Tuesday, March 1, 2011

Granola is good for you

I was inspired to write this post from a discussion I had with someone the other day. This person approached me to see if I might be interested in meeting with her pregnant friend, whose hubby was not up to being her labour support person because of a fear of hospitals. So instead, another friend had offered to step in to be there for the labouring Mom.

I was informed that this labour support person is a med student and "pro-epidural." She had advised the Mom-to-be against getting a midwife. She clarified later that she was fine with people using midwives, as long as they didn't have a home birth. The Mom-to-be isn't sure she really wants an epidural, and feels like she might be able to have a natural birth.

I try to remain calm when I hear things like this, but my blood starts to boil, and I usually end up griping to my hubby, who is probably getting tired of all this pregnancy/baby talk. I think he would rather discuss the eavestroughs or deck plans for our backyard!

So instead I will gripe to you, my wonderful readers.

Now, most of my friends and family will tell you that I'm a "granola" type of gal. I don't wear birkenstocks, but I care a lot about the environment, I cry when birds die or cats are hit by cars, and yes, I believe that birth is a magical experience that doesn't have to be scary. As a doula, I have two lives: one, in which I support my clients regardless of what they want for their birth and newborn; and two, where I am a proponent of midwifery care and home birth. I do not let these two selves mesh in my work as a doula, as then I would be trying to coerce my clients into seeing things My Way. It's not about me, it's about them. I can spend my personal time as an advocate for the things I really care about, involving myself in midwifery consumers groups and the like. Besides, who am I to say that home birth and midwifery care is best for all women!? It's mostly based on what makes you comfortable, and a lot of women feel comfortable in the hospital.

So it bugs me to no end when medical students (or whoever!), who have never witnessed a home birth, start informing their friends and family that birth is dangerous, and that midwives are not qualified to catch babies. I do understand how this view comes to be - students are only seeing what goes on in hospitals, where intervention rates are quite high. They don't always understand that things such as induction and epidurals are what can sometimes lead to complications. Instead they come up with diagnoses like "fetopelvic disproportion." If the woman had never received Pitocin or drugs in the first place, she would have birthed normally and naturally in her own time. (And I do understand here that there are high risk births - but the WHO states that this is usually between 10-15% of the population. So the rest of us are totally capable of having normal, natural births!)

Although I'm granola-y, I also work in health research, and rely on good quality evidence to support my beliefs. And, surprise, surprise, research has shown that home birth is JUST AS SAFE as hospital birth (I might argue even slightly safer because you are able to avoid interventions that have significant risks attached to them). When I discuss this research with others, a nurse friend (or on one occasion, a 911 operator I knew) will usually pipe up that she has seen numerous cases of women who have attempted home births being wheeled into the hospital in an emergency. Well of course there can be unexpected outcomes at home, just like there are unexpected outcomes in the hospital.

Midwives are trained to screen women who might be eligible for home birth (low risk pregnancies), and are also trained to spot any issues that might come up that would lead to a transfer to hospital. It is very very rare for something to happen at home that cannot be dealt with quickly by a transfer to hospital. Baby's heart rate is dropping? Midwives will consult with the OB and transfer! Third stage hemmorhaging? Midwives bring Oxytocin drugs with them in this event, and a transfer to hospital can be done easily if bleeding does not stop. It is extremely unlikely that you will bleed to death at home or in hospital.

And you have to remember that my nurse friend and the 911 operator are only witnessing these transfers. They don't witness the thousands of home births that happen every year that go according to plan, and result in a healthy Moms and healthy babies. And remember what the research shows - Moms and babies can have bad outcomes in hospitals as well, and the chance of this happening is exactly the same as in a home birth.

My family has wondered whether my witnessing hospital births as a doula will slowly convince me that being at the hospital is safer. So far, it's been the opposite. With each birth I attend, I'm more and more convinced that home birth is for me! If ever I had a problem, thank god that an OB would be there to guide me with his/her expertise. But my first pregnancy was completely normal, and I'm sure I'll go on to have another normal one in the future. And it's just that I'm so much more comfortable at home when I'm in labour. For other women, they feel more comfortable getting to the hospital. And that's GOOD! We want women to feel safe, because that's when labour will be able to progress normally. Fear can have a negative impact on the labouring woman.

As for my friend's friend, I will not be attending that birth. I'm booked as it is, but even if I wasn't, I would not look forward to butting heads with a labour support person who is not on the same page as the labouring woman.

Now if you'll excuse me, I'm off to get a snack. Plain yogurt and hemp granola, with a sprinkling of flax seed...yum yum!!

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