Back in March the American Journal of Obstetrics and Gynecology released q study that confirmed what a lot of midwives and doulas (and yes many OBGYNs) have been saying for a while. Pregnant people need more time to push. In fact, the study proved that if women and pregnant people were given as little as one extra hour to push their rates of unplanned C-Section went down by roughly half. HALF!
According to the Huffington Post article about the study, while this information has he potential to radically change how people give birth in the U.S, it may not actually amount to concrete change. Author Catherine Pearson writes, while the study is small, it's "unlikely to fundamentally change medical norms any time soon, researchers say it offers a much-needed critique of potentially outdated standards."
Just how outdated are the standards you may ask, well the allotted time a woman is "allowed" to push was adopted in the late 1800s. “[The time recommendation] came from expert opinion from the 1800s,” said Dr. Alexis Gimovsky, a fellow in maternal fetal medicine at Thomas Jefferson University in Pennsylvania, and an author on the study. “Since then, there’s really only been retrospective data used to validate that guideline.” In the 1950s, researchers looked over earlier data and found that women who delivered their babies within two hours had lower rates of infection and serious postpartum bleeding, for example. In 1955, another team concluded that most women without anesthesia give birth within two hours."
So what does this all mean? In my opinion it goes back to the idea of B.R.A.I.N, being armed with knowledge, and being confident that your body knows how to give birth.
As a review B.R.A.I.N is an acronym I suggest pregnant folks and couples start to using during prenatal appointments with your caregiver.Using it early on in pregnancy and frequently helps you get accustomed to the process of coming to your care provider with questions and being ready with responses that are best for you and your baby. Frequently using B.R.A.I.N also is great so that when something is suggested during labor, you're ready to ask:
B: Benefits - What are the benefits of doing this?
R: Risk -What are the risks of doing this?
A: Alternatives -What alternatives do we have?
I: Intuition/Instinct - What's your gut say?
N: Nothing - What happens if we do nothing?
I will close by saying that there are many reasons that birth visions fall off track and interventions and potential c-sections are how some babies are born. I like to say that there is no "right" or "wrong" way to give birth. And this evidence-based information about not rushing into pushing and giving you, the person giving birth, time to ease into pushing and to let pushing happen can result in the birth you vision.
The topics of pregnancy and birth seem to be open season for anyone and everyone to give an expectant mother information; solicited or otherwise.
All of a sudden your mother, mother-in-law, Great Aunt Mildred, your barista, cashier at Whole Foods, and yes, your doctors and nurses and doulas have become experts on what kind of birth is best for you.
"Both you and your sister were big babies, it's genetic, you'll need a c-section too."
"I wanted a natural birth, too. But after 5 hours of labor, I bet you'll be screaming for an epidural."
"An epidural is safe, and it allows you to rest during your labor."
"The drugs are there for a reason!"
"Don't be a hero, you don't have to have a natural birth!."
With so many choices, how are you supposed to decide what's right and what's wrong? You use your B.R.A.I.N.
I've often seen the B.R.A.I.N acronym used in relation to the labor process when interventions are offered to a birthing mother, but I think it has merit in pregnancy as well.
So what is B.R.A.I.N anyway? I'm glad you asked :) When someone (anyone from your neighbor to your provider) brings a suggestion for your birth or pregnancy ask yourself the following questions:
B-What are the Benefits
R-What are the Risks
A-What are the alternatives?
I-What does your Intuition say?
N-What happens if you do Nothing.
It's my opinion that no one is trying to scare you or deter you from your wishes when you are pregnant. Most unsolicted suggestions come because some cares, or they want to share their story. It can get pretty loud with all of these suggestions coming at you at once. So, this Tuesday Tip is to use your B.R.A.I.N
What more information that's Evidence Based. Check out one of my favorite resources, Evidence Based Birth.
Hi there! I'm Erika Davis and I'm a doula working in the Seattle and South Puget Sound area.