Happy Mother’s Day!
Mother’s Day is a big deal for the Midwives of New Jersey. Mothers are our passion. What is important to them is important to us – their health, their children’s health and their right to make decisions for themselves and their children (autonomy).
The Midwives of New Jersey along with the American College of Nurse-Midwives (ACNM), the Midwives Alliance of North America (MANA) and countless other birth workers and organizations are fighting for women’s rights to make choices during their pregnancy, labor, birth and postpartum time. Women are STILL unaware of the evidence-based choices they should be offered, choices that include: Midwifery care, intermittent auscultation of the fetal heart in labor, water labor and birth, homebirth, doula support, nitrous oxide for labor relaxation, food and drink in labor, spontaneous rather than artificial rupture of membranes, natural cesarean, freedom of movement in labor, delayed cord clamping, Vaginal Birth after Cesarean Section (VBAC), upright positions for delivery and many more. These choices are not just for the “granola” crowd, they are the BEST choices for most women and their families because they result in the best possible outcomes. Despite overwhelming evidence to say that intervening in the normal process of childbirth is detrimental to women and their babies, we continue to intervene.
Most People in America Still Believe Things Like:
- Routine obstetrical care for low-risk women should be administered by a surgeon (OB/GYN)
- Induction and augmentation of labor is often necessary
- Women often make a baby too big for their body to deliver
- Continuous fetal monitoring is necessary to keep babies safe
- Epidural anesthesia is necessary because labor pain is intolerable for most women
- Women need episiotomy to avoid irreparable damage to their genitalia
- Lithotomy is the best position for delivery
- Hospital birth is the best thing that happened to birth in the past 100 years
- Repeat Cesareans with no trial of labor is safer than Vaginal Birth After Cesarean
- Cesarean births where mother, father and baby are routinely separated are necessary to bring the birthing family through the dangerous, unpredictable process of childbirth safely
- We don’t want to offer women choices because they cannot be trusted to make good decisions for themselves and their children
All of these things have no basis in fact, Americans have simply become accustomed to these interventions and consider them part and parcel of a normal healthy birth.
In 2017, The American College of Obstetricians and Gynecologists, the most influential group in the country for establishing norms for childbirth, published documents that state the following:
each woman has the right to make a medically informed decision about delivery.” (source)
Obstetrician–gynecologists, in collaboration with midwives, nurses, patients, and those who support them in labor, can help women meet their goals for labor and birth by using techniques that are associated with minimal interventions and high rates of patient satisfaction. Many common obstetric practices are of limited or uncertain benefit for low-risk women in spontaneous labor. For women who are in latent labor and are not admitted, a process of shared decision making is recommended. Admission during the latent phase of labor may be necessary for a variety of reasons. A pregnant woman with term premature rupture of membranes (also known as prelabor rupture of membranes) should be assessed, and the woman and her obstetrician–gynecologist or other obstetric care provider should make a plan for expectant management versus admission and induction. Data suggest that in women with normally progressing labor and no evidence of fetal compromise, routine amniotomy is not necessary. The widespread use of continuous electronic fetal heart-rate monitoring has not improved outcomes when used for women with low-risk pregnancies. Multiple nonpharmacologic and pharmacologic techniques can be used to help women cope with labor pain. Women in spontaneously progressing labor may not require routine continuous infusion of intravenous fluids. For most women, no one position needs to be mandated nor proscribed. Nulliparous women who have an epidural and no indication for expeditious delivery may be offered a period of rest for 1–2 hours before initiating pushing efforts. Obstetrician–gynecologists and other obstetric care providers should be familiar with and consider using low-interventional approaches for the intrapartum management of low-risk women in spontaneous labor.” (Source)
Trends Moving Toward a More Natural Approach
The trends are moving toward a more natural approach toward birth but history has shown that it takes 30 years or more to disseminate scientific evidence into the general practice of the medical community. The evidence for delayed cord clamping is 40 years old and there has never been ANY evidence to support continuous fetal monitoring or episiotomy yet they still exist and are used in most deliveries. Despite tons of evidence and the support of National organizations like ACOG, ACNM and Improving Birth Network, reform in childbirth may ultimately come from the visual and emotional impact of the media rather than scientific facts and figures. In the past 10 years, there has been no better promotion for natural childbirth than The Business of Being Born which came out in 2007.
This Luv’s diapers commercial helps to normalize breastfeeding in public.
Now The Honest Company has gotten on-board helping to normalize birth choices in this beautiful commercial that I thought would help us all celebrate Mother’s Day.
The Midwives of New Jersey continue to lead the fight for better birth outcomes in New Jersey. We are hosting a conference this fall:
New Jersey Symposium for Physiologic Birth
2017 The Evidence for CHOICE
This conference is reaching out to birth workers and parents alike offering the Evidence for the safe choices mothers should be offered in childbirth. You can register now for the Parent’s workshops and/or the Professional conference. We hope that you will join us and invite your friends and colleagues too.
We wish the Mothers in New Jersey a very special day. The Midwives of New Jersey salute you.