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Saturday, August 13, 2011

Traditional Care in Pregnancy

 Motherhood is what every woman dream about. Given birth to a child is the greatest gift we could ever imagine. Traditionally, across time and cultures, pregnant women have been surrounded by knowledgeable women, family, and close friends, who supported the transition to motherhood with affirmation and great excitement. Pregnant women were treated differently, given the best food, and protected as much as possible from stress and overly hard physical work. The woman knew she was pregnant when she noticed physical changes: a missed period, sore breasts, darkened areola, nausea, aversion to certain foods, and fatigue.

A woman's due date was determined by noting the start of those signs and, then, the timing of first movements of her baby. She got to know her baby through his movements. The pregnant woman was considered the expert in her pregnancy. She was encouraged to pay careful attention to her changing body, heart, and mind, and to her growing baby. Family rituals insured support during pregnancy and labor and the postpartum period. Pregnancy and birth were family events, and the care and support the pregnant woman received were from people she knew and who knew her well. Although pregnancy and birth carried more risks than today, women developed strong attachments to their unborn babies and worked with family, friends, and caregivers to insure safe passage of their babies. Life was different, healthy and free of tegnology.

Today, pregnancy and childbirth are treated as medical events rather than as normal life events. Women are treated like it is a business. It has become a money making business but at the same time a big cost to healthcare budgets.  Most women take commercial some kind of home pregnancy kits doing their own test to find out if they are pregnant or not and, then, anxiously visit their healthcare provider to confirm the fact of the pregnancy. As we know right from the start, the pregnant woman affirms that the obstetrician is the expert who must be consulted to find out every detail of how things are going.

Obstetricians are the main experts and women around the globe are bragging about their OB/GYN. Because of this, women typically worry from one prenatal visit to the next that everything is going well. “Expecting trouble” has become the trait of contemporary prenatal care. The experts GYN/OB exaggerate the risks of pregnancy and birth and increase women's fears for themselves and their babies. “Expecting trouble” has resulted in an exaggerated concern for safety, “intervention-intensive” pregnancy as well as labour and birth, and, not surprisingly, an escalating caesarean rate around the globe. Having a caesarian section has become the norm.

The days are gone of just a simple routine care and antenatal visit to the midwife. OB/GYN is doing routine sonograms, sometimes done at every prenatal visit in some countries because an increasing number of routine screening tests are considered standard antenatal care today.  Mostly, pregnant women panic if their OB/GYN did not perform such a tests. Strangely, all these tests lead to large numbers of “positive” results. In most cases, a positive screening result does not mean that there is a problem; in fact, there probably isn't one. The way to find out is, of course, to do more tests, and these further tests become increasingly invasive and risky. Most women feel pressured, once on the merry-go-round, to keep going. Women find themselves having to make decisions they never expected or wanted to be in a position to consider.

I think most women don’t realize that birth can be natural and feel that hospital birth is the normal. Most women don’t realize that even homebirth is a legitimate option because their overwhelming fears of birth and of what they hear from their healthcare provider. Most women probably found labour scary because they didn’t have the assistance of a doula, or midwife, didn’t have an undisturbed birth didn’t work through their fears in advance…nine out of then these couples were on their own, left to stumble through it alone. Now this is scary. I pray that most women become educated in childbirth. I hope women find self confidence to trust their bodies and birth and not believe in the fear by the whole “what if something goes wrong” argument. For me as a midwife, it is beautiful to watch labour progress undisturbed…labour is a challenge…