By Valerie L. Colgate, Birth Doula and Midwifery Student

your body

your baby

your birth

your choice

educatedinformed empoweredequipped

Reclaim Birth

Share with me 5 words to describe birth. The first words that come to mind!

Were your words: Positive? Negative? Emotional? Colorful? Dark?

Beautiful? Scary? Creative? Concrete?

Why?

Why do we think this way?

INFLUENCES!

Culture, Family, Beliefs, Money, Media etc.

What labor position comes to mind when you deliver your baby?

Standing? Squatting? Hands and knees? Sitting? On your side? Why?

I’m sure this position came to mind first.

Where would you like to give birth? How? With whom?

Do you know your options?

If you could have ANY type of birth you wanted, how would it be? Why?

Home birth? Water birth? VBAC? Hospital? Alternative birthing center? Hypno birth? Unassisted?

Inside? Outside?

Modern Maternity Care

United States England & Other Countries

What are the differences?Which experience is appealing to you?

Why or why not?

Pros/ConsIn-Hospital

likely you will be asked to be in bed issued a hospital gown monitors applied increase chance for medical interventions I.V placed no food or drink visitors/family limited during labor best for high-risk pregnancies obstetricians and specialty staff available to handle

emergencies unfamiliar, cold, sterile environment you are a “patient” that is “sick” increase chance of acquiring infection birth viewed as pathological labor under time constraints often provider and staff unknown interrupted support by shift changes more expensive!

Out-of-Hospital

move freely wear what you want no monitors decreased chance for medical interventions no I.V you can eat/drink what you desire unlimited visitors/family best for low-risk pregnancies back-up plan in place in event of transfer comfort, safety and security of home you are a “woman” that is “healthy” decreased risk of acquiring infection birth viewed as a normal life event labor without time constraints personalized care i.e. your provider and doula of

choice continuous support by care providers far less expensive!

(Total running time about 8 minutes)

In-Hospital Birth

http://www.youtube.com/watch?v=qwrqLa1kx9Q

Out-Of-Hospital Birth

http://vimeo.com/storyframes/staceyandcody

Pause for discussion. ♥

Did you note these differences?

In-Hospital woman perceived as “sick” sterile, scary, busy and noisy environment monitors a huge focus, not woman bed confinement, laboring on back

FYI-the WORST position to labor! partner uneducated he’s “scared”, her “pain”,

her “suffering” strange people in green! ineffective pushing—in face I.V, epidural etc. doctor delivers baby, not woman possible vacuum , forcep or episiotomy at end vaginal laceration mom and baby separated to “take care of

hospital business” and “clean” baby delayed breastfeeding

Out-of-Hospital woman healthy/normal life event relaxing and nurturing environment no monitors—focus is solely on woman positional changes throughout labor support team calm and collected no strange people in green! great team of

family, friend and pet support! effective pushing noted. woman able to feel

and sense progress of labor to work with her baby! (no meds to mask)

woman delivered her baby, not the doctor mom and baby NEVER separated woman safe and comfortable in own home water eases labor pains instead of drugs no time pressure immediate breastfeeding

Making the choice that’s best for you.

By making informed decisions.

How do you make informed decisions?

Take a detour and explore your options!(research, read books, internet, friends, co-workers, classes, speak with different

types of providers, doulas, childbirth educators, support groups, other women, moms etc.)

How to Achieve a More Gratifying BirthEXPLORE your options. (Yes, you have options!)a. Hospitalb. Homec. VBACd. Water

DISCOVER the type of birth you desire. (Key word is “you”.)a. Whereb. Howc. With whom

Acquire KNOWLEGE. (Educate yourself.)a. Learn as much as you can to make informed decisionsb. Participate in 6-12 week childbirth education classes c. Learn about and practice optimal fetal positioningd. Exercise oftene. Eat Nutritious meals

Midwives Model of Care Medical Model of Care

Definition: Definition:

• Birth is a social event, a normal part of a woman's life.• Birth is the work of the woman and her family.• The woman is a person experiencing a life-transforming event.

• Childbirth is a potentially pathological process.• Birth is the work of doctors, nurses, midwives and other experts.• The woman is a patient.

Definition: Definition:

• Home or other familiar surroundings.• Informal system of care.

