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trust and faith in her ability to give birth. It is our goal to promote safe and
loving birth experiences through education, introspection and confident
action.
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...for the mind
Keeping an “Open Mind”
How many times have we heard the expression, “You should keep an open mind”? This expression is especially familiar to pregnant women, particularly those who share their plans for giving birth free of medications and other common labor interventions. “Keep your options open,” well-meaning friends, family members and medical professionals tell them.
Our culture is such that the confidence that your body can birth beautifully on its own has been largely lost.
I invite women in my classes to keep an open mind toward unmedicated birth.
Everyone knows that medication is available. This is an option that everyone knows is there for consideration. But I appeal to women, why not consider the other option? Plan for the natural birth that you want, because if you fail to prepare, your options may be limited. Certainly a woman who has considered an unmedicated birth may change her mind, but for the woman who never considered natural birth and has not prepared for one, the option may not be open to her because she has not learned the coping skills which facilitate that type of birth.
There have been many occasions where I’ve seen women advised to keep an open mind, told that if they plan on giving birth unmedicated and then opt for an pain medication or require some intervention, that they will feel guilty, disappointed, as if they had failed. I have been teaching childbirth classes for 10 years and have not seen women experiencing these negative feelings in the instances where they had to give up some portion of the birth that they wanted in order to get the birth that they needed. They know that they did everything that they could to have the birth that they had desired, that they did the best that they could with the information that they had and the circumstances that presented themselves. They do not say, “If only I had known __________, this might have been avoided.” They know that they are not to blame when they used all of the strategies that were available to them, and kept medication as their last resort rather than their first.
When women ask me about what a successful birth is, and whether medication means failure, I tell them that the only thing that I consider a failure in birth is a failure to educate yourself, and none of the women in our classes fit that category. A successful birth is one that results in a mother and baby who are healthy both physically and emotionally, and this means a birth that leaves the mother feeling good about herself, her baby and her experience.
With the overuse of epidurals, pitocin and a wide range of labor interventions, perhaps if more women kept an open mind to unmedicated childbirth, there would be less disappointment, guilt and blame, and more ecstasy, euphoria and elevated self-esteem after birth.
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...for the body
The Cesarean Conundrum
The current debate over “on demand” or “maternal request” cesarean sections leaves birthing women and the professionals who work with you facing difficult questions. Should a woman be able to choose to give birth by major surgery and the risks that it entails without a medical reason, simply because she prefers the surgical route to vaginal birth? Should doctors oblige women who want a cesarean section when there is no medical indication for this surgery? How, as childbirth educators and doulas, should we best advise women who ask us for our help in making this decision?
Those who feel that women should have the option of “maternal request” cesareans say that women should have the right to choose, to make a well informed decision. However, many women who choose cesarean surgery are not accurately informed of the risks of cesarean birth. They may feel that a cesarean would allow them the “convenience” of a scheduled birth so that they can plan time off of work, or arrange for help at home. But they fail to consider that a cesarean is likely to lead to more complications and a longer recovery time than a vaginal birth, so although they can plan to have their mother come for two weeks to help with the baby, by the time Grandma leaves, the new mother may still be exhausted, in pain, possibly recovering from an infection that she would not have contracted had she had a vaginal birth. Some women prefer a cesarean to the pain of labor, without fully understanding the implications of major surgery. The pain of labor is a day, but the pain of a cesarean recovery is weeks, or possibly months. But when these mothers are recovering from their cesarean surgery, they think that the pain is simply a part of childbirth recovery.
Should women have a right to choose surgery that they do not need? When this question was posed in a childbirth class recently, every expectant mother said that although they would never choose this option themselves, they felt that it should be a woman’s right to choose, as it is her own body. But what of the baby she carries? Is it right to expose the baby to the risks associated with cesarean delivery when the cesarean surgery is not being performed to improve the birth outcome or the health of the baby or his mother?
Doctors may feel that it is ethical to allow women to choose to have cesarean surgery that they do not need, but yet they would not perform an unneeded appendectomy or mastectomy, and these surgeries do not affect another person. So why would it be ethical to perform unneeded surgery in the case of cesareans? And a question that begs an answer of the medical professionals who feel that it is ethical to allow women to choose an unneeded cesarean is, “In today’s society, why are doctors willing to allow women to make the decision to have a cesarean, but not to choose a VBAC?”
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... for the spirit
Just Saying No
In childbirth classes, we teach women that they have many choices – whether or not to eat or drink during labor, different ways that they might have their baby’s heart rate monitored, various positions that they might choose from for birthing. But the most important option that women have, and often do not realize that they have or do not take advantage of, is the option, the right, to say “No.”
Because we are often conditioned to see a doctor as an authority figure, many women feel intimidated to question the doctor’s judgement or to decline his medical expertise. When faced with a situation of a doctor pressuring her to accept intervention, an expectant mother will often give in to the doctor’s pressure even if she feels that what he is advising is wrong for her.
Doctors typically do not tell women, “Remember that you have the right to question or decline any treatment that I recommend.” Many women do not realize that they have these rights. Their rights may be presented in a way which they do not understand.
I recently had an expectant mother in my class who wished to avoid internal exams during her pregnancy. After her 36th week appointment, she told me that her doctor was not happy that she declined the exam, but that he told her he would “allow” her to have her way this time but at the next week’s exam, he would have to “insist” on doing an internal. I reminded her of several things. First, that if she did not remove her clothing, there was no way that the doctor could perform the internal exam. Second, that if she asked the doctor how she or her baby would be healthier or safer for her having an internal, that he would be hard pressed to come up with an answer. And third, I reminded her of the four powerful words that all expectant mothers should know that they have the right to say, “I do not consent.” Her doctor could insist all that he wanted, but the decision about who will touch your body and what they will do to it always rests with the mother. It is important for all birthing mothers to understand what is happening during labor and whether recommended procedures or drugs are truly medically indicated, as they may be in some instances.
Women’s spirits in labor soar when they realize that the power is theirs, and that they are in control. Their labors will progress much more smoothly and their self esteem will be boosted when they feel taken care of rather than victimized during their births, and it is our job to help women realize that this choice is largely theirs.
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Birth Works E News has been written to provide information on Birth Works® International programs and general information about pregnancy, childbirth and breastfeeding. The information provided is not intended as a substitute for professional consultation with a childbirth educator, lactation consultant, doula, midwife, or physician.
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