"The new normal" a phrase I have heard way more than I would care to this year, but here we are at the very end of December (now Feb 2021 still not change) and well things don't seem to be going anywhere but further in the direction of saving lives from COVID but losing them to depression. The gloom has invaded our most private spaces as we skip seeing family for the holiday. It is surreal to see all of the changes that snuck up on us and how quickly they became our new reality. Suffice it to say that this has left so many families seriously worried, stressed, and on edge about how their birth experience will be. Suffering in silence they go on to birth in less than ideal situations because they have been limited to the number of visitors they are "allowed" to have and then reassured that the hospital is the safest option. I won't go into my beliefs on home vs. hospital births or into the belief that the birthing person should have the ultimate say as to who attends them in birth but I do want to go into seemingly small yet GIGANTIC change that has happened to the birth community at large, what it has meant to me as a semi-new doula and how you can be mad but still make a plan that helps you have the birth you want and deserve.
Now I am not going to lie, having a baby during this time can be a bit tricky. The obstacles are more prominent and switching providers is not as simple as it was before all of the policy updates and re-updates and re-updates... One thing's for sure, all the policy changes have not helped the people who are doing the actual work. Putting more constraints on the ones giving birth has not made our standing with one of the highest death rates from birth related incidence go down. Noooo, yet here I sit telling you that even with all of the changes and the obstacles, you can still find the location and the birth team that will help you birth your babying safely into this world. You may have to look a bit deeper though. So what are the changes? Well in general it has to do with how many support people may be present during your prenatals and your birth. This small policy change however has meant that siblings are not allowed, making sitter arrangements a necessity and not a choice by the birthing person who in some cases may want their child to be present for the birth of their sibling. This change has meant that parents who choose to only have one kid will not be allowed to have a photographer present to capture the once in a lifetime moment. More importantly it means that the person giving birth must chose between their SO or a trained birth support person. Which if I am being honest I would choose my husband each time even knowing that a doula is what I really want. The thought of my husband, who has been fully invested (going to class and reading with me) being nixed for someone else just seems, oh I don't know... wrong. This policy change means that the pregnant person must go to prenatals alone and hear all of the information given to them quickly. Then, when it comes time to relay all this information to their spouse it can become tangled and scary, making it difficult to research and understand. This can makes true informed consent tricky. This simple policy change that is enacted by hospitals has not been practiced identically across the board, however. Take my local Birth center, CPB for instance, to cut back on the number of attendants that have lowered the support persons allowed to 2 instead of 1 that most hospitals have been practicing. The reason is simple. Birth centers are not hospitals and as such they do not see sick people. They see families who are embarking on one of the most memorable journeys of their lives. It is because of this subtle difference that they are able to allow just a bit more leeway on this policy. Only one hospital in my local area, MUSC, continues to allow a certified birth doula and 1 support person. Why is it that one hospital can do this but others cannot? Speculation brings me no gain, but again this allows me to remain hopeful.
Now I have to be honest for a moment. These changes scare me. Not because it means I can't attend births but because it means that the person giving birth has even fewer "perceived options" than they did before and we as a country were already on a slippery slope before COVID. I hear families express their fears of being pushed into procedures they are not comfortable with and not realizing that they have any say in the matter. If you can't have a doula present, for most this means not hiring one at all. This is hard for me because my support spans past the birthday and comes in the form of resources, support from a friend who just happens to know a ton on the subject of birth, and someone to help you feel small yet golden moments of clarity postpartum which for some is priceless. I would be lying if I did not confess that my doula business has seen the impact. I continue to support those who choose to birth at facilities that allow two support persons and homebirths of course but for those who feel safest at the hospital, I am sadly not able to support them in person and must try to bridge the gap virtually. Don't get me wrong, I have had a virtual birth package since day one because I recognize that some families just need my information and pre-coaching but don't want me at the birth physically. The package means I am available virtually during the birth and for some, this is perfect. However, for those that need more hands on support this package is simply not enough. Touch has been proven to provide pain relief and if I can't touch those that need this comfort measure, they are missing out on support that can help them have the birth they want and deserve. I am soured by these changes but if you know me at all, you know I am quick to turn all that sour into lemonade. I will not let this be my "new norm" I will continue to express and push for the need for birthing people to be fully supported by the those they choose. I am hopeful too, seeing NY impose regulations that require hospitals to allow the support of doulas makes me see a brighter future for the birthing community. We are not a new fad or trend, our presence is affirmed by the many studies that prove our continuity of care changes the outcomes of birth in a very real way.
