?
    4. Midwifery model vs the medical model of care=What do most women choose? Obstetricians are by far the most common choice in the United States, although certified nurse-midwives are becoming more popular: In 2006, CNMs attended almost 8 percent of deliveries in the United States and over 11 percent of vaginal births. provide handout
    5. CIMS questions to ask
    6. Marriage – then date- can lead to divorce- when is it too late? Don’t stay where the rules of the games are different than the game you want to play.

“Midwives see birth as a miracle and only mess with it if there’s a problem; doctors see birth as a problem and if they don’t mess with it, it’s a miracle!” Barbara Harper in Gentle Birth Choices

“Unfortunately, the role of obstetrics has never been to help women give birth. There is a big difference between the medical discipline we call “obstetrics’ and something completely different, the art of midwifery. If we want to find safe alternatives to obstetrics, we must rediscover midwifery. To rediscover midwifery is the same as giving back childbirth to women. And imagine the future if surgical teams were at the service of the midwives and the women instead of controlling them.” Michel Odent, MD

“When meeting with my OB, I described—in a light way—the feeling I had about the baby telling me he was coming out vaginally. Unfortunately, this kind of thing does not provide confidence to everyone in the medical community! And much to my dismay, they wanted to schedule me for a C-Section, just like that. Thankfully, at least one very important local midwife did believe me and believe in me (and my baby). She encouraged me to do what I needed and go where I needed to get my try at a VBAC. “– Jenna’s story

“Switching practices mid-pregnancy was perhaps the best decision we have made. Last week I was so fed up with being pregnant that I just about begged her to induce me. Had I stayed with my old practice, they would have scheduled a date right then. But not Janet. She just calmly reminded me that no one stays pregnant forever and that my baby would come when she was ready. She talked through natural things we could do to help get labor started and walked us through what would happen if she doesn’t come by 41 weeks.

As we left her office I turned to D and said, “We picked her for a reason. I don’t really want to be induced. But I was desperate. And instead of letting me cave to my uncomfortableness, she talked me out of it. Gently. I’m thankful for that.” She has been a rock for me during the last half of my pregnancy. I’d recommend her to anyone. {This is Janet Fedullo with Alpharetta Women’s Specialists}”- Chrystal Rowe from the blog (more…)

If you were going to build a house and only had a saw, you would be in bad shape. Thus the reason why a childbirth method that puts all your pain coping skills in one basket may not serve you well. Our recommendation is to have a lot of tools in your tool box. In our comprehensive childbirth classes it will not be unusual to leave with three dozen or so ideas for helping manage pain in pregnancy, labor and birth. I would want the construction team building my house to have a lot of tools. We want you to as well.

toolbox

But are too many tools dangerous? I was at a labor recently where the mom in labor had a tribe of friends. They wanted to assist her so badly they were offering her things she did not seem to need at times. She loved the support and hands on, but we prefer to use a tool when it is actually needed and called for. The best advice my first childbirth educator, when I was pregnant decades ago told me after teaching me a ton of tools, was to not use them until they were needed. Otherwise by using them randomly and without real purpose, they can lose their effectiveness. They can also mislead the mom into thinking they will not work later if she did not find them effective early on.

And how about the doula’s tool box? Sometimes I use very few things in my birth bag. I almost always use lotion, my rebozo, some peppermint essential oil and of course my hands. But I have a lot of things in my bag that rarely get pulled out to be used. I have heard it said that if you have a full toolbox as a birth professional you are tempted to use things that are not needed. What does this mean? For instance if someone has been trained in fetal monitoring but you are using a skilled birth professional, your doula should not be using this skill unless she is an assistant to a midwife. And things like neonatal resuscitation skills, vaginal exams, and other medical procedures are not within the scope of a doula. But skills like acupressure, reflexology, essential oils, massage therapy, aromatherapy and similar skills could come in handy and if she is properly trained could be very resourceful.

And how about your care provider’s tool box? If you need a great surgeon, you want him or her to have excellent surgical skills. But if you want a non interventive birth, have you considered asking your provider how they plan to help you achieve that? Tools like patience and belief in birth are essential. If 95% of their moms end up with an epidural, why do you expect they will not recommend that to you? If 40% of their moms end up with an induction, do you think you can dodge that bullet? If breaking your water is their go to tool for getting your laboring moving, perhaps you should ask a few more questions about the risk to that procedure. If they are asking you what you desire instead of sharing their agenda for how your birth should go, they may indeed have the right tools for you. But if their cesarean rate is the local average of over 35%, you may want to change providers.

So pack your tool box full of pain coping skills and hire a doula who has the correct tools packed for the skills that are within her scope.

What exactly does that mean? Citizens for Midwifery offers this definition:

The Midwives Model of Care is based on the fact that pregnancy and birth are normal life processes.

The Midwives Model of Care includes:

  • Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle
  • Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
  • Minimizing technological interventions
  • Identifying and referring women who require obstetrical attention

 The application of this woman-centered model of care has been proven to reduce the incidence of birth injury, trauma, and cesarean section.

And here you can download the pdf or read online the brochure that offers a more complete explanation.

sq anjli

There are some groups in Atlanta who offer midwifery in their services but really lack the midwifery model. They are often nicknamed medwives since they follow more the medical model of care. It reminds me of someone who goes to a “more holistic” type physician but he calls in antibiotics before seeing the patient in the office to determine if they really need antibiotics. We have had midwives walk in the room and immediately spout, “I love epidurals, ” before even asking what type of birth the mom desires. There are some midwives who want to practice midwifery but are being dictated to follow more of the medical model since they are employees of the OB practice. There are a few groups in town who have only one midwife. Since that midwife is not able to be on call the whole month every day, it means that often you will see the OB instead of the midwife. That is not the model of midwifery care. And it also makes you wonder if the physicians really support the model of care. There are groups in town who share call with their midwives- you never know who you will get, perhaps the midwife or one of the doctors. That is also not the midwifery model of care. That does not mean you won’t get good care, it is just not the model that is considered midwifery.

In Atlanta there are a few midwifery groups we enjoy working with a lot since they follow the midwifery model. There may be a midwife or two in the group who is less personable or more interventive, but overall the groups are true midwifery models. One group who is led by a midwife with over 40 years of supporting this model is Intown Midwifery under the leadership of Margaret Strickhouser, CNM. They support birth out of Atlanta Medical Center and offer water birth – even to VBACs.  They offer their meet and greet the first Wednesday of each month. Here is their facebook page.

Marsha Ford, CNM is part of a group: OBGyn &  Midwife Associates. She has been the solo midwife in that group for a while. But recently they hired a new midwifery graduate, Angelina Ruffin, CNM. They also provide services at AMC and offer water births and VBACs and take medicaid. I personally know Marsha but have not attended a birth with her, and although that is a reason I would usually not refer to her until I had, a few of our doulas have attended births along side of her and attest to their wonderful midwifery model of care. Their facebook page is located here.

Another group, or should I say two groups is Providence Women’s Healthcare and NileMidwife Group. They share call with each other but are two groups really. Providence offers a Meet and Greets  to meet the group of midwives. We are invited to this and usually have one of our doulas attend this meet and greet.  Isis offers a meet and greet too, but the person who overseses it makes it a  closed affiliate group and have as an affiliate program that you must not be a group of doulas. Since we are a group of doulas and educators, they do not “allow” us to attend. I know, weird, but the marketing person for Isis does her things her way irregardless of it being best for folks to meet all the doulas who want to attend. But I digress.) So if you want to meet the midwives who cover each other I am guessing you need to try to attend both meetings to do so.  They offer water birth options but not to VBACs at North Fulton where they practice. They have a couple of different offices, but as of today only practice midwifery at North Fulton. Their facebook page offers info on their meetings- Providence Midwifery and Isis Midwives.

