So it has recently been brought back to my attention that many people don’t know that there is any other way of giving birth other than at home or at the hospital.
Many think that when you birth at home, you giving birth alone and taking huge risks with your health and the babies. This is simply not true. Most people who home birth are overseen by a midwife and have to meet a set of regulations set forth by her, or the state, in order to qualify for safety of everyone involved. Births in this setting are (typically) using the midwifery model of care.
Next is in the hospital. A large majority of the States’ population believes that the hospital is the place to giver birth. It also comes with it’s own set of risks, mainly that of obstetric violence and the ‘Cascade of Interventions.’ Now I am not going to go into these, but it is possible to give birth without experiencing either in a hospital. However, hospitals, for well-known reasons, follow what is called a medical model of care.
So what is the difference? Which is better? Can a doula help in either?
Which is better completely depends on your own philosophy about birth. Some believe that birth is normal and natural and only rarely truly needs assistance. By going to a hospital you are asking for unnecessary interventions. Others think that complications are unexpected and frequent and therefore should be overseen by a professional who is ready and trained to perform surgery when needed. Neither view is necessarily wrong, they are just different.
For people that see birth as normal and natural, they usually search for like-minded provider. These providers are typically midwives and so here is a list of beliefs/benefits/standards for the ‘Midwifery Model’ of care:
•Understands birth to be a life-altering, physiological event for the woman and welcoming a new family member for the family unit
•Birth takes place best in a relaxed atmosphere with chosen loved ones
•Individualized care to each expectant mom/family and their needs
•Can be hands-off (out of the mom’s way except for occasional monitoring) or very involved (massage, counter-pressure, etc.), depending on mom’s wishes
•Minimize interventions
•Typically only accept ‘low-risk’ women (this can vary state-to-state, or even midwife-to-midwife)
•Trained to keep a watchful eye so they can refer women on when needed
•Have documented better birth outcomes (possibly partially due to ‘low-risk’ status)
• Shared evidence-based decision making, usually as equals
•Offer longer, more frequent prenatal visits and a ‘Continuity of Care’
And lastly
•Birth is WORK but it should not be SUFFERING
For people that are more inclined to see birth as a unpredictable, uncertain medical event, they are more likely to thrive on the ‘Medical Model’ of care:
•Understands pregnancy as a diagnosis and childbirth as unpredictable, variable, and uncertain
•Birth takes place best in a sterile atmosphere with trained and educated professionals
•Has a ‘Standard of Care’ that they follow across patients
•No interaction in birth until pushing. Typically nurses do all the monitoring and adjustments
•Trained to utilize modern interventions and technologies
•Takes women of all risk status
•Are trained to identify potential problems and may ‘Jump the Gun’ in certain situations
•Have a higher C-section rate (likely due to the above)
•Typically decision making is as provider-client and as such is prescribed by the provider and carried out by the patient
•Shorter visits and no ‘Continuity of Care’ so there is a potential for a different provider attending on baby’s birth day
•Believe that people should take advantage of modern medicine and eliminate the work/pain of labor.
Now that these are listed, it is clear to see neither is perfect for everyone. It is also very possible to come across a OB that abides by the Midwifery Model and a Midwife that adheres to the Medical Model. Things vary so much geographically, culturally, and even individually. So what can you do to help improve your chances either way? Well, outside of the normal eat well, exercise, attend a child-birth class, etc. You can hire a doula ❤
What? How is an extra person in the room going to help?! I used to be of the mind, unless you had a part in making the baby or are my attending medical professionals, you shouldn’t be in the room. However, I had no idea of the value of a doula.
Before that she answers calls and helps direct you to up-to-date information for your research. She gathers a list of referrals that you might need to chiropractors, yoga studios, lactation consultants, and more. She helps you with your birth-plan and is a reassuring voice.
A doula is on call around the clock from the time you reach around 36 weeks (can be earlier, especially if pre term labor is likely) to 42 weeks. When you are in labor, she can help you recognize the signs if it is active or not. When you decide it is time to go, or tuck in, she will meet you and start support in more physical ways. She can help you by providing reassurance to you or your partner, by massage, counter-pressure, or hot/cold therapy. She can help by keeping you in your rhythm, and reminding you to be conscious of your breathing. While there’s a break between contractions, she can write down events and timing so that you have it on hand for professionals, or just for a keepsake. She can help you find a more comfortable position or keep you stable.
After baby is born, her role isn’t done. She helps make sure mom is stable, that the partner is fed. She helps establish breastfeeding. She is an experienced set of eyes to the post-partum period and can help identify issues that have come up after everything has quieted down. She is full of resources for where and how to get the help you need.
There are so many uses for doulas in all birth settings and they have been proven to improve birth outcomes for women and for babies. It is past time for us to standardize the practice of women supporting women ❤