Archive for October, 2014

So, I wish I wrote this about the cesarean rate. And I wish I made all the great graphics to go with it. But, even though I didn’t write it myself, I’m in love with this piece. It’s really helpful for answering the question I get all the time, “So, why do you think the cesarean rate is so high?” I can talk, talk, talk about all the reasons, but this piece just quickly runs through the reasons and more importantly gets to WHAT WE CAN DO actually.

Let’s get to it!


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Childbirth Classes: Necessity or Luxury? Redundant in the Internet Age?

Hello pregnant women!

Fewer of us than ever before are signing up for traditional childbirth education classes. You know, those old-fashioned classes that meet in person. With a teacher. And maybe a textbook. Perhaps “class” reminds you of high school. Or college. And you do not want to be in SCHOOL any longer.

Besides, everything you need to know about birth is on youtube. Right? OK, well, then. Maybe it’s on Parenting.com? Or Childbirth.org? Or the American Pregnancy Association? Or WhatToExpect.com?

Oh, dear. There’s a lot of websites that offer “childbirth information.” And the information they offer conflicts. A lot. More importantly, the information is not well-tailored to your unique situation.

No, problem, says the modern mama-to-be. I know how to get information tailored for me! I will jump into some chat rooms or join a website and ask my specific, individualized questions. Then the magic of the Internet will quickly provide me with the answers I need.

This is, indeed, how the majority of American women are preparing for childbirth. But childbirth is a very different process than researching what car to buy or whether or not to cut bangs this week (Michelle says, “Yes!”). Preparing for childbirth on-line is sort of like preparing for a triathalon on-line. There are good tips out there, but we all know that the REAL preparation is occuring off-line in what I would call “real life.”

Childbirth is a unique life event and probably nothing you have ever done in your life (except give birth previously!) can serve as a good model for how to prepare. I don’t know of any other event that requires the combination of social (how to interact with hospital staff and birthing professionals well), emotional, relational (negotiating the needs/wants of partners and parents and siblings), intellectual, and physical that birth requires. Many people compare birth to endurance sports events like marathons, but the fact is that few marathoners have to negotiate important medical decisions with doctors while they are running.

So, what you get in childbirth education classes that you CANNOT get on-line is the opportunity to practice in the presence of an experienced guide. When you READ information, it does not stick with you nearly the way it does when you have practiced what that information tells you to do. As Yogi Berra said, “In theory there is no difference between theory and practice. In practice there is.“

You learn SO much by getting to ask a question and having a personal INTERACTION about your question. You get to practice — try out — different ideas in this safe place that is not yet your labor or your baby’s birth. In this place, you get to practice thinking and feeling and relating different ways. You have a teacher, who has probably been at a number of births and seen some of those ways play out in real life, who can guide you in your thinking and feeling and relating.

Childbirth education classes are not really about information. The “facts” are readily available on-line. It is the practice of trying this idea and then this one or, hey, maybe this one that makes this information useful for you. When you are in labor you do not need theoretical knowledge. You need very, very practical knowledge.

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I ran across this article on holisticmamas.com today. It feels great when other doulas write about advice in my book. Doulas collectively have a lot of birth wisdom that is really about how to help mothers achieve the births they want… which is a very different skill set than that of a doctor, midwife, or nurse. Their job is not focused on the mother’s birth experience in quite the same way. Here’s what Patricia Madden had to say:

A Doula’s Advice: “Routine Interventions” vs. “Medical Solutions”
Posted on April 3, 2012 by Mare
Patricia Madden, Doula
Guest post by Patricia Madden, DONA-Certified Birth Doula

“Routine interventions versus medical solutions.” I heard this phrase many years ago, and I’m pretty sure it came from Pam England of “Birthing from Within” fame. In my 14 years of experience, I’ve noticed that this is the kind of phrase that relaxes couples and doctors alike.

Most of my clients are very dedicated to having a natural birth, but as we talk more they come to understand that what they really want to avoid is routine interventions that can snowball into surgery. When a birth mother puts that simple sentence in a birth plan, she lets the hospital staff know that she is not against technology at any cost; she just does not want the normal routine things that most laboring moms get when they DON’T state a preference. The birth mother then also does not feel like she failed if she ends up saying, “You know, I’ve been laboring on and off for 3 days, and now I’ve been in active labor for 12 hours, I’ve had almost zero sleep for 3-4 days, and I’m still at 4cm. Maybe the next best thing might be an epidural.” (This was also from Pam England.) 🙂

Stating a preference: ah, that brings me to another thought I got from the new book by Cynthia Gabriel, Natural Hospital Birth. Her advice to doulas like me: “I have learned over the years that you must say what you want or the [hospital] staff will think that what they routinely do will be fine. In every job, people have routines. Routines make life easier for us. The more your client talks about what she wants and doesn’t want, the more the [hospital staff] will help her achieve her goal, because they know she is serious. At every prenatal your client should talk about her preferences …over and over, and the fact that it is not medical solutions that solve a unforeseen problem that she wants to avoid, but the routine interventions that could eventually cause the problem that she wants to avoid.”

Just thought I’d share an effective wording for your birth plan to swing things in your direction, if you’re of a mindset to try your best for a natural hospital birth, but yet are open to medical solutions in case anything should go wrong. – Patricia

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