Sunday, May 18, 2008

Childbirth classes: Perspectives of a man versus a woman


We just finished our last childbirth class today. It couldn’t have ended sooner for my husband. Knowing his tolerance level would be low, I wanted to take a 2 day all day course. My husband, due to scheduling conflicts, suggested a 3 day course. He survived the first two but he could have definitely gone without the third session. I’m just thankful we didn’t sign up for a 5-6 day course.

The issue is not so much the ‘ick’ factor but more of my husband likes to question authority. I don’t mean he’s an anarchist. Merely, he doesn’t like to be told to think one way. When you lean too much, a lightbulb pops in his head and gets into the zone. He will question anyone on their views. If he was around during Magellan’s lifetime, he’d question whether the earth was flat. When Magellan’s crew came back to prove circumnavigation, he’d question that. It’s just his personality. In his past life he must have been a debater or political spin guru.

Well, stick that in with an instructor who obviously will advocate natural childbirth and control over your pregnancy and you get some vocal comments and discussions from my husband. “Why would a doctor tell you to get an episiotomy when it wasn’t necessary? “ “Women have been giving birth for centuries. Why does my wife need to pay someone to be her doula when she can have a friend who has an investment other than monetary?” “If the episiotomy rate is 85% in NYC, there must be some reason other than a doctor’s personal preference. Maybe it’s because there are higher incidences due to poor obstetrical care in lower income areas. Maybe it is because of the increase in advanced maternal age pregnancies or multiple pregnancies. I don’t think you can say episiotomies are on the rise because a doctor prefers them because it is easier for them .”

I knew my own threshold for his comments hit a peak today when I caught myself murmuring under my breathe when my husband raised his hand for the umpteenth time. To be fair, he does have valid points on occasion but today he raised his hand at a comment made by the instructor about pain management through chemical means. Her exact words were, “I can’t think of one reason why you should opt for chemical pain relief immediately.”

Now, the thought in my head was simple. “Oh g*#, please do not let my husband raise his hand. He’s smart enough to know this is a prenatal class. If there was anyone with the right to raise her hand, it would be a female not a male……….. Oh no, he’s raising his hand. “ That’s when I vocally said, “Oh Geez.” It wasn’t very loud but loud enough for my husband to respond, “Are you ok? Is everything ok?” Bless his soul, he lowered his hand and didn’t keep it up.

Later on, sensing he disliked the emotional and crunchiness of the instructor, I mentioned how if he wanted more scientific and clinical information, I had a great book from the American College of Obstetricians and Gynecologist he could flip through. It’s a kick and easy read and he could search the index by topic to read a paragraph or two. I thought, he loved his college textbook layouts, he may just prefer that approach.

My husband then commented these classes offered little for him except positions and massage techniques to support me with. That’s when it dawned on me. Childbirth classes aren’t meant to be educational tools so much as support tools. Men think of the classes as a educational tools while women may come into it as a resource, among many other resources on the clinical spectrum, but more so as a support and emotional resource.

Yes, there is the clinical how to of childbirth but let us be honest. Most women have already read at least 3-4 books, perused the internet and called their doctors a billion times with clinical questions. These classes aren’t for us to get clinical information but to learn and share the emotional aspect of childbirth. Not only is this a bonding experience for the couple but it’s also a very scary, exciting and terrifying experience for a woman.

You can discuss the clinical piece with your doctors and midwives but as a woman we need to let out our apprehensions, discuss our fears and know we are not alone. That’s why a doula is so appealing. A doula will not judge you. A doula is an outside person who will put you at ease and let you know that you are strong and capable. She will offer comfort, advice if asked and emotional and physical support without the complication of emotional family and friend ties. You don’t have to worry about politeness or social graces. You don’t have to worry about snipping at your family or friend member. You don’t have to worry about emotional investments/experiences clouding family and friends.

Sure, these classes can lean to the right but classes administered by hospitals and physician’s offices can lean to the left. My husband was concerned at the stance that one should question the doctor’s decisions. He felt it was as if we were being told to second guess the doctor. I didn’t take it as that.

What the instructor was advocating for was a push away from the 50’s and 60’s mentality of being a passive participant in the delivery and rather be an active participant. Know your options. Ask questions. Communicate.

I also take it as a very western approach to things. What I mean is we, as Americans, want to feel as if we are in control of as much of our lives as possible. We try to schedule everything. I’m even more prone to this because of my Obsessive Compulsive tendencies.

With labor and delivery, there is a certain degree of decision making on the laboring mother’s part but in general, I firmly believe you really can’t go into delivery, let alone pregnancy, thinking you can control every aspect of it. Heck, you don’t have control when your baby decides it’s time to enter this crazy zany world. I know some women try to control this by scheduling an elective c-section or an induction.

That’s why I’m not really into the whole birth plan thing. I have an idea of what I’d like but I also realize I’m not really running the show. I have a huge part in the decisions made but neither my doctor or myself will know what will happen on delivery day. I just have to trust in my care givers, myself, my baby and my God that we will get through this and the right decisions will be made to ensure the safety and well being of my baby and myself.

Maybe it’s because I’m coming from a different perspective. I have always been around clinicians my entire life. I have family that are physicians, nurses or in the healthcare field. I am constantly surrounded by clinicians, clinical professors and clinical researchers in my line of work. I trust physicians very much but I also know there is a degree of protocols that physicians follow. Introducing options outside of textbook procedures for some docs is not within their comfort zone.

I think you just need to know your audience. Are you going to a childbirth class run by a hospital or provider’s practice? If yes, expect it to lean more towards clinical approaches. Are you going to a childbirth class run by a private organization? Most likely, it will lean towards alternative methods first before clinical protocols.

I chose the later because I believe there are some methods that can assist but I’m not shutting the door from textbook methods. I remind myself when things start leaning too left or right, the main objective that all parties, clinicians, laborers and support folks should aim for is the well being of the baby and the mother.

Same goes with delivery day; know my audience. I need to make sure I discuss my preferences for my delivery but inform my docs I also understand when these preferences are not advised. There needs to be a discussion not an ultimatum. My husband hates this but I think of it more as a negotiation. “Semantics. In the end, you want it done your way.” In the end I want what is best for the baby but if my body suggests that lying on my side is more preferable to pushing, then I should be able to express that to my doc and my doc should be open-minded. If he/she says it is ill advised and explains his/her apprehensions, I will take it into consideration and reassess.

I think my approach to labor and delivery is summed up best by four verbs: Communicate, Discuss, Reassess and Relax. Who knows, tomorrow, I may change my mind and right a 25 page birth plan.

After discussing our views of the classes and my idea of ‘negotiating’ with the doctors, my husband said it best and won my heart again. “Honey, if I have to be assertive to get what you need, I will. That’s my job. I will do what it takes to support you and your desires. So long as the doctors say you and the baby are safe, I will do whatever it takes for you and our baby.”

If you are a guy who has take these classes with your partner, how did you feel about it? Where they helpful? Where they a waste?