If you were a mainstream mama....

[2+twins]

what would you most want to learn about options available for giving birth? I'm going to be giving a talk to my local Mother's club about birth choices and this group of women is by-and-far a mainstream, epidural upon admission type of crowd. In fact, our 1 local hospital has a 99% epidural rate and does not permit VBACs (no local hospital does, in fact). I'm hoping to present them with information they can use to personalize their experience even if it's not what I would want (really trying to avoid coming across like the ncb/homebirth militant that I am :LOL). Anyway, I can't really ask mainstream women what they'd want to know b/c how would they know what they don't already know, so I thought I'd ask here. So far I plan to highlight:

1. Location (Home, Free Standing Birth Center, Hospital) - this topic alone could go on forever though since location can dictate your choice of options

2. Medicated vs. Non-Medicated

3. Routine procedures

4. Special Requests

I'll give them a pros & cons rundown of each and provide a handout or two since I won't have time to talk about absolutely everything I'd like to. I'm thinking the primary thing I could say that might make the most impact is that they simply HAVE the option to decline routine procedures. I don't think most people realize that. Oh, and that they shouldn't necessarily use the OB they already have - they should shop around and find the best match for them. Anyway, what do you think you'd want to know if you didn't already???

[De-lovely]

Doula-what they do and the benefits?

[2+twins]

Ah yes, I did think of that but forgot to write it down. Thank you!!!

[SKK]

i would want to know about the pros and cons of some of the more commonly used routine interventions (i.e., induction and epidural), and the "cascade of interventions" including c/section, that could follow). No one else is likely to tell them about the downside of these things.

[JennP]

the benefits of a doula, I would have been considered a mainstream mom for my first birth. I didn't want things to go that way but they did. I feel that if I would have alteast had a doula I would have had better support. Emphasizing that doula support in addition to dh woudl be great, incase dh needs a break. I was also really shocked and disappointed when shift change happend and my nurse left. What was I to do? The next nurse was different I was too far into labor to 'like' her and she was not calming or comforting. Having someone there all the time would be AWESOME!

I plan on using a doula this time. Also staying home longer. You will know when you have to push don't spend the night in the hosp. so a nurse can tell you!

[Storm Bride]

I'd definitely want to know about the risks of various routine/common procedures. When I had ds, I thought I was fairly well educated, but I had no information about the risks of c-section, the risks of induction, the downsides of epidurals, etc. They most likely won't be told these things by their doctors, and they really should know about them.

[ObsessiveAndrea]

the truth about the differences in care providers. Alot of women think DEmidwives are witches or some such thing...the legalities of birth in your state. I think throwing in a little facts about circumcision rates in the US and some benificial information regarding that would be insightful too. A lot of women don't even know to question it. (everyone does it, right?)

[fire_in_july]

Originally Posted by love_homebirthing

I'm thinking the primary thing I could say that might make the most impact is that they simply HAVE the option to decline routine procedures. I don't think most people realize that.

YES. This is so important. I can't tell you how many women I know who treat every standard procedure as though they had no choice in the matter - "Well, the doctor said I had to", "Well, they do it to everyone, it is hospital policy."

I think the most important things to know are that:
1) They can decline ANYTHING, even if they get attitude for it
2) They will be able to make much more informed judgements about what to accept and what to decline if they do their own research about the possible complications, effects, and cascade-of-intervention things of various procedures and interventions
3) All about doulas!
4) The advantages of non-standard birthing positions (all-fours, modified hands-and-knees braced over the bed, standing, squatting, etc.) Many women have NO idea that the baby that was posterior, "too big", shoulder dystocia, failed to progress, etc. and "needed" a c-section probably often (though of course not ALWAYS) could have been delivered vaginally with ease in a different position. Of course, this brings up the fact that these better positions are difficult to get into if one is hooked up to tubes and machines, or especially if one has an epidural.

[nurnur4evr]

You may be able to convince many of them to at least delay their epidural until active labor (4 cm). This will greatly help to reduce the subsequent interventions associated with receiving an epidural too early in labor. Many women don't know this, and are encouraged by anesthesiologists to receive epidurals at 1-2 cm. The other ideas presented here, such as doulas, can help them with this.

It might not be realistic when talking to this crowd to expect too many great, radical changes, although you never know. If you read all the literature, there is a consensus among HCPs of very different viewpoints, that receiving an epidural too early can really cause problems, so I would kinda stress that.

When I taught prepared childbirth classes in a hospital setting, there was always a lot of fear the first night. I would spend the first class addressing the emotional stuff - what is your greatest fear, etc. as well as some technical book knowledge about recognizing signs of labor, etc. You may want to ask the mothers first thing, what topic they would most like to have addressed. It will probably be pain relief. Remember that epidurals have a place, after many hours of labor when mom is becoming exhausted, etc. so I would emphasize them in their proper place - not painting them as bad which would probably turn off some in this crowd (although not all).

Best of luck! It sounds like you have a chance to make a positive impact!

