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    Find out what other moms-to-be are asking. Join in the discussion with Henci Goer, whose expertise is determining what the research tells us best promotes safe, healthy birth. If you would like to contact Henci outside of the Ask Henci forum, send an email to Goersitemail@aol.com.

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    Jan 19
    2008

    Desperate for guidance and change

    Archived User
    Hello fellow advocates of normal birth. I come to you in desperation and frustration. I'm working on my LCCE right now, a slow progress that has been interrupted by my own second bundle of joy arriving. In the process, I've been exposed to the horrifyingly limited experience that every single woman living in this area is exposed to. There is nothing here to offer a woman who might be seeking a normal birth. It literally is impossible to have a normal birth...that is if you'd prefer not to have a screaming match with the doctors and nurses at our hospital. I'm sure the doctors and nurse recognize that women must consent, but so many women don't realize they have that option. Every woman regardless of circumstance is on continuous EFM because of the somewhat recent loss of a baby at our only local hospital. Our induction and cesarean rates are through the roof, a good bit higher than the national averages. Our pediatricians are the biggest threats to breast feeding success. There are no midwives within an hour and a half's drive. There is only one doula. There is only one place to receive childbirth education classes, and that's the hospital. Due to politics, those classes aren't based on normal birth. I've heard time and time again, you have to walk the line if you want to create change. You have to create change by introducing your students to the possibilities and letting them seek out the options they'd like. The thing is.....the options don't exist. I'm so discouraged by the idea of teaching a class on normal birth. It will only lead women to frustration and disappointment in their own experiences when the options don't exist and their doctors betray their confidences by pressuring them into unnecessary and potentially dangerous interventions. Walking the line is a wonderful idea if the options at least existed on some level. But they don't, and I fear I would lead the women to worse memories of birth experiences if I taught normal birth. Where do I turn? What would make it possible to recruit normal birth advocates, like midwives and more doulas? What do I need to do to at least make normal birth an OPTION? Please help!
    Archived User
    Could you start your own child birth classes somewhere, like at a community center, your home, the local coffee house, etc? Then make flyers, advertise in the local newspaper and leave signs at stores?
    These things have a major ripple effect even if on a small scale. I don't we can change the birth culture within the hospitals. Educating women and giving them the tools to stand up for themselves and being able to back things up with researched based evidence is probably the best thing to do.
    If there is nothing there, there has go to be a need, knowing women!!
    Make stickers and T-shirts to spread the word to give to moms at the meeting :-)
    Local yahoo group might be an idea too. Where are you? I know a lot of women all over the States.
    Just some thoughts.
    maria.

    Archived User
    Ah, I see after re-reading that this may not work because of hospital policies. I don't know about that fight. I chose to go the other way and educate women about unassisted birth when they are in a situation like this. I will at least mention it because there is no way I am going to let them be subject to compromising procedures without giving them all the options!

    How so very aggravating! I am lucky to live in a city with rather good maternity wards compared to what I have heard. This situation sounds pretty bad.
    Henci Goer

    Let me start by saying that I like the idea of starting independent birth classes, which you could specifically advertise as being around promoting normal birth. You could build them around Lamaze's Healthy Birth Practices. Handouts could include Having a Baby? Ten Questions to Ask from the Coalition for Improving Maternity Services, one of Lamaze International's partners in normal birth advocacy. Even better, try to catch women before they feel locked into their decisions. See if there are any adult education venues through which you could teach a class on childbirth choices aimed at women planning to become pregnant or in early pregnancy. Don't be afraid that the options you want for women don't as yet exist. Women need to know that. As Korte and Scaer wrote in their classic book, A Good Birth, A Safe Birth, "If you don't know your options, you don't have any."

    I strongly recommend seeing what you can do to promote a normal birth advocacy group. Think about starting a birth network in your community. Lamaze even has grants available as seed money. I'm willing to bet that you will find allies if you can create a center point around which they can rally, that doula, for example, lactation consultants dealing with the train wrecks, the midwife even if she is at a distance, women unhappy about their birth experiences, other childbirth educators--for several years, I co-taught a Choices in Childbirth class with a Bradley teacher.

    In the interests of making an informed decision about becoming an agent for change, though, I must warn you that if you take this on, you will need those allies because if you start to have some effect, there will be a backlash. I don't mean to discourage you, but it is wise to think through the ramifications of this choice. Forewarned is forearmed.

    -- Henci

    Archived User
    Thank you for the yahoo groups idea I had no idea how inclusive they are!!! I've been addicted to answering questions too. haha... That aside, I hope to be able to reach as many women one on one about normal birth and help them learn that there are options beyond what their care providers state. Its just hard because I don't want to become "the person that makes people afraid of their care providers", but I want these women to know that our area is so very lacking when it comes to maternity care. Anyway, I did start a yahoo group, and I sent an invite to some people that I know, but its very slow going so far. There have been other details that haulted my recruitment effort for the time being, but if you want you can stop by. Its delmarvabirthnetwork. If I wasn't allowed to mention that, I'm really sorry. I'm going to go re-read the rules of this forum and I'll take this post off if I just broke the rules.
    Archived User
    Thank you so much for your words of wisdom, Henci. I've actually been taking baby steps at starting a birth network. The educator at the hospital has facilitated a first "meet and greet" meeting for January 31st. I've been anticipating the backlash, and I've kind of realized that that is why so many are hesitant to do anything but remain politically correct in the birthing world. I think that our area (I'm on the eastern shore of Maryland, by the way) needs something a little more drastic than politically correct, though. We are so far behind when compared to care offered in more rural areas, and playing politically correct has gotten us nowhere so far. That said, what are your thoughts on the potential for leading women into disappointment when you do help them realize there are better options that they cannot have? And if I do teach my own classes privately, do you think there may be a way to spin the controversial backlash in a positive way as to perhaps be a type of advertisement?
    Henci Goer

    My response to concerns about leading women into disappointment over the lack of better options is "Consider the alternative." Right now, for lack of options that support and promote normal birth, women are ending up with preventable major surgery as well as other medical interventions with potential to do harm, and they, their babies, and future babies are ending up with avoidable physical and mental morbidity as a result. I believe that it is our moral and ethical responsibility as educators to give women the information they need to make informed decisions about their care, and we know--not as a matter of opinion but of fact established by the consensus of the research--what policies and practices promote optimal outcomes.

    If you advertise as a class that specifically promotes normal birth, you can talk about these policies and practices, make explicit the sources on which what you are teaching is based, teach what questions to ask, and then it is up to your couples to decide what they want to do with what you have taught them. Here's an additional source to the ones I listed in my earlier post:

    Informed Consent/Refusal

    -- Henci


    All Times America/New_York

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