The main factor in a good birth is the empowerment of the woman. - Page 2

[Quagmire]

Originally Posted by sapphire_chan

Okay, let's go to a different aspect, discuss the following statement:

Hospital births are inherently disempowering.

To clarify, although I'd like to let this stand on it's own and see people's comments, I don't mean that people *can't* have an empowered birth in the hospital, just that it requires more work.

(I finished reading the American Way of Birth and I'm not going to the library for a couple days. I'm totally using everyone, sorry..)

Ok, I definitely agree with this one.

The thing about hospitals is that they are a business. Caregiving professions and business are a tough mix, because it's hard to do the right thing for each individual person when you're always thinking about the bottom line. This goes for non-profit hospitals too since they have a budget which they want to meet (lest it be cut next year) but not exceed.

Hospitals are also in a dangerous business. Frivolous lawsuits abound in this country, and if they are not always protecting themselves, then they stand to lose a tremendous amount.

So given those two factors, it comes down to making money and enforcing hospital policy above all else. Not great for the patients.

Which is going to lead to things like:

* Pushing pain meds (to recuperate the cost of a full time anesthesiologist on staff)
* Unnecessary c-sections (lest someone sue the hospital over a loss)
* More "procedures" (which they can bill to insurance )
* Over management and medicalization of labor
* Narrow range of "normal birth" and immediate swooping in with interventions at the first sign of any problem or deviation from "the norm"
* Failure to honor patients' wishes - baby and mom are treated like hospital property, with "policy" being the excuse for everything doctors and nurses need or want to do to a patient.

It also seems like there's more "been there, done that, seen one seen em all" attitude in hospitals. It's a big organization, not all employees are there because they love the work. As someone pointed out, midwives are much closer to the woman and the work... a hospital insulates employees to a certain extent. So it's easier to stay in the job and hate it (relative to the work of a midwife).

Just my $.02

[AnditheBee]

I think it is generally a true and empowering statement. And I certainly believe that the mind and the body interact and depend on one another for best functioning.

However...and I don't mean to poop on anyone's optimism and enthusiasm...the truth is, we can't control the outcome of birth, even with the most positive attitude and the best preparation. This is a hard lesson, one that I am personally learning at this moment. Birth is unpredictable and uncontrollable (despite the fact that many doctors constantly try to make it a predictable and controllable process); we can only control how we approach it, not how it actually occurs. I think we can certainly sabotage and otherwise good birth with our own fears or lack of preparation, but I don't think we can consciously "create" a perfect birth.

As I say, I don't mean this to be a negative message to birthing mamas...I just think that I would have been better off if I had truly believed this before I approached my births. I knew it with my head, but not my heart...I read so many birth stories where women's attitudes and minds helped them deliver their babies, and I felt I could do the same. I could make it happen. Ultimately, it hurts like heck to lose something when I know I did everything possible to make it happen. My belief in my ability to do it made no difference in the end, and that really stinks.

We all have to be willing to accept the outcome no matter what it is, if we are going to have a baby. It's a scary concept...a big step into the unknown. And we are all the braver for undertaking it. That's where our empowerment must lie, at least in my experience.

Hope this post isn't too much of a downer.

[OnTheFence]

Originally Posted by Lousli

I agree that it is probably the main factor in a good birth, but I think it is important to remember that empowerment may not be enough to protect someone from a "bad" or traumatic birth, especially if there are factors beyond her control.

I disagree with the statement, because I agree that the birth you have is more about luck or destiny.

I went into giving birth with such empowerment, believing I could do it. I prepared only for a natural, vaginal birth. I meditated on this. Prayed about it. And visualized the whole experience. I read and talk to other mothers who had experienced the type of birth I wanted. But there were factors beyond my control, and I ended up with an emergency cesarean due to an anomaly.

I've talked to hundreds of women who did all the right things, prepared, empowered themselves and they still ended up with traumatic, bad vaginal births or surgical births. It came down to strictly luck. Sadly other women in the natural birthing communities, even midwives, told them that they got the birth they earned or deserved -- even when it was so far out of their control (the mother who birthed). Its zealous and sad.

I guess this is just my point of view from this side of the fence.

[Quagmire]

Empowerment in itself doesn't prevent a traumatic birth, but it sure does help to prevent what can be prevented.

After reading "Thinking Woman's Guide to a Better Birth" I realized that for my first birth, I was not at all empowered. I wasn't an informed consumer. I made decisions and I allowed decisions to be made for me that led to dissatisfaction with my experience.

*NOT* being empowered is far more likely to generate feelings of grief and loss.