Most of these midwifery groups offer family centered cesareans if needed. (working toward this at North Fulton) And they all welcome the support of your doula in attendance for the birth. The staff of each hospital is different but needless to say the staff is used to hearing sounds from their labor rooms of women in labor and giving birth naturally!

It is nice to live in an area where the midwifery model of care is being practiced. There are a few other groups outside of the metro area who offer true midwifery as well. We doula in Athens and the Gainesville area where midwifery is offered. This is not an all inclusive list for sure. I am hopeful that there are other groups of midwives offering this type of care in Atlanta. If you want to share your group in the comments section on the blog so others can know of this care, please do so. But as the owner of a busy doula practice, I can say these are the groups we are most familiar with and we feel offer the most options. We are lucky to live where midwifery and water births are offered.

I remember the days when you would meet a doctor for the first time in his office. He would sit behind his desk- you could look around at his diploma on the wall; and get a sense of who he or she was by the way the office was decorated. And then he would enter in and talk to you. Yes, really. You would be fully clothed and he would chat with you about your needs and concerns. Then afterwards you would go to the exam room, undress, have the exam and then meet him back in his office. They do not really do that any longer. Why? It took too much time. It was not an efficient way to see patients for the amount of reimbursement they would get from your insurance plan.

doctor at desk

Now you are in the waiting room- you fill out your questionnaire and are ushered hopefully without too long of a wait into an exam room. The nurse tells you to undress and may ask some questions that she puts into her words into the computer. The doctor enters and stares at the screen and then turns to you to do the exam. He meets you undressed and addresses your needs after the exam while you remain undressed. But he can see twice as many patients if not more this way.

We ask few questions and get little sense of what is really going on many times. The doctor is up and already has his hand on the door knob when he briskly asks if we have any further questions or concerns.

We have to start taking back our medical care. Come armed with a list of questions and concerns. Demand to be listened to. Don’t leave until you understand the plan of action for your care. They may mark your chart with the code of someone who needs more time than the usual appointment allotment. But that is okay. You will be getting the information you need to make the right decisions for your care.

And a very important thing to consider is your level of communication with your provider being authentic.  If you do not understand, ask him to explain it differently so you can understand it. If you do not like the way you are being treated, you need to stop them and tell them how they are making you feel. It is time that feeling intimidated by a person with a degree makes you feel less of value. They are there to serve you.

I heard that a doctor recently told one of our clients that she did not need to be fully informed and then given time to decide on the next course of action for her birth. She was hiring him- a professional with expert skills and knowledge. He would know the best thing for her. She needed to just listen to him and do what he said. I don’t know that would send hair standing up on my back for sure. I want to be a part of the decision making regarding my body and my health. I love the word consultation for that very reason.  I had a mom last week tell me she was taking a supplement that is actually an induction agent because her midwife told her to do it. I wanted to scream. She had failed to ask any questions about what to expect from taking it, the real purpose behind doing so or the possible negative side effects from doing so. Take ownership of your care. Trust your providers but understand the advice they are giving you fully.

Here is an email conversation I had this week:

I am very interested in hiring a doula to support me and help me VBAC (Vaginal Birth after previous Cesarean) in *************.”

I asked a few questions about her due date and location for her birth.

I am birthing at *************, and am looking for someone who have assisted in VBACs before. I was ten days early, spontaneous labor with my first.”

Well if any doula has been doulaing for very long she has experience with VBACs. I was curious if she was setting herself up for a real chance for a VBAC. So I asked a few more questions about who she had chosen for a care provider and what preparations she was taking this time and the reasons for her previous cesarean.

I have seen Dr. ****** for two appointments thus far and have another one next week. Is there a certain Dr/practice that you are familiar with that are VBAC friendly? I am still early and have not had an in-depth discussion about VBAC, but was told from the first appointment that there should be no reason not to allow me a TOL. (Trial of Labor)”

I have to be honest. I was quite shocked at the practice she was with offering her support in having a VBAC. This practice is not known for natural births nor supporting VBACs as of the last I had heard. I told her she needed to have some really frank conversations early on to make sure they had changed their policies. Ask them how many VBACs are successful within the practice. I also found out that her first labor was where her water had broken- no labor started- and yes she had recently had a vaginal exam- and then the augmentation had failed to have her give birth vaginally. She then shared this with me:

I was starting to get this feeling that maybe they would try to bait and switch me at the end. I have an appointment on Wednesday of next week and will discuss in detail the likelihood that they will really support my VBAC wish. My water did break and it was four days after an exam. I progressed to a ten, but baby was “sunny side up” and after 4 hours or pushing he was not fitting through my birth canal. I ended up needing a blood transfusion  from the cesarean and just had a hard recovery, and would like the chance to have a positive birthing experience (either vbac or cesarean). You have definitely enlightened me on taking more action now and not waiting.

So the baby being OP was the issue. Not the size of the baby. She is a perfect candidate for a vaginal birth. And her intuitive voice had already led her to believe the practice was not really being fully supportive of her desires. I suggested she take our Aligned and Ready workshop to help her have an optimally positioned baby this time. I also encouraged her to ask more questions and question their evasive answers.  I encouraged her to do a bit more research of her options.

“I called my current hospital and they stated they could not give out which doctors perform VBACs, but to call around to the providers and ask. So I just called my current practice without revealing who I was and she stated that no doctore there who was VBAC friendly. Definitely an eye opener.”

bait and switch

She is doing her research. She is aware that the Trial of Labor was not really going to be a true trial of labor at all with her current practice.  A few days later I received this email from her:

 I just wanted to update you since you have been such a blessing thus far. I have officially switched to Dr. ****’s office. I will officially be his patient in May. I researched and just loved everything I read about him. At what week would you suggest coming to your workshop “aligned and ready”? Also, at how far along should I book one of your doula’s? Thanks a million times over.”

I was happy she had done her research after I offered her a few names of practices that were truly supportive of VBACs. I encouraged her to take the class at her earliest chance. And it is great she is hiring a doula- hopefully a Labor of Love one and encouraged her to do so sooner than later!

I am often still shocked -although I see it a lot- when practices lie or lead a woman to believe she has their support in the type of birth she desires. There are no excuses for a bait and switch mentality ever.

 

 

 

I recently attended a birth where the mom wanted to decline getting an IV access. This was not news to her doctor. She had told her doctor numerous times that she wanted to decline this procedure. My client was well informed and knew that evidence did not show this was an essential intervention for a healthy mom birthing. She had done her research and read the articles like this one in Evidence Based Birth.  She had planned to keep well hydrated and felt it would restrict her.

When she arrived to the hospital she was well rested, hydrated and contracting regularly and moving along in her labor. She was put on the monitor for her twenty minute strip and within 40 minutes was told the baby looked great and she would be coming off the monitor. BUT when the nurse went to set up for placing the INT – IV access and the mom declined the nurse changed her tune and she was told she had to remain on the monitor until the doctor who was in a delivery would come in to talk to her.

choppy waters

So we waited another twenty minutes or more for the doctor to arrive. She sat on a stool and discussed the reasons for doing an INT. She mentioned that she once had a mom who needed a cesarean and did not have an IV and they almost had to use lidocaine on her belly to do the cut for the cesarean. THERE IS NO WAY that would have occurred. The vein in the bend of the arm is almost always accessible and can be done in an emergency. And this mom would have been put under general anesthesia before doing such a procedure.

Then the nurse decided to chime in. She said that if the mom who had desired to get in the tub wanted to stay in the tub as she once had agreed upon (Not funny how the nurse had to agree to allow this mom to get in the tub), she instead of staying in the tub for 50 minutes and out for 10 for a monitoring strip ( she said the one telemetry unit was in use and did not  work well with the jets on in the tub) she would instead have to get out every 20 minutes for a 10 minute strip. She said without the INT she would be worried about the wellbeing of the baby. And she reminded us that it was about her license.

I knew this mom had just been told two LIES to try to manipulate her. Coercion has no place at a birth. Then the kicker- her doctor is going off call after saying she felt the mom could stay in the tub for the full 50 minutes of every hour. And the new doctor coming on is not happy that the mom does not have an INT. This is a doctor in a completely different practice- one she has never even had an opportunity to meet. Did you know that your practice may be one of the practices that shares call with another whole group or two or three of doctors? This doctor said they would not have accepted a patient who was not willing to allow an INT.  So of course he wants her to get it. So now the nurse is still making the 20 minute rule stand.

The dad was fabulous! He said, “So wait. because my wife is declining the INT you are going to punish her?” I had to bow my head to hide the huge smile that spread across my face. This is not my battle to fight for them. I can remind them of what they desired and support them but my words should not enter into this negotiation. So this dad stepping up with such raw honesty was fabulous.

The mom and dad talked about having some time away from the manipulators and decided to get the INT. The freedom of being in the tub for longer lengths of time was more important in the end. What is sad about this story is this should never have happened. Having an INT IV access is not essential to a birth. If the mom had been dehydrated or wanted medication she could have gotten it early on. This was not this situation.

Sometimes you make a decision to use a provider or birth location you will find more choppy waters to negotiate than others. This couple was well prepared. They had had several discussions about what they desired in their birth. Their provider never said that they HAD TO HAVE an INT. She only asked them to keep considering it. The dad said he felt the doctor had been a push over or conflict avoider. I feel that she was a bait and switcher. She never told them what she knew she would inevitably make them do. The nurse who had lied and been manipulative all of a sudden found the telemetry unit and started to be kind after the INT was placed.  She even told the mom she was lucky she was the one placing the INT since she never put it in the moms hand so she has more mobility and she used lidocaine so it was less painful. Gee- you mean the other nurses if she waited would not honor those same desires? Thanks!

I respect this couple for standing their ground- although I do think all of that adrenaline and lack of ability to relax and go to her laborland space interfered with her labor. I do think that when they repetitively asked her why she was declining and she repeated herself over and over, she was not being respected or heard. I do think that having to fight in your labor is counterproductive. I think they were worn down a bit but I feel in the end they chose their battles. But why do we have battles in labor to begin with?

When will informed decisions by a woman in labor be respected? Several times the word dead baby was used in the conversations about this procedure. When you use such phrases as sick or dead baby, it makes women fold. That was not true in this case because this couple recognized the lie. I hate that this couple had to even have any of these conversations taint their beautiful birth.

This couple negotiated the choppy waters of this hospital. They knew there would be some battles when they learned that this hospital had protocols that were not evidenced based and were more interventive. I am unsure if they knew that several practices shared call with their practice.  Negotiating beforehand does no good at all in this case.  Making a concession to get the INT for more freedom in the tub was one I would have made as well if I had been in this same situation. Having her husband as her protector and extra emphasis to her voice was priceless.

Understand the choices you make may mean you need to learn how to negotiate choppy waters in labor to get closer to the birth you desire. Ask your questions long before you get into the last months of your pregnancy.

I posed this question on our facebook page to women and asked them what it was that their care provider did that made them love them. These are some of the answers I received:

I loved that the doctor for my second baby was humble and really took the time to listen to my questions, thoughts, and concerns. He made me feel like I was his only patient of the day and treated me and my husband with respect.

I love that my provider encourages me to learn about my birth options and shares worthwhile resources (books, websites, birth groups, doula services, etc.) with me to become as educated and knowledgeable as possible.  I visited several practitioners and always asked the question, “What books do you recommend for me to read?” And when they struggled to come up with an answer or only suggested “What to Expect When You’re Expecting”, I knew they were not the right fit for me.

A good provider doesn’t tell you what you have to do, they give you options & information and allow you to choose.

