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

Tuesday, March 25, 2008

var articleheadline = "Women 'are misled into thinking that childbirth can be pain-free'";
Women 'are misled into thinking that childbirth can be pain-free'

Half of women who do not want pain relief will need it
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By Jeremy Laurance, Health EditorFriday, 14 March 2008
Childbirth hurts – rather like taking your bottom lip and pulling it over your head, in the unforgettable image conjured by the American comedian Bill Cosby – but too many women today are being wrongly led to believe that a pain-free and drug-free labour is possible, a dream that is shattered by reality.
A review of 32 studies of women's experiences of childbirth has revealed that hope too often triumphs over reality. The experiences of most women differ markedly from their expectations, which can lead to disappointment when labour does not go according to plan.
"Childbirth is one of the most painful events that a woman is likely to experience... A woman's lack of knowledge about the risks and benefits of the various methods of pain relief can heighten anxiety," say the researchers from Newcastle University's Department of Public Health.
Joanne Lally, who led the investigation, said antenatal education programmes needed to adopt a more honest approach. "Women should go into labour with hopes of what they want it to be but they should also be realistic about what it is likely to be," she said. "If they want a natural labour that is fantastic and they should be supported in that. But if the pain gets too much and the decisions are taken out of their control that is when it goes wrong and they can end up feeling disappointed. Women need to be fully equipped beforehand with the information to make decisions."
The review published in the online journal BMC Medicine found that, in one study, more than half the women who said they would not use pain relief ended up needing it. In a Swedish study, women were able to give the pain a positive meaning, as when one mother said: "I think it's a happy pain, though its hell."
Researchers concluded that positive attitudes to pain reflected satisfaction with the way they had coped with it, rather than the pain itself. In most studies the pain was worse than expected – in only one was it better than expected.
Mary Newburn, head of policy at the National Childbirth Trust, said: "Pain is tied up with fear and anxiety. If women are provided with good support they may be able to cope with the pain and have a good experience and emerge triumphant."

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Helen said...

I will comment on this soon.

Helen said...

This refects the need for us as childbirth educators to be clear and realistic. It's one of the reasons I do not teach a birth "method". Too many women have learned a "method" and try hard to apply the techniques only to be shocked that they still feel pain! Let's be realistic and honest. We are working with grown-ups equipped to handle the truth. Childbirth is painful. No doubt about it. Rare is the woman who claims to have had a painfree natural birth. Now, once we have admitted that, we recognize that pain- the pain of normal labor- is manageable.
We offer information about the physiology of labor and birth but too often we ignore the psychological and emotional changes that accompany pregnancy, labor and birth. These have an impact on a woman's experience and perception of pain. Physical and emotional support is vital to a laboring woman, as is privacy, a feeling of security and the freedom to labor as she chooses. Well, I could go on about that but what I mainly wanted to address was the the disappointment, feeling of "failure" etc that a woman may have if she finds that the pain of labor was more than she could handle. Women do not need to have performance anxiety thrust upon them.
I remember one woman who was apologizing to me, her doula, because she wanted an epidural. I examined myself to see what I had said or done that contributed to that apology. Why would she feel the need to apologize to me? It was not my birth- I was there to support her and her decisions. I handled that in the best way I knew how but I have never forgotten that moment. As doulas, and as childbirth educators we must teach confidence and trust in women's bodies and the birth process while acknowledging our inability to control the whole process. Having the "ideal birth" to live up to can be self defeating. We must promote flexibility and acceptance of what presents. I like to share a birth story before each class. One of my favorites is in a a book called
Adventures in Natural Childbirth edited by Janet Schwegel.
It is Reinekke Lengelle's story. It's wonderful and she ends it with a poem Here it is-

So forgive yourself
for not being perfect
For saying, enough is enough.
For setting out a dream and landing on a bed of nails.
So forgive yourself,
& don't say "I didn't do it right"
because you did.
So forgive yourself,
for being the judge
of your own heart.

Mo said...

What a thoughtful commentary. I have often felt that some childbirth educators unwittingly set women up for feelings of failure and disappointment (when they request medicinal pain relief) by downplaying the amount of pain involved in having a baby. The intention is good - to not scare the mother away from an unmedicated birth, but the result is disaster - fear, panic and a sense of betrayal. I remember during my first labor screaming to my husband: "She lied!" Needless to say, contractions were nothing like holding an ice cube in my hand for a minute!
Good job, Helen!
**Who you KNOW does not have painless births!**