Passionate birth educators, help me out - Mothering Forums

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Old 02-09-2004, 06:02 PM - Thread Starter
 
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This is kind of a spin-off of the education/balance thread. I wrote this as a response to something someone said there, and then realized, HEY! I really would like some help thinking about how to educate my pregnant coworkers about how to have a low- to no-intervention birth. Here's what I wrote:

Okay, I'm at work. There are two women at work who are pregnant, and several who have had babies. Of the women who have had babies, two had c-sections--one with a breech baby, she then "couldn't nurse" (said her doc) and she had a hellish recovery. She's in her early 30s might have another baby. The other one is past childbearing age and it sounded to me like her c/sections were unnecessary, but I haven't drawn her out about it. (I know who had a c/s because people tell you everything about their births when you are pregnant. )

One of the pregnant women told me she didn't really like her OB. she also doesn't like the u/s tech in the OB's office. She has had trouble eating during this pregnancy, she hasn't put on much weight, and is a little afraid of having no pain meds during her pregnancy. I work with her closely and she ranks me in the organization. I like her a lot.

To whom should I say what? How do I talk, IRL, with mamas who are not committed to natural childbirth (as the folks on here are, even those who had high-intervention births) and help them not to have unnecessary interventions? I can talk to people at length on the lunch hour, and I can also give them books or articles. How would you educate them?

(Just to make things extra complicated, I had a HIGH intervention, vaginal birth! : I don't know if that makes a difference.)

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Old 02-09-2004, 06:10 PM
 
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I have found that the best way for women to absorb this information is to let them start talking. You can usually gage how much info. is enough; I'd start with a couple of non-intrusive questions, and if the mood is right, maybe saying something like: "I had a similar experience with x, y, and z. You know what I found out when I did some research?" And start the education from a common ground, kwim? If it seems like you are genuinely interested and simply throwing out some suggestions, I'm sure they would greatly appreciate the input. Just be careful not to preach and not to overdo it too much.
Good luck!
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Old 02-09-2004, 09:32 PM
 
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Proceed with caution, and know, you may have some new pals on your bandwagon!

candiland offered great advice, esp. because people always love talkin' about themselves!

People just don't know stuff, they don't think outside the box, as a rule, and this applies to EVERYTHING.

Why question an OB? A procedure? Birthing in a hosptial? But look...your pal already has started to think critically, and is suggesting that she doesn't like her OB or u/s tech.

WHY not? The shoes these people wear, their bedside manner, what bugs her? You could ask that, to get the ball rolling.

And I think your interventive birth is not a liability, but an asset!!! You've experienced some of the things that are associated with unfun hosptial births, and your personal familiarity with that will lend that special touch to your evangilizing! :LOL

Seriously, though....I do think it is valuable and perhaps neccessary to one's own integrtiy to try to share the information you know. Maybe you could think of sharing childbirth wisdom as akin to driving safety...wear your seatbelt, don't drink and drive, and be extra cautious in bad weather.

You're not able to guarantee that someone won't experience a dangerous car accident just because you say the classic, "drive safe", but it's worth it--to remind someone you care about of the facts, AND TO convey to someone that you care about them.

To finish answering your query, CO, work the preggo first, & see what happens.
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Old 02-09-2004, 10:15 PM
 
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To the woman who's had a C who's past childbearing age, say nothing. However, if she says something you *know* is erroneous in front of you to one of the pg women especially, think strongly about countering her (and remember, that if you stay calm and seem reasonable to the pg women, you will look like the more credible source).

To the woman who had a breech C and couldn't nurse, say nothing. But if she gets pg again, think about bringing it up with her. Tell her you feel for her in how horrible her recovery was, that she couldn't nurse, and that you sincerely hope that this experience is better. If she's open to it, ask her if she wants to talk about what can be done to make things better this time.

To the close co-worker who's pg... especially if this is her first pg, you might think about passing on some info to her. (When I was pg with #1, I found advice from women with children *whom I liked and trusted* was really, really valuable.) She may not realize that if she wants to switch care providers, earlier is better/easier than later in pg. Tell her you feel for her eating difficulties and that you sympathize with her fears... if there are any books which really helped you with these things, tell her about them, ask if she'd like to borrow them. See how she responds.

Who's the other pg woman?

Remember that pg women especially can be extra sensitive and that we're often *bombarded* by advice... Good advice is wonderful, but these women have to trust that you're providing good advice before they open up to you...
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Old 02-09-2004, 10:43 PM
 
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Captain Optimism, I am sure that you will be sensitive and caring!

I totally agree that getting the moms to talk is the most important thing.

Changing caregivers is a big deal for most of the moms I work with--most of them will not even consider it, even when their dislike is strong. I often talk about the woman I know who did change caregivers, and how it was a tough choice for her, but in the end she found someone she really liked, and she was very happy with her choice.

