Episode 38: Medical Interventions, Compassionate Use & My Bias

Let's talk about the compassionate use of medical interventions, and my bias. Yep. Every medical care provider you work with has a bias, so it's best we're honest about them. Of course, I generally call them 'perspectives' or 'philosophy' towards birth. But in other terms, they're our biases.

My bias is that the most important part of birth is that the birthing person and their birth partner are seen as the boss of the birth room. All decisions are run through them as the final decision makers. Everyone else in the room is simply a professional advisor.

My bias is that birth as a normal physiologic process that is best left undisturbed. That when birthing people are supported in finding their own coping practices and positions easing the baby out, they generally do so very well. However, I also believe that sometimes birthing people need help. And that sometimes medical interventions are the most compassionate and wise choices to implement. We can hold the complexity where both of these are true.

As such, whenever we're talking about medical interventions in the Brave Journey Birth Preparation Program, we have a balanced discussion about the benefits and intended purpose of each intervention -- as well as their risks. Knowing your options and learning balanced information is the foundation of informed decision making.

I have many years experience ensuring survivors of sexual violence know their rights, and ensuring refugees and asylum seekers know their rights -- my personal emphasis on ensuring birthing people know their options and are the final decision makers in the birth room is a result of my professional experience leading up to my start as a birth worker in 2013.

Full Transcript:
[00:00:00] Welcome to the next episode of the free weekly Brave Journey Birth Preparation Videos, where I pick a topic related to birth and postpartum. And I talk about it today. We're talking about interventions and specifically, we're going to talk about the compassionate use of interventions and particularly my philosophy towards interventions and how to look at how medical interventions may be a part of your birth.

And I'm going to be honest about some of my bias. And my biases, we all have a bias and we need to be honest about them. I'm Cara Lee, I'm a birth doula and a childbirth educator and a mother of two, and let's get started.

Let's before we dive into my perspective specifically on the compassionate use of interventions. I want to start with telling you a little bit about my bias. My [00:01:00] bias is that I believe there is no one right way for a baby to be born. What I do believe is that birth is a normal physiologic process. And is usually best left undisturbed. Usually all birth needs is time and patience and time and patience. I believe it's normal. However, I also believe that sometimes we need help. Sometimes birthing people need help. And we have beautiful medical interventions for when they are necessary. So I can believe that birth is a normal physiologic process, best left undisturbed while at the same time, believing that sometimes medical interventions are the wisest and most compassionate choice for the birthing person and the baby. These can both be true. So let's all agree that we're going to enter this conversation with an ability to hold complexity. [00:02:00] And this is how we talk about interventions in the brave journey birth preparation program. This is how I talk about interventions when working with birthing people in the birth context as a birth doula, we can hold the complexity.

Birth is a normal physiologic process and best that's left undisturbed. And at the same time, sometimes medical interventions are the wisest and most compassionate choice. These can both be true. So what does this look like when we're talking about interventions and learning about interventions? I believe that one of the most important things in the birth room is that the birthing person and their birth partner, if they're making decisions and collaboration are the boss of the birth room and that all the decision-making revolves around them.

So I believe that the birthing person should be the final decision maker when it comes to their own body, body autonomy and their baby. What this means then is that we all have to give information. We being birth workers, birth attendants, medical care providers, the teams supporting, the professionals [00:03:00] supporting these T these one or two individuals birthing person, and maybe their birth partner have to be giving high quality evidence-based information. The medical care provider can give their professional opinion. And there may be more than one professional opinion. Always remember that. And then you, the, the birthing person are making the decision based on having connected and attuned to your own body sensations, your own knowledge of yourself, your own knowledge of your body and your baby, and also your own beliefs and values around medicine & risk. And everybody has different beliefs and values around medicine and risk. So you, the birthing person or the only one who knows those elements of your own connecting with yourself and being attuned to your own beliefs and values around medicine and birth. So then all the rest of us in that birth room are giving you information.

So what does that look like? When I'm going through the interventions? The intervention section in the Brave Journey Birth Preparation Program is the longest lesson. Every other lesson I tried to keep to [00:04:00] 10-15 minutes because I believe very strongly that they shouldn't be too long and I wanted it to be bite-sized so that people could go through and watch a lesson every night before they start Netflix.

Um, if that's you. Um, but the interventions lesson is long because what I do is I go through a whole list of interventions, the most common interventions in our modern medical context. And we talk through the benefits, usually the intended purpose of the interventions and the risks. And if there are any alternatives. So if you're talking about interventions from this context, then you're looking at the intervention from a nonjudgmental lens. You're saying here are the benefits to this medical intervention say Pitocin, the benefits of Pitocin that it brings contractions. It strengthens contractions. It's may bring your baby here. The risks of Pitocin is that those contractions can be really, really strong, very difficult to manage sometimes unmedicated without pharmacological pain relief. So we can look at the [00:05:00] benefits of Pitocin and why, pitocin is often used, it brings contractions. The risks, and then we can also look at alternatives. So there's all sorts of different ways that we can think about trying to make contractions stronger, longer, and closer together. And sometimes, you know what, that, it goes back to me talking about my bias in the beginning, it just takes time. It just means having time. But sometimes you don't have time. It depends on your body and your baby and your context and your circumstances. There may be a reason that baby needs to be born quick. So. You can't just make blanket statements about anything. I use Pitocin I'm using it as an example, because I've just been seeing people talk about all the risks of Pitocin without talking about the benefits and why it might be useful. And then you have people who go in and give birth and they use Pitocin and then they're vilified. And I just. I'm just not here for that. I'm just not here for that. I think that sometimes interventions are the wisest choice and they're the most compassionate choice. And so when you are engaging on whether or not to utilize an intervention in your birth context, it is important to me [00:06:00] that, you know, the benefits that you know, the risks and you know, the alternatives and you make a decision from that place.

So that's just a little bit about my perspectives and philosophy around the compassionate use of interventions and a little bit about my own bias. I think it's important to be very clear on that. I also talk a lot about this in the beginning of the breakdown of birth preparation program, what my biases and my perspectives on birth. So, you know, who's talking to you. And you know, where you're getting your information from. And what my angle might be. So then when you're collecting information from all these different sources, all over the internet, all from your medical care providers, your friends, your maybe your birth doula in your community, uh, the moms group that you showed up to with your first baby, when you collect all this information, you bring it all together, you know where it's coming from, and you have an idea then of some of the biases that come behind it.

So my bias birth is normal. It's a normal physiologic process that's best left undisturbed, except when it's not, except when it needs help or when you need help or when your baby [00:07:00] needs help. And that we can compassionately utilize modern medical interventions in a mindful way, in a compassionate way, by carefully looking at benefits, risks, and doing the next best thing.

This takes courage. It takes bravery. Birth is not for the faint-hearted, so it's good to cultivate your Brave Journey energy and, move forward to to bravely meet your baby. Thank you. I'll see you next week.