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Originally Posted by TheDivineMrsM  But I feel like DH alienates them by going off on the evils of our system.
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Oh that is SO ME! I'm very passionate in general & opinionated on the whole. & modern American maternity care makes me FURIOUS!!!! I feel the need to WARN PEOPLE! Women & babies are abused by our system & I feel like
not warning people is standing by & letting it happen - so I feel compelled to warn them.
Put all this together & I find it exceedingly difficult to
not scare people by talking about the evils of our system.
But I realize it is not an effective way to spread the word among what I refer to as "mainstream" people. I realize that, so I
do attempt to chill! It's
really tough for me though.
I love this topic. So please forgive me, I've decided to play devil's advocate here. You all make good points, but I've seen many of these points simply bounce off mainstream people leaving them still thinking I'm a crazy hippy & utterly dismissing anything coming out of my mouth. So I'd love to hear your input on my devil's advocate responses. Thanks!
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Originally Posted by •Adorkable• Pregnancy is not inherently a medical issue so I don't feel it needs a Person chomping at the bit with a medical solution.
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But the problem here is that I've found many mainstream women think,
"OK, sure, lots of times birth goes just fine, but babies & women can die! Birth used to be a common killer of women centuries ago! So I want an OB who is on top of things & will take care of me & my baby to make sure we're OK if need be. & I'd rather not have to transfer from the care of a MW to an OB if I do need a CS or something.
Why isn't it better to have the OB as your HCP in the first place? Just like it would be best to go the hospital with the highest-level NICU since it's better to have it & not need it than to need it & not have it."
& then where does the conversation go? Then how do you possibly begin to explain that when HCPs view birth as a 'problem' they actually CAUSE problems with unnecessary intervention? In order for someone to believe that, they must believe that typical American maternity care isn't always "good", therefore - they can't blindly trust their HCP. That's really tough for people to wrap their head around.
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Originally Posted by bella99 Anyways, I would be turned off by anyone, man or woman, who went off on the "evils" of the system.
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But there
is a lot of evil in the American system. There really is. There are so many facts I could point to of what can reasonably be considered "evils." Why should I deny that fact?
Although I totally get what you're saying. (Ha - & as I said, I realize I turn people off!) & I think there's a world of difference between saying something like, "GBMC is an awful place for a healthy woman to give birth," to a woman who's not even TTC, and me saying that to a woman who actually
is planning to birth there!
In the former case, I'm giving my opinion - which I'm entitled to & is based on a lot of facts. It is a rational & reasonable statement. Whereas in the latter case, I'm judging someone's choice. I can see the need to respect others' decisions & not make such a statement to someone about
her particularly choices.
But to non-PG ladies or newly-PG ladies picking a hospital? You bet I'm gonna warn them away from that butcher shop! Heck, I almost feel guilty or feel like I'm doing a disservice by
not giving at least some slight words of warning.
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Originally Posted by gemasita -OB's specialize in the pathology of pregnancy and birth (good one on its own!
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I've said this too but the fact of the matter is that OBs do attend like 90% of births in America! Everyone assumes that when you're PG, you have an OB - even other HCPs (I've had my ENT & my dentist ask me who my OB was. Not to mention other family members & friends who still don't remember I see MWs.) So it's difficult to try to convince a mainstream American woman that an OB is really NOT the appropriate care-provider for all healthy woman with healthy PGs because it's such a foreign, unusual concept.
and, again, see above - they tend to think you are 'safest' with the higher-level care provider. I actually had one mom tell me I was "brave" for choosing MWs - even though I had a hospital birth with CNMs!
I can just imagine the look on her face now that I'm choosing HB for #2!
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Originally Posted by Twinklefae I mostly point out why I like it -
<snip> Not because [hospitals] are horrible dens of evil, just because I don't like them. Never have.
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Well, in the US, HB is less than one-half of one-percent of all births. It's very rare & viewed as VERY STRANGE - even free-standing-birth centers aren't common & at least one state has actually outlawed them!! ACOG & AMA have official policy statements against HB.
