A midwife friend told me this story. She lives in New Zealand where all families have their own continuity of care/primary care midwife, choice is respected, maternity service is part of the national health service and free to consumers and women can birth at home or hospital. Yet the Caesarean rate has almost tripled in the years since The Midwifery Model of Care was put into place in 1990. New Zealand is the pinnacle of what a Choice-based approach to childbirth looks and functions like and its huge failure to recognize the essential need to have expectant families learn, practice and use birth and birth skills.
Anyway, this midwife pretty much committed herself to growing a skilled birthing population in 2000 when Edition #1 of The Pink Kit became available. After 20 years in practice she was TIRED! Serving the general population was nothing like she expected. Women didn’t want home births (only 10%) and most wanted epidurals and elective Caesareans. It’s been a long haul for her to move from her ‘choice-based’ relationship to her clients to just plan insisting and demanding that all families learn birth/coaching skills and write a Skills-base Birth Plan alongside the conventional Birth Plan. 85% of her clients (60-80/year) get on board. 5% absolutely will not and 10-15% say they’ve learned and then behave unskilled.
She had such a client who received a Pink Kit package at first appointment as all her clients do. Every appointment, this midwife would ask the woman ‘what skills have you learned?’ The woman always had one of the reasonable reasons why she hadn’t learned any. Time passed and this midwife became more frustrated with this client who wanted a natural birth at home yet didn’t seem to want to prepare wisely for this experience. Finally the midwife asked the woman what would happen when she had painful contractions. The woman said to her ‘You’ll help me?’ Well, that just triggered the midwife who once again told the woman it was not her job to get her through the birth. She told the woman that she and her husband absolutely had to learn and practice the skills.
At her next appointment the woman had still done nothing. The midwife saw a bunch of catalogues on the side table for baby products. She picked them up and asked the woman ‘How much time do you spending looking through catalogues?’ The woman said that she and her husband spent hours and hours going through them and searching online for the right stroller, crib etc.
The midwife told me she lost it. She said to that woman ‘Do you mean to tell me you spend hours on baby products but not on learning skills?’ This is a perfect example of how off the mark childbirth preparation has become. This is followed by those women who research every medical assessment, monitoring and procedure that might be done to ‘choose’ which ones they don’t want or would accept. This has become how women prepare for the birth of their child. The focus on external factors during and after The Birth but spend little or no time learning how-to give birth.
Part of the fault for this terrible state of affairs is the childbirth books that have been written in the past 40 years … full of ‘information’ and actively dismissed the skills essential for all birthing mothers to own within themselves so they can always work through their baby’s birth journey as it unfolds. While our present Choice-based approach has attempted to deeply change childbirth, it has not be as successful as hoped for. By dismissing skills a huge component has been left out. Now we can see this. Now is the time to do something about it.
As women we must wake up and change. Join our Movement for a Skills-based approach to childbirth. Let us awaken our capacity to be skilled birthing mothers and fathers/other.
You can purchase The Pink Kit at amazon.com, amazon.co.uk and thepinkkit.com