• Hospital, unfamiliar territory to the woman• Bureaucratic, hierarchical system of care

Definition: Definition:

• See birth as a holistic process• Shared decision-making between caregivers and birthing woman• No class distinction between birthing women and caregivers• Equal relationship• Information shared with an attitude of personal caring.• Longer, more in-depth prenatal visits• Often strong emotional support• Familiar language and imagery used• Awareness of spiritual significance of birth• Believes in integrity of birth, uses technology if appropriate and proven

• Trained to focus on the medical aspects of birth• "Professional" care that is authoritarian• Often a class distinction between obstetrician and patients• Dominant-subordinate relationship• Information about health, disease and degree of risk not shared with the patient adequately.• Brief, depersonalized care• Little emotional support• Use of medical language• Spiritual aspects of birth are ignored or treated as embarrassing• Values technology, often without proof that it improves birth outcome

Midwifery Model of Care vs. Medical Model of Care

Birthing at a Hospital

It’s been mentioned that birthing at a hospital is best suited for high-risk pregnancies. However, you may prefer to birth at a hospital.

This is your choice!

PLEASE be aware of the following common interventions.

Know before you go!

“The Domino Effect”Can occur at any point. Sequence of events may vary.

Just ONE medical intervention INCREASES your risk for more.

Disclosure: This section is meant to inform you. Interventions may be medically necessary. Please research the risks, benefits and medical indications of each procedure.

Admission Requirements:No more food or drink!

I.V & external fetal monitoring (EFM)

Why? In the event an “emergency” arises! A woman’s body and the birthing process is not trusted! Denying a laboring

woman (and baby) food/drink is inhumane and a set up for failure. Are you going to have energy to labor and push your baby out after 12+ hours with no food or drink? Your body needs this energy to function properly!

Thus, the common need for more medical interventions. EFM’s: Focal point of assessment. Ultrasound waves have not been proven safe.

InductionArtificially starting labor. (Often before baby is ready).

42 weeks is still ok! Be patient.

PitocinArtificially stimulating contractions.

Makes contractions stronger, longer, closer together AND more painful.

Please click link below. http://www.youtube.com/watch?v=3fPauJEy7fc&feature=results_video&playnext=1&list=PL8C868E312F8009CD

Epidural(Often brought on by the Pitocin or woman requests for coping.)

Can lead to a stalled labor, malpositioned baby, ineffective pushing, fetal distress etc.

Foley Catheter (Bonus with an epidural!)Due to bed confinement and lack of sensation.

FYI: ANY object that enters your body creates risk for infection!

OxygenMay be used prior to and/or during delivery

due to fetal distress.

Vacuum or Forceps and/or EpisiotomyPossible results due to an assisted delivery.

Last but not least

A Cesarean

Sound like a good time?

“The Domino Effect” is seen far too often in the hospital.

~If you will be birthing in the hospital,

PLEASE be informed. ~

Not all hospital births are this way, but sadly, a large percentage of them follow a part of this

sequence.

Things you can do to help avoid interventions:

Become educated.

Make informed decisions.

Stay at home as long as possible. (Movement/gravity and food/drink!)

Learn & practice optimal fetal positioning.

Recruit, experienced labor support i.e. a doula

When Labor BeginsTry to follow this cycle:

• Change positions/activities every 30 minutes• Eat nutritious meals/snacks• Stay well hydrated water/electrolyte drinks• Empty your bladder often!• Rest/sleep

For example:

take a walk, snack/drink, birth ball, rest, shower,

snack/drink, climb stairs, birth ball etc.

Various Positions

Do you desire an easier, shorter & less painful labor? What pregnant woman wouldn’t!

Learn about and practice optimal fetal positioning.

• www.spinningbabies.com• http://optimal-foetal-positioning.co.nz/

Create The Optimal Laboring Environment• The woman needs to feel safe, supported and nurtured• Have the room or area dark or dim lighting• Calm, quiet and private (limit visitors)• Minimal distractions i.e. no mobile phones or T.V• Talk softly• Nutritious food and drink nearby• Consider aromatherapy such as lavender • Cool cloths• Relaxing/soothing music• Candles• Pillows available• Perhaps a mat for kneeling • Birth ball

Relaxation, Rhythm & RitualKeep your body relaxed

Create a rhythm i.e. rockingCreate a ritual i.e. focal point, moaning, breathing

Balance, Movement & GravityKeep your body balanced

Keep movingRemain in an upright position

During labor, you’ll want to practice:

Questions? Please contact me.I hope you’ve enjoyed my presentation.

Wishing you a joyous pregnancy

and beautiful labor and birthing experience,

wherever you choose and how you choose!

♥ Valerie