Childbirth Choices - Be Informed

By Barbara Behrmann, Ph.D.

Giving birth is a common occurrence, but if you are anticipating it for the first time, it feels anything but ordinary.
Little in life affects you profoundly as becoming a mother. Although the choices you confront may seem
overwhelming, a little education, introspection and planning, can make the road much easier to navigate. Take
charge of the trip by considering the following few issues.

Educate yourself on different ways of viewing birth.

Obstetricians are trained to view pregnancy and childbirth as medical conditions requiring treatment and
intervention, while midwives tend to see them as natural, healthy and normal occurrences. This philosophical
distinction is significant and affects how your pregnancy, labor, and birth are managed, as well as what kind of
outcomes you have.

Studies confirm, for example, that many routine obstetrical interventions used during pregnancy and birthing do
not improve birth outcomes and undermine a woman’s ability to give birth naturally. And a single intervention such
as inducing labor may set into place an entire cascade of interventions, often culminating in a C-sections, half of
which are medically unncessarily. C-sections have been skyrocketing in recent years – 32% in 2005. That means
your odds are basically one in three! Many refer to this as an “epidemic.”

Obviously there are situations when technology and interventions save lives. But how a health care provider views
pregnancy and childbirth – not to mention women - can dramatically impact the kind of experience you have.

Think about what kind of health care provider you want.

Obstetricians are surgical specialists and their expertise is clearly needed in high risk situations. While the majority
of women in the U.S. today receive obstetrical care, such expertise is typically not required to manage healthy,
normal pregnancies. In fact, outside of the United States and Canada, explains, Marsden Wagner, neonatologist,
perinatal epidemiologist, and former director of Maternal and Child Health in the European Regional Office of the
World Health Organization, the majority of women receive not obstetrical care, but midwifery care.

Midwives are qualified health care professionals, trained to assist healthy women with normal pregnancies and
births. Some are CNMs, (certified nurse-midwives who are registered nurses with additional education in
midwifery), and others are independent midwives with differing credentials. Some are CPMs (certified professional
midwives) and some are CMs, (certified midwives), but both follow programs leading to national certification. And
all are trained to act in emergency situations and recognize problems requiring the consultation or care of a
physician.

A third alternative is a family physician. Although fewer family doctors do deliveries than in years past,
approximately 25 percent offer obstetrical care for healthy women with low-risk pregnancies. Their approaches
vary considerably, as does their reliance on medical and technological intervention.

Regardless of which type of provider you choose, it’s important to find the setting and practitioner with whom you
trust and feel comfortable. Explore all your options, sit with the information, and then listen to what your heart tells
you.

Explore different birth settings.

The vast majority of U.S. births take place in hospitals. If this is your choice, find out ahead of time what options
are available and who can be with you during labor and birth. The Coalition for Maternity Services, a coalition of
individuals and national organizations working to promote a wellness model of maternity care, recommends asking
what happens during a normal labor and birth and finding out how often various procedures are performed, such
as labor inductions, episiotomies and C-sections. A list of ten helpful questions to ask is available at:

http://motherfriendly.org/Ten_Questions/tenquestions.html.

Hospitals, however, are not the answer for everyone. Birth centers and home births offer women with normal
pregnancies the option of more individualized, personal and intimate birth experiences. Many people shy away
from home births fearing they are not as safe as birthing in a hospital. Numerous studies in scientific and medical
journals, however, conclude that for low-risk women, planned home births are associated with fewer interventions,
lower costs and equally safe, if not safer, outcomes than those of physician-attended, hospital births.

For more information on birth centers, visit the National Association of Childbearing Center’s web page at: http:
//www.birthcenters.org/. For more information on home births, as well as midwives, go to Citizens for Midwifery at
http://www.cfmidwifery.org/

Take a childbirth preparation course.

“The difference between taking a class and not taking one can mean the difference between a vaginal birth and a
cesarean for something as simple as the positions you choose for your labor,” explains Barbara Hotelling, Past
President of Lamaze International, the oldest childbirth education association in the U.S.

But look around. Some classes are designed simply to prepare you for what to expect in the hospital setting, while
others aim to empower you to be active participants throughout pregnancy and birthing. Likewise, instructors’
training may differ. Those trained with organizations such as Lamaze, Bradley, Birthing From Within, and
Birthworks, understand the distinction between normal birth and medicalized birth. Hotelling recommends speaking
with several instructors before making a decision.

Gather support.

The focus in our culture is on the birth of a baby. Little attention is given to the birth of a mother. If at all possible,
surround yourself with supportive people and think about who you would like to have with you at the birth. "Birthing
women need loving, reverent support, asserts psychologist and doula, Lauren Korfine. “as they do the hard work
of surrendering the life they have known and crossing over into motherhood.”

Doulas offer emotional and physical support during labor and childbirth, as well as postpartum support. Studies
show that the presence of a birth doula can result in shorter labors, less need for pain medication and
intervention, and lower C-section rates. It also increases women’s birth satisfaction. In other words, birthing women
without someone whose only job is to support them, are likely to have longer and more difficult births. Doulas of
North American (DONA) is a good starting place and has the website has a link on how to find a doula near you.
Visit: http://www.dona.org/ or call 1-888-788-DONA.

Read and Learn.

Although the number of pregnancy and childbirth books on the market seems to grow exponentially, here are four
excellent choices:

• The Thinking Woman’s Guide to a Better Birth by Henci Goer

• A Good Birth, A Safe Birth by Diana Korte and Roberta Scaer.

• Gentle Birth Choices by Barbara Harper.

• Ina May’s Guide to Childbirth by Ina May Gaskin.

Barbara Behrmann, Ph.D. is the author of The Breastfeeding Café: Mothers Share the Joys, Secrets & Challenges
of Nursing, University of Michigan Press, 2005. She is a freelance writer, a frequent speaker in the U.S. and
Canada, and has appeared on a variety of television and radio broadcasts. Barbara maintains a growing website
at http://www.breastfeedingcafe.com, offering information, resources, articles and products for parents and health
care providers alike. The mother of two formerly breastfed children, she lives in upstate New York.

Article Source: http://EzineArticles.com/?expert=Barbara_Behrmann,_Ph.D.