Tuesday, December 3, 2013

Why I Want to Do Birth Work (And Why I Don't Hate Doctors)

   Before I get into the particulars of why I want to pursue birth related work, I want to get some things straight. I know there is a stigma for those that are involved in natural birth or alternative medicine in general that they hate doctors or Western medicine, or whatever. I chose to wear a green shirt today. This doesn't mean I hate the color red. Or people who wear red. It doesn't mean that I won't ever wear red myself...follow? Basically, one person's choices are not a judgement on other people's choices.
   Moving on from there. Do I think some doctors and nurses are idiots and totally suck at their jobs? Yup. I also know of a few midwives and doulas who suck. Some people just suck, in all professions. I also know some great nurses and doctors. The reason why I am so adamant about advocacy in this field is because there is a cultural perception that all doctors/nurses/whoever are good and competent just because they are wearing the scrubs. Medical school is hard, yes, but it is not the end-all, be-all litmus test for competency. I have heard or been told of some pretty terrible things medical professionals have told pregnant and birthing women. Things that directly contradict medical evidence and actually have proven to have negative outcomes. Let's see...
    I have heard a birthing mother told her body was progressing well so she only needed a "little              pitocin" despite the fact that pitocin is contraindicated for non-emergency births.
    I have heard of doctors making episiotomies so that women don't "tear" despite evidence that              shows episiotomies increase tearing.
   I have heard nurses suggest feeding on schedules or supplementing with artificial nipples despite            these practices being associated with low milk supply, slow weight gain, and failure to thrive.
   I have a friend who had a nurse break her water without telling her or asking during a vaginal                check.
   I have known countless people who have been induced based on baby size estimated from late                pregnancy ultrasounds, despite evidence showing ultrasounds after 24 weeks are unreliable and baby size is NOT a medical indication for induction.
   I know of only one person who birthed at a hospital with intermittent rather than continuous fetal          monitoring, despite the fact that continuous monitoring is associated with an increased risk of  surgical birth.

The list goes on and on. Now, I have also heard a lot of good things, like the doctor here in Tucson who is always on call for breech births because he is the only doctor who was appropriately trained to vaginally deliver breech babies (even twins!). Or some truly wonderful nurses who ended up being doulas as well for many of their patients. So please, don't mistake my passion as stemming from a hatred and mistrust of medical personnel. It's actually quite the opposite. I don't advocate for women because of the "bad" OBs. I advocate for women because there are too many great OBs and nurses for us to continue giving the bad ones our business. We can change the birth culture (and the god-awful maternal and infant mortality rates) of this country by demanding evidence-based care and seeking out those professionals who provide it. But how is a woman supposed to know the difference between providers?

   THIS is why I want to do this work. I want to help women make the best choice for them in their birth instead of having to just roll the dice and take what they get. I don't care what you want for your birth- unassisted birth in the woods or scheduled c-section. I just want you to make that decision based on evidence and knowledge, not fear and lack of options. Because no matter how you want to give birth or how you need to give birth, it should still be the most amazing moment of your life. Birth shouldn't be a scary, painful obstacle to having a baby. Birth itself should be an incredible experience. You are doing something wonderful- it should make you feel wonderful. Not scared, or sad, or angry. To achieve this, it is my experience that women need three things- they need to be informed, they need to be empowered, and they need to be supported.
  How is someone supposed to know if what her doctor or midwife suggests is best for her if she doesn't know her options or the risks and benefits of each choice? Medicine is just a drop of water in the 5 gallon bucket of knowledge that exists in the world. Obstetrics is an even smaller part. Then take into account where the person went to school, what books they used, which journals they follow and read...you can't expect a person to know everything. Women need the tools and knowledge so that they can be educated about their own care. So that when they hear bad advice or are offered procedures that contradict evidence-based care, they see a red flag.
   When women have this knowledge, they are empowered. They can take control of their pregnancies and births and advocate for themselves. They don't have to close their eyes and hope that their providers know what they are doing. They can make decisions, including the decision of which providers to hire. Did you hear that? You are HIRING your providers. You pay them to provide a service. If you don't like their service, don't pay them. Find someone else. So many women stay with their OBGYN for their births just because that was who did their annual pap smear. Swiping your cervix with a q-tip has nothing to do with having a baby. Interview your providers. Find one that works for you. Make a birth plan. Prepare for your birth.
   Then surround yourself with support. Find supportive providers, for sure, but make sure whoever else is invited to take part in this experience with you is 100% on board. This may mean they need to be educated about the decisions you made so that they understand. If someone is not supportive, they have no business being in your birth space. This is YOUR body, YOUR baby, and YOUR birth. I have seen women with all the information and capabilities available to them let go of their birth experience because when it came down to it, they weren't supported.

   This is what I hope to accomplish. I want to provide women with the tools they need to be informed, empowered, and supported. I want women to be able to own their birth experience. This doesn't mean that everything will always go perfectly. Sometimes, rarely, complications do occur. But if you are an active participant in your birth and you own the experience, you will be the one dealing with problems if they arise and you can still be empowered and supported in those situations. Birth should be something you accomplish, not something that happens to you.

For more information about the movement to improve childbirth, check out Improvingbirth.org

Here is an awesome album from their Facebook page of why women want to improve birth https://www.facebook.com/media/set/?set=a.509315189141974.1073741832.255657527841076&type=3

For more information about evidence-based birth, evolutionaryparenting.com and evidencebasedbirth.com are great resources!

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