Between heart attacks, hormonal birth control, and maternal mortality, you do not have to dig deep to find stories of women falling through the cracks of our medical system. It is so bizarrely upsetting that we live in a reality where we cannot trust the status quo in health care to keep us safe and healthy. In some ways, though, what an amazing opportunity this provides. We are being forced to learn more about health from a variety of sources and then, find, and trust our own instincts in concert with mainstream medical advice. As someone who supports women through the perinatal experience, I see this as being critical during pregnancy, birth and the postnatal period. Is there a time more anxiety provoking then when you have to start making decisions on behalf of a tiny new human?
As soon as you get pregnant you’re hit with advice and information, left and right. It is not always clear how to make your way through the noise to find a path that feels right for you. This is even more complicated by the fact that there is no standard of care when it comes to medically supporting someone through pregnancy and birth. Should you get genetic testing, ultrasounds, or monitor the baby’s heart rate during labor? What leads to the safest outcomes? Does epidural medication get to the baby during birth? Can you eat and drink in labor or not? Is a cesarean really worse for mom or baby than a vaginal birth? Will having a doula mean your husband just has to sit on the sidelines? Can you go six weeks after birth without seeing a medical provider? It all depends on who you ask. So. Que: brain explosion.
I became a doula in 2011 in order to regain the wisdom of birth for the women in my community. I was seeing, again and again, how completely overwhelming it was for friends to navigate pregnancy and wanted to understand the history and biological process of childbirth in order to help them think things through. A one-weekend training turned into quite a career as I have continued to learn just how desperate expectant parents are for trustworthy and straightforward information. Information that could literally be the difference between life and death. Or said less severely, information that could be the difference between surviving and thriving.
Not all cases are as extreme, but Serena Williams’ birth story speaks volumes to the intensity of this time period. If you haven’t heard Serena Williams’ story, her daughter was born via unplanned c-section, and the morning after Serena nearly died due to a blood clot. Luckily, she suspected the clot when she began feeling short of breath, and immediately pressed her doctors to give her a CT and heparin drip (a blood thinner). She knew her body (she had a similar experience, previously), advocated for herself and saved her own life. Given the maternal morbidity rates in our country, Serena Williams was unbelievably not a fluke experience. In fact, NPR and ProPublica recently reported Black women in particular being 12 times more likely than white women to die due to childbirth regardless of socioeconomic status.
What do you do with this information? You do you!
When you have not been pregnant or given birth before, it is hard to separate instincts from anxiety. How can you find and trust your instincts? First surround yourself with experienced and thoughtful experts. We know that where you choose to have your baby is the greatest factor in whether or not you will have a cesarean but your whole village can determine how you feel about your pregnancy, birth, and body. Interview doctors (this is not the time to just take a recommendation from a friend). Consider hiring a doula (I typically say you know you need a doula if you’re not the kind of person who would send food back in a restaurant if it came out wrong). Take a good comprehensive childbirth education class. (The good ones are totally worth it). And use your BRAIN.
In my classes, I teach the acronym BRAIN for navigating medical environments.
When faced with a decision to make, ask yourself:
What are the Benefits?
What are the Risks?
What are my Alternatives?
What does my Instinct/Intuition tell me?
Do we have to do this Now or can I do Nothing?
There is a similar acronym floating around. Be a BRAT. (Benefits, risks, alternatives, time). Besides the negative connotations of that word, I much prefer BRAIN for the inclusion of “I”. Had Serena Williams not trusted her instinct and intuition and spoken up, or had she waited longer for medical assistance, she would never have made it home to her daughter. That’s what makes her story so powerful.
It’s scary and unfortunate that we have to prepare to navigate a medical community. As if preparing to cope with contractions, pushing, breastfeeding, and raising newborn were not enough. But, having practiced using my BRAIN for myself in labor, my mother through Lymes disease, and two children through all that comes with parenting, I have grown to appreciate this simple framework for thinking and ultimately trusting myself.
Written by: Ashley Brichter