Instead of posting myself today, I’m going to continue the topic, by reposting a comment I received on my first Cesarean Epidemic post. I asked how we can turn this epidemic around, and here’s what one of my favorite birth enthusiasts had to say. (Note: her comments in quotes and my commentary after each quote)
Melek says: “I think an important place to start would be to get an idea of what kind of birth a woman wants. If she wants a natural birth, does she know what it will take on her end to get this? As I learned, it is more than just saying you want one–it takes a lot of work and the willingness to take personal responsibility for so much in your pregnancy. If we know a woman wants a certain type of birth, we can give her a lot of the knowledge and resources necessary to make this happen. For example, if she doesn’t even know, or think to ask, what her doctor’s policy is on going post-dates, she may be staring down the barrel of an induction around 40 weeks when she never even thought of that when she chose her care provider.”
Right on, mama. As Ina May says, “Ask the woman. She will tell you everything you need to know.” The first step is remembering that this is her birth.
“I think also erasing, or at least trying to address, a lot of the fear around childbirth and the unknown would be really helpful. So often a woman’s only information about childbirth may come from mainstream media or people who are all too happy to talk about how painful the experience is and create a lot of fear and anxiety around the whole thing. This can lead to a woman accepting all kinds of interventions she might not otherwise want for fear of not being able to handle the pain of labor. I’m not saying every woman should have to go all natural, but I do think it is important that women are informed on the risks and benefits on all procedures associated with the birth they desire.”
Yup. It’s all about the fear. I like to ask a woman questions, like “why are you afraid of the pain” or “what are you afraid will happen if you do/don’t do xyz.” When we really listen to the woman, we can let her express her fears. Those media and societal messages have penetrating her for her entire life. It makes sense that it will take a while for her to process her programmed beliefs and decide whether or not to let them go. Sometimes this is about needed information, but I think sometimes it’s more about having someone listen without judgment.
“As far as care providers, I think it would do a lot of good if doctors (and midwives) would be really up front with what their practice is comfortable handling. It would be great if they would spell out their policy on going post-dates, when they would consider inducing a woman (whether she asks or they feel it is time and how difficult would it be for a woman to refuse), a woman’s ability to refuse routine prenatal testing and/or ultrasounds. As far as VBACs specifically, I think the post-dates issue is especially important, as well as if they would induce (and how). That can really be important information for a VBAC mom to have. And, of course, you don’t want to have a mom get to the end of her pregnancy and have a VBAC mom, who thought everything was proceeding well and normally, all of a sudden be on a timetable to have her baby. I think if a CP is going to have a policy, that’s fine, but I think they should also be willing and able to explain the rationale behind it, have that be supported by scientific evidence, and be open and honest with their patients so that no one is blindsided.”
Absolutely! One of the most important steps in stopping the epidemic is treating the woman like an intelligent human being, capable of processing information and making good decisions for herself and her baby. She might still choose the option her care provider recommends, but being honest and upfront builds a trusting relationship, necessary for good outcomes.