This post echoes previous ones. Presently most pregnant women prepare for the birth of their child by making ‘choices’. When there were no choices, women give birth within the standards of care that were the norm of their hospital and the beliefs of their obstetrician. And women went into hospital to a private room if the family had the money … and left alone for hours between being checked by the staff obstetrical nurses. If the family didn’t have the money for a private room then women were often in labor with three other women in the same room separated by curtains … and left alone until 3-4 hourly checks.
It’s always been curious to me that the concept ‘women should be left alone to discover birth herself’ is one of the foundations for natural birth advocates … promoted by a famous author. In previous posts we reflected on the fact that in some traditional cultures women did go off by themselves to give birth so there is cellular memory in all of us that we can birth on our own.
One of the ways women prepare for birth now is to choose who will be with them during the birth. Some hospitals only permit one support person while others permit several at one time. Home births of course often have many people attending. What exactly is the role of these people.
When women prepare for their birth by choosing who will be with them (not focusing on their birth provider yet), do they choose people who are just going to stand around and watch? Or people to just clean up or cook or take care of other children in the household? Perhaps … all those things are important. They also choose people who they believe will help them navigate the experience of giving birth. In the present childbirth paradigm … the choice-based trend … that person is encouraged to just be there and support the woman and do simple things like: hold the woman, wipe her brow, bring her water, give her a back massage when she wants to, hold hands or be hung on. In other words, it means a great deal to the woman that her partner, friend or relative is present and attends her. When asked often these support people will talk about their role as: useless, helpless but trying to do what the woman needed.
So women prepare for the birth by choosing who will be there. They also choose to some extent their birth provider. Usually they make this choice on two factors: like and shared beliefs. In smaller communities there aren’t a lot of choices. In other communities the only choices are obstetricians and not midwives. For most American women, they cannot choose the staff who will be present the day they give birth and the obstetrician is usually present for short bursts of time just to check in and do the delivery. The staff still just comes and goes and does not act as a labor coach.
What else do women do to prepare for birth now? They choose what books they read and classes they attend. They choose as suits them natural therapies. And they think about how they would like their birth to unfold. Due to the rise of The Birth Plan, expectant women become the Director for their birth. And it is in this role that the present Choice-based childbirth trend tends to fall apart. There is no script for the coming birth, just a hope and a wish. There is no way to plan for the birth because birth will remain unknown until it unfolds. This reality has a depressing impact on women. It makes them feel out of control and this terrifies most women. Letting go as a promoted goal by natural birth advocates is not the motivation of most pregnant women preparing for birth. They don’t want to just let things happen. They want control, to feel on top of the situation and empowered. Letting go symbolizes being blown by the winds of chance.
So today women do have many more choices than they had two generations or even one generation ago. And there is no doubt that the medical profession has made significant changes … hospitals and birth professionals alike. There is a small percent of women who have much more control of their external factors … home births and midwifery care yet the majority of pregnant women will birth in their local hospital with staff obstetrical nurses (and sometimes certified nurse midwives) and either their own obstetrician or group providers.
Are women preparing for birth by having the skills to prepare their pregnant body to give birth … because they are pregnant and will give birth? No … very little. A tiny percent of women take pregnancy yoga and other ‘pregnancy’ related body movement classes and many of these don’t actually prepare the pregnant body in an effective manner.
Are women preparing for birth by learning birth skills? Few take Lamaze or Bradley classes. Some are choosing Hypno-birthing or Hypno-babies but there is almost no societal expectation that all expectant women learn, practice and use birth skills because they are giving birth.
Most women are preparing for birth in the way society now believes … choose where and with whom you birth and write a Birth Plan about what you want and don’t want. No where in the collective societal mind are preparing your body to give birth or learning birth skills part of that meme. Yet, it once was and had an incredibly positive impact on the whole system … women, fathers, hospitals and birth professionals. This is way we must re-enliven a Movement for a Skills-based approach to all pregnancies and every birth.
NEXT POST: What do women want in birth?