As far as (potential) vbac moms, I am very, very careful. I ask if they're interested in vbac. Some women aren't and it's not up for discussion, and I respect that.

As far as talking to people who are not committed to natural birth....In my city, about 97% of birthing women use epidural anesthesia. Most of them aren't even the slightest bit interested in unmedicated birth, so I meet them where they are, and I mainly talk about minimizing the risks of the medication. For example, one of the most important things a woman can do to minimize some risks of epidural anesthesia is to put it off for as long as she can. Studies show that holding off on the epidural until the cervix is dilated to 5cm reduces the need for labor augmentation & reduces the rate of cesarean birth.

Of course, a birth class would teach coping methods and make it easier and more comfortable to get to 5cm without pain medication, so I try to work that into the conversation. One thing that women seem to like to hear is how much my husband gained from the classes we took.

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Old 02-09-2004, 11:02 PM
 
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I am very passionate about natural childbirth, and when I start talking, I don't have an easy time restraining my strong feelings about some things, lol. But having said that, I'm realizing a few things:

It's important to be in the conversation in a way that will minimize defensiveness (which is what it sounds like you want to do). I try to make it known that I have read/researched a lot, own books on the subject and know the local scene as far as birth centers, midwives, doula practices... So that an interested friend knows she could ask me if *she* wants the conversation.

If we are talking about a previous experience of hers, I try to remember the good advice of looking for *some* positive thing to say about a way in which she *was* strong, positive, proactive, etc. Esp in a negative brith experience (which as we know could have been natural or interventive!), it's important to pull out the positive aspects in it -- to look at anything you would like the same. The to build on that, ways it could be different.

If I could get one thing in, it would usually be a referral to something specific that has more ifo than I could ever share in a conversation. Like:
'Hey, I have X birth video at home, which helped my dh feel more relaxed about how birth can go right --would you want to borrow it?'
Or, 'I loved reading whatever I could when I was pregnant! One great website I stumbled on was maternitywise.org.'
Or, 'I have heard such neat things about __ who is a Bradley (or whatever) teacher. Lemme know if you want her number.'
Or I would lend someone The Doula Book.

I wonder, if you feel out the pg coworker for example and she seems open to conversation about epidurals, you could throw in a little known factoid, which might make someone wonder what else they haven't been told. I often share my frustration that more people don't know that epidual anethesia raises maternal temps, leading often to newborn workups for infection. I emphasize that every woman should be able to make her choices, but that I wish care providers were stronger on informed consent. I feel like that puts the emphasis on the care provider's burden as educator, not the Mom's ignorance. Does that make sense?

Anyway, just wanted to say it's something I'm constantly trying to figure out. I'm turning 30 this year, so friends all around me are getting pg. And just having completed doula training makes me a dangerous person to talk to!

mb

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Old 02-09-2004, 11:06 PM
 
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Ds is taking a super long nap! I should be starting dinner, but this is more interesting...

I just wanted to respond to a couple of things mamallama said which got me thinking...

I agree that changing caregivings is a big deal (sigh). It sounds like you've got a great example to tell others about. I wish someone had talked to me and held my hand a bit about it, though, when I was pg with ds, because in retrospect, I wish I *had* changed caregivers. I know this doesn't quite make sense, but I trusted her *judgement* but I didn't like the way she treated me during a prenatal appt or 2....

And I agree that it's probably a good idea to be very careful about (potential) VBAC moms. I'm pg, and I'm planning a VBAC myself. I've been chatting with other moms in my hiking group, and a couple of them have told me they have to have repeats. So I say nothing, but assume they have funky uteri or weird incisions or something. Later it turns out to be not the case. One was breech (total best case scenario statistically if you want a VBAC), the other was FTP (absolutely no judgements there on my part--haven't heard the whole story). I'm trying to be as positive (and as real and realistic) about what I'm going through when I talk to these women about my pg and my birth plans, and I'm very open to whatever they have to say about their births (because like it or not, we all have a shared experience). I have an ongoing relationship with them, but it's not close. I definitely want to respect their feelings and hopefully get them more interested...

I don't know if you, CO, or mamallama have had a VBAC yourself... I'm finding that even though I had a C for a legitimate reason and I feel "good" about it, there's still a whole lot to process and digest in order to go the VBAC direction. There's a whole unique set of feelings and fears most VBACers have to address (and not everyone is the same). Even if you really want it, you may worry that the same thing is going to happen again, if you're like me you *still* have no idea what contractions and labor feel like, you don't want to feel like you've "failed", you do all sorts of reading about uterine ruptures to find out the real story... etc. So if you can gently help a pg woman express these feelings, it's a big help.
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Old 02-09-2004, 11:54 PM
 
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I have not read everyone's posts this thread yet, but I wanted to share something a friend of mine told me when I was extremely frustrated with people not listening to me.

