We spend a lot of time working on birth plans because the message has finally gotten through "my body, my birth, my choice". But antenatal care seems to have been left behind.
Mainstream depictions and definitions of antenatal care are still along the lines of: "It's important for the health and well being of your baby" and many women still rock up to appointments with zero idea of just why they are there, what the benefits and risks are, and simply following the instructions of the care provider. Because we haven't quite got the "my body, my choice" message into our antenatal care yet.
For a truly powerful VBAC journey you really need to start placing yourself as the power in your story - well BEFORE you enter birth suite.
What is antenatal care?
At it's very basic definition antenatal care is care received during pregnancy.
Within our western cultural norms and current maternity care system this care is provided by a healthcare professional - generally an obstetrician, midwife, or GP.
Antenatal care is seen as being a medical thing (gee, colour me surprised) - tests, interventions, injections, scans, and a lot of medical information.
However, it is very important to keep in mind that "care" is a very broad idea. You can receive care, during pregnancy, in other ways. Medical care, emotional care, comfort care, spiritual care. Care that nourishes your soul. These are all important things to consider when talking about antenatal care.
The limitations of the system
The care provided to women in our current maternity care system is VERY hodge podge. (and that's putting it nicely!). Often the first person we see is a GP who may or may not have much experience providing antenatal care. They also have widely varying personal philosophies. For example in my second pregnancy I declined a dating ultrasound, an early GTT, and the nuchal translucency ultrasound - all with ZERO push back from my GP at the time. In my third pregnancy, I made the same decisions and the GP that I saw that time wrote a letter to the hospital advising that she could not provide any care to me due to my "alternative beliefs". I was then able to see a different GP (in the same practice) who supported me as I declined EVERYTHING except for a few specific tests that I wanted done, and continued to support me, as best he could, as I planned for my freebirth after 2 caesareans.
I've heard of women being refused referrals to midwifery care due to the philosophy of the GP that they see. Or being refused a referral to ANYONE until after a certain period of time. Or being refused care due to their decision to decline certain things.
GPs are often the first care providers to disempower women on the birth journey.
Grooming for compliance
One thing we know about the current maternity care system and culture is that compliance is valued and individualised care is not. Largely because the individualised care is generally non medicalised. ie: women choosing to decline routine tests in favour of caring for themselves and tuning into their intuition. Individualised care puts the WOMAN at the centre of her care rather than the care provider. It's about what the woman needs to feel safe and cared for (and for so many women this is NOT hospital and standard procedures).
So we are seeing a trend where care providers can certainly be seen to be grooming women to be compliant. GPs are giving women test referrals without discussing alternatives or even asking the woman if that is what she wants.
This positions the care provider as the decision maker and expert in her body, her baby, and her maternity care.
Meaning that women are often already significantly disempowered by the time they are seen at the hospital antenatal clinic. They do not know that they have choices, options, or that THEY are responsible for the decisions that are made.
But my care provider never even mentioned making me have a caesarean
Many care providers have realised that women want VBACs. We don't want to be told that we must have a routine repeat caesarean. And so that tell women that they support VBAC. They share their amazing statistics and reassure women that a caesarean will only be suggested if absolutely necessary. They are kind in antenatal appointments and ask women how they want to give birth. They acknowledge previous trauma.
And then they disempower the women
"Of course we support VBAC"....just as long as you pass the GTT, baby is guessed to be the right size, baby is head down, you don't go overdue, you don't go too early, you agree to this VE and that type of monitoring. Oh, and you can't have a waterbirth.
Saying that you support VBAC does not empower women. Having a VBAC does not empower women. It has nothing to do with mode of birth, what actual decision is made, or whether the woman has a positive birth.
Women having the power to make fully informed decisions, based on individualised care, and acknowledging that the WOMAN IS THE POWER empowers women.
And we are not seeing this in standardised antenatal care.
Much love, Lizzie.
PS: I'd love to hear your stories - Did you have care providers who acknowledged your decision making power? Who truly put you as the power? Or did they seem to expect you to just follow Drs orders?
PPS: If you'd like support in reclaiming your power and having a truly powerful antenatal care journey, please contact me or email email@example.com and ask about my VBAC mentoring group program. This program positions you to make informed decisions that are right for you and your journey with practical tips and epic support.
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