Tonight, as I began my reading, I couldn't help but think about the task that lay ahead of me. I believe that to be a good childbirth educator, you must be an activist to some degree. This is something I have never done and am cautious about becoming. I don't want to tell anyone that my way is the right way and their way is wrong. What I want to do is inform women of the evidence while being an agent of change in the current obstetrical system. I haven't quite figured out how I'll accomplish this goal.
The articles I read tonight were originally printed in Birth, entitled "Why do women go along with this stuff?" and are a two part roundtable discussion. While the articles focused on a variety of issues, I was most struck by the overwhelming task that is changing standard obstetrical practices and making them safe for all women. As proud Americans, we often think that we have the best medical care available and obstetrics should be no exception, but we're not the best in this instance. As of 2009, there are 44 countries with better infant mortality rates, including Cuba, European Union, Italy, Taiwan, Greece, Ireland, Canada, New Zealand, United Kingdom, Portugal, Australia, Netherlands, South Korea, Israel, Spain, Switzerland, Germany, Hong Kong, Japan, Sweden and Singapore (CIA World Factbook). Many of those countries use the midwifery model of care. I believe it would be in the best interest of most women that obstetricians begin to use this model of care for low-risk pregnancies and leave the high-technology, heavy-intervention care to those at high-risk.
This is a seemingly impossible task and with good reason. Penny Simkin says "[w]e must realize that each woman is a transient stakeholder in the maternity care system..." This is so true. Most women are pregnant for a short period of their lives and don't think much about the maternity system after they are done having children. Simkin also says that "[i]t is unlikely that a powerful consumer movement will materialize, because most consumers move on to other interests and obligations after completing their childbearing. (A few thankfully, remain involved, becoming birth activists, writers, doulas, childbirth educators, or care providers.)" It is very important to keep this in mind with the difficult task ahead. The total change may not happen, but if the effort is never made, we'll never know.
In the second article, Carol Sakala of Childbirth Connection says that "women don't know what they don't know." This seems like an obvious statement, but is the reason I am becoming a childbirth educator. I had no idea how much the typical information was driven by factors and agencies that ultimately don't have mom's and baby's best interest in mind. I could go on forever about it, but I won't do that now. The issue is how do we teach women what they need to know? How do we help them sort through the enormous amount of material out there and determine fact from fiction. I can't say it enough: I don't want to make decision for anyone else, but want to make sure that families have the correct information to make their own decisions.
I'm not sure where that leaves us for now. There's a lot of work to be done and a lot to think about. My next post will focus on some interesting observations I've made about my beliefs and actions while competing The Birth Survey.
References:
Kitzinger, S., Gree, J.M., Chalmers, B., Keirse, M.J., Lindstrom, K., & Hemminki, E. (2006). Roundtable discussion: Part 1 - Why do women go along with this stuff? Birth, 33 (2), 154-158
Klein, M.C., Sakala, C., Simkin, P., Davis-Floyd, R., Rooks, J., & Pincus, J. (2006). Roundtable discussion: Part 2 - Why do women go along with this stuff? Birth, 33 (3), 245-250.
CIA World Factbook. Viewed January 18, 2010.
Monday, January 18, 2010
Monday, January 11, 2010
Where do we go from here?
It has been a while since my last post. Around the holidays, I found myself needing to sort some things out in my mind and my life before continuing with my studies. Here's where I'm at: It's ok to be done having kids. I've been pregnant twice, had two great pregnancies and have two healthy, amazing kids.
That takes care of the personal stuff. Now for the professional dilemma. To be a nurse or not to be a nurse. For the past few years, this has been the question. I am currently observing childbirth classes at a local hospital (more on this later). I have noticed that there is somewhat of a disconnect or uneasiness in the relationship between childbirth educators and doctors and nurses. I've considered midwifery, but am honestly not sure that I want that much responsibility in the birthing process. Being a nurse at a hospital may bridge the gap for me personally between childbirth educators and labor and delivery nurses and doctors, but it would not address the larger issue. Why is there tension in this relationship?
There is a nurse practitioner in the class that I am observing. The instructor admitted to her that it makes her nervous when health care professionals are in her class. I can understand why, but the childbirth educator should take pride in what she does and be confident in her preparation, knowledge and competency to be teaching.
I must admit that when I researched the certification process, I thought "certification will be a breeze." I am enjoying every bit of my studies, but am cramming a whole lot of information into the span of about 7 months. Thankfully, I am engaged in the material and able to thoroughly complete my work in the time I have. This is a lot of work. I am sure that others could skim, hand pick what they will read and still complete the certification process. I am currently enjoying life as a sponge. I'm taking in everything I can. This is a passion. This is a journey. This is a lifetime of work. Certification is not a breeze, at least not for me. It is 100% worth it. With all that being said, I feel as though I will be prepared for the tasks that lay ahead. I will definitely have "first time jitters" and learn as I go. I don't claim to know everything and will always have something to learn. I hope, however, that by the time I'm 10+ years into my career, that I don't let health care professionals intimidate me.
No, this is not a degree. That is a little bit of a struggle for me and a place where I can see the doctor/nurse/childbirth educator relationship becoming a little hairy. I do have a degree in math, a certification to teach and soon a certification in childbirth education. With all that though, I think that we should all be able to find our place in this relationship. With collaboration, big changes could and should be made. It's not about the relationship of "childbirth professionals," it's about families expanding and supporting them throughout that transition as a team.
