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MN Doulas- Birth, Postpartum and beyond

On The Importance of Provider Support

Doula Jen, right, with brand new baby K and his mom and dad after a provider supported “ family centered” cesarean birth in the Twin Cities, MN.

Doula Jen, right, with brand new baby K and his mom and dad after a provider supported “ family centered” cesarean birth in the Twin Cities, MN.

Whether you are pregnant with your first baby or your fifth, the importance of your provider’s support is paramount.  There is no “wrong” way to have a baby, just like there is no “right” way.  There is only YOUR way.  Pregnancy and childbirth are definitely not a one-size-fits-all sort of deal.  Every pregnancy, every birth, every baby is different, because, well, it’s a different set of genes!

I am on round four myself and I can assure you that while there have been some similarities between my pregnancies and births, there were stark differences as well. 

Some of the differences had to deal with the fact that my children are different genders.  I can remember vividly how different it was for me to carry my son as opposed to my daughters.  Other differences were based on what was going on in my life at the time.  It’s definitely a different ball game being pregnant with your first and being pregnant and chasing a toddler around.  I went back to work when I was five months pregnant with my second and was that ever a rude awakening!  I could go on and on about all the little nuances that determined the level of ease or difficulty with each pregnancy and birth, but the one thing that stuck out to me much more than anything else was the level of support I received.  This support can come from friends and family, your employer and fellow employees, your chosen provider, and many other people in your life you may not have thought of as impacting your pregnancy before.  The support you receive (or don’t) can make or break you. 

Pregnant bellies (and babies in general) have a way of making people forget about boundaries all together.  A complete stranger coming up to you and commenting on your belly, maybe even putting a hand on it, is not exactly the politest way to start up a conversation.  Maybe you’re okay with that, but I tend to like my space bubble.  Random family members asking, “How many are you actually planning on having?!” when we announced our third pregnancy, or making comments like, “You already have your hands full!” “You’re just making more work for yourself.” “How much longer are you going to breastfeed for?” “You haven’t started him on solids yet?” and one of my all-time favorites, “You better listen to your doctor!”  These comments were not only none of these people’s business, but they were hurtful at times as well.  As if my husband and I didn’t discuss how many children we hoped to have.  As if we were somehow harming our children by not starting solids at 6 months of age.  As if we had no parental or natural intuition to guide us and only our doctor knew what was the best for our children, the children we interacted with and cared for since before they were born, and whom the doctor spent a whopping 20 minutes with every few months or so.

So, what did I take away from all of these experiences?  I figured out that I knew my body best, I knew my children best, and I needed people in my life who were going to lift me up with positivity rather than drag me down with their differing opinions.  Pregnancy and childbirth are things we are privileged to experience a handful of times in your life, maybe only once!  It should be the magical and wondrous time you are hoping and dreaming for it to be.  No one should tell you that you won’t be able to have the birth you’re dreaming of, that you have no control over the outcome, and that you should still just be happy about it anyway.  But we hear that all the time!  “At least you have a healthy baby.” “At least nothing worse happened.” “You should be happy you have your baby now.”  These kinds of statements are disenfranchising, and do not acknowledge any of the emotions of the parents towards their overall experience.  Is it important to focus on the positive?  Yes.  But it is just as important to acknowledge any residual emotions, even if they are less than positive, so they can be processed and released.  

My first pregnancy and birth were less than ideal.  My husband and I had not been dating very long before we found out we were expecting.  It hurdled us into a kind of adulthood we were not anticipating for at least a few years.  We had known each other since high school, but it was not in our plan to have a baby quite so soon.  

The first provider I saw gave me literature about how and where I could terminate my pregnancy.  She heard the word “unwed” and that was enough for her to determine I didn’t want to keep my baby.  I threw the pamphlet away, walked out of the office and never went back.  I’m sure she felt she was doing her job well by providing me with resources.

Telling our parents turned out to be another adventure.  Some of it went smoothly, some of it didn’t.  In the end everyone came around to the idea.

The second provider I saw was the one I stayed with.  I had questions that were answered, some that were flat out ignored, our visits were short, I was told to do this or that and I did those things because I didn’t know any better.  Everyone in my family was encouraging me to listen to my doctor and do everything he says.  They told me their own stories about birth and most of them were unpleasant.  They told me to not even bother writing up a plan or list of preferences because it doesn’t matter anyway, and the only thing that does matter is if my baby is healthy.  Somehow no one seemed to care about what I wanted, if I wanted to do something different what that might be and how could I get there.  It was obvious to me that it didn’t matter how I felt about any of it as long as my baby was healthy.  

