The medical model of childbirth care (pregnancy as a disease state) in the US is backward and brutal. If you're pregnant or looking to get that way or the partner of someone who is pregnant or looking to get that way, the best thing you can do for your child is educate yourself. Ask questions. Find out what the American Association of Women's Health, Obstetric, and Neonatal Nurses and American College of Obstetrics and Gynecology say about Labor & Delivery care. Insist on intermittent fetal monitoring. Decline IV fluids (but accept IV access). Stay out of bed.
Remember that your caregivers' recommendations about your care are influenced less by quality, researched evidence and more by who got sued for what last week... And that this is not necessarily what is best for you and your baby. Remember also that you are ultimately responsible for your care - your doctors and nurses cannot do anything to or for you without your consent: you have the right to refuse! The goal of an in-hospital birth is a healthy baby and healthy mom. The problem with this model of care is that we see way more problems than are actually there, and intervene at every given opportunity. This is your birth experience! Own it! Do the research, read the books, get opinions! All that said, however, some women have medical problems, poor support, poor access to care, or other problems that make the hospital the very best place for them to get the very best care. Hospitals are very good at taking excellent care of high-risk women.
But if your pregnancy is low-risk, for goodness' sake, give birth at home! Or at least labor there as long as you can!
And please, please don't make a Birth Plan. The moment you hand me that birth plan, I turn around and print out the paperwork I'll need to do your C-section. Murphy's Law: if you are a nurse, a doctor, or bring in a birth plan, something WILL go wrong with your labor.
Discuss the things you do and do not want as part of your birth experience with your physician, and with your nurse, and negotiate a compromise based on evidence and AWHONN and ACOG guidelines. Bring me the studies, not "I want my perineum massaged with this crystal..."
Oh, I sound like a rabidly anti-establishment hippy.
2 comments:
you don't sound too radical to me!
it's the nurses that I feel for in this mess called "modern childbirth" - and I fear all the induction pushing, cesarean freelove and blatant disregard for evidence-based medicine will only further isolate RNs.
having done a few births for L&D nurses, I know the reasons why they choose to birth at home. I know what they see, what they DON'T want and they understand that they can get is much different under the medical model.
the last few births I've witnessed in the hospital have been hard on me. they've also been hard on the RNs. I feel for them - overworked, pushed around by ego fanatic docs....
I'm glad you're out there. Seriously.
Me too. I'm glad you're there too. Thanks for being a hippie! ;-)
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