I recently began offering a pre-childbirth education class called First Things First: Early Bird Course to help mamas earlier in their pregnancies learn about the difference between midwives and ob/gyns, the specialized skills of each, what doulas do, the difference between labor support doulas and postpartum doulas, childbirth education options, and the ins and outs of the four most common venues for birth: home, freestanding birth centers, hospital based birth centers, and the hospital. The parents who have taken the class so far have felt that it answered all of their burning questions and will help them navigate myriad birth decisions. As an NYC labor and delivery RN turned labor support doula and childbirth educator, one of the most valuable things I can offer my clients is honest information so that their births are in alignment with their beliefs, values, and desires.
A lot of the women who I talk with are not even aware of all of the options available to them for prenatal care and labor and delivery. In the US, the vast majority of women choose an ob/gyn as their pregnancy and birth health care provider, and the hospital as their labor and birth venue. For some women this is the ideal choice. For others, it is chosen because they didn’t know there was any other possibility, or perhaps because of a lack of good information concerning the safety, risks, and realities associated with each type of birth provider and birthing venue. Too many books and web posts make it sound like all you have to do is write a birth plan and your wish will be the hospital’s command. Unfortunately, it doesn’t really work that way. Hospitals have policies, standard operating procedures, and certain cultural beliefs and values. Ideal candidates for a hospital birth are mamas whose wants and needs are in sync with the care and treatment that the hospital they choose customarily delivers. Makes sense, right? This isn’t to say that hospitals have no range or ability to be flexible, but that range is often smaller than future mamas realize. In addition, it usually works out best to use a service as it’s intended, rather than try to turn it into something it’s not. To use a food analogy, if I really want a fantastic vegetarian meal, I’m not going to go to Peter Lugar (a famous NYC steak house).
Among the birth community, we have another analogy that we use to help clarify birth desires and decision making: “if you buy the hospital ticket you will take the hospital ride.” (The same holds true for buying the home birth and birth center tickets too.) For families who want to take the hospital ride, this works out just fine. Problems arise, however, when people who don’t really want a hospital experience opt to have a hospital birth. In a meeting with prospective clients this week, I explained that who they choose as their provider (the ob/gyn or midwife) and the location for the birth are the decisions that will most greatly influence their labor and birth experience. I shared that if they buy a ticket for the ferris wheel, no doula can turn that ride into a merry-go-round. Doulas can help make the ferris wheel as comfortable as possible, and can explain what is happening on the ferris wheel, but a doula cannot make something built to rotate vertically, rotate horizontally. Do yourself a favor, and get the information that you need to figure out which ride is best suited to the birth vibe and story you desire. And please know, almost every possible birth option and combination can be the right choice–no one particular birthing scenario is all-right, or all-wrong. I’ve seen unmedicated births, medicated births, Caesarean sections, home births and hospital births all turn into great birth stories of empowerment when they were chosen with care based on what the mama-to-be felt was best for her unique birth.
For more information about the First Things First Early Bird Course click here. For labor doula support to help you best cope with whatever ride you’re taking, click here.
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