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You are not allowed to not allow me

When talking to families in interviews or prenatal visits or in my childbirth education classes, I can’t stress enough how important it is to choose your care provider wisely. This amazing article on Pathways for Family Wellness (a site well worth checking out) does a great deal to emphasize some of the red flags you should be aware of when meeting with potential doctors and midwives and how to empower yourself with appropriate questions to weed out those that might not be a good fit. 

I know in my prenatal sessions and classes, couples tend to get anxious waiting for me to FINALLY get around to the things they thought they were coming in for–What does labor look like? How do I know when to go to the hospital? What are the tools for having a “natural” birth?–as I spend the entire first pregnancy consultation or the first two hours of my first prenatal session talking about your birth team. 

I have to remind them that all the squats and yoga breathing and mantras in the world aren’t going to make an impact if you have a care provider who doesn’t believe birth is an event not necessarily full of management and intervention and doesn’t really seem committed to helping you have an unmedicated birth. 

One of the ways you can figure out if they are going to be harmful or helpful to your goals of a physiologically appropriate birth is by paying attention to language like “We don’t allow” or “I don’t do that.” If you’ve done your research and know you want to have a water birth, why would you stick with a care provider who says something like, “Oh some doctors/midwives do that, but I don’t.” or “We don’t allow births in the tub here.”? It’s amazing how often I hear pregnant folks say something to that extent and either don’t know that they can switch providers, or know that they have other options, or for whatever reason just don’t think it’s going to be a big deal in labor. IT IS A BIG DEAL! And though having a doula can be enormously helpful in advocating for your wishes in birth, we can’t make decisions for you or fire a nurse a doctor or a midwife for you, and so there’s only so much we can do in the end. 

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Sadly, we in the United States have grown accustomed to poor medical care, a lack of true informed consent, and being told that we can’t possibly know much about our bodies. With most women hearing horrible stories of near-death births left and right, they’ve grown to think that they must also have this kind of traumatic birth, so it doesn’t matter if they “like” their provider much, as long as they’re there to rescue you and baby. It’s precisely this culture of fear and misinformation and lack of choice and trust in care providers that is driving the rising maternal mortality rate in this country (we are the only country–developed or otherwise–which boasts a rising rate). 

So, it does matter who your provider is and where you choose to give birth. If you are currently seeing a provider who uses language that takes away choice and support, SWITCH! Even if they have a nice smile and good bedside manner, if they’re not on your team, fire them. Now and not when you are fighting them in labor. That’s not fair. If you are early on in your pregnancy interview a bunch of different providers. Seriously. How much time did you spend picking out a stroller or car seat? Spend 10 times that amount talking to care providers and staff at the place where you choose to give birth and don’t stop till you’re sure in your gut that you’ve found the best fit. Take a month to do it. Make them sit down with you for an hour and answer all of your questions. 

If they don’t want to give you their cesarean rate, but avoiding a cesarean is your biggest concern in pregnancy, keep hounding them or leave and never look back. 

You are 100% entitled to having the birth you want. There’s no being “selfish” or “smug” or “bossy” or “difficult” in asking for care that is supported by evidence and is kind and supportive. Choosing an appropriate care provider who gives you options, supports your choices, and practices according to informed consent is also not just for parents hoping to not use pain medication in labor. This isn’t you not being particularly nice to a waiter somewhere, this is arguably the most important day of your life and what happens in labor has long lasting effects for you, for baby, and for your family. It’s not about being a “smug hippie” or trying to win an award for best mom, this is about you taking control of a very normal, natural process that shouldn’t leave you battered, scarred, and needing therapy. 

Do not allow them to tell you you’re not allowed. 

If you want more information like this, sign up for a pregnancy consultation package or hourly conversation. That first investment can save you stress, time, money, and help you connect to a care provider in line with your wishes and needs in pregnancy and beyond.

Home or Hospital?

I got the chance to be a part of a truly beautiful, peaceful, powerful, well supported, safe, mother-and-baby centered home birth attended by two incredible midwives yesterday. This little one came almost exactly 9 years after I attended my first birth (also at home) and felt like a wonderful full circle.

If you are exploring your options for safe, patient-centered, evidence-based care in pregnancy, birth, and postpartum, I’d like you to strongly consider at least interviewing some home birth midwives in your area and doing some research around why home birth is a reasonable option for most pregnant folks. I’ve included some videos and links here and look out for my upcoming longer article on midwifery care here on the blog.

For those who are concerned about the out of pocket cost: