Thursday, April 22, 2010

Be more, do less

There are few places left in our society where standing back and observing instead of rushing in and doing is considered valuable. In fact, there are few things about our lives that we even trust to unfold in their own time. The major attraction, at least for me, to my former career as a journalist was just that - the standing apart, the observation, the caution to never become part of the story, just tell the story, support the storyteller's voice and let the story unfold. Ordinary people have amazing stories to tell and true journalists and writers are mere facilitators of those stories.

I've never really been an activist. That's not what journalism was ever about for me; though it does have it's place within that field. It's not that I'm particularly apathetic; it's just that I see so little in this world that is within my control. And that just makes me focus more keenly on the things I can control. So what exactly can I control?

My attitude. My mind. My thoughts. That's about it.

For me, childbirth is very much affected by those things. If I believe that my body can't function properly in labor, if I'm fearful of the pain, if I view any part of labor and birth as abnormal, if I pay too much attention to useless, fear-inducing information, I'm going to fail or at least have a harder time succeeding. And just where would I get such ideas?

From a maternal health system that views childbirth as a medical event instead of a natural process. From a system run by people trained and paid to do, rather than just be, for pregnant and laboring women. From a society addicted to information and blind to the mental and emotional consequences of such an overload.

Let me just say upfront that obstetricians are invaluable for high risk pregnancies and in life or death situations. However, the majority of pregnancies are not high risk or destined to end in life-threatening emergencies. When the unthinkable happens, they are my heroes, the people I want in my corner and that of my friends who have had high risk pregnancies and life-threatening emergencies. However, having them in your corner for an entire nine months reminding you of and monitoring you for every scary possibility, no matter how remote, is unwarranted. I think OBs should behave more like a highly trained military force. You don't need them on a routine basis nor do you want them out looking for trouble. You want them highly trained but on standby. You want them deployed judiciously, only as a last resort, lest their involvement disrupt delicate dynamics.

And for pregnant and laboring women, the delicate dynamic is between mind and body, between her and her partner and others in her support system. In normal, healthy pregnancies, caregivers should be facilitators. Too often, though, they are the sowers of doubt and fear. They can negatively impact the woman's ability to birth instead of standing back and letting nature take its course. They should let the mother and her partner work together, stepping in when necessary and offering support and encouragement when asked. They should rely more on external markers like a woman's behavior and urges while laboring than the internal measurements and monitoring that are so much a part of maternity care in this country. Of course, this approach works best with educated mothers and their partners. Sadly, more and more couples are shunning prenatal classes. They know a lot about staying healthy during pregnancy, but precious little about the process of childbirth.

After our daughter was born, my husband noted that our midwife was almost like a ghost in the room. She didn't interfere with the dynamic between us. She and her assistant stood back and watched us closely. She made suggestions when necessary, like when Fiona's heart rate dipped slightly as I wearily sprawled on the floor watching the clock. (It was 2:20 a.m., as I recall.) And between contractions, she and my husband gently nudged me off the floor and into a better position - not something that would happen in a hospital where women are routinely confined to beds and hooked up to monitoring machines. Even when Fiona was born with the cord (loosely) around her neck, it was my husband, not the midwife, who slipped the cord over her head.

A year ago, I left my journalism career behind, but not that  instinct to be a careful observer, to stand apart, to listen carefully and help people tell their amazing stories. Many times in the past year I've wondered where to take that instinct, where would it do the most good. For now, though, my job is to birth this baby and take care of myself and my family.

But one day, I'd like to take care of other women and their families. I want to assure women and their partners that, yes, you can birth safely and normally, you can rely on each other through the process and you can trust your amazing body and mind to do their job. The birth of a child is the most miraculous and amazing story a family will ever experience. I would love to just be with women in labor and help them tell that story. How I'll get to that place, I don't know. The path is not yet clear, but that is just another process I trust will unfold in it's own time.

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