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3 Things We’ll Change for our Next Birth| Midwives, Doulas, and Education

My journey to motherhood as a whole (pregnancy, birth, postpartum) was amazing, positive, and empowering (go read it HERE if you haven’t already). And I’m so grateful for everything that went SO right – that I felt fairly in control, that Ben’s counter-pressure allowed me to relax, that I had a vaginal birth (albeit induced) that felt empowering, that my perineum only tore minorly, that Eleanor knew how to latch so well, and that WE did that together.

Honestly, looking back, it’s pretty incredible that things went so well! Though I taught myself a LOT, I only shared a small portion of my findings with my husband, we didn’t take a thorough childbirth or breastfeeding class, or even really practice any comfort measures. Truly, it’s pretty miraculous. But, alongside all that beautiful good, there were some things about my experience and how I was treated that really bothered me:

  • In general, my experience at my OB’s office was just… impersonable. Not bad – everyone was nice, but all my appointments were really short and often rushed, and it just felt more like a checklist on all our to-do’s.
  • The first time I told my OB that I really wanted to do birth without an epidural, her response was, “you know, there’s nothing wrong with getting an epidural.” And though she eventually told me she was willing to support me, she never asked me why I didn’t want an epidural, wasn’t excited for me and the birth I wanted, didn’t offer education or resources on how to have an unmedicated birth in the hospital setting, or any validation to the risks I was trying to avoid.
  • I wasn’t given an option or the power to decide if I should be induced, I was told.
    • Most of the interventions in my birth felt this way – more of a “this is what we should do” or “this is what we’re doing,” (the perineal massage was the only thing I remember happening without my consent). And though I appreciated my OB and nurses asking for my consent, they never gave me other options or reviewed the risks or alternatives with me.
  • The “welcome to the hospital, leave all of your personal belongings behind in this bag” routine. I started my sacred birth experience in an itchy, drafty hospital gown on a hospital bed with thin, scratchy sheets, and felt uncomfortable, a bit jolted, and cold.
  • The lack of “same team” vibe in my birth team. Again, my nurses & OB were nice, but just… didn’t quite feel on the same page as me – I felt like they were walking on eggshells every time they felt they needed to suggest another intervention, and just didn’t understand my need to know more than just how dilated I was. So, while looking back I’ve been able to see their good intentions, in the moment, I felt very much alone and even defensive.
    • It was especially interesting to me how those feelings were strongest between breaking my water and getting the internal monitor in. I felt like they just didn’t quite have the right resources to help me, but as soon as things got closer to their normal (having constant data from monitors, coaching me to push), they suddenly were able to be excited and supportive, even if it wasn’t quite in the ways I wanted.
  • The hospital policies that were not evidence based: ESPECIALLY that I was denied eggs when I wanted them, but also insisting on checking me frequently after my water was broken, and flipping me onto my back instead of letting me deliver on my hands and knees (their coaching me to push while holding my breath also annoyed me).
  • How quickly they pushed cutting the cord – yes, it was already limp and white, but I would’ve loved to just wait longer (it would’ve been so meaningful to me to have a picture of Eleanor attached to my placenta, and waiting until our photographer was there to cut the cord).
    • I also wish I could’ve seen my placenta! Ben might’ve thought it was gross, but I MADE AN ORGAN, and I wanted to see it! If the OB had just asked if I wanted to see it, I would’ve SO appreciated it.
  • After birth, they were a bit pushy to make sure Eleanor ate every 3 hours. I specifically remember a lactation consultant coming by to try and get Eleanor to wake up and eat – I felt like we both knew how to latch well, but this lady seemed anxious and worked SO HARD to make Eleanor latch, shoving her sleepy little head into my breast instead of patiently coaching me and being flexible – her anxiety just wasn’t helpful.

I’ve thought a LOT about all those things – why they bother me, what effects they had on my experience, what I could’ve done to change it, and what that means for our next birth. All those ponderings have given me 3 major things I want to do differently for our next birth:

  1. Make the effort to more carefully choose my provider (specifically a home birth midwife)
  2. Build myself a true birth team to support us – aka GET A DOULA, and
  3. To prepare ourselves better with more thorough education and birth plans.

Carefully Choosing my Provider

Going into my pregnancy, I honestly chose my OB’s office because #1) it was in-network, and #2) I’d heard good things about it. And, again, everything went fine – but… it still wasn’t the BEST choice for me. It was clear as I talked with my OB that unmedicated birth wasn’t her normal, and…. though the way she responded to my no epidural goal wasn’t wrong, I felt like she didn’t really hear or see me – or really have time to, since we only ever seemed to have about 5-10 minutes to talk during my appointments. And that was a sign that it was time to switch.

I’m not sure if it was my pride that kept me from trying to looking for someone else, or just the inconvenience of trying to find someone else, or my insecurities about doing things different from what’s normal, or worries about being rude and offending the kind ladies at my office… but I wish I’d done the hard thing and kept looking for a provider until I found someone more supportive, someone who responded to my birth plan with “Great! Tell me more about why you want that.” or “Here’s how we can help you be prepared to do that.”

Regardless, I’m grateful I know better now, and I’ve given myself some guidelines to help me find someone better for me next time:

  1. My provider should have the tools and experience to help me achieve my goals, and even be EXCITED for the birth I want (not just “willing to support” me).
  2. I should confidently trust my provider – both their technical expertise and their ability to help make my birth space feel safe, empowering, and comfortable. I deserve someone who will hold space for me, serve me, and protect me & my babe.
  3. My provider should care about me, and seek to educate and empower me; they should help me make decisions, not make decisions for me. (I shouldn’t feel like “just another patient.”)

