This is our weekly series leading up to the Lamaze International 2021 Virtual Advocacy Summit on September 27-29.  The virtual summit is an opportunity to connect with your fellow Lamaze Certified Childbirth Educators from around the world, who will be meeting to address the most critical and timely policy issues that affect prenatal care and childbirth outcomes. In this series, blog readers will have an opportunity to meet perinatal professionals and read their personal essays on why they advocate for evidence based care, improved policies and funding that impact birth outcomes.  You can find the entire "Why I Advocate" Series here. - Sharon Muza, Connecting the Dots Community Manager.

"At its core, this debate is not about the superiority of midwives over doctors or hospitals over homes. It is about treatment intensity and when enough is enough. Nearly all Americans are currently born in settings that are essentially intensive care units: labor floors have multi-paneled telemetry monitors, medications that require minute-by-minute titration, and some of the highest staffing ratios in the hospital. Most labor floors are more intensive than other ICUs in that they contain their own operating rooms. Surely, every birth does not require an ICU." ~Dr. Neel Shah, MD, MPP, FACOG

I teach both in a hospital environment and directly to parents who are planning on giving birth in a variety of settings. In either case, I always ask, “What is your fantasy birth?” In other words, if you knew that no matter what you and your baby would both be safe, what kind of birth story would you like to tell? It should be shocking to realize how low of a bar most people have set for their expectations. I am generally met with the response that the birthing person wishes to avoid surgical birth, or maybe even pain medication and their partner wants to help them experience giving birth in a way that is healthy. Some just want to know when it is too late to get an epidural and others are needle shy or have aversions to bodily fluids. Some cannot wait for it to just all be over and get on with caring for their babies. 

These freshly pregnant people have no idea what to expect in my classroom, much less when they visit their care provider or labor & delivery units. Most are unaware that what they are about to learn has lifelong implications for themselves and the stories that will continue to be told long after their younglings have graduated college and are beginning their own families.

I read, “Thank You, Dr. Lamaze!” as a 12-year old girl, awaiting the birth of my sister’s son. As I read the stories, they were filled with love, fear, excitement and the in-between-the-worlds haze of labor and birth. I, too, desired to give birth in my own power, surrounded by love and support and yet, my experience was far different than that idealized outcome. I gave birth unconsciously, after hours of crying to get out of the bed, to move away from the monitors and probing fingers, desiring nothing more than to feel the comfort of a hot shower and have the reassuring tones of my mother soothe me through the contractions. 

Had I known and understood how my own hormones are affected by my surroundings, advocating for my needs was not being a ‘bad patient’ or that I had the right to have respectful conversations with my nurses or ask for someone who was more supportive as my caregiver was all well within my rights, well, honestly, I probably would not be who I am today.

Nearly thirty years later, I have supported and taught hundreds and possibly thousands of families who had the opportunity to know and do all of those things. I have taught and mentored many birth and postpartum doulas and Lamaze educators who have continued to hold their torches high, illuminating the paths of blooming new families. Many of my students have gone on to become Lactation Professionals, Midwives and nurses. 

The Lamaze Six Healthy Birth Practices continue to be the root of my teaching. As a young, green doula, I would march into Labor & Delivery units with my portable TV and VCR to show the nurses Dr. Nils Bergman’s research on Kangaroo Mother Care. The nurses would watch segments of the documentary, sigh and lament, “It’s so good, but they’ll never go for it!” and yet now, “skin to skin” is mainstream. They went for it. More and more labor nurses are becoming familiar with how movement and changing positions really CAN be facilitated and keep labor moving. Doulas are mainstream! Now if we could simply trust labor to begin on its own and only utilize interventions when truly necessary and limit them to the exception category!

Michel Odent, MD says,  “Experiences have clearly shown that an approach which ‘de-medicalizes’ birth, restores dignity and humanity to the process of childbirth, and returns control to the mother is also the safest approach.”

Can we just? May we continue to advocate at the parent level, with our Obstetricians, hospital administrators, local, state and federal law and policy makers, and insurance providers. We need to speak out against injustices and lift up our families with different color skin, with contrasting cultural identities and preferences from our own. When we shift our priorities to theirs, the world heals a little. My voice unites with yours, and hers, and his and theirs! We ARE making change and yet, so much more needs to happen. 

Will you be part of this change? Lamaze International has so many grand opportunities for you. If you’re a living human, we have a place for you. Do you know someone who is about to or has given birth? Did you give birth? Do you support birthing persons in your home, work community or neighborhood? Are you a Lamaze Certified Childbirth Educator? Contact me or any of my colleagues at Lamaze or OHSU Hillsboro Medical Center. We have loads of work to do. Each simple contribution, social media like and share, connections to anyone with a voice and a heart is needed. A little from a lot goes further than you think! 

About Brenda Kirkpatrick

Brenda is a Perinatal Educator and Family Advocate for OHSU Hillsboro Medical Center. She has two adult sons & a pretty special daughter-in-love who live near her in the greater Portland, Oregon area and is cat-mom to Meu and Claire. She currently serves on the Board of Directors and the Advocacy & Collaboration Committee for Lamaze International.

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