I love that my midwives spend time getting to know me, and allow me to labor and birth the way I want to.

Even on a busy day my doctor would stop what he was doing and look at me if I was talking. He cared what I thought and said.

Sat down with me to go over my typed page of questions each and every visit. I now know what a pain I must have been. But she started scheduling double Appts for me, and inviting her students in I answer some of my “excellent questions”. (I imagine to give them practice with difficult patients)

He treated me like a human being. Most doctors rush in, list symptoms they observe and walk away. My doctor actually showed that he cared and was compassionate.

Sits down to talk at every appointment vs chatting while typing up his note.

Makes me feel like the most important person he or she has….

Listens. Explains (in a non-condescending way). Cares!

Let me just add. We lost our baby at 40 weeks 2 days. Today we received a call from the doctor who took time out to call us and let us know what the results from the placenta/ cord testing were. So grateful for his kindness and time.

Do you see the resounding theme that seems to be in every one of these responses? It is respect.

finger-pointing-dad-w-teen

(more…)

I think it is great when a doctor or midwife practice has a relationship with a childbirth educator or doula. It means that there is a sense of trust that what is being taught or the way someone supports a woman in birth or postpartum is good. I like being on several lists that offices give out. The referrals most often go both ways. When we feel a woman is respected and her wishes honored, it gives us a sense of our referrals will be supportive of what the woman’s birth ideals are. We do tend to quickly find the practices we love to work with. Although it is great to find new ones, it is more often we are reaffirmed as to why some practices who do not support women’s choices are ones we never refer to.

But when a doctors office gives you one referral- says this is who we are “partnered” with and there is an exclusivity to the referral it sends up a red flag for me personally. If someone attends a hospital birth class or a doctors’ office provided class, where payment is being made to the hospital and then the hospital pays the educator, it makes me keenly aware that the hospital controls what is being taught. That does not mean it will be bad, but it often does mean it will be biased. When a doctors’ office says this is the doula group I want you to work with, it means that there may be control in that relationship. It is not that different from a hospital doula program. There are some awesome ones out there across the country- but others I have been made aware of by talking to others who work in such programs have told me they are controlled. Being told what you can not do- even when it is within your scope of practice, or told what you can not say or teach- although it is evidenced based, is never good!

doc partnership

I think the key is exclusivity. Can you go outside their referral? Do they make you feel you have to “obey” them? That is a huge red flag! This is your birth! This is for you to determine who is the best fit for you. If they want to control these things you have to ask yourself, why? Do they control the educators and doulas whom they refer out to? Do they hold expectations for them to be on the same page as them, rather than looking out for your best interest? Couldn’t they be working for the doctor or hospital instead of you?

The days of doing whatever my doctor or hospital tells me to do should be gone. It is time to make decisions that are the right decisions for you as an individual. Otherwise when the outcome is not as you had hoped, will you take responsibility or will you be quick to blame your care provider who you listened to without questioning the things you did not understand or believe to be true for you? You can not have it both ways. You either need to believe it is right and understand it- and take responsibility for your birth or you have to let yourself be led blindly and then accept the outcome as one where you were not making the decisions- but indeed your lack of being fully involved is the decision that you are responsible for. Your relationship with your care providers needs to be one of respect- both ways- where they offer guidance and you are able to ask questions or decide to go in a different direction and still be accepted.

Birth is yours- take it back! But that means taking responsibility! Make the choices that are right for you! Surround yourself with those who will fully support you as a strong informed person.

 

 

This was a question posed on a birth professional group I am a member of online. I wanted to share the top ten things that birth professionals- midwives, doulas and educators had to share.

