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Volume 5 Issue 4

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Page 42 | Abby's Magazine - www.AbbysMag.com legal environment of their profession that they have stopped a ending births and instead are focusing solely on gynecology. Recently I've even had several OBs contact me to learn how they might be able to prac ce in a more "holis c" woman- centered way. They want to love and trust birth again! To Be Fair, e Home Birth Model is Not Perfect Either Lest you think I am on a doctor-bashing rampage here, please let me remind you, I am a physician. I've seen birth from unique vantage points. I've been through conven onal medical training and am part of "the doctor club." And I'm also a midwife. I really have no agenda other than to see women receive the best possible, most respec ul care available, and to see us able to receive that in the se ng in which we feel safest giving birth. I do believe this can happen in hospitals. I recognize the many women prefer to birth in hospitals, and some must for medical reasons. These women s ll deserve to retain their autonomy, and to have unnecessary interven ons minimized and safe and respec ul prac ces maximized. Women can be partners in their care, not subjects of it. As a midwife with 30 years of experience in the birth community, I will also readily admit that there are quite a few not so great home birth midwives contribu ng to not so great birth outcomes. In fact, in reac on to the problems found in medicalized birth se ngs, there's a bit of a midwife 'wild west' out there – anyone can get "the calling," a end some births, and call herself a midwife. Caveat emptor! It's not black and white. A poorly planned home birth or a less than competent midwife (or physician, though most home births are a ended by midwives), in the rare event of a complica on, can be disastrous. There's no roman ciza on about that from me – I've been in the birth trenches for 3 decades and I know some firsthand horror stories from the mouths of the moms and midwives themselves! Can the Birth Climate Change? A healthy, respec ul atmosphere could exist in which the choice of birth place is depolarized and women are supported in making the choice that is best for them and their babies. In fact, ACOG and the American Associa on of Pediatrics have recommended that this be the case amongst their members. Honest informed consent, with accurate disclosure of the best available evidence to pregnant and laboring mothers could occur. Midwives and OBs alike should honestly disclose their beliefs, prac ces, compe ng demands, experience levels, and outcomes. Women can be respected as intelligent clients capable of making smart choices, rather than being treated as helpless pa ents. Cri cal self-reflec on and communica on with a common goal of providing op mal maternity (and neonatal) care in all se ngs is key — and achievable — if we can remove emo onal hyperbole, and actually listen to the concerns of all involved. I believe there is more common ground than difference. Birth can be seen as a healthy, natural, normal experience – unless evidence- based medical indica ons demonstrate otherwise, and in those cases, the least amount of interven on necessary could be judiciously provided. And roman cs aside — medical interven ons are some mes needed even in healthy moms who have eaten all the right foods and thought posi ve thoughts! Healthy rela onships could be established between the medical community and the midwifery community, and women could be supported in their choice to have babies at home, while being welcomed seamlessly into a medical se ng should problems arise necessita ng that care be transferred to a medical team. Be er yet, there could be con nuity of care in which there is no separa on between birth models – where the only care offered to women is compassionate, respec ul, and centered on the woman's wishes, needs, beliefs, and best interests. In fact, this is the type of care I have tried to provide my midwifery clients and my medical pa ents alike – and I know it is en rely possible! All choices and op ons can be respected. And birth itself can be respected as a natural process that offers women a powerful opportunity for empowerment. It is my hope that your birth experiences leave you feeling empowered and whole, regardless of where or how you bring your baby into the world. I would love to hear your thoughts on this important topic! Please leave comments in the sec on below. I will do my best to respond to as many as possible. And please talk with each other – there is so much this community of women can share to help support and empower each other!

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