I’ve also decided now that if I consistently don’t feel like they’re the right fit for me, I’ll be brave enough to SWITCH. After all, birth is an EXTREMELY vulnerable experience, and I need to trust the people I pay to come into that sacred space!

So what does that look like? Well, since I’m generally low risk, and want to have an unmedicated, low/no intervention, spontaneous vaginal birth (i.e. avoiding pretty much all the medical things), I’ve decided I want an out-of hospital birth next time around (most likely at home). So, I’m already getting to know our local midwives, and we’ve switched insurances to one more flexible with out-of-network providers (turns out that Select Health – which I had – doesn’t pay for those or out-of-hospital births). Whenever pregnancy #2 happens, I’ll start interviewing those midwives, and use my goals and criteria to help guide me in choosing the best provider for me and that pregnancy.

I NEED A DOULA!

Having a provider that had the tools to support my natural birth goals would’ve helped a LOT, but MAN I WISH I’D HIRED A DOULA! Seriously. I think wayy too much about how much MORE empowering and wonderful an experience my birth could’ve been if I’d hired a doula (again, I think it’s pretty miraculous we did what we did with such little prep together). My short list of all the things my doula hypothetically could’ve done:

  • Encouraged me to find a provider more suited to my goals.
  • Validated my concerns that Eleanor wasn’t in a good position for labor, and helped me DO SOMETHING ABOUT IT. Probably pulled out the rebozo. Done some spinning babies. Maybe it would’ve helped, maybe not, but if she’d shifted her back off of mine and dropped her head on my cervix… maybe I never would’ve had to worry about being induced in the first place!
  • Helped me feel more in control by offering alternatives and explanations from someone I trusted about all the interventions presented to me (being sent to L&D to be induced, breaking my water, internal monitors, pushing, etc.)
  • Helped me be more confident in my evidence-based research, and GOTTEN MY EGGS.
  • Relieved Ben from constant counter-pressure support, letting him sit down, eat, and be less exhausted and able to enjoy his little girl more after it was all over.
  • Suggested and supported me in different comfort measures to help make all that dilating & effacing more effective and comfortable.
  • Helped me follow my intuition and tell my birth photographer/videographer to head our way when I knew I was in transition. Maybe she would’ve made it before Eleanor’s birth!!
  • In general, just made my hospital experience SO much more safe, warm, and comfortable – by being a constant familiar face, by suggesting small changes, getting music going, etc. etc. etc.

In short, though getting a doula wouldn’t have fixed anything if my provider didn’t support me and my goals, she SURE could’ve bridged that gap between my well-intentioned OB who seemed to just lack the time and tools to really serve me best.

BUT. The past is past, and we can only move forward! I know now that having a doula makes a HUGE impact – on me, on my husband. I want that constant, knowledgable, comfortable support, and evidence agrees with how valuable that support is.

So, I’m already getting to know the doulas in my area and saving our funds away in our HSA to pay for one. I plan on interviewing doulas with my husbie sometime in next pregnancy’s first or second trimester, and we’ll use similar guidelines as picking my provider to hire our doula: that they have the tools and experience to help me with my non-medicalized birth, that they’re excited for my birth plan, and that we both trust them to empower, hold space for, and serve us.

Childbirth Education

Honestly, I felt pretty prepared for birth with all the research I did, and up until this past month, felt pretty good about giving birth again without taking a childbirth class – just continuing to educate myself and give myself a solid birth team to rely on. BUT. This COVID-19 pandemic has reminded me how important it is to prepare for an empowered birth in both ideal AND less-ideal situations. What if I have a super crazy fast labor, and neither my doula nor midwife arrives before our babe does? What if my next pregnancy isn’t low risk and I really feel I need to give birth in the hospital? What if we end up needing to transfer to the hospital? What if something similar to COVID-19 happens, and my doula isn’t allowed in to help us? What if our next child doesn’t know how to latch as amazingly as Eleanor? So, I’ve decided that it really is important for Ben & I to both be more prepared for our next birth & postpartum, and I know that getting us both more educated is KEY to that. And as much as we could practice on our own and Ben could spend hours and hours reading all the books and articles and research I give him, we’re going to make it simpler and find a solid childbirth class to do the work for us.

I would LOVE to take the Evidence Based Birth Childbirth Class, since that would prepare Ben to advocate for me, educate us both on all the evidence, and help us to prepare not only a birth plan, but also a plan in case of transfer to the hospital, induction, c-section, AND postpartum. But, that might not be an option (currently, we don’t have an EBB instructor here in Utah), so I’ve been looking into some of the incredible childbirth classes here that would also help us go into birth prepared, regardless of how it goes! Again, there are SO many incredible educators here – that will be a hard decision!

Sum Up & Encouragement

So, as long as all goes well (when we get pregnant, it’s a low-risk pregnancy, we are still privileged enough to afford to invest in and find our ideal team, etc.), our next birth will be:

  • Prepared for thoroughly – with a solid birth plan, backup plans, postpartum plan, and a childbirth class that educates us and gives the practice we need.
  • Comfortably at home (or potentially in a birth center), with a fantastic, trustworthy, supportive, and knowledgeable birth team, including my midwife (CPM), doula, and birth photographer/videographer.

Hopefully, this has been helpful! I DO want to encourage you – if you haven’t considered hiring a doula, PLEASE do! At the very least, take a few hours to find a few in your area and interview them, just to see if having a doula would fit your goals and needs.

And if you currently have an OB or midwife or doctor that you don’t trust to respect you and your body, or who suddenly starts acting like they actually don’t want to support you in your birth plans, PLEASE consider switching. You deserve to have people in your sacred birth space who care about you and truly are on your TEAM. That can be hard, so reach out for support – to your partner, your doula (or any local doula – they’ll always have suggestions for you!), me, we’re all here for you!

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