The other day, I shared an incredibly well written piece by Cristen Pascucci. Cristen, founder of Birth Monopoly and vice president of ImprovingBirth.org, wanted other women to know that not only does birth not have to “suck,” but through knowing what to expect from your care provider, what to expect when you’re in your birth setting, when to be moved to change from the “red flags” which may come out of the mouths of our care providers in the form of, “You’re not allowed,” or, “We can’t let you,” that through listening to and understanding all of these things, we can ensure we empower ourselves for our best birthing experience. Read the full piece here
This piece brought up some strong emotions for me, and took me straight back to my first pregnancy. My heart racing as I would sit outside of the ‘midwife of the day’s’ consult room door. In those moments of waiting to see who I would meet that day, what their ethos was, whether I would have to dig deep and remind myself I was educated and had a right to be heard, I would turn from strong woman into an intimidated little girl. So why did the fact that I felt so damn uncomfortable there in the midwifery-led unit of the hospital, so completely unsupported, not raise the red flags for me? Why didn’t I switch care providers? I didn’t, because I had already switched once, and didn’t feel that I could continue my search.
Attending my very first antenatal appointment with my partner, we both walked away and knew that we wouldn’t be going back! The midwife personified cold and clinical, and I just wanted to walk out of the room as soon as she walked in.
Deeply disheartened, and quite frankly shocked by the demeanour of a woman who catches babies on a daily basis, I called a friend who worked in the midwifery-led unit of our other local hospital. I felt comforted by her confidence in that midwifery team, I’d heard ‘good’ things from other women, so I felt so much lighter when she helped me to transfer my care to that hospital – I looked forward to my next appointment.
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That first appointment was worlds apart from my last. I was in the presence of a woman who was cheerful and supportive, and who spoke about birth in such a way that eased some of my fears – I felt that I had found my ‘fit,’ but that wasn’t to last long.
Subsequent appointments would see me meeting around six or seven midwives, as they were from my ‘team’ and it was designed that way so that whoever would be on shift on the day I went into labour, I would have met at least once. The idea itself is excellent, and reflects the intention to comfort women – the reality, however, is that of those women I would meet from my team, I only wanted one, maybe two of them at my birth.
Week after week, I would be greeted by a usually flustered woman, some could manage a genuine smile, but I always felt rushed and not in a space where I could speak openly. I would be asked the standard questions whilst having my blood pressure taken – surprise, surprise, it was always elevated, and would be re-taken at the end of the appointment which would give the accurate reading.
As the weeks progressed, discussion revolved more heavily around labour and birth, and I presented my birth plan. There seemed to be this smug undertone that I had no idea what I was asking for, and to expect that my birth plan would not go to plan – that there was a real naivety for me to present such a detailed list of desires. Those desires, in a nutshell, were to be left untouched, and for my baby to be left untouched unless there was a medical necessity.
When I went into labour at 41 weeks and 1 day, I was absolutely rapt to see the woman I had seen at my first antenatal appointment walk into the birthing suite. She hooked me up to the fetal monitor as I laid on the bed, and shortly after I told her I just needed to get up off the bed and walk! She took the monitor off immediately and seemed really happy that I wanted to be active. She spoke softly and positively, and gave Clayton and I plenty of space. I would barely notice when she would re-enter the room. She was respectful and just quietly observed, gently offering encouragement during my contractions. Had I have been in her presence for the remainder of my labour and for the birth, I have every confidence that I would have had a calm and respectful birth, but her shift ended, and her polar opposite took over. The whole energy of the room changed, and once again, I was reduced to the intimidated little girl; not the powerful and empowered woman I was just moments before.
I look back at the whole experience; the stressful antenatal appointments, the birth which was just unfolding calmly and beautifully, which then turned into the threat of episiotomy as I was apparently taking too long and there was a full labour unit, the disempowerment, and just feel dumbfounded that I allowed it to happen.
There’s something that sticks in my memory. As uncomfortable as I felt awaiting my antenatal appointments, the one thing that I would continue to focus on, with a bit of excitement and reassurance, was the pin-board full of baby photos and thank you notes from previous women who had given birth there.
As my partner and I were discharged from the hospital 16 hours after welcoming our perfect baby girl into the world, new, overwhelmed parents who had pretty much been ignored by staff the first day of our life as a family, I realised I wouldn’t be joining those other women in sharing my joy on the pin-board, and that other than the beautiful midwife I had the pleasure of encountering for the first few hours of my labour, there were no other midwives I wanted to thank. In fact, had I have seen the head midwife who took over the shift of the midwife on duty; the one in which she could learn a heck of a lot from on how to listen to a labouring woman, energetically and literally, how to hold the space and trust, I would have had a few things to say to her.
So getting back to the women who felt compelled to voice their thanks, I can’t help but wonder: did these women all really feel respected and supported, or as a culture are we so indoctrinated with “a healthy mum and healthy baby are all that matter,” that we don’t feel that we deserve more? Given the way the head midwife conducted herself, I would not have been the only woman she disempowered. So, are these women only focusing on the joy of their newborn and not stopping to acknowledge, that in fact, they too were treated poorly and disrespectfully? What do these women really mean when they say, “The staff were wonderful?” Do they just not expect more?
To quote the ‘ mother of authentic midwifery,’ the marvellous, Ina May Gaskin, “If a woman doesn’t look like a goddess during labor, then someone isn’t treating her right.” We are powerful goddesses, not ‘princesses’ taking on unrealistic expectations. To be treated with respect, to be supported, to be comforted, to be encouraged, to be listened to, are just the foundations of what we deserve and what we should seek when finding our care providers. Expect nothing less, and then ask all the questions you need to, interview all the care providers you need to until you find where you feel comfortable, safe and nurtured as the goddess that you are. You are about to bring forth new life, so that should be synonymous with respect – respect for your choices, respect for your ability and respect for birth itself. Any person who works in a service role is good at their job when they are passionate about their work, and believe in it, and listen to their customer’s needs – you wouldn’t hire an interior decorator who tells you, “You might want to paint your walls yellow, but you don’t know your own taste. I will just go ahead and paint the walls in the colour I think is best. It might not look like the house you hoped for, but you’ll still have a house…”
From the Womb to the World
A heartfelt thank you to Cristen Pascucci for allowing me to share her powerful and thought-provoking writing. Cristen left a career in public affairs to study American maternity care and women’s rights within it. She is an advocate for mothers, vice president of ImprovingBirth.org, and co-founder of a U.S. legal advocacy network related to childbirth. She works closely with leading national advocates, organizations, and birth lawyers to promote better treatment of women in childbirth. Aside from her websites, you can connect with her on Facebook:
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