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Mother runs the show

Thank you to guest mentor Kalah for sharing today.

The best thing you can do for a mother is to help her trust the process.  If she tells you she feels like something is wrong, listen to her.  Her instincts are one of the best tools you have.  She knows what she needs, and if she trusts herself, she can lead you in your care of her and her baby.

We had one mother who told her doctor that her waters had broken and that her labor was about to start.  He brushed her off when a cervical swab failed to test positive for amniotic fluid.  Two hours later she delivered precipitously into my hands without him.

We had another mother who kept insisting that something was wrong with her newborn a few hours after birth.  He appeared perfect.  We even had the Ped come in to check him for her.  She would not sleep with him in the room so we had him at the nursing station with us.  Around 2am we noticed his color was off.  Turned out he had transposition of the great vessels and almost certainly would have been dead by morning if she had accepted out reassurances.

The disregard for maternal instinct is at the core of the maternity care crisis in America.  Mothers are taught that they are a passive part of the labor and delivery.  The doctor knows best and they should do as they are told or their baby will be in danger.  Mothers who question authority or try to refuse interventions or even pain medications are often treated like problem patients.  Far too many women deliver in lithotomy position, or semi reclined lithotomy.  That is the most physiologically dysfunctional position, but it’s convenient for the birth attendant.

As birth health care providers, we must remember that we are working for mothers.  Everything we do should be for the mother and baby.  It is a crime to go to c-section because it’s close to dinner time, or to scedule an induction so we won’t miss Thanksgiving dinner.

So, trust the mothers and their bodies.  Intervene only when it is actually needed.  Don’t tell her she needs an epidural because the pain is only going to get worse.  Encourage and support her as she does her work.  Trust what she says and does.  Allow her to choose her positions.  Let her be in control.  We are merely support staff in the event.

Kalah

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Jennifer Vanderlaan CNM MPH is the author of the BirthingNaturally.net website. She has been working with expectant families since 2000, training doulas, childbirth educators, and midwives. She has worked with midwives in Central America and Sub-Saharan Africa. Her interest in public health grew in 2010, and she is now a PhD student learning to become a producer of knowledge.

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