At the actual birth, my then fiancé and I were left in a room by ourselves to figure labor out.  The nurses came in, looked at the monitors, asked me if I wanted any medications and left.  I met the OB who caught my baby while I was in labor.  It never occurred to me that the OB I had been meeting with throughout my pregnancy would be on vacation, and no one told me this would even be a possibility.  

I had done all of the things I was “supposed” to do.  I listened to my family, I listened to the doctors and nurses, my baby was healthy, and I was miserable.

Time for round two!

My second pregnancy and childbirth experiences were altogether different than my first.  We found out we were expecting again shortly after we were married.  I was so utterly disgusted with my first experience that I vowed this time would be different.  I went to the library and checked out all of the books on birth.  If they didn’t have the books I wanted I ordered them online and didn’t look twice at the price.  I read blogs and journals online.  I joined pregnancy groups on social media.  I talked again with other people in my life who had given birth so I could hear their experiences with a different set of ears.  I made my list of birth preferences and tweaked it over and over again to reflect everything I was learning.  I made lists of affirmations and repeated them to myself over and over again throughout the day.  And, of course, I changed providers.

I felt so empowered by all of the information I had learned over the course of my pregnancy.  My new providers were more open to my thoughts and alternative decisions.  They took time with me to discuss my options and answer any questions.  They provided me with resources to research topics further.  If we disagreed on an issue they left it at that, a disagreement.  They had their policies and procedures, their traditions and “best practices.”  I had my newfound knowledge and intuition, as well as the intimate knowledge of my body, myself, and my core values.  While I ended up with a birth I was happy with, I still had to fight tooth and nail at times to get it.  Looking back over the years and talking with other birth professionals, I realize now there were still things happening that I would consider to be unnecessary and unsupportive.  

I had a clear vision of what I wanted and I ended up making several compromises to stay with my chosen providers.  Admittedly, it didn’t really occur to me to look for providers elsewhere.  I lived in a small rural town and it was already a 20-minute drive to my clinic and birthing place.  “Why would you want to travel father than that?” people would ask me.  It seemed to make sense at the time.

Round Three!

I was uncompromising.  I knew what I wanted and I was out to get it.  I was not going to fight for it, I was going to shop around until I found a provider who was aligned with my values and beliefs surrounding birth, or someone who would at least support my ability to choose for myself.  I was happy to receive information and resources surrounding topics that we disagreed upon so I could make a more informed choice.  I realize that in the course of researching certain topics a person can look for the information that will support the opinion they have already formed, I am no different.  But, in the end, the choice was just that, mine.  It was what was best for MY body, MY conscience, and MY family.  Because, in the end, that’s what it’s all about – YOUR body, YOUR conscience, YOUR family.  And no one, not even your provider, knows those things better than you.

I had a fantastic birth.

I will say it again; provider support is paramount.  If you find that your values and beliefs surrounding pregnancy and childbirth are not lining up with your provider, then maybe it’s time to make a change.  If you think that you are resigned to a care provider because of your location, I’d encourage you to dig deep and ask yourself if a 20- 30- or even 60-minute drive would be worth knowing you have a say in how your baby is born.  Adhering to policies and procedures that, for all intents and purposes, might not even apply to you, and could potentially negatively impact the smooth natural process that is birth might be worth a switch at 20 or even 30 weeks. 

Birthing in a facility with all the bells and whistles and latest equipment might be your jam.  Birthing at home might be the alternative you’re looking for.  Meeting somewhere in the middle and birthing at a birth center is a great way to blend the best of both worlds.  Wherever you choose to birth is up to you.  Wherever you feel most comfortable and supported is probably the best place to have your baby.  Birth is such a vulnerable time, and one of the most profound, shaping experiences of our lives.  You don’t have to go into every prenatal appointment with your defenses up, armed with information, prepared to argue your case with your provider.  There are providers who value their patients, mother and baby, and who are willing to fight FOR them and not against them.  They will not try to take advantage of your vulnerability during labor.  They will not try to scare you into decisions you don’t want to make.  They will not shame you for your choices.  These providers do exist!  We just have to look for them.  

-Doula Kara