So if I were going to talk to a totally mainstream woman about other options (epis aside), I would not even mention HB because she'd totally shut-down & view me as completely insane. I'm not exaggerating on that either.
HB really is viewed as a bizarre, on-the-fringe thing.
All that being said, if I DO try to
focus on what is so great about midwifery care, or even what is great about natural birth (even in a hospital, or even with an OB), I've often found mainstream women still shut down.
The idea that feeling your birth (i.e. no epidural) can be a pleasant, joyful experience is so bizarre in mainstream America that if someone's not already open to it, the conversation goes nowhere when you try to share how, "Yeah, it hurt, but it was still a really fantastic experience."
Or they dismiss me personally with comments like, "I'm not a super woman like you." (I'm a fitness nut & into weight-lifting, so that makes it easier for them to dismiss me as 'super woman.' Even though we all know darn right well it's not only super-fit, super-strong women who can have fantastic natural births. But, again, it makes it easier to dismiss me personally as an anomaly - a weirdo - an outlier.)
Maybe I can give some advice based on the conversations I've had that have gone south.
I think first & foremost the most crucial thing is:
Immediately clarify the fact that midwifery care & avoiding unnecessary intervention does NOT mean not getting an epidural!
Many women are just not in the least bit interested in considering foregoing the epi. They think, "Why go through all that pain if you don't have to?"
Since I was outspoken about planning an NCB, & subsequently had one, I think
a lot of women immediately dismissed me & my input because they thought it was all centered around no-epidural. So I think in order to open a dialogue, it's important to clear that up.
So while I'd love to clarify the myths inherent in that statement (that birth is always horrifically painful, epis are risk-free, & there's no value in feeling any of the pain,) I think it's more worthwhile to launch into the chasm between evidence & practice in America today. So, I'd ideally love to help educate women that even if you remain dead-set on the epi, look into natural methods for coping with pain because they have a substantial failure rare (I've heard 15%, but not sure if that rate includes the times people have complete sensation on one side, 'windows' where they still feel pain in some areas, etc.) & you can't always get them immediately.
&, again, epi aside:
-avoid unnecessary induction
-avoid AROM (without good cause)
-avoid cEFM (which, obviously you can't do once you have the epi, but in the mean time)
-avoid CS for FTP
-avoid pit to 'speed things up' unless truly necessary
-avoid episiotomy in any case but fetal distress
-Room in & initiate BFing immediately
-etc.
But I think you can only get that message across until after you convince someone, "American maternity-care HCPs
do not always have your best interest in mind (or, they think they do, but they're views aren't based in reality/science.) So
you need to get educated, advocate for yourself, & not blindly obey your HCP.
Ya know, now that I'm typing it all up,
I think even that message alone is scary. "Don't blindly trust & obey your HCP" is a scary thing. It means you need to take on a lot responsibility for yourself. It means you need to get educated. That is scary.
The other crazy irony in all of this is that sometimes what may be commonly regarded as the "best" hospital & OBs are the worst for healthy women. (That's the case here in Baltimore - Johns Hopkins, one of the best hospitals in the nation, is NOT good for healthy birth!)
I don't think there's any way to really get through to people on maternity care until they accept that fact as reality - that the best hospitals for sick people aren't necessarily the best for birthing women. Again, just like the higher-level care provider (OB vs. MW) & the hospital with the highest-level NICU aren't necessarily the best paths to the best outcome.
All this being said, sometimes people aren't interested in learning. So it obviously makes no sense to waste time & energy on it. Then you just annoy them if you keep discussing it - & confirm the existing suspicion that you're crazy!
But I still can't help my feeling of wanting to warn people away from what I view as a way too high risk of evils.
Sure, I also often share the flip side of how great midwifery care is & how fantastic my natural birth was, but again, I find the whole issue of "no epidural" makes people view me as a freak & shuts down the conversation.
The whole thing makes me keep frowning.