With all of that being said, I wonder if I should become a nurse a few years down the road or stand tall and proud as a confident childbirth educator without being a nurse. So many educators and future educators have what I've heard described by one as "nurse grief." I get it. But, how do we fix it.
I am currently 4 classes into a 7 week childbirth series. The first 3 weeks were great. Everything seemed to jive with what I was learning. This past week, we talked about the birth and hospital procedures. I was disappointed in the way that some information was presented, as it was clearly indicative of hospital policy and not necessarily the best interest of mom or baby. I would take a position as a childbirth educator in a hospital, but will work towards private practice in the future. There has to be a way to reach women outside of the hospital and make them aware of the evidence and their rights before they have to make choices. Many people are not aware that there are choices. I've said it again and again, it's about making the right choices for you and your family. You can't make the right choice without factual information. It is far too easy to teach to hospital policy, much like the teaching to the test I experienced as a public school teacher. I don't think I can do that again. It's not fair to the educator and it's definitely not fair to the student. I have to do more digging on the hospital's policy regarding the childbirth education classes. I'm not sure whether there is a set curriculum or if it is left to the individual instructors.
I am so thankful for the opportunity to observe and the instructors willingness to answer questions. I am thankful for her asking for my opinion and input when she feels like it would be helpful. I am learning a lot and getting some great ideas on instruction techniques. While I don't think courses should be taught according to hospital policy, I do see where it would be helpful to know what is standard in the setting that women will be giving birth. Equally important is to know that "standard" doesn't mean "necessary." I'm anxious to see if and when informed decision making will come into play in these classes.
That should be enough for now! I hope to be back more often now that I'm back on track with my studies. I'm making great progress and looking forward to what this profession has in store for me.
That takes care of the personal stuff. Now for the professional dilemma. To be a nurse or not to be a nurse. For the past few years, this has been the question. I am currently observing childbirth classes at a local hospital (more on this later). I have noticed that there is somewhat of a disconnect or uneasiness in the relationship between childbirth educators and doctors and nurses. I've considered midwifery, but am honestly not sure that I want that much responsibility in the birthing process. Being a nurse at a hospital may bridge the gap for me personally between childbirth educators and labor and delivery nurses and doctors, but it would not address the larger issue. Why is there tension in this relationship?
There is a nurse practitioner in the class that I am observing. The instructor admitted to her that it makes her nervous when health care professionals are in her class. I can understand why, but the childbirth educator should take pride in what she does and be confident in her preparation, knowledge and competency to be teaching.
I must admit that when I researched the certification process, I thought "certification will be a breeze." I am enjoying every bit of my studies, but am cramming a whole lot of information into the span of about 7 months. Thankfully, I am engaged in the material and able to thoroughly complete my work in the time I have. This is a lot of work. I am sure that others could skim, hand pick what they will read and still complete the certification process. I am currently enjoying life as a sponge. I'm taking in everything I can. This is a passion. This is a journey. This is a lifetime of work. Certification is not a breeze, at least not for me. It is 100% worth it. With all that being said, I feel as though I will be prepared for the tasks that lay ahead. I will definitely have "first time jitters" and learn as I go. I don't claim to know everything and will always have something to learn. I hope, however, that by the time I'm 10+ years into my career, that I don't let health care professionals intimidate me.
No, this is not a degree. That is a little bit of a struggle for me and a place where I can see the doctor/nurse/childbirth educator relationship becoming a little hairy. I do have a degree in math, a certification to teach and soon a certification in childbirth education. With all that though, I think that we should all be able to find our place in this relationship. With collaboration, big changes could and should be made. It's not about the relationship of "childbirth professionals," it's about families expanding and supporting them throughout that transition as a team.
With all of that being said, I wonder if I should become a nurse a few years down the road or stand tall and proud as a confident childbirth educator without being a nurse. So many educators and future educators have what I've heard described by one as "nurse grief." I get it. But, how do we fix it.
I am currently 4 classes into a 7 week childbirth series. The first 3 weeks were great. Everything seemed to jive with what I was learning. This past week, we talked about the birth and hospital procedures. I was disappointed in the way that some information was presented, as it was clearly indicative of hospital policy and not necessarily the best interest of mom or baby. I would take a position as a childbirth educator in a hospital, but will work towards private practice in the future. There has to be a way to reach women outside of the hospital and make them aware of the evidence and their rights before they have to make choices. Many people are not aware that there are choices. I've said it again and again, it's about making the right choices for you and your family. You can't make the right choice without factual information. It is far too easy to teach to hospital policy, much like the teaching to the test I experienced as a public school teacher. I don't think I can do that again. It's not fair to the educator and it's definitely not fair to the student. I have to do more digging on the hospital's policy regarding the childbirth education classes. I'm not sure whether there is a set curriculum or if it is left to the individual instructors.
I am so thankful for the opportunity to observe and the instructors willingness to answer questions. I am thankful for her asking for my opinion and input when she feels like it would be helpful. I am learning a lot and getting some great ideas on instruction techniques. While I don't think courses should be taught according to hospital policy, I do see where it would be helpful to know what is standard in the setting that women will be giving birth. Equally important is to know that "standard" doesn't mean "necessary." I'm anxious to see if and when informed decision making will come into play in these classes.
That should be enough for now! I hope to be back more often now that I'm back on track with my studies. I'm making great progress and looking forward to what this profession has in store for me.
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