Tuesday, November 4, 2014

A lesson in Expecting Kindness

I attended a hospital birth recently.
I've been a Doula for 17 years, coming up this July, and I have attended A LOT of births.
I have also been teaching for over 16 years, preparing thousands of families by now...about the challenges and magic and beauty involved in giving birth.
Those who know me, know that while I respect medicine, I am also very skeptical of the "for profit" model, especially in relationship to childbirth.  I try to dance on that line, teaching couples to choose their care providers wisely, asking the tough questions in advance, and challenging their caregivers when there appears to be a departure from a low-to-no intervention birth plan.
I do this because I firmly believe a few simple things.
  • A doctor or midwife who is worth a grain of salt will WANT you to to be an empowered, thoughtful, questioning member of your own health care team and anyone who doesn't see you that way should be fired.
  • If a provider is defensive about a procedure they are recommending, or doesn't want to answer your questions about it, one of two possibilities are at the root: 1. It is routine and he/she can't explain why it is the best course of action 2. He/she is an A-hole and finds your questioning irritating and insulting. 
  • While simultaneously billing us hundreds of dollars for supplies that were not even touched, and over-treating women (sectioning upwards of 40%) on a daily basis, hospitals have the audacity to claim that they don't have enough money because of litigations, while still posting ridiculous profits annually for their shareholders.  It is bold faced, obvious, transparent, hypocrisy, and they don't even apologize for it.  Everyone in the business has been institutionalized, which just means that they have accepted the fraud because it allows them to do good some of the time.
  • The most common interventions don't prevent or treat most common complications, which ironically are not the reasons they are usually being implemented anyway.  The "concern" is more often used as a catalyst to use the routine interventions that allow care providers to manage a labor, instead of allowing each laboring woman to have her own unique labor process.  The medical model of birth is methodical, like other procedures, and providers have become accustomed to the version of labor that the hospital has imposed. They have grown accustomed to the passive, quiet, compliant, perhaps even pleasant, medicated woman who believes that she is "being saved" by an epidural or by an induction or by a surgery.  Definitely not always true, sometimes the polar opposite.  For one example, you can follow the link to this  article that discusses the evidence for induction and/or cesarean section when a "big baby" is suspected. http://evidencebasedbirth.com/evidence-for-induction-or-c-section-for-big-baby/
The good news is that with the new guidelines set forth by the American Coalition of Obstetricians and Gynecologists (ACOG), I am already seeing a shift in area hospitals that I once dreaded and steered families away from if they were seeking a natural birth.  More couples who are either planning hospital births, or end up transporting into the hospital during labor, are experiencing more  family centered, holistic, care. I have personally/professionally witnessed this at: Evergreen Hospital, Swedish Issaquah, and Northwest Hospital in the last few months. I am happy to give credit where credit is due.  I am still somewhat of skeptic, however, and will need to continue to see this trend grow and be demonstrated by a variety of providers before I will able to confidently say the words we would all love to say.
Those words are:
"You can have the freedom to choose a low-no intervention birth in any environment, home, birth center or at a hospital, as long as you and your baby are healthy and low risk.  There is no difference in the care provided in an uncomplicated birth.  The hospitals cesarean rate has dropped significantly as a result of ACOG's new guidelines."
I want to say them, we all do, but I can't say them just yet.

If you want to be able to create your desired birth experience in any environment, the truth is that it requires some education.  I teach my classes the same way no matter where you plan to birth, because families who seek to birth at home or in a free standing birth center, may find themselves transporting to a hospital for non-emergent reasons and may still have many options and choices prior to any intervention.  Conversely, families planning to birth in hospital sometimes change their minds and seek midwifery care as their confidence builds with their knowledge...and occasionally babies decide to be born, on a ferry, on the roadside, in an elevator, or at home despite all the best laid plans. It's best to be prepared for both a non-interventive birth, and be prepared to navigate the hospital in the event that interventions become necessary.

Come join me at the beautiful Eastside Birth Center, in Bellevue Washington for my 8 week Childbirth Education classes.  I have space in my next session, beginning November 17th! Select the links to the right for more information about classes and registration.
Not in the area?  You can use my curriculum in the privacy of your own home by visiting my website at www.expectingkindness.com.

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