Empowered Birth

The concept of having an Empowered Birth may be new to some people, so I thought it would be useful to write about it again this week.   Wherever you are in your pregnancy, it’s never too early to think about empowerment.  Choices you make have lasting impacts on how you feel in your pregnancy, birth, and motherhood. 

How we feel about birth, very often, is a product of what we know.  And very often, what we know is from popular culture, our friends, and family.  However, there are other ways of viewing pregnancy and birth.  It’s helpful to analyze where our beliefs come from to ensure that we are making choices that are truly authentic to ourselves.

I define an Empowered Birth as being an educated advocate for yourself.  I’m going to break this down to be clearer. 

Why Would You Want an Empowered Birth?

1)   We have some of the highest cesarean rates in the country.

According to a study by Consumer Reports, two Northern Virginia hospitals are among the U.S. hospitals ranked with highest c-section rates in 2016.

Hospital

C-section Rates
(First-Time Mothers, Low-Risk Deliveries)

Rank

INOVA Alexandria

35%

15

Virginia Hospital Center

33%

24

INOVA Fairfax

INOVA Fairfax did not report their cesarean rate in 2016. Since they are considered a “high-risk” hospital, it’s likely they have a high cesarean rate.

At one point, Virginia was a leader in the country in obstetric data transparency, but the Virginia Department of Health has stopped collecting this data on cesareans. This data was only updated as recently as 2012.  I am including it here for historical comparison.

Hospital

C-section Rates
in 2012

INOVA Alexandria

41%

Virginia Hospital Center

42%

INOVA Fairfax

45%

Check out the full list here

2)   Many care providers do not practice evidenced-base care.

Evidenced-based care is backed by statistics that show that a specific practice is the most beneficial to the health of the mother and baby.  Here is a table that shows examples of how some routine care is not evidenced-based. 

Learn more about evidenced-based vs. routine at Evidence Based Birth (https://evidencebasedbirth.com/updated-table-on-the-state-of-maternity-care-in-the-u-s/)

3)   Birth can be traumatic.  

This is a quote taken from the Prevention and Treatment of Traumatic Childbirth (PATTCh) website, written by Penny Simkin:

Between 25 and 34 per cent of women report that their births were traumatic. A birth is said to be traumatic when the individual (mother, father, or other witness) believes the mother’s or her baby’s life was in danger, or that a serious threat to the mother’s or her baby’s physical or emotional integrity existed.
From: http://pattch.org/resource-guide/traumatic-births-and-ptsd-definition-and-statistics/

Let’s prevent this terrible statistic by being an empowered advocate for yourself. 

4)   Set yourself up for a positive early parenting experience.  

When you learn to advocate for yourself in pregnancy and birth, you are advocating for your baby.  You will feel more secure, well prepared, and more confident about being a mom when you’ve had an empowered birth.  You have less risk for having perinatal mood disorder.  Approximately 21% of women experience major or minor depression following childbirth. (Wisner KL, Sit DKY, McShea MC, et al. JAMA Psychiatry 2013)

Educated: Ignorance Is NOT Bliss

The number one most important choice you make is choosing your care-provider.  Very often, the person you go to for your yearly exam is not who want to help deliver your baby.  How do you choose?  First, look at the two models of care.  The medical model of care vs. the midwife model of care.  Decide how you feel about birth.  Do you feel pregnancy and birth should be managed and treated?  Do you feel birth is a normal, physiological event?   Some care provider practices are attempting to blend the two models.  For example, the Physicians and Midwives practice in our area. 

While choosing the model of care that best suits you is important, remember that the providers still have to follow hospital policies.  This is why the second most important choice you make is the location of your birth.   If you like your care provider, but they practice at a hospital with a high cesarean rate, then you may want to reconsider that location if a c-section is not a part of your birth plan.       

How to Get Educated?

Once you’ve decided you want an Empowered Birth, you need to educate yourself with the positive resources.  Seek out non-fear based books, birthing classes and workshops, evidenced based websites, positive birth stories, and doulas in your area.  Here’s a link to a list of my favorite resources to help you get started: Jessica’s Favorite Prenatal Resources

When you are educated you …

  • know your choices

  • are confident in the birth process

  • have less fear

  • are an active participant with your body/trust your body/believe in yourself

  • make choices that suit your needs and desires

  • know the questions to ask for provider

Steps You Can Take to Advocate for Yourself

  • Write a birth plan (or birth desires)
  • Write a list of questions before prenatal visits
  • Discuss your concerns
  • Learn the B.R.A.I.N method to make informed decisions
  • Hire a doula to teach and remind you to advocate for yourself

You are the consumer.  Policies will not change unless the market demands it. Discuss your desires.  Listen to what the care-provider says.  If you can’t compromise or agree, then you need to find another care provider.

When you advocate you …

  • are empowered in your birth
  • are advocating for your baby and learning how to advocate for your child’s  future
  • influence future changes in routine care
  • have your voice heard
  • reduce birth trauma

Can I still have an Empowered Birth if I have medical conditions, planned/unplanned induction, planned/unplanned C-section?

Absolutely!  No matter what kind of birth you plan—or end up with—you can advocate for yourself, making the best choice for you and your baby.  Check out my Empowered Induction Tip-Sheet.  Consider asking your care provider about having a “Family-Centered Cesarean” otherwise known as a“Gentle Cesarean”.  The key is to be educated so that you can advocate for your birth and baby. 

I hope the idea of an Empowered Birth is helpful to you in someway.  My goal is not to preach or be biased about the choosing one type of birth over the other.  My goal is to be an instrument in improving births for women and babies.  Better births make happier families.