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Sunday
Jul252004

What DO Women In Labor Think?

There is this belief that women in labor, especially once they are in kicking labor, are unable to make decisions for themselves... that they cannot remember to pee or drink or change positions. The belief unfolds even further in that women seem to hire a midwife so that she is able to guide the energy of the labor and birth when (not if) the woman goes into that place of Other-Worldly-ness. Birthing From Within fosters this belief... a book I love! Whole paradigms foster this belief. Birth plans foster it. Doulas foster it. Dads as Coaches foster it.

Is this paradigm reality?

(Paradigm: a set of deeply held beliefs; usually someone else's)

Women who UC know when to pee and move and shift and wiggle and touch and poop and get into and out of the water. Women who UC in other cultures (they call it "birthing") know how to do these things, too. I acknowledge that our culture doesn't see birth in its normalcy like other cultures might (tribal or migration cultures), but can our bodies be so inherently disassociated that we don't even feel when we have to pee anymore? If the woman was so disassociated when not in labor that she didn't know she had to pee, I might buy that she might not know when in labor, but that isn't whom we are speaking of. We are talking about women in their right minds and bodies... merely in labor... a process made to perfection (most of the time).

Is it my job as a midwife to be the Energy Shifter? Is it my job to say to a woman who has remained in bed for 5 hours (or 20 minutes) that it is time to get up and move so her labor will pick up? Is it my responsibility to offer her sips of water between contractions? Will a woman who is dehydrated not know she is and find herself, eventually, dangerously dehydrated? Where does that belief originate? If I can see a baby is posterior (or hear it with fetal heart tones), is it my job to offer ideas to turn the baby? When does that responsibility move to me and away from mom? Is she offering her Power to me so that I can assist with my knowledge and experience? How do I hold her Power in honor and love without her feeling like she failed? If I see the bladder full, do I assume she can't feel it and ask her to pee? How do I traverse that woman's journey with her without leading her by a leash? Is asking enough? Should I even ask at all?

This is today's concern. How can I discover what a woman can and cannot say in labor if most women are brainwashed/convinced in childbirth classes, by doulas, by midwives, and by OBs that they don't know what they feel? Whom do I ask?

With my clients I have now that are pregnant, do I begin with, "When you are in labor, I will let (probably a sucky word, but after trying different ones, I came back to "let") you guide the Energy... you tell me when you have to pee or drink... you tell me what you need from me." (I can hear some clients now! "What am I paying you for?! Aren't you my caregiver? Why would I be the one to know when I need to pee... isn't that what I hired you for?") How in the world do I come off as someone who is encouraging the retention of Power as opposed to someone who wants to slack on the job I was hired to do? When does the discussion begin for a client? At the first meeting? The interview? Do I take clients that only want to retain their Power? Or do I take clients that want the gamut of "care" and then gradually release the Power they gave me back to them (or not take it in the first place).

I work to offer choices, of course, but that is different than the Here and Now of labor and birth where the midwife is assumed to take control of the Energy... it was what I was trained to do!

A discussion on a doula list right now is about doulas not buckling under to the hospital protocols... not signing them... so they (doulas) can stay autonomous and represent the laboring mom in her time of need. What happened that we believe women cannot speak in labor? When did that happen? I have heard women in labor be very, very expressive of their needs. Why do we think that it is an oddity that they would speak up sometimes and not others? What is it that we who work with laboring and birthing women think we have to be the translators for the client... translating medicalese... translating their own body's signals (or lack thereof)? Why can't we share the information prenatally... offer an OB dictionary so they understand the language being spoken around them in labor... role playing telling the caregiver to "SPEAK TO ME since I am the one in labor here!" Why is there information we don't share? Why do we concentrate on the biomechanics of labor and birth instead of the path to remembering our Power and capabilities in times of stress? Wouldn't that benefit humanity much more than how big 10 centimeters is?

I often say that, in my doula role, I am a walking childbirth class... a sort of cheat sheet should something be forgotten or misplaced during the stress of labor. I would like to see myself like that as a midwife, too. Just an augment... a place to turn when confusion is the emotion of the moment... but, ultimately, returning the Power to the laboring mom/baby/couple/family... as they get their balance again. Similar to when I helped that hands-off client when she was saying she was scared at the end of her labor. I could have gone in and touched and "helped," but, instead, I believed in her... and let her know she could do it... that it was okay, that fear... that she could hold it and birth her child. And she did just that and she soared with that experience!

And so did I.

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