Imagine the deep sinking feeling in the pit of my stomach when this question was recently asked during a Trust Birth group meeting. Unfortunately, we live in a time in history where most people are, on a very basic level, taking care of number one – themselves. A lot of childbirth educators rely on referrals from doctors, midwives, hospitals, and birth centers. They choose to teach a curriculum that keeps those referrals coming in because they do not want to burn any bridges that might adversely effect their income. This, from a business stand point, makes perfect sense…..or does it?
If the childbirth educator relies on one of their referring entities for space from which to teach class then teaching information that will keep that individual, hospital, birth center, or practice happy will ensure that the educator can continue teaching. BUT, if the childbirth educator teachers from home or leases their own space they have the choice to teach whatever information they want to teach. If the educator feels uncomfortable about the truth, the educator may gloss over it and make it appear as though the perfect birth can be experienced regardless of birth attendant or birth place chosen OR they may teach that it is best to negotiate and decide what part of your “perfect birth” experience you are willing to give up as well as the fact that giving those things up will be okay. In my mind, giving in to what someone else wants is never okay in labor and birth because no one is thinking about what the baby wants….
As a childbirth educator who teaches from home or leases my own space (or has a couple from class host the class), I choose to teach the truth regardless of where my referrals are coming from….what I have discovered is that while a doctor, midwife, hospital or birth center may stop referring people to me, my students will always refer their friends, family and acquaintances to me. Why? BECAUSE I tell the truth. BECAUSE I not only give them a road map to labor and birth but it comes with as many of the possible obstacles pointed out. If I know something about their chosen birth attendant that will significantly impact the birth they are working toward, I tell them. I teach that true informed consent (or choices) can only be made when one has ALL the information.
Not all the information I share is easy to hear nor is it easy for me to share because it means that I am pulling the wool away from the eyes that have been covered and deceived for a very long time. The truth is that if you are taking a childbirth class from someone who does not trust birth then you will not be told the truth about birth. Nor will you be told the truth about what is really happening in hospitals, birth centers and sometimes even homes across the country.
For a society who speaks so highly about the importance of having only evidence-based medical care most are very unaware of the fact that there is nothing happening in labor and delivery wards of hospitals that has anything to do with the evidence. It has more to do with being able to bill more to the insurance company and couple. This is not to say that all birth places and birth attendants operate this way but most do – so please don’t be fooled.
This fact is one reason why my birth doula rate is triple that of my home or birth center rate. There is far more work for me to do in a hospital setting….work that my clients find worth every penny even though it is also work that does not ensure that the interventions will not happen. The truth is – the moment a laboring women leaves her home to birth some place else is the moment she has allowed the first intervention to occur. I believe that was stated by Michel Odent, a French obstetrician.
Another fact is that pregnancy, labor and birth is the only natural function of the body where society has been led to believe that it is necessary to have a surgeon present. Most who read this statement will probably say, “I didn’t know an OB was a surgeon!” Yep, obstetrics is a surgical specialty.
Here’s another truth for you – postpartum hemorrhage is three times higher in the hospital than it is at home. Or how about the fact that the creator of the Electronic Fetal Monitor wishes he had never invented the machine because it is not being used as it was designed to be used. Not only is it not being used at it was designed to be used but it has led to birth injury (and yes, sometimes that injury is unnecessary cesarean surgery). One more truth is that neither ACOG nor the FDA has ever approved ultrasound (a.k.a. sonogram) for the routine use in pregnancy AND ultrasound/sonogram includes dopplers that are used during prenatal visits as well as the Electronic Fetal Monitor…..I could keep going but I think you get the point.
Childbirth educators may not be telling the entire truth because either they don’t trust birth, or they need to rely on referrals from others who do not trust birth or they need to rely on space provided by someone who does not trust birth. Birth, like all other natural functions of the body can absolutely be trusted and when it is trusted and when couples are taught how to trust it they are prepared to make truly informed choices regardless of what choices others want them to make.
The statement that we all hear is, “knowledge is power” but the truth is that – Unbiased knowledge is power – when we educate ourselves and I mean truly educate ourselves by opening our minds to ALL possibilities, especially the ones that seem absurd to us we are taken on a journey that will fortify us for years, decades, and even generations to come. One of my personal mottos is “Never Stop Learning” and it has brought me to seek truth. If someone makes a statement I don’t believe is true, I stop and research it before I say anything. I am often surprised by what I find but even more surprised by the lie I had believed.
Never stop asking questions but more importantly never stop expecting (nor requiring) honest answers!
(additional resource on this topic: http://mothering.com/jennifermargulis/child-birth/dont-take-a-childbirth-class-unless-you-know-whos-really-paying-the-instructor)