Client #1: Finds out that the provider she has used as her gynecologist does not feel the same way about birth as she does. She has concerns that the hospital where they practice is not offering as many options either. She researches her options and changes practices.
Client #2: Has had some early pregnancy issues that caused her to be considered high risk. Those risks have resolved, but she is loyal to her original doctors since they were with her early on. Although she realizes that staying with them causes her to have to compromise what she had hoped her birth would be like… she continues with their care. It is more convenient to do so.
Client #3: Had fertility issues and she had IUI or IVF at a particular hospital referred by her current physician. She wants a low interventive birth although she struggles with the thought that her body was a bit “broken”. Due to that, she will follow all protocols at her current practice which are very interventive. They induce at 40 weeks, although that is not ACOG recommended. She understands that inductions lead to more cesareans, but she will forgo the dream birth she desired for an interventive birth. After all, this is a “premium” pregnancy. (What pregnancy isn’t?) She gives way to fear and lets it lead her.
Client #4: Had fertility issues and she had IUI or IVF at a particular hospital referred by her current physician. She wants a low interventive birth although she struggles with the thought that her body was a bit “broken”. But she has a birth she has always envisioned. She determines to get that birth she has to make some changes. She determines the location that offers her options she has always wanted and changes practices. She determines she needs to work on the “broken” mentality and move forward with her hopes and dreams.
You must take responsibility for the outcome of your birth when options that were available were not taken.
Clients #1 and #4 could end up with very interventive births in the end. But it will not be because they did not do her their due diligence and seek out options. Sometimes in spite of doing so, births need interventions. Clients #2 and #3 could end up with marvelous births despite being driven by convenience or fear. But the chances of those births being empowering are somewhat limited as their options are also limited. And the odds are stacked against them having the birth they desired originally.
As doulas and educators, we offer truth when someone calls us for input. We want women to be aligned with locations and care providers that align with the birth they desire. If you say to us that you want options and low interventions but then share your birth location or practice that years of doing this has led us to believe are not aligned with your desires, we will tell you. It is up to you to do with that information what you will.
But, you must take responsibility for the outcome of your birth when options that were available and were aligned with your desires were not taken.