In a Nutshell..... Why do I do this?

Last Friday, I rode with the midwife I assist to do our home visit with one of our clients. We typically make a home visit before the birth so we can familiarize ourselves with the route - makes it so much easier than driving cold turkey in the dark- and we get the sense of the layout of the home in terms of the birth. This was a repeat client but she had moved since her last birth. It took a bit of doing to get there and it was a lovely rural type setting. The weather was warm and the sky was clear and blue. She greeted us with her toddler. We chatted and toured her cozy home. Then we did the prenatal appointment- belly check, fetal heart tone check, urine check, blood pressure check- etc. Her little one showed us some of his toys. I admired some of her homemade toys and she showed me how to do the blanket stitch in order to finish the edge of her handmade doll. We lingered a bit and I remembered her last birth. I'm very much looking forward to attending this birth. We hugged goodbye and waved as we slowly drove out of the driveway. I looked out the window as they stood there watching us leave. For me- the next time I see her she will be in the midst of labor, as I'm typically not called until labor is advanced. The midwife precedes me and calls me to assist when she needs me which is usually later in labor. The mama looked so beautiful with her round belly and her precious little one was standing there by her side. It was as it should be. I felt almost moved to tears and I thought " We have the best job in the world!"Every woman deserves this type of prenatal care. We get to know the family. We listen with respect and true interest. The midwife builds a relationship with the mama and the family. When labor begins we attend as invited caregivers. We will be the supporters of the process. The birth will be attended with care and attention. The family unit is respected and supported. The baby will be gently and lovingly welcomed into the arms of his/her mama and in his/her own home. I love home birth. Love it love it love it.Post partum care is equally wonderful. They don't have to go anywhere. We leave them settled in in their own bed. Personal attention. Family support. Breastfeeding support. In addition to the personal visits there is the continual availability for phone consultations. Midwifery does not leave mothers and babies in the lurch. I'm so proud to have a share in this model of care. I wish this type of care for all families.So, there it is..... I love this work. It never grows old. As is the case with this family we build a history with our clients. What a privilege. If only more women availed themselves of this dignifying and respectful model of care. As a nurse part of my role is education. I feel the need to make this model known as an option. I'm using this blog as one way to accomplish that goal.
Posted by Helen at 9:43 PM 0 comments

Friday, March 28, 2008

Why take birth class?

There was another recent study regarding childbirth education and the results were that many women were not taking birth classes. What are the reasons for this? Some feel the classes are a waste of time. Some feel that since they are planning to have an epidural that they do not need to take birth classes. For whatever reason, what used to be an integral part of the pregnancy experience- birth class- is now being viewed as unecessary.
It's true that women do not need a "class" to teach them how to birth. Women's bodies know how to give birth. Women have given birth for centuries without taking a class. The certificate given at the end of the class doesn't mean a woman is now "certified" to give birth. How ridiculous! So, what's the point?
Ahh... what is the point? Birth class typically lasts 3-8 weeks. In some cases they last 12 weeks. Why spend the money and all that time if her body already knows what to do? Well, let's think about what women in our culture are exposed to in terms of birth experience. We do not have trust in our bodies modeled for us. Women rarely witness any birth yet alone natural birth. Television and movies show birth as an emergency fraught with danger. The laboring woman barely makes it to the hospital where she is rescued by medical personnel. Many times the mother is at death's door and quite frequently so is the infant. Technology reigns supreme and thank goodness there are the experts or they would all have died.
Women tell each other horror stories regarding birth and even total strangers feel compelled to share their fear based stories and opinions. We grow up with this type of attitude towards birth and the fear begins to imprint in our minds. In addition, there is the prevailing attitude that if a woman is pregnant she automatically will see an expert surgeon- the obstetrician; and of course she will birth in a hospital where technology will be used on her. This is just common practice- the standard of care for pregnancy and birth. Not to mention the semantics used in obstetrics including saying the physician "delivered" the baby! Delivered the baby from what? It's mother's body? Certain death? Where is the acknowledgement in the power of women's bodies designed to birth babies? So, even the subtlety of common terminology contributes to a cultural view that disempowers birthing women.
Childbirth education serves to reinforce a woman's confidence in her body and in the birth process. Gaining an understanding of the changes that are and will take place allow her to dispel fear. Birth classes should encourage women and couples to retain personal responsibility for their entire birth experience. Endorsing personal research and examining risk/benefit ratios assist families to make informed decisions regarding birth and parenting. Birth classes should help families look at the basis for their decisions. Are they based on what everyone else is doing or because "that's how it is done"? We want to promote informed choice. In promoting that choice we avoid putting ourselves in the equation. The decisions are theirs to make. We must respect their right to make them.
Emotional issues can be addressed and discussions regarding postpartum and newborn care are part of the curriculum. Communication skills are practiced. In group classes couples have the opportunity to connect with others that are on the same journey. Sometimes lifetime friendships are forged. Private classes allow for personalized instruction with information tailored for the couple.
The need to be flexible and realistic should be taught. My thoughts on expectation of a pain free birth can be read in my comment on the study regarding women's disappointment in what was presented in their birth class and what they actually experienced, so I won't comment on that here so as to avoid repetition.
Birth class is not just for natural birthers. Women who plan on having an epidural will still have to endure some pain and they will want to know how to cope. All the other benefits also apply. So, do I think birth class is important? Well, I'm a childbirth educator so of course I think it's very valuable. They can benefit all pregnant women. Certainly,ones presented by independent instructors are of most value. I love teaching birth class. It's very rewarding and I hope the tide begins to turn again to a place where birth class regains it's position as an integral and beloved part of the pregnancy experience.

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