Updated: Jul 15, 2019
Education is very important. The understanding of how labor works, how your cervix and uterus operate and what really exists in the large range of normal... IS HUGELY IMPORTANT.
If you don't know these things, these basic, simple things, you can easily be lied to. I can't tell you enough how important it is for women of childbearing age to be educated on pregnancy and childbirth. Junior High health class is just not good enough!
It's important because there are practitioners out there who are charismatic, and good at manipulating. They have fantastic bedside manner and very fat wallets. I hate to even have to say that. There are lots of great OBs and midwives caring for women with ethical, respectful philosophies. There are honest caregivers practicing out there who feel equal disgust when hearing about the latest butcher shop tactics. But just like there are weeds growing in every beautiful garden, so there are evils among the most sacred of professions - maternity caregivers come in all varieties.
Speaking with an OBGYN friend of mine a few months ago, he explained that it's not profitable to take medicaid patients, but he does it anyway, because his neighboring OB across the road was taking them and signing 85-90% up for what he is touting as necessary cesareans (no exaggeration). My friend believes women do better birthing with support and without interference, and wanted women to have a choice, particularly the more vulnerable, and often less educated immigrant Medicaid population that were buying into Dr. Surgery's smooth tactics across the street...
So we started offering discounts for military and low income students who wanted to get certification from our doula courses online and in-person workshops. We began to provide payment plans to make education more accessible. We wanted to be part of the solution - whatever it takes. We wanted to give mothers a real opportunity to make sound decisions and without "hospital indoctrination" as it can be at times. This means making education for doulas as affordable as possible and raising the standards on what they are taught!!!
Now... We assumed of course, that lower income mothers might not know better and may be more at risk for manipulative tactics. They cannot always afford childbirth preparation classes and many of those in our richly diverse cities don't speak or read english well. It seemed logical to expect that kind of scenario happened in less-fortunate families. Right? I thought so too.
Until recently... I have heard several affluent, (and what I would consider educated) moms tell me that they "had to schedule a cesarean" due to having an "unfavorable cervix" at or near their ESTIMATED due date. These mothers went on to explain that they were told at 38, 37, and even 36 weeks that their cervix was not favorable, was posterior, and/or was too tightly closed to be able to deliver vaginally. Yes, long before their due date with baby #1; and they did not know any better than to believe their doctors who told them with sad faces that they were disappointed right along with them that they couldn't deliver the way they wanted (vaginally) and that this sometimes happens to moms and cannot be avoided (extending sympathy, and even soliciting empathy for their own position as the doctor who was "being forced to do the cesarean" because the mothers' bodies weren't cooperating). Can you fathom this drama? If I hadn't heard it more than once, I wouldn't have believed it!
As a woman, wouldn't you feel horrible if you were told your womanly parts didn't work? Especially if you deep down believed it weren't true, but you had no way of convincing those you perceive to be "in authority" over your health/experience? How can you prove you're not broken when you've never had the chance to try?? There's a deep, even subconscious humiliation and self-worth destruction that takes root in a woman when her pregnancy or birth dreams are thwarted or her ability is deemed to be invalid in the process. This is not to mention the subconscious mistrust that is planted into the mind of the partner. If her body "can't be trusted" to grow a baby safely, or birth a baby safely, how can it be trusted to produce adequate breastmilk to nourish a baby or how can she be trusted to care for the baby alone?
An example of the manipulation: One mom was told that she "didn't do anything wrong" (insinuating she should feel that she had) but that with "her type of cervix", even induction would fail. Preying on her disappointment and feeling of being taken off-guard, Dr. Sneaky Mistruth pretended to be devastated with her, that because of her body's malfunction, he was unable to "allow her" to try for her goal of an unmedicated vaginal birth. Talk about manipulation!
The cervix sometimes does not soften or open until the day labor commences. Sometimes due to baby's position or other reasons which can change suddenly, the cervix light stay posterior until labor starts.
And reminder: on average, healthy outcomes for mom and baby in first time moms - delivery date was 40 weeks and 5 days - when no induction methods were employed.
So, technically, following that average, a 37 week scheduled cesarean would give you an almost 1 full month premature baby.
What boggles my mind is not the bad advice to moms. It's not the "your cervix is unfavorable" which would indicate to me that the practitioner is simply lacking accurate knowledge and could/should be enlightened. No, the thing that really stops me in my tracks is the emotional manipulation of the mother, saying things like "I'm disappointed right along with you" and "I wish you could have the birth you want, but" and "this happens to a lot of moms, and it's not your fault" WOW! What a mind-job.
Click here for the Part 2 of this series on Sneaky Psychology of Birth Expectations.