The Prenatal Orientation Your OB Was Too Busy to Give You

When you visit the doctor’s office to confirm your pregnancy, you are full of joyful expectation.  Even if you don’t admit it to yourself, you are so taken by your new condition that you kind of expect everyone in the office to share your excitement.

 

You imagine your doctor is going to initiate you into your new status with a conversation about how to be pregnant correctly, what your birth options will be and how you can Guarantee the Best Possible Outcome.

 

Instead, it’s weirdly business as usual: the doctor is kind but clinically detached, the techs take your blood and urine efficiently and your next appointment is made for eight weeks later.  Eight weeks?  Can you really wait that long to see me again? Isn’t there anything I should know now?

 

So on your way to the car, you call me.  Yes, there are some things to know.  Here is the prenatal orientation your doctor was too busy to give you.

 

1.  Read only books & blogs that inspire you and make you feel strong.

This is the first step because I know that as soon as your pregnancy is confirmed you’ll start book shopping.  You are excited and hungry for information, and I love that about you!  But, seriously, be careful what you choose to read.  It will frame your whole experience of pregnancy and your feelings about birth.

Pregnancy media — like most things that people have opinions about — is a spectrum with pro-medicine at one end and pro-nature on the other.  The pro-medicine media treat pregnancy and labor like an illness that is cured by birth.  You’ll recognize this mindset because it talks about, well, medicine:  tests, procedures, symptoms, medical options, illnesses to watch for.

You may like this approach if you are already technology- and medically-minded.  Even if you like it, though, the danger with this approach is that it can make you feel like a ticking time bomb.  When you focus on what could go wrong, that’s what you tend to find.

The pro-nature media, on the other hand, reassures you by focusing on the fact that pregnancy and birth are natural and usually healthy processes.  Nature has been honing the design for millennia, and mothers and babies have thrived on the planet all along.  In fact, Pro-Nature leans in close to whisper, birth is actually awesome!  You’ll read stories of births as trials overcome and as peak experiences that mothers are so proud of.

Even if you like this approach, it can sometimes feel too spiritual and ungrounded (hippy-dippy) and, in some cases, lead to feelings of failure if your experience was not all you hoped it would be.

Only you know where you fall on the spectrum.  So, rather than tell you what books to read, I suggest that you read the first page or ten of any book.  If what you read makes you feel strong and healthy and like you’re up for this thing, then keep on reading.  But if it does not put it down.

If you’re in doubt, I do recommend you begin with a pro-nature reading list.  You can’t unread some of the scary stuff the pro-medicine people write about.  I have a great bibliography here, if you want some ideas.

Your reading will help you get to number two on the list:

2.  Decide how you want to give birth.

Once you know that, you can start making plans for it.  Those plans may very well involve finding a new birth attendant; i.e., you may have to fire your doctor.  The influence of your provider cannot be overstated, friends.  One of the most unequivocal statements in her classic, The Thinking Woman’s Guide to Better BirthHenci Goer states that “what happens to you during your birth has little to do with your or your baby’s condition.  What happens to you depends almost entirely on your caregiver’s practice style and philosophy.”  (Find her latest article on the arbitrariness on maternity care here).

You can write a birth plan and discuss it with your doctor and think everything is fine.  But your doctor and the staff who support him or her are human.  Humans like routine and when the pressure is on them – as it will be during your birth – they will only feel safe if they are doing what they always do.

You do not want to set yourself or your birth companion up for a fight on the day you meet your baby.  Instead, set yourself up for success by partnering with a provider who already practices the way you want to be treated.

The only way to know a provider’s practice style and philosophy is to interview him or her and to speak to mothers whose births they attended.  Ask the provider how often mothers like you give birth the way you want to give birth.  What are their rates of intervention (induction? augmentation? c-section?)

Ask mothers how they were treated by the provider.  How did their providers make them feel?  Were their preferences were respected?  If there were differences, how were they resolved?

3.  Hire a doula.

But only if you want to feel strong and loved and have a great birth.  The thing is, you were never meant to do this alone.

If you give birth in a hospital, you will be surrounded by people, yes.  But they are strangers and they do not love you.  Kind and well-meaning as they are, to them you are a patient and a clinical responsibility and they have other patients to attend.

Your beloved will be by your side, yes.  But this is as new to them as it is to you, and they may not know how to help you.

Enter the doula.  Doulas are women who provide continuous emotional and physical support to the mother and to the couple.  They know and trust birth and love and believe in birthing mothers.  And they make a difference.  The benefits of doula care during labor and birth are well-documented.  See the evidence here.

A doula is like an angel in the birthing room, reassuring you that you are strong and amazing and you can do this.  She is skilled in providing non-medical pain relief.  She can help your partner help you, too.  She can help you communicate with the staff, too, and ensure your preferences are remembered.

A doula is also a professional.  High-quality research has found that certified doulas have a more positive impact than doula-like care from hospital staff or someone from your social circle.

 

There you have it, mama: three fundamentals to orient you as you begin your pregnancy. And yes, being pregnant really is as amazing and wonderful as you feel it is. You are growing another human being! You are becoming a mother!  Enjoy every minute.

 

Love,

Allison

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