Statistics show that a birthing person is more likely to have medical intervention birthing in a hospital than at a birth centre or at home. Now this is likely to be for many reasons – higher-risk pregnancies for example – but there’s one that’s really worth thinking about…
Do you know the difference between a midwife and an obstretrician?
A midwife is trained and qualified to provide care and support to women during pregnancy, labour, birth, and the period after birth. They attend births of any type, whether at home or having a caesarean in hospital. A midwife’s job is to attend a birthing woman no matter what the birth, no matter what the birth setting. Yes, you have midwives working mostly on a labour ward and midwives specialising in homebirths (and so this creates differences), but they all have seen and supported physiological births at some point.
An obstetrician is a fully-qualified medical doctor, with additional training in obstetrics (labour and birth). Their training has focused on birth interventions, high-risk pregnancies and emergency situations. Did you know that an obstetrician may never have seen a spontaneous, physiological birth?
This bit’s important: let’s try and understand the perspective of an obstetrician for a moment. Can you imagine if your training had all been in emergency care during birth? You only deal with pregnancies and births where the birthing person needed or wanted your intervention and expertise. Day in, day out, you are talking about risk, managing risk; dealing with complications. You’re also working in a hospital trust: a huge machine with set policies to which you have to adhere (or else risk your job and potential litigation). You are dealing with the lives of parents and babies – it’s a huge responsibility.
How do you think that would affect your perspective of birth? Your confidence in physiological birth? I’m not saying that it’s right, but it is worth thinking about. If a birthing person presents with a problem in a hospital, which is led by obstetricians, intervention may happen sooner than say, in a midwife-led unit (birth centre). Take shoulder dystocia for example (where baby’s shoulders can get stuck after the head is born); a midwife may use different manoeuvres to change the birthing person’s position and maximise space in the pelvis. An obstetrician on the other hand, because of their training and perspective, may more readily reach for the instruments.
And… an obstetrician’s job is finished when the birth is deemed to be over (including any stitches needed and the safe arrival of the placenta). Their focus is on pregnancy and birth, not what comes after it.
There are very good, caring obstetricians out there, but I think it’s fair to say that the nature of their job means that your birth experience doesn’t factor highly for the profession as whole. They will not have to deal with birth trauma, or difficulties with recovery, or feeding.
It is perfectly possible to have a physiological birth in a hospital (or a positive birth experience of any kind). It does however, need you and your birth partner to be a little more aware of the maternity system and the professionals who are supporting you.
And it’s important to keep this perspective in mind if you have consultant-led care. Their expertise can certainly save lives, but levels of intervention have and are skyrocketing. Birth preparation will help you (and your birth partner) learn about how to empower yourselves to discuss your pregnancy and birth with your care team. It will help you feel more confident understanding your options and making decisions.
I hope you’ll come and join me on a course – I’m ready to support you.