I hate to sound like a broken record here but, have you looked into birthing with a midwife? Birthing your baby with the assistance and care of a board certified midwife or Nurse Midwife is a safe and welcoming experience for those who are considered to be low risk. These amazing people are trained to spot signs of possible problems and do not hesitate to transfer you to the hospital if at anytime they believe the birth may become unsafe. For instance, after laboring to 10cm dilation my water finally broke, my fluid was brown, a sign of meconium in the fluid, this small change meant I was instantly transferred to the hospital where I went on to birth my child with out incidence. Had my daughter aspirated the fluid she would have needed a team of people immediately to assist her after birth. Luckily this was not the case but I was transferred to be safe. My NM saw a potential issue and made the call without hesitation. I chose to attempt birthing at the birth center because of and in spite of the hospital policies. I felt calmer at the birth center and all of my innate knowledge on birth was that mammals go off to dark quiet places to have their young and those that need help during birth, enlist the help of the closest and most trusted members of their group. I knew in my heart that I needed to feel safe and for some reason I did not feel safe at the hospital. To elaborate - the hospital felt like a place where I may lose my voice. A place where I could easily become a passive participant in my birth but for as long as I can remember, I have always wanted to be in full control during birth. I have always expressed how scary it would be not able to feel the bottom half of my body. I was afraid I would be coerced into doing things that I did not really want to do such as membrane sweeps, breaking of my water, medical induction, and pain management to stifle my howls (of which I was certain I would do.. I mean ya girl can't even stub her toe without shouting a million obscenities) The truth is, I knew I needed to be in a place where my birth was seen as a normal part of life and not something to be managed. Now more than ever it is important to remember what you want from your birth experience. Are you just ready to get it over and just want to meet your beautiful baby? You are not alone and all of the above may seem like nothing - honestly that is okay. You may not have noticed much of a difference, although it is still pretty stifling to be told your family is not welcome in the waiting room. Unfortunately for a growing number of people the idea of birthing at the hospital has become an unpleasant one. Maybe from past experience or from stories they have heard and these people want a safe alternative, myself included! So in the spirit of YOLO I say it is imperative that you look into what is available in your area and determine what is best for you. Don't settle for the closest hospital but talk to a few different OB's, tour a few different hospitals if possible, and check out your hospitals %s at THELEAPFROGGROUP or Baby Friendly USA. Next find the midwives in your local area and ask them for their statistics and then decide if the hospital, birth center, or your home are right for you.
One last thought. For most the idea of having their baby unmedicated at home or the birth center is unfathomable. I get this - I understand that feeling of, "I am gonna need that pain medication" but I want to challenge you... not to do it unmedicated (that choice must be your own) but to just learn about the mechanics of birth and how fear can intensify labor. A great book is Childbirth Without Fear by Grantly Dick-Read and it, though the language can be a bit outdated sounding, is a great resource for helping you understand all the miraculous intricacies of birth without going into too much detail as to loose your attention. Having the birth of your choosing is not always possible because of emergencies or being high risk but it is in your power to learn about birth which can reduce your fear and this one big step will ease the majority of your pain. I wish for you a safe journey into parenthood and I hope for you an experience that needs no healing. Yet in the moments between when things did not go quite as you hoped, your experience is valid and your story is important. Don't allow those around you to stifle your light or make you feel as if your story and the not so pretty parts matter not when you and your baby are "healthy and alive" because we can be happy about that but completely traumatized by the experience. So if you should need a friend who understands, without judgment, please don't hesitate to reach out to me. I am here to listen and help you find what you need to begin healing if and when you are ready. But until then it would be my honor to simply hold space for your truth.