In the last few posts and this one we’ve discussed the role of those dedicated women (mostly women) who love being around pregnancy, birth and babies who offer services to expectant parents … childbirth educators and doulas and of course midwives.
Childbirth educators don’t often attend births. They work with groups of families and have a unique relationship to building a skilled birthing population. They are either teaching a general ‘information’ based childbirth preparation class often in a hospital setting or they are teaching a particular technique such as Bradley, Lamaze or one of the hypo classes … maybe pregnancy yoga as well. If they do the latter then they are known in their community to have a particular viewpoint about childbirth. While the childbirth educators teaching in hospitals often reach a broader group of families. Because fewer families attend classes, they are often teaching to first time parents.
Childbirth educators, however, have the opportunity to get diverse skills-based resource to expectant couples and can simply explain that families need to self-learn birth and coaching skills. This is NOT difficult to do. Imagine if all childbirth educators did that. More families would know that learning, practicing and using birth and coaching skills is part of preparing for their baby’s births.
Doulas are in a different situation. They see families one-on-one which means they serve a very small % of their local population. While the role of the doula is to advocate and support the family there is no doubt that many doulas are perceived as supporting ‘natural’ birth. This then does not reach the broader birthing community yet growing a skilled birthing population should be for all families as something they ‘do’ … even if at the most minimal. No family should go into the birth of their baby without the most minimal set of good breathing pattern skills and internal softening ones.
Doulas also attend births yet often see families for only a few appointments before going to the birth and doing some postpartum care. The one thing we know … once the birth is over it’s over. All the family is left with is discussing what happened, how they feel and life long memories. This is another reason we need a societal expectation that all families learn, practice and use birth and coaching skills. Skilled families talk differently about their birth experience than unskilled ones and they have different memories. They can focus on what they ‘did’ and not just on what ‘happened’ to or around them.
Doulas can provide all of their clients with a choice of skills-based resources and include the resource in their fees. They can also put fliers up around their local community offering various skills-based resources and give talks about the importance of growing a skilled birthing population no matter where a family gives birth or who attends them.
Midwives have a more intimate role with the families. There is no doubt there is an idealization of midwives and midwifery. With our charitable Trust in New Zealand where all families have their own continuity of care/primary care midwife we know how grateful families are. But begin grateful and admiring the profession has not achieved the goal of more natural birth in New Zealand. Under a total Midwifery Model of Care, New Zealand has a similar Caesarean rate as does any other country … about 30+% … more than doubled the rate when midwives became the lead maternity carers in 1990.
Midwives who offer continuity of care/primary care are in a unique situation to advocate for a skills-based approach to pregnancy and childbirth. When a midwife (in the US or other countries that offers midwifery care but not to all families) practices in her community she will be known for her beliefs. Families will choose her for those beliefs and reputation. This means the broader community of expectant families (except in New Zealand) will not be able to choose or will choose not to have their own midwife. This means independent midwives need to focus on growing their own skilled families by advocating families take responsibility for self-learning birth and coaching skills. Midwives can do this by providing various skills based resources, having the families choose which one or more they want to use and including those in their fees.
Of course, childbirth educators, doulas and midwives need to explain the importance of writing a Skills-based Birth Plan along with a conventional one. Every expectant parent needs to know the difference between a Birth Plan that is really about ‘delivery of service’ (what they want or don’t want the birth provider/place of birth to do) and a Skills-based Birth Plan (what skills they will use).
Over the past 45 years women who work as midwives have talked about the skills they have taught families. They do and don’t. Midwifery is still ‘information’ based. No woman who works as a midwife goes to school to learn how to birth. Many midwives have not had good birth experiences. In fact often women get into the profession because they have either had a terrible experience and want to save other women from having a terrible experience or they’ve had a great experience and want other women to experience that. These two motivations are often the cause of the exhaustion experienced by so many women in the profession.
Women who work as independent midwives (not staff) need to consider the huge benefits of getting their clients to take increased responsibility by self-learning birth and coaching skills. Women who work as midwives, often put their own families aside, are on call 24/7 and have strong viewpoints about childbirth need more support. They deserve to work with skilled families to both decrease the potential for horrible births and increase the probability for positive ones.
In New Zealand where we now have more than a 20 year history of a Midwifery Model of Care without a skilled birthing population we can see how the lack of skills has negatively impacted the population … one midwife at a time. The profession is discouraged by the statistics. This then circles around to some of the previous posts about ‘natural’ birth vs all births or continuity of care for all expectant families vs continuity of care only when there is no medical care needed.
In New Zealand where all families have their own continuity of care/primary care midwife this has put women who work as midwives in constant service to the general population with most families not having strong feelings or beliefs about childbirth. In other countries where families have to pay either directly or through insurance, midwives are serving a very self-selecting group of families … those with strong beliefs about birth. Both of these groups of midwives can grow a skilled birthing population by providing a variety of skills-based resources and requiring their clients to self-learn birth and coaching skills as part of the ‘partnership’ relationship midwifery always promotes. Presently the partnership is hugely out of balance with the woman who works as a midwife taking on 99% of the responsibility and the family merely having to create a Birth Plan of expectations.
Our society is formed by our thinking, beliefs and actions. For too long we’ve thought that gathering information would lead to better births and it hasn’t. For too long we’ve had a belief that ‘natural’ birth is better than other types of birth and this is problematic. For too long we’ve acted as though birth is SO unknown and SO primal that there is nothing we can or should do and that is nuts. Preparing our pregnant body to become a birthing body neither takes much time or is complex. Learning birth and coaching skills is neither a waste of time or required to be taught by others. Growing a Skills-based Childbirth trend is about all of us.
Here’s a link. This link will be put on all the posts. Kristen has 6 kids, the last 3 are PK babies. She KNOWS about birth and is one of our affiliates. That means if you purchase The Pink Kit through her she gets a commission. Her husband Scott’s first baby was a Pink Kit experience. He’ll explain how The Pink Kit made certain he was able to become a skilled birth coach to a woman who had previously had three great births.!
Kristen’s written a time-line calendar for use of The Pink Kit. You just need to sign up to her mail list (we don’t keep a mail list) and she’ll send you the Time Line. She’s worked through both Edition #2 and #3 of The PInk Kit so she knows all it’s imperfections and la-dee-dahs past them to the skills she wants to improve for each birth. Can women and men have better births each time? Sure can! The more skilled, the more we master the experience.
http://blog.naturalbirthandbabycare.com/pink-kit-timeline-from-natural-birth-and-baby-care-com/
Please join the Movement to grow a Skills-based childbirth trend. Don’t’ let another birth go by without that family being skilled.
Change is up to you … as a pregnant family or because you know an expectant family.