By Ana Paula Markel

In this day and age of media and busy schedules, first time parents are bombarded with images and articles about childbirth. It becomes very hard for one to prepare for the birth of a baby without images on TV that most of the time portray the birthing process as either medieval torture or ridiculous comedy.

The United States has one of the highest induction rates, in some hospital nearly 50% of women do not go into labor on their own, and with that a very high epidural rate and cesarean rate (approximately 34% in the US); more than double of what the World Health Organization recommends (10-15% in developed countries). And that is not even the worst. Not only are the cesarean rates high but our NICUs (neonatal intensive care units) are full, so whatever we are doing here… it is NOT working.

Luckily, not all media is bad, and women are learning that the childbirth movement is a human rights issue. Women do have the right to:

1. Be treated with respect
2. Be informed with evidence about their care in labor and in postpartum

Women are finally understanding that birth belongs to them and their families. Childbirth is not a medical event. A woman is never healthier than when she is pregnant. And yes, of course complications could arise, but that is when appropriate medical or midwifery care becomes important, mostly if the mother and her caregiver have an open, honest, and clear relationship.

Here are some of 5 things a woman can do to optimize her chances of having a joyful experience:

1) Choose your care provider carefully.

A midwife or a doctor are ultimately the ones who will make the medical decisions regarding a woman’s care during labor. They are the ones that sign the birth certificate and are in charge of the well being of the mother and baby. Research the best care provider for you, the one that matches your philosophies about the birth process. Some care providers have a very paternalistic relationship with their patients, and that is not wrong or bad if you want someone who will take charge of the experience and make decisions for you…

I do have to say that as a working doula, that is definitely not where the majority of women are these days. Women want to have a voice and say in their care, so hiring a provider who listens to your needs, respects your views, and explain things in terms you can understand will definitely impact how you feel about your experience.

Ask potential care providers how much time they spend with women in prenatal visits, how they view women’s position in making decisions for their care and birth, and mostly if they enjoy attending births even if in the middle of the night, on weekends and holidays. Share your views on childbirth and note how they respond, not only what they respond. Do they seem excited by your questions? or annoyed? Are they defensive or appreciating the dialogue. Ask your friends, ask women on random pregnancy lists and lastly, ask the doulas in your community. Doulas know all and tell all, which brings us to number 2…

2) Hire a doula.

Evidence is clear that doulas have an immense impact on the woman’s experience of her birth. Studies have shown that the presence of a doula (professional labor support and information) will decrease cesarean rates, induction rates, and medical interventions.

But mostly, doulas help improve birth satisfaction by asking mothers what they want and listening to them. Doulas are also incredible facilitators and mediators of conversations between the woman, her family, and her medical team. They do not make decisions for clients or they speak for the woman, but they certainly inform women of pros and cons and risks and benefits of every possible option, allowing the mother and her partner to make informed and conscious decisions. Doulas are supportive of the woman and her wishes regardless of whether she chooses medications or medical procedures or not. Doulas do not judge. They inform, support and mostly listen.

3) Choose your birth nest wisely.

Humans are cute and fancy mammals because we can think and that is fabulous… until we go into labor. Other mammals seem to have shorter and less complicated birth than ours and mostly because they do not think, but rather act on instincts. In order for a woman to allow this primal self to come out she needs to feel SAFE. Mammalian birth is all about safety. Women birth better where they feel safe – and that is why hospital birth is not for everybody and homebirth is not for everybody.

A woman needs to consider what does she need in order to feel safe? Quietness, prayer, people she trusts around her, equipment, skilled professionals, an OR next door? Regardless of what her answers are, they do not mean anything if the place she is planning to birth does not offer that. Most women these days are somewhere in between – they want freedom to move and cope with labor and reassurance that the baby is coping well with labor. That is common sense. A simple hospital tour may answer your questions, but asking the community is vital for you to be certain your birthing location is just right for you.

4) Create a sense of community.

Find a supportive community that trust birth, that listens to and honors your wishes. Think about our ancestors, regardless of where we come from. Women have always surrounded themselves with a village of support. Aunts, grandmothers, cousins, neighbors. In our modern lives we are focused on tasks, schedules, and work. Pregnancy is a time to reclaim your village, to connect with other women who are going through similar situations and the ones who have gone before us. Birth is a right of passage, and even big city, evolved, accomplished professionals need the support of their community

5) Practice flexibility. There is a lot we can plan about birth, but there is a lot we cannot. One of the most beautiful things about birth is that we do not control it. We can’t control nature, we respect it, protect it and allow it to amuse us. It is the same with birth. Every child comes with a unique story that will ultimately equip parents with tools that they acquire in labor.

And lastly, enjoy yourself. Take time to do research, read evidence based information but do not let this process consume you as if birth was a college course. Childbirth is a very simple process, by hiring a team and place you trust you will find time to enjoy this unique and special time in your life.

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Originally from Brazil, Ana Paula Markel is a childbirth educator, a certified doula with DONA (a leading doula organization), a DONA-approved birth doula trainer, and a certified childbirth educator through ICEA (International Childbirth Education Association). She is the founder of Bini Birth, a center in Los Angeles dedicated to childbirth education classes and workshops, doula training workshops, parenting
classes, doula referrals, and green pregnancy retail. Ana Paula created Bini to fulfill her life’s mission to comfort and spread evidence based information and joy about the birth and parenting process. She lives in Los Angeles with her husband and four healthy, happy, and vibrant kids.