The Dark Side

by Bonita Katz, BA RN ICCE ICBD IAT CLC

Regardless of how we got into birth work, most of us stick with it because of the wonderful happily-ever-afters – snuggly babies, happy parents, new lives full of promise. But if you have done this work long enough, you have also seen the dark side – the sad moments, the life-threatening situations, the heart-rending grief.

The last couple of months I have seen much discussion about improving maternity care. Most of it centers on improving awareness and responses to medical emergencies. These are important issues that need to be addressed, but I would like to add to that list – childbirth education and support during labor as well as after birth. Yes, healthcare providers need education and training, but so do parents. One of the key components of family-centered care (often referred to in medical and nursing literature as patient-centered care) is education of the one being cared for. How can we expect parents to make informed decisions if they are unaware of what decisions need to be made?

Childbirth educators and doulas (birth doulas and postpartum doulas) are in an ideal position to help women and their families make the decisions that are right for them. We can also raise awareness of critical issues. A recent study publish in the American Journal of Obstetrics & Gynecology reveals that for postpartum mothers in California drug-related deaths are the second leading cause of death and suicide is the seventh leading cause of death. Would families – and healthcare providers – be more aware of danger signs if they knew this? And who could teach them? We can!

Besides depression, anxiety, and addiction are there other things we need to be aware of? Unfortunately, yes. Until a friend of mine asked me to do a little research last month I had no idea that one in six women is abused during pregnancy. Intimate partner violence (IPV) increases risky behaviors such as smoking and drug/alcohol abuse. Abused women are more likely to have preterm and low birthweight babies. Sadly, homicide is the second-leading cause of injury-related death for pregnant women (after motor vehicle accidents).

This is the dark side of working with new families. We will never see some of these women because they avoid care or are unable to access care. But we can raise awareness. We can offer meaningful support throughout pregnancy, during labor, and in the postpartum period. The very first goal of ICEA is to provide education emphasizing compassion, collaboration, and choice. Doing this will help us achieve another important goal: improving birth outcomes for all families in the international community.

ICEA is committed to supporting you as you support others. The work you do is vitally important. As you make a difference in the lives of each family, you make a difference in this world.

References

https://www.ihi.org/communities/blogs/behind-the-headlines-about-maternal-mortality

(https://www.ajog.org/article/S0002-9378(19)30747-1/pdf )