Who Delivers My Baby?
Who is going to deliver your baby?
First you should know that this is a trick question.
Most importantly, it’s the mama who ‘delivers’ her baby! She grows her baby, and she births it; I do mean vaginally or surgically. The process of birth - all births - encompass our body, mind and spirit. Mothers (and babies) do best when this integrated birth process is respected and honored through the very large and transformative journey to motherhood.
That said, the OTHER answer is that mother-babies may be assisted in their births by a range primary care professionals such as OB’s and Midwives, as well as their partners/spouses, friends, and professional doulas. Women have choice in their birth attendants and birth locations, even towards the end of their pregnancies, or within insurance boundaries, hospital proximity, or tight budgets.
Regardless of who you chose to help you birth your baby, I suggest that there is an essential, though rarely considered criteria for every birth attendant in every setting.
The ideal birth attendant
trusts birth as a generally normal, healthy process. Even, or especially, when they are necessary experts in high-risk birth.
Birth itself is not an illness, disease or accident, yet it’s the only normal biological process that people have come to associate with the hospital. Years ago, I read that over 90% of the people alive on the planet had been born OUT of hospitals. And that half of those mothers birthed their babies without any birth attendants present!
How do you benefit from having your birth attendant trust birth? Many assume that it is better to have an OB physician who can be on guard for any possible medical danger, to save them if anything ‘goes wrong.’ The presumption is that then if nothing ‘goes wrong’, then they’ll just have a safe (or natural, if that’s the goal) birth anyway, right?
“Birth is made to work if no one is there.”
Midwifery Management of Neonatal Resuscitation (MMNR)
Well, no. The life’s work of many highly regarded birth researchers and professional have shown that outcomes vary widely depending on the approach of the professionals.
Dr. Michel Odent who has championed natural, undisturbed birth in all settings, believes that the use of synthetic oxytocin to artificially start labour is interfering with the natural production of oxytocin in women.
Natural oxytocin is an essential hormonal component of the bonding process between mother and child. Dr. Marshall Klaus and Phyllis Klaus MFT, LCSW found that science is on the side of normal birth, which is contrary to the typical practices and protocols found in many medical institutions; normal is undisturbed, noninvasive, non-coercive, and noninterventionist.
And champion of midwifery, Ina May Gaskin, holds that for women to trust themselves and value the experience of giving birth is a fundamental human right.
A birth attendant who trusts birth is more likely understand why they need to help a new mother also trust birth.
They will be eager to assist her in gathering information,
Gaining perspective, developing autonomy, and encouraging her in making empowered choices for herself and her baby.
They understand that mothers give birth, not doctors, and that her birth will be safer, shorter and also more satisfying to both parents if they are supported in making informed decisions throughout their pregnancy and birth process.
Be cautious with a birth attendant of any title who consistently shuns questions, makes you feel small, dismisses concerns, or restricts choices while assuming authority during routine prenatal care; they are revealing their disempowering philosophy of birth.
Here are some ways to explore how the care you are receiving is serving you, whether your birth attendant is a Midwife (CNM, CPM, or Independent) or OB.
Do you leave each prenatal feeling more emotionally comfortable, with ideas about how to ease pregnancy complaints and grow healthier? Or do you feel uneasy, or even upset, for reasons you may not clearly understand?
Your gut is a trustworthy indicator of whether the experience is meeting your needs, emotionally as well as physically.
If this feeling cannot be improved in the next prenatal or two, it may be in your best interest (and that of your unborn child’s) to consider finding a professional that is a better match for you at this time. Birthing well involves a considerable amount of trust and surrender, and do not underestimate the effects that your birth attendant will have on your experience and outcome.
Are you satisfied that there is time for all of your questions to be thoroughly answered at each visit? Not just from your list, but time for the questions that have formed from your interaction during the prenatal visit?
How much time you get together is often beyond the daily control of the practitioner – insurance requirements are said to routinely require Obstetricians (OB’s) to complete each prenatal in about 6 minutes, and Certified Nurse Midwives (CNM’s) in about 20 minutes. In contrast, homebirth midwives commonly take 45-60 minutes per visit. If you feel the need for greater time in your appointment, you could ask the receptionist to schedule you for additional time (which may be on a different day than their regular clinic time.)
Does he or she consistently teach you what you could be doing to ensure a satisfying and safe vaginal birth? Are there topics raised at each visit that are positive and proactive, leaving you with new ideas to integrate, helpful information, or resources to follow-up with?
Attendants who value educated and participating clients/patients will integrate education and educational resources into their care.
And for a specific example, do they calmly explain the risks associated with labor induction and how they are going to help you avoid one, even though a high percentage of American women are experiencing medically-started labors?
Complications are
less likely when there are fewer routine interventions.
If your birth attendant has little experience with the wide range of normal labor, but lots of experience with medically managed or high risk labors, mothers are more at risk for the ‘cascade of interventions.’ This is where one intervention (such as inducing labor just for dates even when there are no medically concerning symptoms) increases the use of other interventions (such as an unplanned epidural to cope with sometimes sharper labor pain), which may increases the disruptions in the baby’s heart rate…. and on.
Women may have satisfying and empowering births in every setting, and with all kinds of birth attendants, or even none. The essential starting place is that pregnant mamas are attended to, encouraged and informed by respectful and considerate professionals/supporters who trust birth, and are excited to help new mamas trust birth as well. This is possible in any setting and with any attendant, from a birth center midwife birth, a homebirth, to the couple encouraging each other in a free-birth, to the medically high-risk and managed, operating room birth.
Trust your gut to
help you find the attendant that will help you, your baby and family have the safest and most satisfying birth for you! And keep asking for what you need.