I recently met with second-time expectant parents. As their three year old played with toys in my living room they told me about the parenting challenges they had weathered since the last time I was their midwife. They had a great home birth the first time around, but wondered why they had focused so much energy on preparation for birth and so little energy on preparation for parenthood.
It’s made me wonder about some things:
About 70% of expectant American parents attend childbirth preparation classes. Parenting is not the main theme in these classes, though. The common thread of all these classes is pain coping for labor. In spite of all this pain-coping practice, over 80% of these women go to the hospital and get drugs for pain relief in labor. Almost all of them will give birth to live babies that will need parenting for many years, yet parenting is seldom covered in the prenatal classes.
To me it seems like common knowledge that the early days and weeks after birth can be a fragile, challenging time. The difference between the kind of care and support home birth midwives provide during this period (many in-home visits) and the kind of “care” hospital birthing families get (next to none) is shocking. Yet, when I look at the statistics for my other web site (Two Rivers Midwifery), month after month the page about postpartum care is the least visited page. Clearly, the people who are looking for a midwife are more concerned about the birth than the support they will need after the birth.
Birth is part of our sex lives and largely driven by instinctive behavior (unless the process is manipulated by medical interventions – usually the case in America). In spite of the fact that things go well when left undisturbed we don’t usually let nature take its course and instead we go to the hospital where birth is managed and often less safe. Once we are there nearly all of us are subjected to medical interventions that cary risks for moms and babies. We prepare intensely for this event by assimilating obstetric information and practicing ways to cope with the pain. Only, most of us don’t use the pain coping practices in labor and instead opt for drugs in labor.
While instinct plays a role, parenthood is largely culturally influenced and learned behavior. Here’s something that could be influenced by prenatal classes, but it would seem that expectant parents are uninterested.
Nearly all American women give birth in the hospital. When asked why, most will say it’s because they want safety. Home birth for healthy women is as safe or safer than hospital birth in North America. According to the CIA World Factbook, May 2007, the US ranks 43rd on the world infant mortality list. This means that 42 industrialized nations (who spend way less than we do for health care per person) have a better birth safety track record. These statistics aren’t a secret.
Many women say they want a “natural” birth yet they go to the hospital and end up with unnatural births. Some of them are shocked afterwards. To me this is like going to McDonald’s and experiencing shock after being served a hamburger.