choices, maternity system, pregnancy

The problem with recommendations

Probably one of the biggest decisions we make very early in our pregnancy is deciding where we will have our baby and who will look after us. To further complicate the matter, this decision may have the greatest impact on how our baby comes into the world and how we are prepared for and supported in our mothering (or fathering).

In Australia, there are a number of options for women, all have strengths and limitations that can be very difficult to navigate, and depending on your location, financial position, and birth-place savvy some options may not be available to you.

So how do we make our decisions? A bit of web-searching? Maybe some well meaning recommendations from friends or family? If it is our first baby the chances are we don’t really know what is “normal”, what a “good” birth is like or a “bad”one.


We expect the worst, accept to be frightened, dismissed, disrespected and damaged and are thankful when the basic kindness is shown and we and baby are alive to tell the tale.


Childbirth has been painted a certain way in modern culture by film and tv. We see women experience one never ending contractions(false), usually followed by an urgent dash to the hospital (usually not necessary at the first twinge), and more often than not some random, frightening emergency takes place where – mercifully – just at the climax a woman and/or her baby is saved from certain death by a doctor, possibly surgically.

Is it any wonder then, that when our friends and family experience anything a fraction kinder, gentler, less terrifying they are eager to recommend the person caring for them as a hero in the birthing world. We expect the worst, accept to be frightened, dismissed, disrespected and damaged and are thankful when the basic kindness is shown and we and baby are alive to tell the tale.

  • What if a doctor or midwife is nice to you, smiles and listens to your question – does it matter if you don’t get a clear answer?

  • What if you meet a care provider and tell them clearly your thoughts and plans for your birth, but months later as your ‘due date’ looms you find your impending birth looking less and less like what you signed up for?

  • Are you wanting a drug free, active birth but keep getting recommendations for a doctor that has a 50% cesarian section rate? (Pro-tip: Unless your doctor exclusively cares for women with high-risk pregnancies, their cesarean section should not be higher than the national rate of about 33%. If for some reason a doctor is avoiding/dismissing/irritated when you ask for these statistics read between the lines).


What if a doctor or midwife is nice to you, smiles and listens to your question – does it matter if you don’t get a clear answer?


When childbirth is shrouded in so much secrecy, like it is in Australia, is it any wonder we accept the crappy care we are offered (and pay for) with a smile. Unfortunately, when people working in childbirth have the view that the only thing that matters is a live baby, and vaginal birth is irrelevant at best, there is no surprise when you are offered a limited set of options and it’s called choice.

Many women in our modern culture don’t even hold a newborn baby until they have one, forget feeling familiar with childbirth.

Women are whisked off to “the hospital” and returned back to us with a pre-wrapped baby and only murmurs of the mysteries of motherhood (“what do you mean you poo??” “did you tear your vagina?” “your boobs leak milk anytime a baby cries?”) that quite reasonably leave us more anxious than when we started. 


OK, new and expecting mother, where the hell does this leave you?

First, hopefully, a little more inquisitive. I can give you some of the options available in Australia, but in your specific area, some options might be more difficult to source or simply unavailable. 

Second, and this is difficult because I know you have a lot going on, but if after perusing the options you find the options lacking/absurd/depressing please write a letter to your local member of parliament/congress. In Australia alone, we have over 300,000 women a year having babies. We are a powerful force, and we ‘spend’ a lot of money, our own and the governments. Don’t feel for a second that your opinion isn’t really important. 

Third, you might benefit from some support. Connecting with a doula or local childbirth educator early in pregnancy might be helpful. These are often the people who are noticing trends and patterns in the area you live.


if you want any further support exploring and discussing your options around birth i am available to talk this through. just call or message me to arrnge a free 15 minute consult.

unsplash-logoBen White

birth, maternity system

Searching for a safe haven in all the wrong places

Nearing the end of your pregnancy, the sun sets as you begin to feel an odd, warm niggle. Noticing your stomach begin to tighten, mild cramping sensations come every now and then like little waves in the lower part of your abdomen. This is it. You think (you hope, but not completely believe) it is the beginning of your labour. 

