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What Your Doctor Wants To Tell You About Birth, But Can’t

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Too often, medical doctors are portrayed as the bad guys in the birthing world. In truth, there is a lot we don’t see and which they really can’t talk about. We are excited to share this guest post today from Jessicca Moore, a family nurse practitioner and filmmaker in Petaluma, CA. Jessica is currently raising money to help finish a film all about medical personnel who birth at home. (There are more of them than you would think!) You can read more about her film, “Why Not Home?“, on their website. Her words are wise and incredibly helpful. Happy birthing!

If you’re planning a hospital birth in the US, you’re likely seeing an OB/GYN. Some of you are seeing a family doctor or a certified-nurse-midwife (CNM) who will attend you at the hospital.

Doctors and nurses are trained not to impose their own values and beliefs onto their patients. To the woman who says she doesn’t want to feel any pain during labor and wants an epidural as soon as possible, our training tells us to accept this as her choice and support her in it. To the woman who says she wants an unmedicated natural labor, our training tells us to accept and support this choice as equally valid.

Your provider is supposed to maintain some professional distance and remain unbiased toward her patients. Because of this, she likely won’t tell you about how difficult her recovery from her c-section was and how she couldn’t pick up her toddler for weeks.

She won’t tell you about the intense rush of emotion and joy that came over her when she gave birth to her daughter after a long 30 hour unmedicated vaginal birth. If she did, you might feel like you should do it the way she did, or do it differently, depending on her story.

In your 10-15 minute visits, it can be hard to delve deeply into all the possible risks and benefits of each decision, the research, and your personal values and preferences. Even if you did, the chances that that provider is going to be the one attending your birth are pretty slim.

So much of birth is out of your control. Once you’re in labor, things can go any number of ways.

If you want to have a natural birth, here are some things you can do to stack the deck in your favor.

  • Get prepared. There are lots of great childbirth preparation programs out there. Try a few and see what fits. Knowledge is power when it comes to birth.

  • Read birth stories. Positive ones. Listen to your friends who had great births. Focus on those. Your birth can be great too.

  • Get support. Hire a doula. Don’t think you can afford one? Call and talk to a few. You may be surprised. If you can’t get a doula, ask friend who has experienced birth and knows your plan to be there to support and advocate for you. Your partner will be having their own experience. Don’t rely on them to be everything for you.

  • Get informed. What is your hospital’s c-section rate? Trying for a VBAC? What’s the VBAC success rate at your hospital? Birth by the Numbers has a great site for getting this information. www.birthbythenumbers.org

  • Ask questions. Especially if something doesn’t feel quite right. Is the induction necessary? What if we wait 2 more days? It’s your body and your baby. You’re allowed to ask questions.

  • Take care. Rest. Eat well. Stay active. Try prenatal yoga. You’ll be that much better off entering labor if your body is strong and healthy.

Do all that, and then let go. Birth is big. Birth is beautiful. There’s no one right way to do it.

You are powerful. You are capable. You can do it.

If and when you need help, it will be there for you.

No one can tell you how it will go for you.

You and your baby are starting your journey together. You’ll have your own unique experience.

Your doctor may have seen hundreds or thousands of births, but they’ve never seen yours.

Nurture Nature Photography and Erin Wrightsman -c- 2013 erin@erinwrightsman.com  2013040920130409-RRL_0819 (1)

Jessicca Moore is a family nurse practitioner and filmmaker in Petaluma, CA where she lives with her husband, two children, and two sheep. She is currently in production on her first feature-length documentary, “Why Not Home?” The film follows hospital birth providers who chose to give birth at home. You can watch a trailer and get more information here: www.whynothome.com and support the project on kickstarter at bit.ly/whynothome through October 10th.

Follow the project on twitter and instagram @whynothome and facebook at facebook.com/whynothome

You can find Jessicca on twitter @jessicca_moore

(Photos by Erin Wrightsman, used with permission.)

What is Mother-Friendly Care?

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Mother-Friendly is short for the Mother-Friendly Childbirth Initiative (MFCI).  There are 10 steps, which an institution or care provider must take in order to be considered “mother-friendly”.  .  They are very specific and some steps are harder to achieve than others.  Do not just assume that your care provider is Mother-Friendly.  Ask them.  These steps are based on evidence and what produces the best outcomes in birth.