It makes a lot of sense to expect the best. You don't see athletes preparing for the Olympics by imagining themselves coming in last. They use positive visualization in conjunction with their training... birth is no different. The athlete is human, and is limited by whatever physical (and emotional) constraints s/he has, just as the birthing woman is. However the mind body connection shouldn't be overlooked. If you think you can't, you probably can't. If you think you can, you're halfway there.

Empowerment is a combination of being informed, understanding the process, and being able to assert your convictions. It's neither zealous nor sad to be any of things, nor to feel that you worked hard and played an important role in having the birth you wanted to have.

However I do think that understanding that there are certain factors which are out of your control can help you make good decisions when things don't go as planned, and prevent you from blaming yourself.

[pageta]

I think you have to know the difference between what you can control and what you can't. Remember that saying about changing the things you can, accepting the things you cannot change, and the wisdom to know the difference? You can be completely empowered and still, for some reason, end up with a surgical birth. But if you were truly empowered, the surgical birth should be a blessing rather than a curse because medical technology was there when you actually did need it (vs. when someone convinced you that you needed it but you really didn't).

My first birth was not a surgical birth, but it came very close to being one. I wanted a birth with no interventions and I had one with interventions. I placed the power in the team I surrounded myself with because I believe they would be the best at helping me have a natural birth. While I still believe that I had a very good team, I was not empowered. I was looking to them for direction rather than listening to myself, and when they did give me direction, I was not open to it. I'm sorry, but when I'm in a lot of pain, I'm not open to new ideas. Had I thought through those situations and processed those ideas beforehand, I think I would have intuitively put them to use and had a much more natural birth.

So in my case, while I had a better birth than most in my situation, I still blame myself mostly for the results. My OB was very empowering, but he is used to dealing with patients who are not empowered and do not want to be empowered. My doula is where I think the problem was - she was very knowledgable, but she was not empowering at all. Now that I'm expecting again, I've spoken with both her and my OB, and those conversations have only solidified my opinion regarding empowerment.

But again, there are things we can control and there are things we cannot. Knowing that we did our best with what information and situation we had is what matters.

[Quagmire]

Originally Posted by pageta

You can be completely empowered and still, for some reason, end up with a surgical birth.

I totally agree with this. Being empowered is less about the final outcome then it is about your feelings throughout the experience and after. You understand the process, you have a plan for each of the potential occurrences (e.g transport, epidural, c-section, NICU, etc)

I think it's possible to be empowered even if the birth wasn't what you planned or desired. It's about knowing that you did everything you could under the circumstances. That you were educated and able to assert your wishes.

I think the difference for many people between being at peace with their experience versus feeling angry or mournful is knowing that you did the best you could with the factors you could control.

[Lousli]

Originally Posted by Quagmire

I think it's possible to be empowered even if the birth wasn't what you planned or desired. It's about knowing that you did everything you could under the circumstances. That you were educated and able to assert your wishes.

I think the difference for many people between being at peace with their experience versus feeling angry or mournful is knowing that you did the best you could with the factors you could control.

I don't agree. Feelings of grief, sadness, rage, trauma, guilt are all things that i have experienced after my daughter's birth. I think no matter how knowledgeable and prepared you are, there is no true way to prepare for what you might feel and experience if you have an emergency birth situation followed by a NICU stay. No matter how well you prepare yourself, you may feel guilty wondering if that one cola you drank three months ago made your child premature.

It may sound ridiculous, but when they tell you, "We don't know why this happened." you search for reasons. If you are inclined towards feelings of guilt/depression anyway, then you may spend a lot of time wondering how it could have happened and was it your fault. I have yet to speak with a NICU parent that didn't have traumatized feelings over the whisking away of her newborn. I have yet to speak to one that didn't have a hard time "getting over it" for many months, even years.

[CalebsMama05]

I totally agree. My birth experience with ds1 was one of loss of control. "hey we're gonna do this okay?" and whether i said yes or no they did it. or if i said no they kept harping on it etc until i felt guilty for WANTING to say no. I had my water broken on my dr's lunch break (so that hopefully i would deliver before dinnertime) resulting in contractions that never ended and pure agony for my back. I was not allowed into the tub (where i desperately wanted to be since it had been my sanctuary for getting rid of back pain during my pregnancy) because my water had been broken and after almost 2 hrs of constant back pain that felt like my back was on fire i got the epidural. that meant i had to be in bed. that meant I had to give birth on my back. that meant that my son had a difficult time coming out.

the ONE positive part of my birth? getting the episiotomy i finally wanted so badly just so he would be born and it would be all over. I begged for it for almost 10mins before i started showing stress lines (he said there were trickles of blood showing i was about to tear the full way down and considering what i saw i totally believe it) and he agreed to cut me. why every other intervention under the sun was pushed except the one i asked for is beyond me.

this time it will be completely different. there will be no one around but me and my baby and my body doing what it is meant to do. of course i'm aware that there might be things that will happen to prevent my *ideal* birth. there always are. but I will be empowered knowing that it WAS a true emergency and that all those interventions were actually needed and i can be grateful for them.

empowerment. oh yeah.

