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What constitutes a good pregnancy/birth?

I'd love to hear your answers!

Photo of Hannah Lennett
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I was recently speaking with Allison Schneider, a resident physician in OB/GYN in the Bay Area, who posed the following question to me: What constitutes a good pregnancy/birth? 

I'd love to hear everyone's thoughts. If reality doesn't match expectations, do you still consider the experience good? Is a good pregnancy/birth one that is planned to the second, or simply one where the mother and baby are both healthy and happy after the fact? 

Are you currently an employee of Sutter Health or UCB Pharmaceuticals?

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Photo of Kate Rushton

Interesting provocation, Hannah!

I am tagging a few OpenIDEO members here that might be able to share their thoughts on 'What constitutes a good pregnancy/birth?' - Beccah Bartlett Redwing Keyssar chloe wright Priya Rebello Claire Espey Meghan Anson Lauren Forbes Fonda Ruiter 

Photo of Beccah Bartlett

Thanks Kate Rushton  for the tag. I've worked for years as a midwife and before that, in high- risk obstetrics as a nurse, I have been privileged to see the full spectrum of pregnancy and birth experiences from low/no intervention water births to high-intervention C-sections and perinatal loss.

For me, what constitutes a good pregnancy/birth is subjective to who you're asking.

First and foremost, for the woman who is pregnant and experiencing the birth directly. I've asked literally hundreds of women over the years what this means to them and whilst on the surface level many say "a healthy baby" or "no pain" or "a quick recovery" when I dig a little deeper what they really want is to be a part of the decision-making process surrounding their body and their pregnancy/birth experience. Even if culturally they expect their partner/family to make the actual decisions, they want to know what those decisions are and what comes next.

Women, the world over, want to be treated with dignity and respect. They are acutely aware of body language and throwaway comments and they remember everything. They may always not feel comfortable speaking up but they notice when they are being shamed or dismissed or ignored completely.

Feeling like they have some control in the process, even if that control is simply an understanding of what comes next (and why), is essential to ensuring she is confident in her parenting abilities.

Birth partners also want this and should not be left out of the equation. They're often at a loss of what to do and how to support the women during this experience and this can translate to defensiveness and protective behaviours that confront healthcare workers in this space. Working with all parties to open communication in a respectful and safe way that includes all perspectives seems simple enough but is historically not what I've noticed and I've worked in rural, remote, overseas, public, private and home birth settings.

Finally, for the birth professional. I believe most of us turn up every day because we want women and their babies to have a safe and meaningful birth experience. What happens along the way for many, depending on their work and training environment, is a culture of bulling and inadequate mentoring/support which filters down to the treatment of the woman who is in turn bullied or ignored and sometimes outright mistreated (see the Respectful Maternity Care movement for more on this). Some are trained that the only good birth is a birth that is completely free of intervention, others that a woman and baby must be continually monitored without any consideration to her agency or self-determination in the matter.

Ultimately, a woman and her body need to be trusted to do what comes naturally and the birth professionals need to be trusted to manage what comes next if this doesn't happen. When we start using a woman's body and her experience as a battleground, the only person that misses out is the person who is the reason for why we are all there in the first place.

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