A Mother-Friendly Care Provider, Hospital, Birth Center, or Home Birth Practice: Read more

Rules for Talking to a Laboring Woman

Preparing for birth is a unique time in a woman’s life. Many women spend their lives looking outward, seeking to serve others. But in labor and birth a woman has the opportunity to be at the center for a brief moment, and to have those around her serve her, listen to her, and help her in any way they can.

Occasionally, however, those close to a birthing woman use it as an opportunity to fill their own needs or express their own fears to the mother or those closest to her. While it may seem obvious to most, dumping our own emotional baggage on a pregnant or birthing woman is actually inappropriate. Sadly, there are many who have missed the boat on this particular subject.

How many birthing women are surrounded by people (including family) at their birth that they didn’t even want present? How many pregnant women must listen to the horror stories of others simply because they have a round belly and are, obviously, expecting? Birth, however, is not about making those that surround a woman happy and comfortable. A great birth team seeks to make the mother and her closest loved ones happy and supported so that they and the baby can have the best experience possible both physically and emotionally.

The Goldman and Silk “Ring Theory,” as discussed in this LA Times article, explains the idea that during times of extreme stress (such as turmoil or illness) the person most affected or at the “center” has the privilege of receiving emotional support, and the ability to “dump” outward. That is, the person at the center can ask for help, and the people outside can offer.

The idea that “support goes in, needs expressed go out” doesn’t just apply to illness; it works beautifully in labor, too.

When a woman is in labor she should be at the center of the circle, the center of attention, and the person who is focused on. She can request anything from those around her. Support should always flow towards the center from the outer circles, and requests should flow outward. For example, random strangers should not act as though the birth is theirs or that their needs are more important than those of the laboring mother. The mother should not have to support her partner, doula, or family. When the focus
of support stays on the mother, the entire labor goes better and she feels safe and secure.

Remember this simple rule of birth etiquette when attending a birth. Remember, also, that very soon that laboring woman will be a mother and all of her attention will be focused outward on her precious child. We can focus our love and support on her for a few hours to help ensure that both mom and baby receive the best start possible.

Choosing a provider: Understanding the medical and midwifery models of care

What is the difference between the midwifery and the medical model of care?

One of the first decisions that a woman makes, after her discovery of pregnancy, is her choice of care provider. In most countries, there are two basic care providers available- the obstetrician and the midwife. There are many factors that contribute to which provider will work best for your birth. A basic understanding of the common differences in their approach can help you make the best decision for your family.

Midwifery model of care-

Most midwives, whether working out of a hospital or attending home births, practice what is known as the “midwifery model of care.” The basic midwifery approach to birth and the pregnant woman tends to be more holistic. This means that they look at all factors which may contribute to the health and safety of the woman and her birth. Emotions, living situations, nutrition, and education should all be addressed by someone providing the midwifery model of care.

At the time of birth, this care provider will be aware of and trained to spot things that may go wrong, but will, overall, consider childbirth a natural process that frequently proceeds normally and safely.

Those trained in the midwifery model of care routinely refer out to an obstetrician when they observe that the pregnant woman needs to be cared for by someone with a deeper knowledge of pathology.

The Citizens for Midwifery note that,

“The application of this woman-centered model of care has been proven to reduce the incidence

of birth injury, trauma, and cesarean section.”

Medical model of care-

A practitioner using the medical model of care, as is common among western medical doctors, tends to approach the patient from a problem solving approach, searching for the defect or dysfunction and trying to fix it. Unlike the midwifery model of care that seeks to understand the whole person and prevent unnecessary intervention or surgery, things are viewed from a pathological model searching for the problem and a solution.

Obstetricians, who provide the bulk of medical care for birthing women in the United States of

America, frequently approach their patients and their pregnancy and birth from this angle.

Which is right for me?

When choosing your care provider, there are many factors to consider. One would be your own philosophy towards birth. Do you view birth as a normal life event or as a pathology or disease?

Assessing your own beliefs will help you choose a care provider that best matches your own needs.

Another thing to consider is your own health and wellbeing. If you or your pregnancy are high risk, for some reason, then choosing an obstetrician who approaches birth from the medical model of care and who is versed in your risk factors in particular may be the choice that works best for you and your family.

It is also important to realize that not all midwives use the midwifery model of care and not all obstetricians use the medical model of care. You may be able to find an OB who views birth as a normal, healthy life event and approaches it with minimal interventions. You will also find midwives who have come to view birth as dangerous and pathologic and who have high intervention and cesarean section rates in their practices. Interviewing your individual care provider and asking for experiences from other mothers, doulas, and your childbirth educator will help give you some idea of their practice and philosophy.

