As the EDDs of women I'm supporting approach and come and go, I find myself in a similar mindset as a doula to what I felt like waiting for my own labors to begin. "Should I schedule our car for service tomorrow, plan to go to the zoo as a family, host dinner with friends this weekend or will baby decide that this is the day and I'll be called to a birth?" It's easy for me to get antsy from time to time and to hear myself say "Well, it all depends on if there's a baby being born or not." What I'm trying to remember is that like all of life, we make our plans and then adjust accordingly. I encourage the women I'm working with to go on with life and to enjoy the moments and memories they have before birthing their baby... and I'm telling myself the same thing. Live today. Live now. Live.
I've seen doctors mention possible interventions to their patients (my clients), such as "cutting a small episiotomy because the perineum seemed short" and then changing their minds moments later, resulting in a woman birthing her baby just fine with very little natural tearing. I keep on hearing that "episiotomies aren't used all the often anymore," and while this may be the case, I can count at least five births where I've heard them be discussed or used in the past year. My advice here would be to ask your care provider under what circumstances they would suggest this procedure and then make certain that they know that you are wanting to avoid one unless absolutely medically necessary.
I posted this on my Facebook page in November and it's truly at the core of who I am as a doula. "I'm all for 'healthy mom, healthy baby,' as being of the utmost importance when it comes to birth... BUT I'm for 'HOLISTICALLY healthy mom, healthy baby,' meaning that mom's and baby's emotions and psychological state are of utmost importance too. Women giving birth deserve to look back on their experience and feel that they were heard, respected, and cared for on all levels and that they were an active participant in making decisions regarding their care." At the end of the day, whether a birth went along without a hiccup or a birth took unforeseen and surprising twists, my deep desire for the families that I support is that they know without a shadow of a doubt that they made the best decisions for their specific situation. This looks different for each woman and each situation. Whether a labor and birth are intervention-free or riddled with necessary interventions, my hope and prayer for the maternal care system is that women and their families have trusting and mutually respectful relationships with their care providers and that they have the information and space to make informed decisions for their individual labor and birth.
I'm convinced more and more that choosing a care provider is one of the most important decisions a woman will make. I want to shout from the rooftops that just because you've gone to a specific care provider for your gynecological care DOES NOT mean that they are necessarily the best fit for you when it comes to prenatal care. You might find that your OB/GYN is too medical for you and you'd fit better with a midwife or an OB/GYN who takes a more "midwife model of care" approach to pregnancy, labor and delivery. Before conceiving and then in the early prenatal period, it is vital that you think about what approach to birth you are more in line with. I go into this at length in this post. It's unlikely that you've been concerned with your OB/GYN's cesarean rate, their birth philosophy, or under which circumstances they'd recommend induction when only seeing them for gynecological care. However, these are of utmost importance to know and be on the same page with as you're figuring out what your values are for the birth of your baby.
This year I witnessed the following:
- a medically necessary induction that went on and off for three days resulting in an otherwise unmedicated, vaginal birth
- women overcoming deep fears they had about giving birth
- women taking ownership of their care and switching care providers at the end of their pregnancies
- an unmedicated, vaginal birth of twins
- women showing up at the hospital complete and ready to birth their babies
- babies born in their homes
- women who were planning for an unmedicated birth choose an epidural and it being the very best decision they made... helping me shape my opinion that epidurals are not all good or all bad, but that it's key to be wise with when to have it, if you have it
- women having uneventful labors and births and very eventful third stages (postpartum)... showing me again and again that birth is unpredictable
- a baby being born en caul
- women who go to the hospital thinking they are in active labor only to be sent home since they were not dilated 4cm yet, only to head back to the hospital a few hours later in very active labor, almost transition... showing me that letting go is everything
- women laboring very quietly and women laboring very vocally... women birthing very quietly and women birthing very vocally
- husbands and partners being AMAZING supports and anchors to the mothers of their children
- women knowing what they want and what their rights are and in a firm-but-kind-manner, communicating their wishes to hospital staff
- women who have rapid labors and make giving birth look like such a piece of cake (yet I know that it is intense for them, all the same)
- women birthing with their families surrounding them- children, husbands, mothers, sisters, dads, in-laws, friends... all privileged to witness new life entering this world
Here's to 2012 and all that it brings. I'm ready for it... eager to learn and grow and be shaped some more.