In a recent virtual one-day intensive childbirth class, one of my students, at 36 weeks pregnant, during the introduction told us that she gave birth 12 years ago by C-section and was excited and quite anxious about having a vaginal delivery, this time. When she indicated where she was going to give birth, I knew that VBACs were not commonly done there. Even at 36 weeks, she wasn’t clear what birth options were available to her for this birth. Unfortunately, this is not the first time I have heard such stories. Finding a maternity healthcare provider, who invites active participation from the birthing individual and provides access to minimally interventional birth options can be difficult. According to one article, the ways in which an obstetrician views birth affects the options presented to a patient and affects the decisions the patient is allowed to make before and during the birth.
Do expectant mothers know that when choosing their maternity care provider, they may be unknowingly signing up for limited birth options? Limiting access to multiple birth options, can reduce the quality of the birth experience and indirectly affect the breastfeeding journey. David Arrell, author of the 2020 book, Welcome to Fatherhood: The Modern Man’s Guide to Pregnancy, Childbirth and Fatherhood, said, “having a fully supported birth journey is a very important and powerful process for new families.” Arrell went on to say, “I feel bad for people who aren’t encouraged to explore all their (birth) options”.
During pregnancy, with the excitement of welcoming a new baby, exploring birthing options can be less important. The birthing family is likely unaware of how the lack of birthing options may place restrictions on the positive birthing experience they hope for. Being acknowledged and respected for personal birth preferences is key to an empowering birth experience. As an experienced childbirth educator and doula, I encourage families to maintain ownership of the birth journey, by being fully involved in all aspects of decision-making inherent in pregnancy, birth and the postnatal period. Unfortunately, this is not always the case when care providers want all the decision-making power.
Birth Settings in America, Outcomes, Quality, Access and Choicea newly released book asks how an evidence-informed maternity care system can be designed that allows multiple safe and supportive options for childbearing families. care and support for women deserve and what they actually receive. It also states, “the expectations of a woman, the amount of support received from caregivers, the quality of the caregiver–patient relationship, and participation in decision making seems to be the greatest influences on a women’s satisfaction with experience of childbirth”.
In Nashville, at Vanderbilt University Medical Center, there’s an alternative style of maternity care practice that seems to be getting right. They promote a progressive model of quality maternity care with multiple birth options baked into their practice style. They are known as, “baby + co” (now Vanderbilt Birth Center) with 14 CNM’s, an OB, a full education department and a dedicated client experience coordinator, all of whom work together to offer a range of birthing options. One of the tag lines on their website states, “Any way you want to have your baby, is the right way”. They truly promote personalized birth experiences, where their first priority is to make sure they are listened to, cared for, and feel comfortable and safe during pregnancy, birth and beyond. The baby + co website also makes the bold claim that, most OB practices restrict birthing options. Baby + co, offers a new approach to birth by offering…a handbook full of tools and education to help navigate all the different care options. They encourage long prenatal appointments so patients have plenty of time to ask questions. They will then be better able to assist their patients in developing a fully customized birth preferences plan for pregnancy, labor, birth, and postpartum care options.
For a milestone life experience like childbirth, being encouraged to explore birth options that are personal and meaningful, is inherent in having an empowering and positive birth memory. I love the “baby + co” philosophy of perinatal care. I strongly believe that treating a patient with their level of respect is truly empowering for a birthing individual and the entire family. I would like to see more maternity care practices implementing a “baby + co” style policy, leading to a more personalized approach to perinatal healthcare.
Resources
- Cook, Katie, and Colleen Loomis. “The Impact of Choice and Control on Women’s Childbirth Experiences.” The Journal of perinatal education vol. 21,3 (2012): 158-68. doi:10.1891/1058-1243.21.3.158 retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3392605/
- Arrell, David. Welcome to Fatherhood: The Modern Man’s Guide to Pregnancy, Childbirth and Fatherhood. Independently Published, 2020.
- National Academies of Sciences, Engineering, and Medicine. 2020. Birth Settings in America: Outcomes, Quality, Access, and Choice. Washington, DC: The National Academies Press. https://doi.org/10.17226/25636.
About the Author
Gwynne Knap has been a dedicated and passionate birthing professional in the Atlanta area for the past 10+ years. She has taught Confident Childbirth of Atlanta and Kopa Birth classes to hundreds of couples since 2009. As a labor doula and postpartum doula, Gwynne has supported hundreds of families through the birth journey and the transition to newness. parents Her doula practice now focuses primarily on postpartum doula care. Gwynne graduated from Georgia State University with a degree in Spanish/International Business, since then, he has had a 22 year career, marketing commercial architectural materials imported from around the world. Gwynne is a mother to a son and a daughter, as well as, a proud grandmother of two. She finds training new birthing professionals very beneficial.