 As the evening wears on you may experience some diarrhoea, notice a “show”, and begin to feel a little out of your head, somewhat separate from the world. 

You have prepared yourself for birth and discussed early labour in your birth class. This was confirmed by your midwife or doctor, and you know that this doesn’t mean your baby will come straight away. It could be hours or even days for these mild (and still exciting) niggles to build into the powerful waves you are expecting “active” labour to be made from. Do you call your midwife/doctor? 

No? yes? when?

 

 

You have been forewarned that until your contractions are rhythmic and regular, with a rawness and real intensity you are better at home. “stay at home as long as you can” they said. Armed with heat packs and a little guidance on warning signs, as long as things “remain normal” you are told you don’t need help.

But this is only partly true. Of course you need help. But what is the price of seeking help early in labour?

Your body is telling you this is the time for you to start to retreat into your nest, to ensure you are safely in your birthing space.

While your wits are still about, your neocortex is still firing and you haven’t travelled too deeply into labour land, now is the time to draw near to you the people you trust and care for, who will take over your higher reasoning. This is when you should be able to safely switch off the part of you that needs to think and reason and instead focus inward on your child and your inner self. This will help increase your oxytocin production and (you have been told) that is the key to effective contractions. Contractions are of course the ticket to meeting your new baby.


Your body is telling you this is the time for you to start to retreat into your nest, to ensure you are safely in your birthing space. While your wits are still about, your neocortex is still firing and you haven’t travelled to deeply into labour land


But you have been forewarned the hospital is not the place for you right now. Instead, women are told, openly, honestly, from a place of love and care; “stay home”, “not yet”, “it’s too early”. It is known, the midwives cry “You don’t want to be here too long/ too early”. If you are found in hospital labouring in the early stage, the pre labour, the false labour, all names for the stage of birth when productivity and efficiency are not generally expected/demanded, someone here will take umbrage with your inability to withstand isolation in your most vulnerable state.

You thought to come to hospital wanting someone to see you, to witness. But instead, now, you’re being watched. You feared being ignorant of labour and now you’re surrounded by authorities in birth, and your body is their jurisdiction. 

In a perfect world, women at the beginning of labour (if not birthing at home) will use this time to transfer to the safety and warmth of their birthing space. To wrap themselves in the sacredness of this time and patiently await the progression of their labour. Allowed space and time for this to unravel organically, not needing to be consciously analysing the strength and regularity of their contractions to determine the perfect window of time to relocate to the hospital. Now we fear arriving too early, only to be told to return home, or too late. At best they have an experienced friend or doula who can help guide them through this decision, at worst she is alone or with her partner who is equally terrified and overwhelmed.

Women are told constantly throughout their pregnancy, in many subtle ways, that birth is dangerous and that only with the experts are they ever truly safe. Then the moment their body sends them the signal to seek out sanctuary they are dissuaded from listening to that most primal instinct.


Women are told constantly throughout their pregnancy, in many subtle ways, that birth is dangerous and that only with the experts are they ever truly safe. Then the moment their body sends them the signal to seek out sanctuary they are dissuaded from listening to that most primal instinct.


During the majority of their labour; slow and cyclical as it may be, women are told their place of birth is not available to them. 

Come in pushing they joked (or were they serious?). Stay home with your fear, don’t squander our reassurance – we are stockpiling it for later. So call us if you’re worried, we do this all the time, your body says find safety, but it’s wrong, trust us, we know. 

We know this place isn’t safe for you yet. We can’t keep our hands to ourselves, and you need to be untouched for as long as possible. 


 

Jennifer Hazi is a mother, midwife, childbirth educator and doula educator & mentor in Sydney, Australia.

She is really passionate about women having voices and choices in maternity care and absolutely loves working alongside women and their loved ones during this time. 

She teaches childbirth and parenting education online and in person, works clinically as a midwife and provides physical and educational support to families with new babies up to 3 months old.

Jen also speaks and writes regularly about childbearing, motherhood and transitioning to parenthood.

Find her at www.jenniferhazi.com