Woman Affecting Change In Birth

The 60’s and 70’s birth experience for a woman was going to the hospital, separated from her partner, laboring virtually alone and medicated. Times gave way to a surge of women seeking an unmedicated birth. But the 90’s brought the epidural epidemic, climbing to 80% or even upwards of 90% of Atlanta women giving birth this way. What has happened to women’s bodies – why do they no longer feel able to birth without the use of medications that numb their bodies and for many, their birth experience?

When a woman asks can wear her own clothing in labor, or if she can choose her birth position, she has fallen prey to the idea that once entering the birthplace, she gives up rights that are not medically indicated. Choices are available.

Location for a birth is a paramount decision- home or hospital. With no birthing centers in the Atlanta area, there are limitations. Homebirth is alegal in Georgia. This means if all goes well, no one cares, turning a blind eye. If anything goes wrong, the midwife can be prosecuted. There’s fear and lack of information regarding home birth. Home birth costs substantially less, but is rarely covered by insurance plans. Therefore most women will choose a hospital birth. This insurance company determines the prearranged contracts with the hospitals. Location may be something a woman feels she has little control over.

There is choice of provider. Choosing a midwife rather than a doctor may open up options for birth. Midwives, in this state work under the supervision of physicians. The provider book may not state if a practice offers midwifery care, so research is essential. Midwives tend to look at birth as a natural occurrence providing care for most normal pregnancies. Many doctors’ perspective is one of a medical emergency about to happen, being quicker to intervene.

Who will be your primary support person- only her partner, or mother or sister or friend? Many like the idea of being with just their partner. Others will want to include a woman to “mother” her in labor. Surrounding the mom with those who are fully supportive of her choices is important.

Doulas are professionals who specialize in mothering the mother in labor. They are trained and experienced in supporting birthing women, knowledgeable regarding birth options; pain management techniques and positions. Studies show a remarkable difference in birth outcomes- less medication and interventions, and also the mother’s perception of her baby and herself as a mother. The doula and partner join together insuring a smooth working team helping the mom achieve the birth of her choice.

Having her other children in labor and present at the birth is an option. If so, it is advisable to have someone solely as his or her care provider. The child can come and go as their needs arise. The mom may need help controlling the visitors. Calling a few friends at the onset of labor can mean a party begins to take place in her room. The mom should be allowed to limit or control who is part of her birth environment.

What to wear in labor becomes a concern. The stiff, impersonal gown opening in the back, leaving you feeling vulnerable and exposed is not the only option. Women find big t-shirts, their partner’s shirt or a loose fitting gown is more comfortable, offering security. Making her feel more relaxed will help her to allow her body to release and open.

Women are bringing music, sound machines, aromatherapy and birth art to their labor rooms. Physical therapy “birth” balls provide a comfortable seat in which to keep their pelvis open and moving. The environment should be one in which a woman feels safe and is able to let go and let her labor unfold gently.

Choices of birth positions are available. Many midwives and some doctors are open to positions in which to give birth. Squatting, dangling, kneeling, leaning, and standing are available to many women. (Most of these positions are available for only unmedicated births.) The studies show that if you allow a mother to choose the position to birth in, the birth will go easier and faster.

There are a number of ways to manage pain during labor. Movement-rocking, walking, bathing, swaying and even dancing are good coping measures in labor. There is hypnobirthing, guided imagery, non-focused awareness and other techniques that allow a woman to let go and labor. Informed decisions about her choices in medication if she should choose, should begin before her labor.. Her decisions should be based on information that she has acquired from unbiased sources.

Moms may choose to touch their baby’s crowning head or reach down and lift their baby onto their own abdomen. The days of dad just cutting the cord have also changed. Dads many times can assist in the actual birth as well.

If she needs to have a cesarean birth, who does she wish to accompany her? Only in rare situations are there the restrictions of no one accompanying her. Does she want her partner, mother, sister or doula? Would the hospital allow two to attend her? Each hospital has it owns policies. Asking brings about change. To fail to ask for a change in policy changes nothing.

Once the baby is born, couples have options as well. Does the mom want the baby placed directly on her skin after the birth? Do they want the new born procedures done on the mom’s belly, or in the room? Does the mom want to nurse right away? Do they want to be a part of the first bath? Do they want to delay medications such as erythromycin and vitamin K or do they want to forgo those all together? These are all the parents’ decisions unless there is a medical reason to do so. Does the mom want to avoid any artificial feeding? Does she want to breastfeed on demand? Has this couple decided to leave their son intact instead of a routine circumcision? Possibilities are endless.

In the 70’s and 80’s we fought to ban those things that made birth more pristine and proper for the doctor but had no medical bearing to birth- routine enemas, pubic hair shaving and episiotomies and birthing in the supine position. What has made the change? Women. This is a consumer driven industry. Women are taking back their birth experience. The use of medication, where you birth, who is your provider, who accompanies you, what you wear, how your room is decorated, what position you birth in, what happens to the baby after the birth; these should be your choices.

You can affect change in the birthing environment by asking for what you want. Question protocols. In teaching I use the anagram BRAIN: B is the benefits, R is the risks, A is the alternatives, I is the instinctive and intuitive voice that is within you- listen to it, N is for the “now what”- or what needs to happen now- how will this affect me and my choices? So, women use your brain in making your childbirth decisions. Women can effect change by asking more questions and questioning more answers.