BRAIN – Benefits, Risks, Alternatives, Intuition, Nothing

Last fall Serena Williams gave birth to her first child. She experienced complications during childbirth which caused her to have a cesarean section. She was featured in an article in Vogue where she talked about her experience.

Not having been there or having access to her medical records, I can still make some fair assumptions about what happened to Ms. Williams that contributed to her dangerous experience.

In January the NY Times ran an article discussing Ms. Williams experience in light of the disparities between white and people of color when it comes to maternity care and outcomes. The factors that led to Ms. Williams having surgery in the first place and the assumption in the NYTimes article regarding childbirth as a “harrowing ordeal” are connected to the artificial and dangerous culture of childbirth that we have cultivated in our hospitals in America.

Doctors, nurses, and the birthing public alike have been brainwashed that childbirth is an emergency waiting to happen. This is because the medical community has embraced interventions like Pitocin, inductions for non-medical or overly cautious reasons, immobility and withholding of food and drink, and reliance on medical forms of pain relief which can all lead to these sudden emergencies that they see on a daily basis.

There are undeniable disparities between black and white, but all women are suffering from this culture of not listening to women and not trusting women’s bodies and the birth process that we are literally made to perform. And add to this the generational stress that women of color, especially black women, have endured and continue to endure in the pervasive racism that is American culture.

In Ms. Williams situation, she would have benefitted from a more home-like environment with all of the medical support necessary for back up purposes. I would bet money that she was induced and was on Pitocin with an epidural (stuck in the bed strapped to monitors, starving of food and drink for hours if not days) when her baby went into distress causing the ‘emergency’ cesarean.

Only an emergency because a perfect storm of events was carefully followed to its inevitable conclusion. In some hospitals in Florida, you have a better chance of having an unplanned cesarean than of having your baby vaginally. The truly unfortunate fact is that for a client with a history of blood clots who was likely on blood thinners throughout her pregnancy, she would be the last person you would want to induce – potentially triggering the cascade of events that lead to major surgery. This is because a history of blood clots is a risk factor for future clots, and pregnancy increases this risk as does major surgery, so it’s a triple whammy that you would want to avoid at all costs. But our medical community is so attached to their way of doing things, even with bad outcomes.

It is time for evidence based childbirth to become the norm instead of the exception. Women and families shouldn’t have to study birth like a college course in order to get appropriate and safe care. We know what works, and what doesn’t, and it’s time for consumers to demand what works! Demand evidence based care; ask questions about why a particular test or course of intervention is necessary and what would the alternatives be?

Think of the acronym BRAIN – Benefits, Risks, Alternatives, Intuition, Nothing (as in what if we do nothing?). Find a provider that will listen to your desires and concerns – remember that evidence based care is a three-legged stool: best evidence, provider experience, client desires.

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