mom blogs
April 19, 2024

Midwife advises: Do not give up at the delivery room door!

Woman with fine senses: Jana Friedrich, author of the midwife blog, at work

Our blog favorite: Jana Friedrich lives in Berlin, is the mother of two children and has been working as a midwife for 14 years. Previously, she advised her pregnant women, "Do not read the internet!" Until she decided to provide better information with her midwife blog. Here we get tips, inspiring stories and exciting facts about having children - without dogmas and scare tactics.

Self-determined birth: (how) does it work?

I do not know how many birth patterns I've heard and seen in my life. But whenever people hear about my job, they start talking too. These may be young women who have just given birth, or older women who have been around for a long time. But the experience of birth? is it positive or negative? burns into your memory.

Beautiful births are told with bright eyes. The women then report an incredible sense of happiness, the strength and self-confidence that gave them this event. The others, who did not run so well, often say, "If I had had a home birth, it would have ended badly." Is that true? I say: "In the vast majority of cases, that is nonsense!" I go even further and claim: Some of these births would have been much better at home! And women, who would have complications, would have been transferred to the clinic. In need of blue light.

No, this will not be an article per home birth. I will write it another time. But the comparison of hospital and home birth makes a few things very clear.

Birth patterns are not preprogrammed

The German Midwives Association wrote in 2002 in the "plea for normal birth":

"The vast majority of all births in Germany take place in clinics (98%). In about 90% of all births, interventions are routinely performed, such as venous access, opening of the amniotic sac, too early pressing instead of active pushing, episiotomy and Kristellerhilfe, { ...} In addition, about 25% of all children are delivered by Caesarean section or vaginal surgery, and the cesarean section on request is increasingly being discussed and offered as an alternative to spontaneous birth. "

Does that sound self-determined? Of course, apart from the desired Caesarean section, none of these interventions is intended. So the question is whether and how these measures can be prevented.

Action? reaction

It is very rare that complications just pop out of nowhere. As a rule, an unfavorable course begins. No matter whether at home or in the clinic.

When I am told of births, at some point comes the point "of no return", which is intervened by the clinic staff in the birth event. This does not happen with malicious intent or even lack of empathy, but on the basis of guidelines that have to be complied with easily in hospitals for legal reasons.

An example: In a woman, the cervix already opened a few centimeters at birth. Then the events stagnate. As a consequence, the clinic will certainly be followed by a sore eye. The birth is in progress and should continue. It is therefore intervened in the birth process.

At home, of course, there is no vacuum. The midwife would find that the body needs a break and the woman to stop just to rest.

The woman with the weeping drop may be exhausted too. But her body is not granted this break. So she has to endure further rising labor, although she really does not have the strength to do so because of tiredness: So she needs a painkiller! And by laying a PDA is thus the next intervention .... And so it goes on.

To make sure

Many birth patterns usually only take a new turn through medical interventions. We in the clinic, both doctors and midwives, of course, know that too. But we are, through the knowledge of the legal consequences, simply restricted in our actions accordingly. Because the logic is unfortunately simple: As far as I know, has never sued a doctor who has followed the guidelines exactly. Not even if the course was foreseeably unfavorable.

"More interventions and technique do not achieve better birth results." (German Midwives Association e.V.)

Do not be scared of bad birth reports so please! Of course there is a destiny component that you can not influence. But in obstetrics, one's own attitude and the quality of birthing often play a crucial role!

If a woman clearly states what she wants and what she does not do under childbirth, then often a lot is possible.

So you have a lot in your own hands: It is always possible to question measures and show alternatives, except in real emergency situations. Often there are some. The vacuum, from the example above, could have been completely rejected.

When a woman clearly and clearly states what she wants and what she does not do under the birth, quite often a lot is possible. At least that's the way it is in my clinic!

Less is more

This does not mean that I fundamentally reject conventional medicine and its technology. I like to work in a clinic myself and am glad that I live and work today and not just 100 or even 1000 years ago. But in my opinion we have reached a point in our society where obstetrics can not be improved by still "doing more". But maybe exactly the opposite. Even the German gynecologist and scholar, Professor Dr. Willibald Pschyrembel (1901-1987) said:

"You have to know a lot in obstetrics to do little."

We know a lot about everything, but we do not do that much, so unfortunately we have forgotten something.

Naturally ? but fast

And not only the medicine, but also the women themselves have often forgotten to wait: Hardly is the due date reached, do you want to be initiated? sometimes even before. And during childbirth they often demand measures to speed things up. The will to wait for natural processes does not have many. If you ask them "Of course?", It says, "Yeah sure!" But it should be short and painless anyway.

The "normal" birth

But what is normal? In the "plea for a natural obstetric" from the BDH states:

"Midwives know that 'normal' in the sense of 'undisturbed' or 'natural' is not always the prime criterion for a woman when deciding on a place of delivery or a form of childbirth. to choose for herself what kind of care and birth she wants, but in order to be able to make well-informed decisions, she must first have been sufficiently informed: a low-intervention birth should be available as a choice, also in the clinical area. " (P.E. Treffers 2000).

Probably the numbers in the obstetrics are also so good because women who decide for a home birth, have long and thoroughly dealt with it. By talking to her midwife they just know exactly what to expect. On the page of the Quag e.V. ("society for quality in the non-hospital obstetrics") it says:

"More than technology and medical support, these women trust their own competence, intuition and strength as well as the expert assistance of a midwife to give birth to their child undisturbed in their own rhythm."

So 98% of all women, those who opt for the clinic, have bad conditions for a "normal" birth right from the start? Or do we just have to redefine "normal" just once again? The WHO (World Health Organization) states in its "Recommendations on normal birth" ** that

- Every woman has a basic right to comprehensive care during pregnancy. - Focus on all aspects of this care and participate in the planning, implementation and evaluation of the precautionary measures. - In addition to medical care, social, emotional and psychological factors are crucial for comprehensive care during pregnancy.

Of course, I do not think that we can always start from these ideal conditions, but at least the structures are already there.

Optimal conditions

In the fall of 2012, I took part in the DHZ Midwifery Congress. The motto: "midwifery art - the salvation of normal birth". Ina May Gaskin, midwife and alternative Nobel Prize winner, was one of the speakers. She pointed out to us how well we have it here in Germany. Unlike many other countries. And she did not mean developing countries. We have:

- The possibility of comprehensive midwifery care at every stage of pregnancy? paid by the health insurance! - The opportunity to attend a birth preparation course? is at least paid for the woman, but increasingly also for the partner. - Free choice of place of birth (clinic births are partly compulsory in other countries) - The possibility of midwifery care in childbed? also paid!

For example, American women who do not even have a midwife present at birth are dreaming of these rights! So there are some ways for us to deal with the upcoming birth event and to arrange things accordingly.

Conclusion

Self-determination could be the new normal! The self-determined birth is possible, necessary and absolutely recommendable. Do not just give yourself up at the delivery room door!

More and more women come with small "wish lists" for registration. I think that's good.Of course, a birth can not be planned in detail. But you can already set some points. It is your birth! Think about what's important to you. Then you have the best chance of a nice and good birth experience.