An Alternative Childbirth© promotion for women to make well-informed decisions during the childbearing year.

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Latest Activity: May 11, 2010

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Discussion Forum

Education for CPM

Started by Rachel. Last reply by Emily Neiman, CNM Jan 17, 2010. 50 Replies

I'm just curious if anyone knows what kind of education CPM receive in their state. I am also wondering how it compares to those in Europe or Canada.

Birth Blog Roll

Started by Rachel. Last reply by Andrea Rose Jan 11, 2010. 6 Replies

Please add any blogs/websites here that you know of that discuss birth/labor. All view points welcome.

What are your views about the Modern Maternity Care System?

Started by Vanessa Simmons. Last reply by Rachel Nov 13, 2009. 4 Replies

I am interested in getting some real-time feedback from others about their "views" in regards the system that is already in place for the average American woman giving birth.…Continue

Tags: modern-maternity-system-views, giving-birth-in-America

Comment Wall


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Comment by Kaitlin Rose on January 2, 2010 at 5:06pm
In order for women to care more about birth, they need more information in regards to the natural process of labor and delivery, as well as to be educated and informed about elective induction, the side effects and risks of Pitocin and epidurals, as well as c-sections, especially scheduled.

What is the best way to inform and educate women? Media and marketing. I think we have to target them rather than the doctors, since the doctors' education is so deeply ingrained.
Comment by Cherylyn on January 2, 2010 at 3:47pm
Financial incentives? Sorry, that was my cynical side. I'm really not sure.
Comment by Rachel on January 2, 2010 at 9:54am
So, the question is, how can we encourage both women and doctors to care more about informed consent?
Comment by Cherylyn on January 2, 2010 at 9:20am
I found an article that talks about informed consent: Prenatal Testing and Informed Consent

Here's part of it that I like:

"Informed consent means much more than just showing up for a scheduled ultrasound or amniocentesis. You have the right to:

Understand in detail how the procedure is administered.

Understand all the risks associated with it.

Know what the alternatives are: is there another test or procedure that poses less risk?

Carefully consider the physical and emotional impacts.

Feel free to say no to any tests you don't feel are necessary.

Before you can decide to give informed consent, you need to understand the tests and procedures that are routinely administered during pregnancy-ultrasound, the triple screen, amniocentesis, and chorionic villus sampling."
Comment by Cherylyn on January 1, 2010 at 5:48pm
I'd like to clarify my last statement. I didn't mean it in any demeaning way. I have friends who love their epidurals and all the interventions they can get, including c-section. When I try to talk with these friends about other birth options they tune me out the moment I bring it up. They usually tell me things like "You're crazy" or "I could never do that" and they don't even listen to anything I say about it, and I feel I've just wasted my breath even broaching the subject. It's so refreshing to get online and interact with other ladies who are looking for options and better ways of birthing.
Comment by Cherylyn on January 1, 2010 at 4:54pm
Emily, I'm so grateful for midwives like you. I do wish every woman could be educated completely on pregnancy and birth and know their options, but I also understand that some women frankly don't want to know and would rather just trust the system. Ignorance is also a choice.
Comment by Emily Neiman, CNM on January 1, 2010 at 4:44pm
Thanks ladies! I agree that most women are content with the care that they receive (our practice definitely gets the women who are looking for something different). And it's fine if they're content with that.

I just want the women in my practice to know the risks and benefits of every option and to make an educated decision.
Comment by Cherylyn on January 1, 2010 at 4:19pm
Emily, I really appreciate your input, and I agree with both of you. I found in my varied birth experiences that I had to ask for what I wanted, and most of the time I was given what I asked for, within reason and protocol ;)
Comment by Rachel on January 1, 2010 at 4:05pm
Emily, I agree with you. I think many women don't know they have choices to make though. For instances I told one of my friends that I try and make sure that the women I take care of are able to have fluids, she was surprised that that was even a choice.

In reality, most women are content with the care they receive and don't say anything. They don't even know that there is something different. And care for women is really not going to change unless women demand it. I guess that's the problem we have.
Comment by Emily Neiman, CNM on January 1, 2010 at 3:52pm
I hope that I don't get jumped on for saying this, but I feel strongly that it falls to the woman to choose a caregiver with whom she feels comfortable and trusts in order to have both informed consent and to have her decisions respected. I do wish that we had more providers who were upfront with their clients, but that does not seem to be the trend in this country.

I'm a CNM working in a part of the country where midwives are not particularly well-respected. However, my partner and I both make it clear that while we cannot guarantee an intervention-free birth (we attend deliveries in a hospital after all, and it's just not the most likely scenario), nothing will be a surprise during labor and delivery. We spend copious amounts of time during prenatal visits discussing what will happen in labor and delivery. We talk through hypothetical situations and about what would be our suggestions during labor and delivery. We also make it clear that it is their body and their birth, and that we are not going to hold them down and force something on them.

Our clients know that we will do everything in our power to respect their birth plans and that we will try everything to ensure a natural labor and birth. I think the key to having that relationship with your care provider is that you trust them enough to intervene when it really is necessary (and sometimes, despite everyone's best intentions and efforts, intervention is needed).

In my experience, the policies and regulations at hospitals are very bare-bones. It is the provider who determines how far beyond the policies they want to go with their orders. For example, the hospital I attend deliveries at has policies for both intermittent monitoring and waterbirth. However, we are pretty much the only providers in town who will "allow" our clients to use these policies. Other providers go above and beyond by ordering continuous fetal monitoring and no hydrotherapy. It's important for women to understand that their provider is the one giving the orders. The nurses are just the ones following the orders. Additionally, I am at the hospital with my laboring women the entire time so I am able to run interference and make sure that the women are not attached to the monitors and are up and out of bed. The docs don't usually come in until it's time to deliver the baby...

Just my 2 cents :)

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