Sunday, December 26, 2010
Obstetric Myth #98- You Are High Risk
Any woman, if tested sufficiently, and stressed enough, can become high risk while pregnant. I truly believe this.
I have talked to women who are high risk for a variety of reasons: previous miscarriage, age, weight, gestational diabetes, prior c-section, high blood pressure, their own choices, their own fears, and many many more. I have also seen many of these women go on to have totally natural births, even at home, and do it seemingly easily.
I also must say, just to be honest and straight forward about where I am coming from, that I find the current obstetric model of "care" that basically involves five minute visits and every test imaginable, laughable and not really care at all. I think it is preparation for birth fear, not trusting your body, and a very sorry replacement for real prenatal care.
(What should actual prenatal care consist of? We will talk about that later.)
First- a story-
I was chatting with a relative the other day. He happens to read my blog and so is always telling the ladies he knows about the benefits of natural birth and the like. He happened to know somebody who was currently pregnant and was "high risk."
Now those two words make me want to grind my teeth every time I hear them. What better way to prepare a woman for her inability to birth without technology than to tell her from day one that she is an accident waiting to happen?
This mama had the sad misfortune of being (gasp) 40!!! Not only that, to top it off she had developed gestational diabetes! Gasp again! Then- (yes she can get more risky) the baby was consistently and persistently breech at 36 weeks. (Breech is another post all together so I won't even touch on that here.)
I was not surprised to hear that the woman's doctor scheduled her for a c-section and she was not sad, she was in fact, relieved. She had just been saved the inconvenience and guilt of attempting a natural or vaginal birth that she had been prepared through her entire pregnancy to believe that she was not actually capable of.
I am not going to tell you that age, gestational diabetes, and baby position don't matter and don't present risk factors. But I will say that the words we use to describe a woman's ability to incubate her child will have a huge impact on how she experiences birth.
Do some of these issues need to be addressed so that a woman can have a safe and low risk pregnancy and birth? Yes- but telling her her body doesn't work is not how we deal with them. Not unless we are more interested in filling beds and maximizing insurance billing and keeping "patients" coming back for more than we are in a positive and safe birth experience.
Now a note on real prenatal care-
There is a big difference between care and testing. You can run tests all day long on various rare conditions and factors. If you run enough of them and if you are LOOKING for something to go or be wrong, it will not be hard to find it.
What does real prenatal "care" consist of? It consists of getting to know a woman. It means finding her normal. It means meeting with her in a place where she lives so that you can see a glimpse of what her life is really like, not just the face she puts forward. It means talking to her. It means education about what it really means to have a healthy pregnancy. This includes talking about good pregnancy nutrition. Care means touching somebody, listening to their concerns, hearing them, and talking to them and sharing wisdom and experience.
It might actually include some tests. Tests are not necessarily a bad thing- but they are a tool for communication, not an end in and of themselves. Let me give you an example- I am almost almost always, pregnant or not, anemic or borderline anemic.
I recently met with my midwife. She tested my levels. They were low. I was not surprised. This is something I knew about myself long before I ever got pregnant. I was not sent for another test or reprimanded. My midwife talked to me about some of the benefits of improving my iron levels. She talked about numerous natural and nutritive ways I could address the issue. She gave me information that empowered me to make better choices. She did not label me or scare me.
How can this and many other similar issues be handled differently? The woman can be scolded. She can be sent for more tests. She can be scared. Seeds of doubt in herself and her abilities and her natural innate human superpower for growing babies can be planted. Women can be "transferred" to another care provider. The list goes on and on.
So, how do you stay (or become) low risk?
1. Don't underestimate the power of taking care of yourself while you are pregnant. Good nutrition and exercise can prevent a myriad of risk factors before they even happen. I am of course a big fan of the Brewer diet. Why? Because it is simply a healthy diet. Dr Brewer told his patients to cut out all sugar and refined carbohydrates. They were to replace these empty foods with nutrient dense ones like greens, fruits, vegetables, whole grains, and protein. They were to drink water and eat WHOLE food. The simple importance of nutrition is often ignored, much to our detriment. Here are some great articles about nutrition.
2. Find a care provider who will actually care for you-
I have seen so many woman who are being labeled high risk switch to a home birth midwife and go on to have a great birth. They can not believe the difference between the five minute test result visit and the one hour "how is your life" visit they get with their midwife. I have also seen women undergoing midwifery care, accidental see an OB and instantly become high risk. Puke.
3. Believe that you can birth and gestate normally-
Many many women have had experiences that undermine their faith in themselves. Maybe you have struggled to get pregnant for years. Maybe you have had one or more c-sections. You can still do this. Those things don't make it impossible to have a normal birth. You may however have to work harder to find somebody who truly supports your birth power and you may have to work harder to believe it yourself. But it can be done.
4. Want to be low risk-
I don't mean this to sound offensive, but yes, I think we have to want to be low risk. As women we are often ignored, marginalized, or encouraged to put others first. The fact that pregnancy is treated like a disaster waiting to happen in our culture makes it a great opportunity to get some much needed attention. (Believe me, I need a break too and pretending I am super woman is not easy 24 hours a day.)
It is easy and even tempting to get some of that much needed attention by talking endlessly about all the things that are wrong with us, all the tests that we failed with the OB and all the aches and pains. It is also kind of scary to attempt a natural birth when all around you you are surrounded by people saying it is impossible. But do not fall into this trap.
You do not have to be high risk to be cared for. You do not have to be wonder woman either. You deserve a break or some help or some love or rest. Ask for it. Take it. Own it. You do not need to have something WRONG with you to deserve this. You need it just because you are doing the important work of growing a child.
Part of an empowered birth is an empowered pregnancy. This means owning our own health. It means making good choices in not just our foods but the people and information we surround ourselves with.
The term "high risk" is a natural growth from our obsession with the various risks of pregnancy and birth. Are there risks involved? Well of course! But everything worth while has risks. You can choose to believe yourself to be healthy and capable of birthing your baby, no matter what the label.
(Disclaimer- you may very well be high risk. I am not saying that it never happens. I am not a doctor or even a care provider. )