[Storm Bride]

Originally Posted by fire_in_july

4) The advantages of non-standard birthing positions (all-fours, modified hands-and-knees braced over the bed, standing, squatting, etc.) Many women have NO idea that the baby that was posterior, "too big", shoulder dystocia, failed to progress, etc. and "needed" a c-section probably often (though of course not ALWAYS) could have been delivered vaginally with ease in a different position. Of course, this brings up the fact that these better positions are difficult to get into if one is hooked up to tubes and machines, or especially if one has an epidural.

Yes! Definitely this. In BC, we have a government-issued publication called Baby's Best Chance. It includes various positions and some advise on when they might be comfortable. So, I think that lets women know that flat on your back isn't the only option. But, I suspect that many women have no idea that that's the case.

[mom2threenurslings]

I would try to get across the fact that our bodies know how to birth babies and that in most cases, no interventions are needed if mama is allowed to listen to and follow her body.

Things I would have found helpful the first time around include:
- a printout with the warning labels from pitocin, cytotec, nubain, epidural drugs, etc. so that I would have been educated about the possible side effects (including uterine rupture, etc.)
- info on doulas
- info on changing positions during labor and birth
- info on the benefits of water during labor and birth and of being upright during labor and birth
- knowledge that I could refuse procedures and that the decisions were truly up to me (not nurses or my OB)
- reminder that it's MY BODY, MY BIRTH, MY BABY
- info on circumcision
- info on routine labor procedures, what they're for, what they can lead to
- info on routine newborn procedures and whether or not they're necessary
- the safety of homebirth, birth center birth, hospital birth
- info on normal, natural labor - including the natural labor plateau, which is commonly diagnosed as "failure to progress"
- info on PROM and possible complications
- info on induction and possible complications

[FrumDoula]

While I would certainly present information on doulas, alternatives to the hospital and interventions, I agree with a previous poster about addressing fears first.

Instead of simply lecturing, lead the ladies on a discussion of fears, and how to resolve them. Consider bringing a big piece of butcher paper and a ton of crayons or markers and have everything color a picture of what labor might be like. (A very Birthing From Within kind of idea.)

The point is that you want to get their attention, and pregnant ladies get so much information overload on everything from AFP to carseats that simply lecturing may not hit the spot.

Consider too showing a natural birth video. I wouldn't personally start with Birth in the Squatting position, but something that doesn't show the typical birth we see in America.

Ask them what they already know - sometimes people have a lot more knowledge than we suspect.

And be sure to hand out your phone # and business card during the session as a resource to hook the mamas up with doulas (preferably doulas who have a wide variety of birth philosophies). You might get a few calling you with questions.

Good luck! It's not easy being a zebra among horses!

[Starr]

Could you maybe at the end of the discussion hand out information packets on more AP parenting? Or let them know if there is a list of doulas who would be willing to talk to them and answer questions? Just something to keep the ball rolling.

[amanda2b2]

you do not have to do everything the Dr tells you and they have to ask before you before doing things. I was giving stadol with my first because the nurse not even my midwife decided i needed help relaxing. I was also given a catherter (sp?) after his birth so I wouldn't have any pain the first time i had to pee :rolleye I wasn't asked if I wanted one, I was told I needed one and I just blindly believed it.

[dnr3301]

I think a good topic of discussion is the use of water during labor. Even if they don't want to/aren't allowed to (grrr) labor/birth in a tub, water can be an extremely helpful comfort measure. Showers/baths/washclothes/wet towels/listening to ocean sounds/however it works, use water.

[Pepper]

nak

How about how incorrect late-term u/s can be in guessing weight. and how our bodies can birth the babies we grow (barring a real medical condition..).

I just watched Baby Story (why?! : ) and the clueless first-time mom elected a section for no other reason than "the baby looks really big and I'm a small person".



ps. the "big" baby was 7lbs. 10 ozs. the dad said "well, I guess you weren't the bruiser we thought you were." sigh.

[orangebird]

What I wish I had known, and I wasn't even mainstream when this happenned, rather just ignorrant of L&D politics or whatever. But even as a mama wanting and preparing a natural birth, I had no idea I would have to fight to get it. I didn't know that nurses and doctors would actually lie to me to get me to do what they wanted. I don't know how you could word that nicely when teaching but I had no idea. I trusted them when they said "your baby will die if..."

I think moms deserve to know that the stuff they do in the L&D isn't evidence based practice, I think they deserve to know the truth about the different interventions.

They absolutely need to understand their rights.

There is so much moms need to know. So much it is overwhelming. It is a whole new world than what mainstream moms "know". But I think they deserve to know all of it.

I don't know how one can educate on all this stuff without coming across militant. I know I have a hard time doing it lol!

[anonymommy]

baby's angle

I haven't seen the movie What Babies Want yet, but perhaps part of it could be excerpted.

Perhaps you could also show a film of a circumcision.

I think there are some people who are more likely to start questioning when it involves their children's welfare rather than there own, and most typical approaches are the benefit to the mom. So it might be good not to leave the other group out.

[orangebird]

"What Babies Want", is that the new one with the guy from ER? If it is I saw that video. It was pretty good.

[EmmalinesMom]

I would have wanted to know that some "childbirth classes" are really just "how to be a good patient at our hospital" classes.

Maybe include a list of books that might be of use to them? Some of Dr. Sears books, maybe Bradley books, etc?