(One person said it was hard to pick just one since there were many issues.)

one thing

  1. staff was shared- the lack of education on their part and the lack of desire to support laboring women.
  2. many said it was the lack of education on behalf of the woman- about her choices, her options and even the birth process itself, leading to a lack of informed consent. And women not knowing what they do not know until it is too late- and women not taking responsibility to make sure they know.
  3. induction was sited by many, the lack of trust women had in the birth process and allowing someone else to intervene in the process.
  4. profits and lies was mentioned- lies between women talking to women, lies between medical professionals to women, lies between parents to children.
  5. laziness, passiveness and apathy- it is easier to just show up- get the epidural or the planned cesarean than it is to learn what you need to learn to actually labor to birth- looking for a reward without putting in the work.
  6. power over instead of power within- women giving up their power.
  7. fear- fear of the unknown, fear of failure, fear of not being accepted, fear of being treated badly if you do not obey.
  8. fear mongering by pharmaceutical and medical professionals- and preying on this ignorance of the consumer.
  9. lack of support- being more focused on machines to tell us how a woman is doing rather than looking at and supporting the woman.
  10. the medicalizing of birth and women no longer being taught to trust birth and own their birth and their decisions.

I do realize that all women do not want a non interventive natural birth. but as a birth professional I will say that often we say many women do not know what they do not know. Now this is not every woman- but I will say it is the majority of women today. They may read a few books- many of them instilling more fear with a splash of comedy but no real truths revealed. They may watch some youtube videos and maybe even get one from netflix but they do not really seek out information about their particular community from those who will reveal the truth. Birth has become a business. Women are looking for quick appointments with no waits. They want a fancy office decorated beautifully. They want a local hospital to be a close drive that is beautifully decorated with the newest of all the gadgets. They want to be directed by their doctor and told what to do so they do not have to take much if any responsibility for the outcome of their births. They want a nursery with the highest level of NICU for the just in case, not realizing that many of the interventions is what causes their babies to be in the NICU. They want someone to help them perfect breastfeeding with one quick visit since they did not take the time to take a prenatal class. They want a comfortable bed for their partner and great food for them both while being taken care of in both labor and postpartum. The idea and benefits of getting home quickly are not something they would fathom.

What we do know- for a healthy mom- the fewer interventions the better outcomes for both her and her baby. The shorter the stay, the better outcomes with breastfeeding and less intervention for the baby. Healthy mom and healthy baby relies on less intervention not more.

do not disturb

Birth will not change until women change birth. Doctors and hospitals cater to the consumer. If you demand a different experience, they will begin to listen and offer you options you desire. Birth will not change until women take back their birth responsibility. Preparation is up to the woman. You can not expect an outcome without putting in the effort to make that ideal birth happen.

Change is happening. Inductions were at such an increase that cesarean rates rose so high insurance companies started to look into the situation. Why was birth costing so much more? Women were getting more drugs, having more surgical birth and babies were spending more time in the NICUs across the country. When the cesarean rate is upwards to 40% something is really wrong. When women begin to believe that an induction at 37 weeks gives them a full term baby to only find that baby born prematurely and needing NICU support for weeks, something is really wrong. When women elect to have major surgery after their first birth ending in a surgical birth, not realizing the risk to their bodies and their baby’s because of the fear put in them to have a VBAC, something is wrong, especially since the rate of rupture increased only due to doctors fiddling with a woman’s body after having done so the first time leading to that cesarean.

If you want to change your birth experience from the “normal” birth today, you have got to take responsibility in doing so. Take a childbirth and breastfeeding class that is taught by an independent educator- not where you pay the hospital or your doctor.  There is control over what those educators can teach. Get your team together- your partner needs some classes too! Hire a doula- not just a friend but someone who is trained to help you have a better chance for a better outcome. Eat a nutritious diet, growing a baby with a healthy diet and get exercise. Learn about optimal fetal positioning and help your baby line up for an easier birth. Choose your care provider wisely. Does he or she listen to you in a respectful way? Do they guide you to explore options that are right for you? Do they encourage you to investigate choices that are available?  Choose your location for birth carefully. Every hospital is not right for every woman. Find out what the stats are at that hospital. It is great if your doctor has a low epidural rate if you want a natural birth, but if the staff only sees medicated births, how supportive will they be or even know how to be for you?