Really back now - and the baby's okay

I attended my first birth last week - my first birth since coming back into doula work after nearly two years off. Lovely family, very inquisitive, worked hard to get the birth they wanted. Nearly sabotaged by an ob resident who just was not on the same page at all.

It really does feel like I never left. I've been wondering what sort of changes I would see in the hospitals I go to, the care providers I come in contact with. I was very excited about this birth because the parents were just so willing to ask questions, do some research, do some work and keep their experience and their baby's experience of childbirth as centrally important concepts.

Sometimes people have difficulty getting it, though. Even a family member, when I was talking about my disappointment in the care my clients received, said "but was the baby okay?". Yes, the baby was okay - of course the baby was okay. The doctors want the baby to be okay, I want the baby to be okay, and I guarantee you that the parents want the baby to be okay more than the rest of us put together. If it happened that the baby was really not okay, the parents would be more than willing to change their plan and do what was necessary. But that's not all that matters.

Have you had an experience with a doctor who was overbearing, who tried to scare you into compliance, who steamrollered over your requests because "that's the way we do it"? Were you okay? Were you okay physically? Were you okay emotionally? If the answer was yes to the first but no to the second, did you go back? Many of us have changed specialists because we did not feel emotionally okay with the person. Sometimes we're able to separate these feelings to the extent that we realize the person is probably competent and will do their job well, but we just don't like them. Sometimes we can't separate those feelings: a doctor who makes us feel bad emotionally may very well leave us feeling that we can't trust their clinical judgement, and we just don't feel safe with them.

Feeling safe is critical in birth. Fear and anger flood the body with the kind of stress hormones that can slow labour, create tension in the muscles and make it very difficult for a woman to release - or even want to release - her baby out into the world. Late in labour, fear for her child's safety can make a woman push in ways that may be designed to get the baby out faster, but which compromise her oxygen supply (and thus the baby's), increase her risk of tearing, and affect her ability to welcome her baby with openness and joy, rather than just relief.

On the provider's side, fear and anger make a patient/client suspicious, resistant, and disconnected. Why on earth would you want that? If you can gain compliance, get your patient to do things your way, you may have a good outcome: a physically healthy mother and baby. But what about their emotional health? What about your emotional health? It can't feel good to be having to bully patients into compliance. It can't feel good to have families toss you out of the room and know they're discussing your actions in your absence. On paper, the baby may be okay, the mother may be okay, your actions may be okay. But is that really all that matters?