Dear Friend, can I just open up my heart to you for a few minutes?
In my imagination, we are sitting across from each other, a warm drink in our hands, a light breeze on our faces and the sun warming us ever so gently. And you can hear the love and pleading in my voice and the absolute earnest desire I have for your very, very BEST birth.
Because I want to talk to you so badly about a potentially touchy subject.
CHILDBIRTH IN A HOSPITAL
As thankful as I am for modern medicine, doctors, nurses and the wonderful hospitals in our area, the truth is these places can get W.E.I.R.D. when it comes to childbirth. There are a lot of reasons for this, not least of which is the high number of malpractice suits that obstetricians risk. Their liabilities are nuts. And the cost of that may potentially warp the priorities of care. Because although their original aim is to provide the best care for women and babies, that goal may morph as physicians are navigating the risks associated with the care they give.
It's so hard to explain but put very simply, OB's are in an incredibly difficult position in terms of liability. But beyond that, philosophies around medicine and childbirth are so ...tangled.
Just think of nurses, example? Their job is to alleviate pain. To fix things. It goes against all of training as a nurse to stand by and "do nothing" while a patient is uncomfortable and maybe even downright miserable. It must be exhausting to care for women who are struggling through labor and watch their family glare at you, like, "Why aren't you helping?" or "Why aren't you doing anything!?"
YOU'RE NOT BROKEN
Think about it. ANY OTHER TIME you go to the hospital, it's because you're sick or broken somehow and you need someone there to fix it. For childbirth, you're not sick. You're not broken. Everything is fine except that you've got this incredibly challenging job ahead of you. Ideally, you just want to be in a place where you can receive help or support if you need it. For most women though, we don't need the interventions that have such a knack for actually complicating matters.
As for childbirth education, I really can't recommend it enough. The more you know about what's going on with your body, the less frightening and interestingly, the less painful it all seems.
When you get a shot, for example, a good nurse will usually prepare you by explaining exactly what you're going to feel and for how long. Then when the "pinch" comes and then the five seconds of burning (or whatever she described to you beforehand), it's so much more bearable because you knew exactly what was coming and how long it would last.
This mental preparation is exactly the same in childbirth. Obviously it's just a much longer process. The more you know, the less stressful and the more bearable it all is.
Having a doula's support is also invaluable, especially in a hospital setting. The doula is a "disinterested third party" in some ways. She's there to care for the mother, but doesn't care the same legal burdens the medical staff bears. A good doula is well-educated, certified, and an expert in the birth world. With a doula's help, the laboring mother doesn't have to depend entirely on her own ability to recall information when her mind is not at it's best and the stressed out husband doesn't have to either. They can discuss all plans beforehand and then during labor, make the best decisions for proceeding based on the wishes of the couple prior to entering the process.
I will never forget the sight of my husband and doula pow-wowing next to me as I was hitting an emotional and physical wall during labor. What I didn't understand in that moment was that I'd made it through some of the toughest bits and was on a clear course for an awesome, natural delivery. But I was not exactly rational in that moment. They were able to talk me through comfort measures we hadn't considered yet.
This brings up one other item.
YOU'RE MAKING A LOT OF DECISIONS
When you get an appendectomy, you don't really have a lot of choices about how things are done. The patient plays a 100% passive role. When you're giving birth, not only do you do the work, but you're also making a lot of decisions along the way, some very, very significant to the outcome of your birth.
Early on, one of the most significant decisions you will make is what practice to work with. And when you're making this decision, I would urge a few things:
Don't wait to start childbirth education! You'll have so much to chew on and it will help you in the process of choosing a practice.
Don't wait until the month of your due date to tour your potential hospital. This is an interview process and you're choosing whether to hire them or not. They should knock your socks off. You should feel comfortable with and confident about the facilities and staff.
If anything gives you pause or concerns you, you can always change practices! It's totally reasonable to do this and within your realm of rights. I have a dear friend who was able to transfer her care to a birth center just weeks before her due date and she was so happy that she trusted her gut on that decision.
Research C-section rates.If it's not a high-risk practice, find out how your potential doc's C-section rates compare to that of others in your area. What about the hospital's overall C-section rates? How do those compare to other hospitals? C-sections aren't the worst thing in the world, but they're definitely not a cake-walk.
Research the standard practices for that physician or practice. Do they welcome birth preferences? Do they cut the cord immediately or wait two minutes? Do they acquire APGAR scores on a cart or can they do that with baby in mama's arms? Do they ever pull on a cord to deliver placenta? Do they administer pitocin as soon as baby is born to deliver placenta even in a natural birth? Do they allow you to choose what you'd like wear for delivery? Do they allow photographers? Do they allow video (if you desire that)? If you have a C-section, will they allow your photographer to attend? ;)
GET INFORMED. GET A GREAT DOULA. THE END.
I feel so strongly about this that I'm considering changing the terms of my service to require both formal childbirth education and a doula.
The thing is, I care so much about my clients and want the absolute best care for them. And yet, I have sometimes found myself in situations where I have serious concerns and yet, in the "just-the-photographer" role, I don't have much of a voice in speaking to the situation. It's so difficult for me to stand by, knowing what I know, and not speaking up.
I only bring this up now because my tendency is to be soooo excited about connecting with a new client, but I fail to ask questions. I assume my clients are preparing as they see fit. And then I end up in a hospital room where nothing is going "right" and decisions are being made, and the direction everything takes is leading to undesirable outcomes. And my heart is breaking and the mom is crying because, A, B, or C is happening and it's exactly what she didn't want to happen. And at that point, it's just too late and probably just inappropriate for me to "offer suggestions."
I wrestle so much with this urge to care, but not knowing how. That's why I went ahead and partnered with agroup of doulasthat I love. They're committed to excellence in every way. And they're as supportive and loving as you'll find. Seriously. These are just some of my favorite folks on this green earth.
Are these things even my business? I often try to tell myself, "No." I'm only there to take photos. Just take the photos. "Just keep your mouth shut," I tell myself. But the truth is, this would require me to emotionally distance and make myself stop caring. This is not a healthy option for me. So here I am. Pleading. Get lots of education. Get a great doula. Get a great team. Get a plan in place.
And best of all, just get ready to be a mama. It's really is going to be amazing.