4 Tips on Being an Active Participant in Childbirth

4 Tips on Navigating Healthcare While Pregnant

My grandmother recently had a stroke. It was relatively mild, and she is now at a temporary rehab facility. Overall, she was treated respectfully, but most of the time she did not understand what was going on. She did not understand the medications that were given to her, the procedures done to her, the reason for the G-tube (a tube surgically placed into the stomach to feed her, since she was unable to swallow) that was placed, or why they were not giving her any food (My grandmother LOVES food; she can out eat anyone! So no food is a big deal!).

At one point, my grandmother said, “I’m lucky I have you and your mother because this is all so confusing!” She’s right, the medical world can be very confusing. My mother and I are nurses, and were there to speak to the doctors, nurses, therapists, social workers, and anyone else that was involved with her care. We were able to ask what “pill” they were giving her, or which lab the “little bit of blood” was for, or the risks and benefits of the feeding tube. Then explain this to her. But really, she was not an active participant in this process.

I felt so guilty, knowing that she did not fully understand what was being done to her, and why. It reminded me of how women often say they feel during labor and childbirth. How scary and confusing that must be for them. Medical professionals go to school for many years to have the training, experience, and knowledge that they have to practice medicine. However, you do not need a degree to be an active participant in your healthcare. Here are some tips:

WRITE THINGS DOWN

Pen and paper can be great tools for keeping track of appointments, questions, or your to-do-list. There are many things to consider when planning for your birth; write them down. Write down questions for your OB/Midwife appointments, important advice, words that you don’t understand or topics you need to research. When I was pregnant, I used a binder to keep it all organized.

ASK QUESTIONS

Ask your doctor/midwife questions. If your care provider never has time to answer your questions, this may be a “red flag”. Part of their job is to answer your questions. However, sometimes they are simply overbooked, so tell the clerk you need extra time when scheduling your next appointment; and they will give you a longer block of time.  If you don’t like your care provider’s answer, you can always get a second opinion.

KNOW YOUR RIGHTS

Hopefully, before you are in labor, you asked a lot of questions and found the birth place and care provider that is right for you. Ideally, you and your care provider will have a mutually respectful relationship. Regardless of your relationship though, it is important to understand the risks and benefits of any procedure that they suggest during your pregnancy and labor. It is equally important to know that you have the right to DECLINE, as well as CONSENT, to procedures.  It is YOUR body and they need YOUR permission!

BRING SUPPORT

Bring support! Many athletes have support personnel to assist them on game day, you should too! In addition to their partner, women often invite close friends, family, or doulas to their birth. Ideally, it should be with someone you are comfortable with (after all, there is a good chance you will be naked and poop in front of them), who is supportive of your birth plan, and who can help facilitate communication (not speak for you) between you and medical staff. It is also helpful if this person is knowledgeable about birth (either from personal experiences, training, or education).

Navigating the medical world can be confusing, but it is possible! You’ve got this!

Have any other suggestions? I would love to read them! Please comment below.

I am a childbirth and parenting educator, as well as a doula. I am also a registered nurse, breastfeeding mom, and active in my local birth community. For more information on me, my comprehensive childbirth classes, and services please visit MY – Birth & Baby.

What a Childbirth Class can Do for YOU

5 Ways to Prepare for Birth

I recently met a sweet pregnant woman that was glowing with excitement about her unborn baby. Throughout her pregnancy she has been gathering items to comfort and care for her baby once he/she arrives. During our conversation, she revealed that she did not have any plans regarding her birth besides showing up at the hospital in labor. Internally I cringed. I REALLY hope she has a good birth experience! The thing is, there is more to preparing for the baby than decorating the nursery. Between 25-34% women report birth trauma (that is 1 in 3 to 1 in 4 women!)! Birth trauma can affect bonding, breastfeeding, mood, coping with future pregnancies, and so much more. Babies actually do not need many things, but they do need a healthy mama. Here are some additional ways to prepare for baby:

EDUCATION

Education is SO IMPORTANT! I realize that I am a childbirth educator, and this advice probably seems biased. BUT, how will you know what you want if you don’t know YOUR options? I know of some women that had multiple births before they discovered that they had options. It doesn’t have to be that way. Understanding what is going on can decrease a lot of fear, and hopefully trauma as well.

SUPPORTIVE CARE PROVIDER

Find a supportive care provider that has similar birth philosophies as yourself. How do you know if your care provider is supportive? Ask around. Ask friends. Ask local birth workers or advocacy agencies. Ask your care provider questions! In my Birth Boot Camp childbirth classes we discuss possible “red flags” and the questions to ask your care provider.

SUPPORTIVE BIRTH PLACE

You can choose where to give birth! Common birth places are hospitals, birth centers, and home. Tour your birth place. Ask questions. Find out policies/rules. Doctors and hospitals may have different policies. You need to ask for the rules of BOTH! Which location do you feel the safest? The safer you feel in your birthing environment, ideally the easier you will progress through labor.

SUPPORTIVE FRIENDS

Find people that will support you, not try to scare you. People LOVE to share war stories. Pregnancy might not be the best time for that. When I was pregnant, I found my support through my childbirth classes and the local birth community. Many communities have free or inexpensive groups that you can join. If you are in the Lafayette, LA area, check out Louisiana Constituents for Safe Childbirth (LCSC), Louisiana Natural Birth, La Leche League, and Postpartum groups. These groups have online and person-to-person support. They also often have birth workers that can provide resources, as well as other mothers that can love and support you!