[loudmama]

Empowerment is WAY beyond having the birth you envisioned, whatever that is. Empowerment is not just feeling in control. Birth in & of itself is something that is out of everyone's control, be it at home, a birth center or hospital. Empowerment to me means being respected by your care givers, being allowed time & space to ask questions & make decisions, feeling like you are in charge as much as you can be in that situation.

I tell my clients that birth unfolds in a variety of ways, that's just the way it is. My goal as a doula is to create a space for them to make decisions they feel good about, whatever they are. To respect them, support them & their birth goals & to be there for them in whatever capacity they desire. In the two c-births I have attended, I feel I made these Moms empowered because I helped them try to change the situation (1 breech at term), I helped them ask whatever questions they needed, I made sure they had time to process what was going on, I listened to them & gave them space to mourn the loss of a vaginal birth. They were empowered because they got what they needed. It wasn't the birth they desired, but they felt better about how it went because they weren't manipulated, coerced, rushed,etc.

No, you can't empower someone that won't do it for themselves. I've volunteered on a DV hotline. However, you can help them as much you can based on where they are at them time.

I hope I'm making sense. I feel pretty stongly about this because of my own personal stuff. I had a c-birth with my DD that was not at all in the plan, & while I feel there were things that should have gone differently, I feel that we did all we could to be in control of the situation at hand. Same with complications this weekend in my current 29 week pregnancy. The bleeding & contractions were out of my control. However, I asked the questions I needed & let all the staff know that I was knowledgeable in birth & that they were to expect a lot of questions & that I would keep asking until I got all my questions answered. One nurse even gave me a Drug reference guide for the info I wanted!

Ok, I've gone on long enough. Again, lets hope I'm making sense!


L

[gentlebirthmothr]

Originally Posted by party_of_six

I mourn for women who will never know that feeling. I know that birth was meant to lift women up....bring families closer together....strengthen women and give them the courage to trust their instincts and protect their children. Its not meant to be a humiliating denegrating experience where you surrender all of your power to the "professionals". What does that teach you? Dependence.

party_of_six and everyone else as well,

2nd that for sure even though I'm not at this stage yet, but see it in the media and the local hospital's Maternity/Womens Units that I volunteer, even though I do clerical work do, but still see it, well after it. Other things as well, I which I can't think of now.

Thank you.

[Quagmire]

Originally Posted by loudmama

Empowerment to me means being respected by your care givers, being allowed time & space to ask questions & make decisions, feeling like you are in charge as much as you can be in that situation.

I don't know that empowerment is as much the actual *being respected* and *being allowed* time and space as much as it's the ability to *demand* what you want despite pushy doctors and nurses who think they know everything and are trying to thwart you at every turn.

I don't mean for that to sound all conspiracy-theory, but tons of women come in here with horror stories. The empowerment, I think, comes from making decisions where you can and standing your ground: refusing interventions and laboring in the position in which you are most comfortable, for example. Sadly I think the women who are waiting to be heard and respected in the hospital are the ones who end up getting steamrolled most often

The other thing is that problems happen really fast. So the doctor is telling you your baby is at risk, in distress, time's a-wasting, every second counts... basically using fear to get you to consent to whatever. This is incredibly unfair. I think being as informed as possible about the complications that can arise allows you more ability to either recognize a true emergency, or say wait a minute, I am not going to be swayed by scare tactics, and helps you ask the right questions. Which helps you be more certain when making decisions that feel right to you but are being questioned and/or criticized by your caregivers.

Though you bring up a good point about having a doula... even aside from the labor support, having a third party with you who has some experience with birth and can help you make decisions without the emotional stress that you or your DH might be feeling (due to scare tactics or general strain) is probably a huge step toward empowerment.

[sapphire_chan]

Let's move this in a new direction since we seem to be headed that way any how, two statements:

Women control their empowerment.
Care providers empower or disempower women.

Thoughts, opinions, experiences, beliefs?

[Emilie]

at the hospital i not once had a nurse tell me i could do it.
my midwfie not only told me i could do it-
she pointed out that i was
and she loves me with all her heart.
there was love in the room.
there was not at the hospital.

[Raven]

Originally Posted by ashleep

nak

Raven,


Do you mind if I print that to give to my cousin?


:

sure

[Raven]

Originally Posted by velcromom

Great article Raven, may we use it/distribute it? & if so, do you have a byline for it you would like us to use?

you can use it if you like, I really don't mind at all. Can't think of a byline tho you can just put my name: Shireen Freeman