Your Responsibility in Labor

Wednesday, March 3, 2021

Your Responsibility in Labor

I am bringing you my takeaway from recent births today on the blog. All of them had a layer of nature that we could not control, which is something I talk about all the time. You can control 90% of labor and birth, but that other 10% is nature. That's life, right? Those are the pieces that no matter how hard we try as humans or even medical professionals, we'll never be able to control nature. Nature will always kind of reign above us, because it's nature. We are the smaller beings when we think about nature and humans, humans actually depend on nature. Nature does not depend on humans. Nature will always have this way of playing its hand in birth. So your responsibility with that 10% is not to give up on it. Your responsibility is to know what could happen within that 10% of birth. To understand what your options are at each of those places.

When you find yourself in some of those situations, because remember it's inevitable, nature will always reveal its hand in labor. You want to feel in control and prepared. You need to do the work to educate yourself on your options, on the research, on your provider/hospital. We can help you do that work, as doulas and through The Birth Lounge Membership, but YOU have to take responsibility. You have to help carry through that preparation. So that since when. you do find yourself in a situation, you know how to respond and react.

The final piece of your responsibility in this is actually speaking up and advocating for yourself. Here's the deal: Your providers definitely have the space. There is room in birth for them to be in total control. This is oftentimes what we see in something called 'active management', where we try and actively control birth and control what happens in birth. And usually it's done under the guise of 'trying to prevent something bad from happening'. But really, if we look at birth and labor, birth is a natural thing. Birth is a very natural event. So what we actually see is when we intervene as humans, as medical professionals, as providers, we see our numbers kind of decrease in certain things. Our C-section rate is increasing. Meaning we are decreasing the number of vaginal births and vaginal births is obviously obviously the preferred birth method, because it's so much easier for the body to heal from.

Now don't get me wrong. I am SO grateful we have C-sections for those times we do need a C-section. But again, if we go back to the research (Check out Ep. 107 of The Birth Lounge Podcast!), I talk about the astronomical rate of C-sections in the US. I also cover what you, as a birthing person, can do to reduce your C-section. I chat with Dr. Neil Shaw, who is really pioneering the science on how do we use C-sections appropriately and save lives, but drastically reduced the number of unnecessary C-sections because it truly does have a soured aftermath for so many birthing people. It increases your risk of chronic pain, increases your risk of pelvic floor dysfunction, increases your risk of abdominal dysfunction, and increases your risk of infection. There's so many complications that are added on once we introduced the idea of a C-section. Your power here, your responsibility here is actually speaking up in labor. There is room for your doctor to be in control, but only if you allow them to be in control.

So let's play something out. Let's say your doctor comes in and says, 'You know what? I'm suggesting a C-section.' and it's the first time that you've heard this. And they say, 'I really think you need a C-section this is not going to happen for you'. And you're like, 'Wow, this seems kind of all of a sudden and I have questions about it. Can we have a few minutes?' And you ask for a few minutes and they come back in and they go, 'All right, let's get you prepped up for a C-section'. This is not consensual care. That is not informed consent. That's not shared decision-making. That is your provider being in control. There needs to be consideration for your birth goals, your thoughts, your questions.

I've seen this exact situation way more times than you would even believe. And there are two very distinct outcomes and the power in that totally lies in your hands. So in this moment, when you're having this immense pressure from your provider to make a decision that you're not even sure you want to make. The first place to start is to ask questions. You're gonna want to say, 'We're not sure that we want a C-section right now, we have a few questions that we would like to discuss with you'. What this does is it takes the control from your provider's hands and it stops the ball from rolling in the direction of a C-section and puts the control in your hands of asking questions until you're ready for the ball to roll. And at that point, you get to choose what path you go down.

It's hard in labor to not feel overwhelmed. It can be very hard to advocate for yourself. This is why it's extremely important to have the education and the preparation, but also to have someone there with you that can advocate for you, whether this be your partner, whether you join The Birth Lounge, whether you hire us for virtual services, or you hire us/a local doula to be present at your birth. Someone that you trust needs to be in that room. Someone who is not afraid to speak up, but can also speak to medical professionals in an educated and polite way so that you're more likely to get a provider to be open to your suggestions.

Now, I want to be extremely clear here. It is not up to your provider what happens to you. It is up to you, you get to make the decisions for your body and your baby. Of course, your medical professional is someone that you've hired. You're paying them for a service. You chose to have your baby with this practice. Or maybe even this particular doctor - so don't lose sight of that. But every now and then people do find themselves in what we call a 'bait and switch', meaning that all of your pregnancy went great. You were feeling supported and then all of a sudden, now that you're in labor, a switch has seemed to flip and your provider is not as supportive as they told you they were going to be. When you're 24 hours into labor, this bait and switch can be really hard when you find yourself in it, but you still have the power and you still have the responsibility to speak up.

You can speak up. Having discussions with your doctor and saying, 'I hear you. And I'd like to discuss my options, but I'm not sure X, Y, or Z is the right answer for me right now. I still have questions.' You can even say, 'I would like to take 20 minutes to discuss with just me and my partner. Please.' You can request a new nurse or a new doctor at any point in your labor. Please remember that nobody gets to do anything to you that you don't consent to, but it's your responsibility to set that tone, to hold that boundary, to ensure that no one does anything to your body without asking you.

That means if someone simply taps the inside of your leg in order to put in a catheter, which I have seen done before, the nurse did not even tell this patient what she was doing. You can take the control back here to say, 'Oh, I'm sorry, are you tapping my leg? Do you need to, do you need to do something?' You can be more direct and ask straight out, 'What is that? And what are you trying to do?' The control here is in your questions. The control here is understanding exactly what is being done to you before it is done to you. This is called shared decision-making. This is something that your provider should actively be engaging with you all throughout your labor. If you find that things are being done to you and they're not being explained, and consent is not being gotten, and discussion is not being had before these procedures are done- you have to do is take a pause and ask the questions. What are they doing? Why are they doing it? And are there any alternatives you might want to inquire about?

Remember that it's your responsibility as a birthing person to understand normal birth variations, common practices, and what your options are at each of those twists and turns. When you do encounter them, you can control 90% of labor. The rest of that 10% is totally up to nature. 100% out of our control. But, what we can do is be prepared to be able to respond and react no matter what comes your way in labor. This is exactly what I teach you in The Birth Lounge. If you are reading this the week it is posted- you are in luck! Our doors are open for Spring members through the first week of March! Join us here!

Also, don't miss out on our free training: How to Avoid a C-section!

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