Published in Birthing Magazine, July 15, 2011
As a childbirth educator in Calgary, I’ve shared many conversations with expectant mothers who wanted a midwife but didn’t make it further than the waiting list. I listen to them express their feelings and often shed tears in disappointment.
Women say things like, “All my family has given birth with midwives and I have been so inspired listening to their empowering birth stories.” “I am so confident, researched and prepared. Of all people, I deserve to have my homebirth!”
What great news it is that Alberta gave their support by funding midwifery in April 2009 and, just recently, Mount Royal University introduced their Bachelor of Midwifery Program beginning this fall. It appears this is the “turn” in childbirth the natural birth community has long been waiting for. But for those on the midwives’ waiting lists, this is just a carrot dangling in front of them. The reality is that the demand is much greater than the supply. What do we do in the meantime?
Women should be made aware of the many beautiful births experienced in Calgary hospitals under the care of doctors. With a little know-how and support, it can be done! With all the focus on midwifery since funding in 2009, the demand for midwives has been all consuming. People are so fixated on wanting midwives that they cannot focus on the positives that still exist. When faced with adjusting our birth ideals, all too often an US vs. THEM attitude rears its head and couples become fearful of what is to come.
I believe that one of the reasons childbirth has become so medicalized in past generations is because we have put all the responsibility for the outcome of our birth on the shoulders of our caregivers. For many decades now it has been, “I’ll just go the hospital and my doctor will take care of things and deliver my baby for me”.
This redirection of responsibility has only compounded over the years. Women are often demanding doctors to “take away my pain, make my birth safe, make me comfortable…” and so on. I’m probably preaching to the choir now when we talk about how much this shift has changed how a woman is perceived when she arrives at the hospital to birth her baby. The hospital staff is often confused when we, as couples planning a natural delivery, arrive and express our desire to “feel all the pain”.
We are occasionally met with sarcasm and other deflating comments from nurses and doctors. I’m sure these comments do not come from a malicious nature but rather from their social influence and what they see day in and day out. In the hospital environment the intervention rates are high resulting in plenty of drama. In fairness, the majority of women are not adequately prepared mentally, physically, or emotionally for labour and therefore, do legitimately need “help”.
A simple approach to changing your hospital experience is to be confident and respectful. As you introduce yourselves, demonstrate your competency, they will soon catch on that you are “different”. You’ll hear comments like: “Wow, you guys are really well prepared”; “You have great support”; “We rarely get to see this”.
If you are concerned that your doctor does not share your enthusiasm to birth naturally, the most effective approach to gain their support is to share and demonstrate how important it is for you to birth naturally. And show how committed you are. Whatever the personal, intellectual, emotional, or spiritual reasons you have for desiring a natural birth (for yourself, your baby, and your new family), this is something that cannot be argued. Therefore, it is far more likely he/she will feel compelled to help you achieve your goal.
To have the birth you desire, you need only represent yourselves as you are – knowledgeable and prepared for the task at hand. With that alone, you are able to ask intelligent questions, advocate for yourselves, set boundaries in a respectful way with your doctor, and be willing to “do your part” to make sure that your birth is safe and enjoyable.
Even those with midwives may be led to believe that when you are under the care of midwives your birth will be “perfect”. “I have midwives and they will take care of me guaranteeing a great experience”. In fact, this is only part of the equation. Let us not forget that WE are still the ones who have to birth our baby! It is an unrealistic expectation that your doctor or midwife will make your birth what you want it to be. The good news is that your preparation and approach are the biggest factor in achieving a safe and satisfying birth experience regardless of birth location or caregiver.
Giving birth is a healthy process and research proves time and time again that it is best for women to birth naturally when possible. When you are low risk and healthy (95% of women) and labour is progressing normally, the role of your caregiver (whether doctor or midwife) is really more that of a lifeguard or coach. A well prepared woman will birth on her own without “help” and should not be perceived as a patient requiring medical attention.
Our doctors and midwives are there for the rare instances when things go wrong – and thank goodness we have them for that. If we approach birth with this in mind, we automatically take back the responsibility and we increase our chances of achieving our desired outcomes. How naive the woman who is fortunate enough to be under the care of midwives but does little for herself to prepare for a healthy birth outcome. She may be blindsided to find herself moving from her planned homebirth to a hospital and under the care of a doctor because complications have arisen.
Giving birth is hard work. Regardless of your caregiver, you need to be determined enough to complete the task. More interventions happen in the hospital simply because many can be enticed when vulnerable and going through the tougher stages of labour. The epidural is right down the hall vs. at home where you would have to drive to the hospital to receive one. Many women who have homebirths will later confess that if they were in the hospital, they very well may have asked for an epidural or other forms of “help”. When the options aren’t there – women simply tough it out.
This difference is what gives the illusion that hospitals or doctors are fully responsible for our birth outcomes when the truth is we DO have choices. The vast majority of interventions are very much avoidable when we have a deep understanding of labour and birth practices.
Your steps to success: All these things are necessary and achievable, regardless of your caregiver or birth location. They are sure to make a significant difference in your outcome.
- Stay healthy and low risk so all those doors stay open for you;
- Take quality childbirth education classes that teach the physical, intellectual and emotional aspects of birth, along with how to have a natural birth in hospital.
- Get your support system in place. Well trained partners can do more for you than any amount of drugs. Some may consider hiring a doula for additional support.
- Tackle all your fears leading up to birth so that you enter into it with a feeling of safety, confidence, and calm.
Perceptions, beliefs and fears
“Birth is an emotional issue,” as Barbara Harper explained in her presentation at International Day of the Midwife, in Calgary on May 5, 2011. I’m sure all natural childbirth educators, doulas, and midwives would agree that we, as women, must first address the FEAR we have surrounding birth if we really want to move beyond the current state of high-intervention birth. Fear causes stress hormones that interfere dramatically with the progression of labour
You may have fears about going to the hospital and the routines that may come with that birth location. You may feel as though these are the very things that may get in the way of you having an enjoyable experience. I can empathize with that worry but want to encourage you again by saying that when you are well prepared and educated, you will be able to negotiate, avoid or adjust to many of these routines.
I tell hospital bound couples to think of birth as an intimate and perhaps romantic time for them as a couple. If you create an environment that supports this, your labour will progress more effectively. Can this be done in a hospital? Absolutely! You can still bring comfort items from home, turn the lights down, have music, and surround yourself with supportive people as you desire. Your number one priority is to create an environment where the labouring woman can feel protected and safe. This is an instinctive need all labouring women share. You can set this atmosphere for yourself with the help of your partner and other assistants at birth.
So for those of you who wanted a midwife but couldn’t get one, don’t worry unnecessarily. You CAN have a healthy, positive, and intimate birth experience in the hospital. In fact, I encourage you to use this opportunity to demonstrate to your medical team, how beautiful natural birth can be! The more natural births they see, the more it will be accepted and promoted for those women who follow the same desire. You will be part of making the change that so desperately needs to happen for our future generations.