This journey is going to be so weird for me.
I've been working in birth for four years now and have attended home, hospital and birth center births, VBAC, cesarean (planned and otherwise), unmedicated, inductions, Pre-E, etc. I've seen a shoulder dystocia (there's a photo of it on ShoulderDystociainfo.com!) and a baby come out with an Apgar of 1, I've certified in NNR to practice as a midwifery assistant (that never worked out).
From my perspective, the doula, the woman's support person, it has always been difficult to navigate the "allow" the patient to do ____ mindset. I've always taught women that they have a right to have all of their questions answered (barring an emergency, of course) before consenting.
Just tonight I was on a mothering board where she was saying that she was going to be birthing in a hospital, and that she was worried that her doctor wouldn't *let her* get out of bed, or *let her* not have an IV, *let her* eat, etc.
Pregnant women are not sick, birthing women are not manifesting the product of a 10 month illness. Surely, we all know that emergencies happen and I'm not saying anything about that- but there is a LOT of humanity missing from the process of hospital birth, even with the nurse/doctor's best intentions. The *process* does not allow for normal birth. No animal that I know of births better when being interrupted every hour, being limited to one position in the bed, disallowed food and water, and strapped down with monitors. I'm not saying these things don't have validity, I'm saying that to require EVERY woman to undergo these things causes (in my estimation) to cause more problems than it prevents. The Freudian curve... if my docs had kept to that I would never have had vaginal births. Why not -? Because of some scale. Like the 28 day cycle.... 🙄 I was talking with my OB (a man I respect very much even if we do disagree sometimes) about NPO in labor and how archaic a thought that is. He argued that '1-2 women a year DIE from aspiration because of eating in labor, it is absolutely valid' ... to deny thousands and thousands of women food during one of the most physical events of their lives... to save one or two women? Does it really save them? No one's pumping the stomachs of laboring women so how worried are they, really? And why are we giving Cytotec which has much higher risks than eating in labor, if we're that worried about protecting 1-2 women a year? I know, I know... I digress. 😉
I can't wait to finish school and teach women about their cycles, how to chart their fertility so that they can be educated about their bodies and partners in their care, and not submissive to my diagnoses and decisions. I know some (most) women want that, but I want to contribute to change. Don't piss on my idealism, let me have it for a while. 😉
I see so many holes as a doula, as a woman, as a premed student, in obstetric care. I see incredible, inspiring, caring doctors who are limited by the routines of the hospital. I see frightening care about which no one does anything. I have seen terrible abuses of women, women treated like meat, like dolls upon which to teach and experiment. I have seen profound generosity and respect in the most dire situations and it inspires me that I might be able to do the same for my clients.
I come into OB/GYN not to learn to care for women. I come into it caring for them. I come into it to learn how to care for them in a different way, to bring my experiences, and my background into the field. I look at other specialties and I think, is there another I would want to do? I don't know of any others that I (at this time) am even remotely interested in.
I've heard that OB's either have elective cesareans or homebirths. LOL I don't know how true that is, but we are currently TTC and I am hoping for a homebirth this time around, but planning for a hospital birth. Once I'm pregnant I'm going to talk with the hospital about getting a birthing tub in my room (won't birth in water there, no one is trained and I feel like that's just too much to ask) to labor in. I'm not afraid to fight for what I want. I'm willing to hear "No", and I'm tenacious enough to keep going.
I know these issues (every single one mentioned here) are far more complex than anything I've experienced and I respect the balance beam that physicians must walk between their patient wishes, their opinions about what is best in the individual situation, and what they must to to protect themselves, which sadly weighs as heavily as the other two issues in patient care, from what I have seen and heard from my physician friends.
I would never tell my clients to argue with their doctors. I have heard doulas tell their clients to have their OB sign their birth plans. ?? I don't get it, and I always call doulas to the mat about it. The power dynamic should not be fiddled with at 39 weeks. If you don't like your care, find another provider, but don't start pissing in the corners to get what you want when birth is relatively imminent. It's just not the time. Women should be taught about birth far before they are close to it so that they have time to research and learn, discuss with their docs what they want and what they need in their situation.
Maternity care in this country is SO sucky. *sigh* It's not women centered, it's not baby centered- it's completely about *health*, and it devalues the *experience*. I'm tired of hearing from docs that 'at least your baby was healthy', or that a 'good' out come is one where everyone's alive. What about when mom goes home with severe PPD and breastfeeding fails and her family falls apart? It's not an exaggeration. What about when care providers forget that the patients are human beings who have a right to decline your hand in her vagina, thank you very much, and shove it in there anyway? What about the doctor who stuck his finger in my client's rectum after reparing her 4th degree episiotomy and never said a word to her, to warn her, to tell her why... He touched her in a place not even her LOVERS had and never said a word. Stuff like this... it's the subtle things. It's the little things that make a good outcome. Even if the birth goes nothing like what was planned or hoped for- little things like a compassionate touch, talking to the patients instead of over them, avoiding the "if you're going to get your epidural now is the time to do it" sort of language that undercuts a woman's strength. Not standing against the wall with your arms folded, or over her as she labors in the bed.
Bah! Some of these are such pet peeves for me. LOL
Wow, I don't know where all that came from.
