Updated: May 4
Happy 4th of July, dear reader! Today is the day we celebrate the birth of our country, the United States of America. We honor our forefathers and foremothers who risked their lives envisioning and creating a whole new way to run government, creating a new society. To this end, we were promised life, liberty, and the pursuit of happiness.
With freedom comes responsibility. The responsibility for making choices to ensure this privilege of life and liberty, as well as our ability to pursue happiness. This is not a guarantee – this something that must be constantly protected. Considering this, I hear Professor Moody’s words, “Constant vigilance!” (from the beloved Harry Potter saga - yes, you will enjoy this lovely piece of literature one day with your child!)
You may wonder why on earth I am writing about this on a blog focused on pregnancy and the transition to new parenthood. Here’s the crux of it - right now, during pregnancy, is the time to really consider how your rights and freedoms as a new mother are being supported and honored.
If we are looking at mainstream birthing practices here in the U.S. – there is neither a lot of freedom, nor respect for individual autonomy in the birthing process. Birthing in the hospital is standardized. It’s often authoritarian driven, diminishing the power of the birthing parents and baby by putting agency into the hands of hospital personnel and giving the glory to the doctor.
This is hard to write. It’s probably hard to read. We are dealing with belief systems here. We all want to believe we have a health care system; that “they” are looking out for our best interests – especially the interests of mothers and babies. We want to believe in a system that ensures that new families are set up with a good foundation. Such a system would be a right and honorable endeavor.
But that’s not what we have here – not during pregnancy and birth, nor the early years of parenting. We do not have a health care system here in the U.S. We have a consumer based business model. The industrial medical care system is a powerful industry. It has built itself as the authority and placed itself on a very high pedestal. Unfortunately, it doesn’t always live up to the hype.
The statistics for birth outcomes and the health and well-being of mothers and babies tells a completely different story than the one we are being sold by the technology driven model of care wielded by modern obstetrics. Even though the facts about what leads to good outcomes (midwifery care) is well-established in scientific literature and is implemented in countries with the best maternal and infant outcomes (such as Sweden, the Netherlands, and England), the American medical community continues to push evidence aside preferring to protect the present status quo rather than putting the interests of mothers and babies first. This is discussed in public health circles. Other countries shake their heads at the American maternity care crisis. However, it is not well known among consumers (birthing parents.)
The institutional setting of the hospital is one that puts its need for rules and protocols, measurement and charting above the needs of each individual mother and baby pair. This isn't done purposefully to interfere with personalized care. It's just a down-stream effect of an institutional setting. The hospital is a place of business. It must keep its beds filled and have a turnover rate in the labor ward in order to keep itself in the black, rather than in the red.
I don’t write this to make anyone feel bad about birthing in a hospital or with an obstetrician. I totally understand this. This choice completely makes sense in the context of our society and how we have come to understand birth. I’ve delivered a baby in the hospital with an OB myself. Most of my students hire OB’s. It’s not wrong. It can be the right choice for you. I do want you to understand the truth of the situation - the provider you choose and the environment you choose to birth in - this has a profound influence on your experience during pregnancy, birth, and postpartum. Understand your choice and know what its limitations are. When you understand the limitations, you can make other choices to support yourself in a situation that can make birthing a little human a challenge. Identify the positive and work around the negative. But, don't ignore it.
In our modern world, you are a consumer. This includes when you are pregnant. It includes all health care choices during pregnancy and birth, not just the fun stuff you get to buy for baby. It is understandable to think that when you are pregnant, you have entered a special place where suddenly all consumer economy stops and you enter a special “health care system.”
To me, you are, indeed, a goddess – glorious in your capacity to give life. You deserve the utmost in respect and care. But know that, if you are living in the United States, you are the one in charge of determining what is the best and most supportive care for you and your baby during pregnancy, labor and birth, and postpartum. There is no health care system here looking out for you, ensuring that you and your baby will be well-cared for and not fall through the cracks. And there are a lot of cracks.
If you are lucky, you have lots of extended family support during this time – that can be helpful in your transition to your new role and life. However, the type of experience you have during pregnancy, birth, and breastfeeding depends largely on the choices you make, because there is no "system" in place that supports new families in this transition. It's completely piecemeal. I wish it were not so, but it is. So, please become aware of what your choices are and how they can impact your experience and your baby’s experience. Find out out what you need to have a good experience and to be supported.
And it’s not just you. Making sure your partner is informed and knows how to support both you and your baby is critical. Critical to your experience – physically, mentally, and emotionally. Critical to your baby’s experience – physically, mentally, and emotionally. Critical to your partner's experience – physically (less so), but definitely mentally and emotionally. As parents you are a team. How engaged is your partner? How is he coming to understand his role and responsibility? How is he obtaining the knowledge and tools to support you and your baby? You are setting the foundation for the health and well-being of your family. There is no going back. No re-do. The pregnancy and birth of your child is like a pebble dropping into water – the ripples expanding far out into your future life.
We do live in a free county. We are so fortunate. You do have the freedom to make choices that are in your best interest - whatever those choices may be. With this freedom comes opportunity. You have the opportunity to make choices that positively influence the outcome of this new phase of life.
Ask yourself - am I going to hand my pregnancy, my birth over to an authoritarian figure? Or am I going to fully embrace my individual self-agency? I invite you to embrace your personal power. Investigate what you believe and why. Consider fully what your choices are and how you came to make your choices. Understand that you are powerfully and beautifully made. You are perfectly designed to birth. Your baby is perfectly designed to be born. Find health care providers who will honor you and support you in your glory.
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