Honesty in Birth Preparation

Last month I read a book by Elizabeth Noble called Childbirth with Insight. This book was published in the 80's, but has a great deal to offer birth educators of today.

One if the sections I particularly liked addressed the issue of being honest with childbirth education students about common obstetric practices:

"...instructors in the community cannot afford to discuss obstetric practices in ways that will aggravate local hospitals and obstetricians if they wish to fill their classes. One childbirth educator comments, 'Imagine if we told couples how it really was...perhaps we'd lose fewer teachers from our group.' No wonder many of these dedicated and enthusiastic teachers suffer 'childbirth preparation burnout.' They are caught in a triple bind. If they describe accurately how birth is managed in some hospitals, couples would become very fearful. If expectant parents anticipate a warm and flexible birth environment and find that such is not the case in the hospital they use, their disappointment is inevitable and bitter. If the instructors advocate childbirth without drugs or anesthesia and these are needed, parents may harbor feelings of guilt and failure."

The author concludes this segment of the discussion with a very potent and powerful message to birth educators:

"Each instructor must teach what she knows in her bones to be true. A dynamic teacher is constantly changing, becoming more self-aware. At the same time, couples must be warned that almost all hospitals and doctors have expectations based on the mechanical model of birth." [emphasis mine]

I identified with this section of the book because I find it a difficult line to walk sometimes--to encourage confidence, trust, and joy in childbearing, while being straightforward about the challenges couples may face when seeking a natural birth experience in a hospital. I always encourage couples to "assume good intent" from hospital staff--they offer medication because they feel like they are helping. I also remind them that routines are powerful and if the majority of births occurring at a specific hospital are induced, medicated, heavily intervened with, etc. it can be difficult to buck the trend. Again, not out of some sketchy motive from hospital staff, but simply because of routine or "this is what we always do" or "this is what mothers want from us."

--Molly Remer