What is a good way to approach women about their choices surrounding birth without having them become defensive?
Q: I am 40 weeks pregnant and will be delivering in a birth center with a midwife. The past 9 months have been a life changing, educational journey for me and now I am extremely interested in birth activism. I would like to share my knowledge with women everywhere but I have noticed a great deal of women are defensive about these issues. Many women I talk with feel the need to defend their OBs. What is a good way to approach women about their choices surrounding birth without having them become defensive? Thanks!
A: You’ve certainly hit on something. When U.S. women learn they are pregnant, the vast majority call their OB/GYN for prenatal and birth care–it’s a cultural reflex. For many women, this is the person who took care of their first pap smear, their first Pill prescription, their first yeast infection. There’s a doctor-patient bond, made even stronger by the intimate nature of reproductive healthcare. So before activists and educators can even begin a conversation about birth options like midwifery care, they first need to recognize and respect this relationship.
At the same time however, pregnant women need to know–and childbirth educators and activists need to convey–that there are pressures and constraints on OBs and hospitals that often prevent them from providing optimal maternity care. For instance, most doctors I’ve talked to readily admit that continuous electronic fetal monitoring during labor is unnecessary and unhelpful, yet they have no choice but to require it of their patients for liability reasons. Optimal maternity care requires that a provider support the physiological birth process and intervene only when necessary. But if you are a typical maternity care patient, intervention will likely be routine rather than as-needed, and skilled labor support may not even factor in. I think one key to educating women is talking about the system as a whole, recognizing that there are forces stronger than any individual OB, no matter how progressive they are. Women can still maintain that doctor-patient relationship but may ultimately decide that they will get better labor support outside the traditional maternity care system. Choosing one doesn’t require giving up the other.
Jennifer Block
Author, Pushed: The Painful Truth About Childbirth and Modern Maternity Care
www.pushedbirth.com
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