A few weeks ago a midwife colleague shared this article "The Scary Truth About Child Birth" and shortly after I heard a compelling interview with the author .
While I’m not too keen on the bloody scalpel-beaked stork banner image, I fully accept the criticism that we haven’t yet perfected childbirth preparation or postpartum support. Perhaps in our efforts to combat an era of “let-the-professionals-take-care-of-this-dear,” we have swung the pendulum to the opposite extreme of “your-body-will-do-this-if-you-only-believe.”
Neither is really fair to anybody.
Striking the balance is so hard.
We try to educate women about their choices without implying total control over outcomes.
We try to acknowledge risk of complications without instilling fear.
We try to protect a woman’s hopes and expectations without setting her up for disappointment.
Yes, choose a midwife, but you may still need an epidural, or a cesarean. Yes, eat nutritious foods, but growth restrictions may still happen. Sure, try Spinning Babies, but that doesn’t guarantee your baby will be LOA.
There are days when I feel like I’ve really nailed it, helping a client write out a realistic, informed list of birth preferences that helps her feel prepared but still open to the mystery inherent in the path to any birth. And then there are days when I cannot, despite my best efforts, disarm a woman’s certainty that she is to blame for her baby’s breech presentation or perineal laceration.
The Mother Jones article at times seems to assume we can somehow predict what will happen for any given woman based on statistics. We can’t. When faced with a woman who has been crowning for 30min after pushing for 2 hours, we don’t know whether her pelvic floor will be better off with an episiotomy, a vacuum delivery, or a little more time in a new position. We’re also thinking about her baby’s brachial plexus. We make the best choice we can in that moment. We try to involve her in the decision. We carry it home with us wondering whether we could have done something differently to give her a better outcome.
But let's keep trying, anyway. Let's share what we know. Let's admit what we don't. Let's support women when they feel let down, either by us or by their bodies. Let's do appropriate assessments at all stages and offer postpartum referral for physical therapy or urogynecology or counseling, or all three. Even if we already are, let's welcome the reminder. And let's talk to each about what a challenge it is to get it all just right.
Amanda Alba is a Certified Nurse Midwife at the North Shore Birth Center