Throughout the summer, I’ve been participating in and helping organize regular events with the Vancouver Birth Rally group. We started it with just a few members, and every week we get more people joining in on our online discussions. There are new faces at each different event. Some of our regular supporters include a psychologist who studies birth trauma, a french-trained midwife, a traditional birth attendant, doulas and prenatal educators, and mothers who have birthed with our BC maternity system.
Part of my focus as a doula has been supporting women who have had a previously challenging birth experience in having a more positive experience with their second (or beyond) birthings. Although I have been to amazing, beautiful, satisfying births, sometimes birth can feel like a difficult or even traumatic experience, and women hire me in hopes of making their next experience better. The Vancouver Birth Rally group wants to reduce the number of women who have traumatic births in the first place.
I attend the Vancouver Birth Rallies because I want to increase the number of women who walk away from their births feeling strong and positive about the transformational experience of giving birth. Our group wants to raise awareness of some prevailing issues in maternal health care we believe are standing in the way of this goal. Here’s a video of our very first rally:
You can read a full list of our goals on the Birth Rally Facebook Page, but here I want to talk about two major issues which led me to participate in the rallies: transparency in maternal health care and informed consent practices.
Transparency in Maternal Health Care
I can’t tell you how many clients I’ve had tell me “Well, we considered home birth because we really value normal birth, but we’re just not set up for that right now. We’re just going to do hospital birth this time.” Reasons given for choosing the hospital even though women are desiring a physiological birth without medical intervention include being mid-moving, mid-renovation, living in a small apartment, or being a little nervous about the first time giving birth.
The assumption women who plan physiological births often make is that as long as they are having healthy, uncomplicated pregnancies and births, they will be left to have their simple births regardless of whether they choose home or hospital. They think the hospital is there “just in case”, and that interventions will be reserved for women and babies having serious complications.
I’d like hospitals to be more clear and honest about what they are offering. Hospitals offer managed birth. They offer diagnostic services and treatments from highly trained medical staff who are familiar and comfortable with managed birth, and their priorities are getting a healthy baby out efficiently with a mama that survives the process. Most of them have never seen a birth that was completely intervention-free from start to finish. Hospitals use technological advances to monitor you and baby throughout your birthing and make sure your birth is happening according to statistical averages in terms of how long birth “should” take, how tired you “should” be, how fast you “should” be dilating, and they are constantly monitoring to look out for signs of potential fetal distress, ready to intervene at any moment.
When you walk in the door to a hospital, you are generally on a timeline, and I would like hospitals to be honest about that. Hospitals are busy places, and there are always more babies waiting to be born there. For the system to work smoothly and free up beds for the next birthing moms to come in, efficiency is often made a priority. If you want your baby to be born according to medically-set guidelines, where your baby is born within 24 hours of your membranes releasing, where you dilate at at least 1cm/hour during active birthing, hospitals will help you achieve these goals.
What I’d like to see is transparency about the managed birth that is being offered in our medical system. This way, women are making informed decisions about where and how they choose to birth their babies. If they, like me, subscribe to a philosophy of birth being a normal, natural, safe event that happens on it’s own timeline as opposed to staying within the lines of the medical model of birth, they deserve to have a more clear idea of what hospitals are offering to be able to decide if it’s right for them.
Informed Consent Practices
I’ve been to births with Registered Midwives and nurses and OBs where informed consent was presented beautifully. Honestly, though, these births have been in the minority unless the woman has great prenatal education, feels supported and insists upon it. Many of the required steps in informed consent practice are often skimmed over or skipped altogether. I’ve seen multiple health care providers on different occasions flat out lie to birthing women in order to encourage them to comply with their recommendations. I’ve seen a nurse blatantly ignore a refusal of consent and perform her procedure even as the mom asked her to stop. One of the biggest reasons women can end up feeling traumatized by their births is that they feel birth happened to them and that they weren’t given enough information or the opportunity to give informed consent before procedures.
I would like medical staff to understand that when a woman walks away from her birth, there is more to it to her than being alive and having her baby in her arms. Her physical, psychological and emotional health are all extremely important, and have long-term impacts on her and her family. For women who choose to birth within the medical system, one of the easiest ways to prevent traumatic birth experiences is to make informed consent a very serious priority.
I’m working on a brochure on why informed consent matters and how to achieve it during childbirth. Sign up for my newsletter to get it when it’s ready.
Why rally? Because we want to be heard. We want to be heard by medical staff, hospital policy makers, and by women. Because we want women to have access to the best, most positive birth experiences possible. We’re rallying to tell maternity professionals that some of what they are doing is not working to achieve this for women, and the hope is that they’ll talk to us and start to look at how things can continue to improve.
At our last rally, BC Women’s hospital expressed their preference for us not to use the area outside the hospital as a location for raising awareness about issues in maternal health care. You can see footage of how that transpired here:
BC Women’s Hospital, we know by the sign on your front lawn that you strive to be Canada’s Leading Maternity Hospital. I’d love for you listen to the BC Women you have named yourself after (and who’s taxes pay your staff’s wages), and talk to them about continuing to improve practices to prevent emotional and psychological trauma during childbirth.
This is what I’d like from the hospitals. From you, women, I ask you to own your birth experiences. Look into your options. Get educated. Choose your birth support team carefully. Know that you have the option to birth with a doctor, obstetrician, or registered midwife, and that you can choose your medical professional or hospital according to your desires. Know that you can choose to birth at home or in a hospital. Consider hiring a doula to support you along the way. Know also that you can choose to birth outside the medical system altogether if you wish, on your own or with a traditional birth attendant (yes, this is legal here in Canada!). Birth belongs to you, women. If a positive birth experience is important to you, make sure you take the time to create your best chance of it.
If you’re interested in more information about how and why I’d like our birth culture to improve, check out The 3 Sided Approach to Improving Birth.
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