Take your time and research your care provider. Your birth and your baby are worth the effort!

References:

Citizens for Midwifery- “Midwives Model of Care” brochure

http://cfmidwifery.org/mmoc/brochure_text.aspx

CIMS- Coalition for Improving Maternity Services

http://www.motherfriendly.org/MFCI/

How Birth Boot Camp Supports Midwives


 

One thing that is very important to us at Birth Boot Camp is supporting and encouraging the midwifery model of care. We are honored to have a very experienced and insightful midwife, Melody Morrow, CPM, as a member of our Advisory Board. Why is Melody so excited about Birth Boot Camp? She has seen the classes improve outcomes for her clients. Here are a few of her words. Thank you, Melody, for your support!

*****

Birth Boot Camp childbirth education has had an incredible impact on my midwifery practice.  As a midwife, I have found that the midwifery clientele has shifted recently and become more mainstream. Women are now choosing midwifery care that haven’t necessarily researched and taken responsibility for their choices in birth. Some just want to try a waterbirth because it looked cool on television. What this means for me as a midwife is that if I take these clients, I have to make sure they are properly educated before the birth.  If they don’t receive that education, I will likely be spending many, many more hours with them in pre-labor, labor and possibly a traumatic transport to the hospital.

I began to require that all my primips (first time moms) and women birthing outside the hospital for the first time take a childbirth class. While something was better than nothing, I didn’t necessarily notice a significant difference in outcomes for my clients who took a short class (4-6 weeks). However, I did notice that clients who took a longer Birth Boot Camp class did often have very different outcomes. Women were less fearful and more determined. They participated in their care and were making informed choices. Dads were providing excellent, confident support throughout pregnancy and, noticeably, in labor. Moms who would have otherwise had epidurals or C-sections, were having unmedicated births.

I believe Birth Boot Camp will enhance and support your work as a midwife because:

1. It promotes and affirms the midwifery model of care.  The Birth Boot Camp curriculum is based on the Mother Friendly Childbirth Initiative.  What they teach aligns perfectly with how I practice.

2. It gives parents 10 weeks of intentional education.  This enables parents to make appropriate decisions for their care and increases their ownership of responsibility. In short, more families “own” their birth choices.  Education lasts approximately 18-24 hours, so they simply have time to learn what they need.

3. The live classes promote peer support, encouragement and determination.  Think of these couples meeting for 10 solid weeks to learn about birth with like-minded people and a dedicated teacher who has done it before.  They are supported and positive about their birth and having more of their emotional needs met.

4. Someone else, besides you, is encouraging the same things you want them to hear.  Good nutrition, exercise, positioning, and much more are all things they are learning about OUTSIDE of your visits, not just during them.  My clients are more likely to be intentional in caring for themselves when they are given directed information, statistics, etc. and discussing these things with their partner and other birth workers.

5. Dads become more confident, involved and less fearful.  A confident and involved dad really helps with mom’s well-being.  Many clients will become even more passionate and appreciative of the choices they are making, even if they don’t have their desired outcome.

6. It is contemporary. The films are current and interesting.  The topics concerning birth and interventions are up-to-date.  In class, they discuss babywearing, cloth diapering, chiropractic care, doulas, Spinning Babies™, and other things that we want our clients to know about, but may not have time to fully teach them.  Their class will connect them to resources that I might not be able to.

7. It forces couples to stop and focus on their pregnancy in this fast paced world.  Couples connect with their pregnancy and with each other. They discuss issues and they come to an understanding. They appreciate their baby and the experience together.  I wish every couple did this!

 8. Knowledge is power. This means less confused, fearful phone calls and false labor runs for you.

In short, when my couples access the kind of quality childbirth education provided by Birth Boot Camp they have a better birth experience, my job is easier, and if things don’t go as they planned, they are comforted in knowing that they did all they could.  This kind of childbirth education truly makes a difference.

Melody Morrow, CPM, LM, BBCI loves babies and birth. Since 1998 she has attended over 1,100 births and assisted in the training of over 70 midwifery students. She is passionate about preventative, respectful care for mothers, babies, and their families. Melody works in Texas at Edenway Birth Center as the administrator and senior consulting midwife. She is enthusiastic about her calling and loves to help empower families as they become informed and educated about their choices during their maternity and birth experiences.

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