My friend recommended that I simply ask people, "Can I share some advice?" or "Can I share what happened in my experience?" and wait for an answer before I continue. This sets people into listening mode so then you are sure that they have heard what you are saying. Sometimes, people will still choose to continue sharing their own ideas, opinions or experiences, but other times, it initiates a dialogue from which you both can learn.

warmly,
claudia
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Old 02-10-2004, 12:10 AM
 
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:::starting over after toddler pressed delete:::

Okay, one of the things I do when I am friends or aquaintances with a new mom, I often get them a book that promotes natural child birth or low intervention. One of these books is the Dr. Sears Pregnancy and Birth Book and things by Sheila Kitzinger.
I have had mixed response doing this but over all it started dialogue. I never try to sound preachy if someone mentions epidurals, csections, pit, etc. I may make a casual informative remark, or say something like "I think I read such n such, what do you think about that?"
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Old 02-10-2004, 12:11 AM
 
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I cut it short because it was time for me to tuck my little ones in.

My last thought is that we all know how quickly women get turned off and tune us out. Birth is important in and of itself, but there are times when (for one reason or another) women just can't/won't "hear" us. If we, as activists, burn them out early on by disrespecting their pov or by suggesting things that are just too far "out there," they will not be at all receptive to anything else we have to say. I want women to have the best possible experience *for them.* If that means suggesting they write a birthplan for their scheduled c/s, so be it.

And no, I am not a vbac mom. I've never had a cesaerean birth. Last year I doula'd for a mom who went all out for her hbac--she ultimately had an emergency c/s with general anesthesia. Her birth opened my eyes in a way that I was only able to experience by being there; but I freely admit that I still have a lot to learn.

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Old 02-10-2004, 12:22 AM
 
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Aloha!
This is a tough question! I've often wondered myself about how to deal with this....
I had a friend who had a very unnecessary c-birth. She felt that the doc saved her baby's life (she was just a slow dilator-- baby had no probs). When she became pregnant again, she was planning a VBAC, so I gave her a copy of Silent Knife- which i hadn't read in years. I gave it to her because in my memory, it had tons of positive VBAC stories and I thought she'd enjoy.

Well, she read the book and her eyes were opened. She realized that she'd been duped-- that she just didn't fit the mold of dilating 1 cm/ hr. So her whole outlook changed.
Now I felt really bad.... i hadn't intended to make her question everything....but in the end it turned out well and she had a lovely, yet long VBAC.

My point? I don't know if there is one... just that you never want to make a mom feel bad about the choices she made in the past. Unless she starts it, I woulnd't question her last birth at all. You can respectfully let her know that there are other choices out there! Some women aren't aware that they don't HAVE to have an epidural and follow the "rules". Maybe the book idea is the best.... I certainly don't have all the answers!

Good Luck,
Karen
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Old 02-10-2004, 03:56 AM
 
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I never volunteer ANY information. If someone asks, I tell them that I am a former CCE who homebirthed, breastfed, non-vaxed, my four DC's and that is where I am coming from; any advice I give comes from that perspective.

I always give the caveat that they need to educate themselves and make the decision that they can live with because it is the honest-to-G-d-truth! The doctors and nurses sure do not live with the decisions they make over other people's lives and health unless you drag them off to court.

"The great enemy of the truth is very often not the lie, deliberate, contrived and dishonest, but the myth, persistent, persuasive and unrealistic."
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Old 02-11-2004, 06:43 PM - Thread Starter
 
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Thanks for your input.

I spoke with my friend/supervisor about her pregnancy care provider. I told her that it was really important that she feel comfortable with her provider. I said, "I know a natural, drug free birth was my priority and it isn't really yours, but it's really important that you like your doctor." She said, "I like the nurse practitioner who is providing the prenatal care." I said, "Will she attend your birth?" No. Then she said, "My husband likes the doctor." I said, "That's good, but you have to like her. You are the one whose body will be in labor." Then we had a good laugh at the idea of our husbands in labor.

She said she's going to go to a few more appointments and see how she feels. She is starting to be more able to eat, to show a little and to actually seem into it! She's doing prenatal yoga.

I know I should try to get her to think about a natural birth, but to me, after my experience, having a practitioner you trust seems more important. I know that having a midwife I didn't trust be the one on duty at the hospital when I needed to go was a very bad thing for me. I also know that getting another midwife midway through whom I DID trust made the difference in my ability to have a vaginal birth and not a c-section.

I would like to give her a low-key book so she knows more about birth. The book I liked best during my pregnancy was the old Ina Mae Gaskin book, Spiritual Midwifery. It was very reassuring! But my friend doesn't want that one because she says "It's not reality." (???: ) So maybe the Sheila Kitzinger book would be good, The Complete Book of Pregnancy and Childbirth? I have to get that one back from my other friends' house.

