Some thoughts on birth and being a consumer.
While “teaching” childbirth class the topic of being a consumer is addressed often in a variety of ways. I have a firm belief that a woman has the ability to understand, be well educated, and make her own decisions. It is in no way in my job description to tell someone else how she must birth or how to do it in the right way. She is the one who needs to take the information, explore it and apply it to her self and situation. Being a consumer in her childbearing year is a key component.
I have a great and deep sense of obligation to give truthful, helpful, real life applicable information to the families I am blessed to work with. Because of this my mantra is, “You go home or stay home with your baby and are the one who must live with the decisions and outcomes from them. Not the doctor, midwife, nurse, doula, educator – no one else. We all go home to our own lives. So if you have to live with all that happens then do your best to choose wisely to what you can live with.” No mother escapes the outcomes and the legacy it leaves behind forever no matter who makes the decisions for her. Even if it seems easier at the time to allow others to call the shots, I can hope the epiphany of this will help the pregnant woman to push for what she really needs and wants instead of being a passenger in her own process.
Birth options are integrated into prenatals and/or class structure as we discuss birth philosophy, birth planning, re-interviewing care provider, realistic expectations for chosen birth location, and interventions and medications. Most often I find that women have no idea that there are so many options available for the asking or available in a reasonably close proximity to our local area. This tells me that care providers expect the burden of knowing the options is to be on the pregnant woman to find out about, explore, and ask for. She may find that in this process she and her care provider/birth location are either well on or not on the same page with her needs and desires. This is where she can decide if needed to seek another provider and/or birth location. There almost always is a way, it may mean more work, effort, and at times out of pocket expense. Some women choose to relocate, ask for help with out of pocket expenses in lieu of baby shower gift, petition insurance to cover the “right” provider…
Really as a consumer the burden is on her to find the right fit and go for it. It is not for her to fit into whatever is the local expectation for her as a birthing woman. This comes down to something akin to buying a car because the dealer tells you this is the car you must buy because everyone else has bought it and even though it clearly does not suit your needs, you still buy it. I have never heard of that happening, yet I hear of women day in and day out having this sort of exchange from prenatal care through the birthing day with their care provider and/or birth location staff.
When it comes down to it, I really want women to have what is individually needed and desired. Who is paying the bills? Who is keeping the hospitals, birth centers, ob/gyns and homebirth midwives in business? Those caring for birthing women ought sit up and take notice. You all wouldn’t exist without birthing women paying for your services.
Every provider or birth location has a practice style, protocol base, etc. So why not honestly explain expectations, protocols, practice style in detail at the first visit or during the tour so the mother who is hiring you or birthing at your location can decide whether or not right off the bat if this is a solid fit? No one provider or location is going to fit with every mother nor is every mother going to fit with every provider or location. Whatever a provider or birth location is good at, expects, and is striving to be, put it out there so the mother coming in knows what she is buying in to.
My dream is that every birthing woman will know all the options and subsequently exercise her want to the care she desires even if it means walking with her cash or insurance card, since ultimately she lives with all that transpires positive, negative, or in between.