1.18.2008

Momma's On A Roll

O.K. ladies, since I know that many of you are expecting or expecting to be expecting soon, I figured a preparation post might be in order.

With all of the advocacy going on right now, a woman has many options at her finger-tips, but she needs to know what she wants and what she is going to stake out as her territory.

One of the biggest choices a woman has is her Childbirth Class. Many American women are opting out of CBE classes all together nowadays. This is SCARY. Women who don't practice, prepare, and educate for the birth experience find themselves at the mercy of those who have read the textbooks and written the policies. The type of childbirth class you choose will have a profound affect on your birth experience. I recommend that, if you don't want the 'All American' birth experience (tubes, monitors, medication, time constraints, nothing to eat for hours or days, and possible a nice scar to show for all your hard work) that you take an independent childbirth course. This type of class is non-affiliated with hospitals or offices and thus they can give you unbiased and accurate information. A list of some independent childbirth education programs are:

Choose your Birth Place carefully. Many women say "for my first, since I don't know what it will all be like, I just feel better being in the hospital. But for future births, if all goes well, I would like a home birth". That is faulty thinking. PLEASE understand I am not anti-hospital or anti-doctor (I had mine all at the hospital). But, if you desire a home birth and are low risk - have one! Don't wait. Once you check yourself into the hospital, you WILL have interventions, whether they are small or large - and some may make you feel dependent on the hospital for safety, even though they did not ensure a thing. And this would take away your desire or emotional ability to have a home birth for subsequent births. I see it time and again in the mom's that I attend. Remember - you WILL birth best where you feel most comfortable. Listen to your intuition. Some facts:
  • Home Birth is as safe if not safer than hospital birth for a low-risk, healthy mom.
  • Free Standing Birth Centers offer more safeguards than home births, but are less rigid in policies than hospitals
  • Hospitals are a good option for those who are not low-risk or who feel most comfortable in a hospital setting. I had to add this link simply because it is so uncommon in hospitals. :o)

Along with choosing your birth place is choosing your Birth Team.
Most states have Obstetricians practicing in hospitals only; one exception is Illinois. If you are interested in a midwife, though, there are different types of midwives who assist in different settings. For a breakdown on the different models of care of each, see here.
  • Obstetricians - (OB) most states have them only practicing in hospital births. A few states allow them to assist in home births. Notice the link says 'management' - meaning they control it.
  • Certified Nurse Midwives - (CNM) most often, they assist in hospital births, under the tutelage of an OB. Some work in free-standing birth centers and have an OB backup working directly with them. Very few states have CNMs that do home births.
  • Certified Professional Midwives - (CPMs) most often do home births. A few states have CPMs who run free-standing birth centers. No state allows CPMs to practice in a hospital.
  • Lay Midwives - (LMs or DMs) are direct entry midwives who have learned through hands on experience and mentorship. They are the only form of birth professional that has not had formal training, though most have extensive knowledge of techniques and forms of assistance in variations of labor (difficult, high-risk, multiples, shoulder dystocia) that other professionals have either not learned or not practiced (been skilled in). Many states have laws making Lay Midwifery illegal - though it continues to thrive underground as a valid option in birth.

For more information on a breakdown of different types of midwifery, see here.

Writing a Birth Plan is the next step.
Once a woman knows what her options are and what she wants out of her birth, I recommend (though some professionals disagree) writing a birth plan. Writing a birth plan will help you to actualize your preferences and solidify your desires. It will also help communicate to your birth team your plans and preferences. This is not an outline, this is not a blueprint, this is a plan. I feel these are VITALLY important in hospital settings, rather important in free-standing birth center settings, and a good discussion topic for midwives and moms in home birth settings. A great template is found here.

And for a fun option, consider Your Attire. This is not a necessity, but I have to tell you, after being through labor myself many a time, and witnessing women on this journey numerous times, women are women even in labor. When we feel beautiful and powerful, we are beautiful and powerful. There is something de-humanizing about putting on the hospital gown at admission. You loose your autonomy. It is frumpy. It is heavy. It is UGLY. When a woman labors nude, or in a Binsi or a sarong, or something that is beautiful to HER - she simply blooms! I can't explain it any other way.

Ladies, happy planning, happy options, let m know if you have any questions as that is what I am here for. Sorry for the link fest, but I had them on my puter anyways, I figured that I might as well help ya'll out.

1 comment:

gen-here said...

There's another option in birth team members... a family practitioner. I would have loved an assisted home birth, but lived in a state that made assisted home birth illegal for the assistant. So I stayed on with my FP - and had a great experience. I labored and birthed naturally, unmedicated, and with minimal intervention. I chose which tests I would and would not accept prenatally. And when my child was born, his (and her) "pediatrician" was right there, too. As they grew, the oneness of our breastfeeding relationship was seen and respected by OUR mutual doctor.

Don't get me wrong - we've relocated for other reasons to a homebirth friendly state... and if we're blessed with another child, s/he'll be born at home. But I'm SO thankful for my awesome FP - I sing her praises to anyone who will listen!

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