HIRE A DOULA

A doula can also help you prepare for your birth. Doulas provide informational, emotional, and physical support for you and your partner. A doula does not replace a childbirth class, but can help remind you of what you learned. She can also help you navigate through the birth world and recommend other local professionals as needed.

There you have it – 5 ways to prepare for an AMAZING birth! 

I am a childbirth and parenting educator, as well as a doula. I am also a registered nurse, breastfeeding mother, and active in my birth community. For more information on me or my classes please visit MY – Birth & Baby.

Fight for Birth Options

Ask Lakeview to Support Women

If you have been on any of the birth forums in Louisiana lately, you probably have seen this petition. A hospital in Louisiana, Lakeview Regional Medical Center, is requiring that doulas go through a credentialing process to practice in their hospital. Some of the requirements include Proof of Doula certification, Flu shot, background check, drug screen, client confidentiality class, tuberculosis testing, and some other yearly testing. Originally the cost quoted was over $700. Now, with doulas and other entities voicing their concern the cost was reduced to around $100. Even at $100, if this requirement spreads to other hospitals this could become very pricey. Lakeview is a HCA hospital. Louisiana has five other HCA hospitals in the state. Click here for the complete list.

BENEFITS

For the Doula – You will likely get business from this hospital. Your name will be given to prospective clients. You will be “approved” by the hospital, so hopefully reluctant staff will embrace your presence.

For the Client – You will be given a list of approved doulas. This will make researching a doula easier for you.

For the Hospital – They can control which doulas work with their clients. They make money from the qualifying fees.

CONS

For the Doula – The doula will have more out-of-pocket expenses. The hospital will have more control over them, even though they are not employed by them. The concern with this is that doulas will be working for the hospital (without being paid by them) instead of the client (who’s paying for this service). This article discusses some of the dilemmas labor support may face. I practiced as a nurse for 7 years. There were many times when I felt that my patients did not receive the best care because of hospital rules. There are a lot of politics involved when working for a hospital, and unfortunately sometimes patient care is sacrificed. When deciding to switch from nurse to doula, the idea of simply focusing on my clients needs, instead of the hospital’s needs, was very appealing to me. Will this hospital certification change this? Only time will tell.

For the Client – The client loses autonomy. Women are smart human beings, capable of researching and making their own decisions. What matters is that women feel supported, not if the HOSPITAL thinks the doula is qualified. To read one woman’s thoughts on this topic, read this Improving Birth post. Instead, the hospital will offer a small list of doulas, that may, or may not be, the best fit for that mother. Additionally, prices will go up to pay for extra certifying costs, especially if other hospitals jump on this bandwagon. Many doulas travel at least an hour to a client’s birth place. That will include a lot of hospitals.

For the Hospital – “Boycott” is being whispered throughout the state. They may lose business from clients that do have other hospital options. They will not be the hospital that is known for supporting women’s choices. Women talk, we give advice, and we give a lot of referrals.

 SO, WHAT IS A DOULA OR A CLIENT TO DO?

The answer is easy right? –

For the Doula – Sign the petition if you don’t want this to happen. Spread the word. The more people who know about it the better. This is easy with so many social media forums. Don’t get credentialed through this hospital. Don’t take on clients that plan on using this hospital.

For the Client – Sign the petition. Choose a different hospital and doctor. (I only mention doctor because some doctors are only affiliated with one hospital, so it may be an all or nothing deal.) You are the consumer! You or your insurance company is the one paying this bill. Make your thoughts known! Let them know that you are capable of making your own decisions about hospitals, doctors, AND doulas! Birth workers are small in numbers, consumer’s numbers are much larger. The hospital is more likely to listen to you (the paying customer) than a doula. You are more likely to make change happen! Get involved! Louisiana Constituents for Safe Childbirth and Citizen for Better Birth are some groups that are working toward change statewide. If you are in the Northshore area, join Northshore Birth Options.

BUT WHAT IF BOYCOTTING IS NOT AN OPTION?

For some women, switching hospitals and doctors is not an option. It’s easy for women, with birth options, to tell a woman not to go to this hospital, but if their insurance only covers this hospital, that may be THEIR only option. Many people cannot afford to pay out-of-pocket for a hospital birth, or want to. They also may not want to switch doctors. Additionally, they may have limited transportation. Some families do not have cars. I’ve had many co-workers that depended on bikes or public transportation to get around. Or they may not want to labor in a car going to a farther hospital. Whatever the reason, this is THIS consumer’s decision.

What about these women? Doulas chose birth work to support women. If women choose to birth at this hospital, do they not deserve this support? Should all doulas boycott this hospital to take a stand? This is the dilemma that many doulas in the Northshore area are facing. These are tough questions, and I do not know the answer. I do, however, hope that our birth communities stay a safe and supportive place for consumers and doulas alike, as they make these tough decisions.

GET INVOLVED!

As we remain respectful to doulas and mothers alike, I hope that more consumers will make some noise. Sign the petition. Contact the hospital. Write letters. Go elsewhere is you can! The petition should actually say Ask Lakeview to Support WOMEN. This is really about women having birth options, not doulas having employment.

I would love to hear from consumers! What do you think about Lakeview’s new policy? What should these doulas do? Take a stand and boycott the hospital? Refuse clients that choose this hospital? Go through the credentialing process, even though they don’t agree with it, so that they can still support women? Or better yet, do you have another suggestion/solution? Comment below!

I am the President of Louisiana Constituents for Safe Childbirth. We are a statewide non-profit with a mission of providing research, education, resources, support of birth options in Louisiana for healthy moms and babies. Check us out: Facebook page, Facebook group, Twitter, Website.