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Old 02-12-2004, 12:38 AM
 
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Good for you! You couldn't ask for more--you've gotten the topic out in the open, and now the two of you will be able to have meaningful pg/birth chats together--whether or not you sway her to the Realm of Natural Birthing! :LOL

Shelia's a great author--her 'Homebirth' book, now called 'Birth Your Way' (ha ha ha!) turned a friend of mine on to the needless interventions so common in hosptials today.

I know for me, a couple Bradly books (one by a woman, one by Dr. Bradly himself) shed light on the idea that birthing is more of an athletic event than a disaster area. Mainstream obstetrics meets common sense (but still cuts an episiotomy.)

I haven't read those books in a while, so flip thru 'em before you pass along my suggestion.

OH--and Penny Simikin's book has a nice natural slant, but I was unable to notice it when I was into hi-intervention obstetrics w/ pg #1. You may want something with more nature "punch."
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Old 02-12-2004, 12:48 AM
 
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Quote:
Originally posted by captain optimism

I would like to give her a low-key book so she knows more about birth. The book I liked best during my pregnancy was the old Ina Mae Gaskin book, Spiritual Midwifery. It was very reassuring! But my friend doesn't want that one because she says "It's not reality." (???: ) So maybe the Sheila Kitzinger book would be good, The Complete Book of Pregnancy and Childbirth? I have to get that one back from my other friends' house.
That or the Dr. Sears books on pregnancy and birth. I have given both and got a good response from both when I gave them as gifts.
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Old 02-12-2004, 01:13 AM
 
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I am coming from the same place sorta as the op and am wonder and trying and failing i think at helping my freind who is preg w/first. today, i upset things by getting preachy. i have that tendendcy and now i want to apologize and let her know i will not be so preachy and passionate or whatever i was in the future!
We were just talking about the u/s and then i went off about not believing everything a dr says and doing what they say and how birth is over-medicalized and ..... i think i said too much.
I've already given her books- one of them "birthing from within"
Which i know she has looked at a little. She told me she doesnt have time to do the research and i insisted she did. anyway, she mad and im sad. sometimes I hate being so passionate. sometimes I wish it wasnt so complicated but hey, we're talking about women and childbirth~ what a heavy and emotional subject

Laura
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Old 02-14-2004, 01:38 AM
 
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I would tell someone, especially someone who was pregnant with their first child, not to automatically rule anything out and then offer to collect information for them.

When I was pregnant with Eli, I remember saying things like "I'll never get an epidural, those things do x,y,z, they're horrible... " etc, etc and so forth. In retrospect, my epidural (yes I did have one) was the *best* thing about my labor. I had totally ruled it out, not because it was so important for me to have a natural childbirth but because I am not a pain wuss and there's no way I would possibly need one. Who plans to labor for 4.5 days before their child is born? I certainly didn't. I was expecting a quick and easy delivery like my sister, mother, grandmother and great-grandmother had had.

Who plans to spend a day in the hospital and end up with a vacum delivery for a 7.5 pound baby, even though your hips are huge and you're in a squatting position (and I was... they sat me up on the table so it looked/felt like I was going to slide off and hit the floor)? Not me.. My grandmother was a tiny person with narrow hips and birthed her first child, my 9 lb 14 oz uncle in a few minutes with no problems, no tear, no episotomy, no shoulder dystocia, nothing.

I don't understand how a nulliparous woman can decide they want an epidural before they've ever experienced labor, and I was sure that I wouldn't understand it afterwards either. Today, I'm much more understanding. If she's an analytical type, I'd offer her facts and figures, always explaining first and foremost that *I have been through the pain* and I wasn't expecting the birth that I had. Nor was I able to come to terms with it right away (I'm still not sure that I have.. but that's a different story). Volunteer to inform, let her know that you're available if she wants more options or questions what her care provider tells her.

If she's not comfortable with her OB, she should *definately* get a new one!!! I wish I had heeded this advice myself, I think it would have spared me a great deal of agony (I didn't like my OB but didn't want to say anything because I'd already switched three times and I was 32 weeks). DO IT AS SOON AS POSSIBLE and don't look back. There's nothing worse than being in a position (labor!) where you're forced to take advice/orders from someone you don't trust. DO NOT GIVE THEM THAT POWER.

Not ruling anything out in advance includes medical interventions as much as it includes things like homebirth, midwifery care, etc. Advise your friend to learn everything they care to learn, and again offer to share any information you have collected over the years, and do so without any agenda aside from informing. The more objective you are, the easier it will be for her to be objective. Except about switching from a care provider you're uncomfortable with. That should be carved in stone. :LOL

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