Yesterday I taught a childbirth class, something I haven’t done in a while. I was really dreading it, quite frankly, but they needed an instructor and I needed money. The class was small, which I find makes for a better session, and they were engaged in the conversation. I didn’t feel like I was lecturing, which never feels right for a childbirth class but more often than not these couples never seem very interested. And then, a father asked, “So why is it that almost everyone talks about how they ended up needing pitocin?”
Ah-ha! My segue to the soapbox.
This question came soon after a birth video in which the woman was having regular contractions every 9 minutes apart. She had a midwife, who said to the woman when she asked if they could speed up her contractions to make the labor go quicker that she was not going to mess with a process that was working fine on its own. I love that line, because it reinforces what I want to teach, not the medical dogma on how to be a good patient while in labor.
I posed the question back at the class, using the birth from the video as an example, about how each labor is different and if progress was being made do we really need anything to make it faster or better? I got an overwhelming response, and got to talk about all the reasons they’ve heard about women “needing” pitocin. I’m always amazed at the things that they hear, like a woman needed pitocin as soon as her water broke because now the baby was in grave danger of infection. Or pitocin was needed because the woman was in active labor and having contractions every 4 minutes apart with cervical change, not the 2-3 minutes that are supposed to occur during the active labor phase.
I got to tell these couples that they had a right to make decisions for themselves, and that most decisions made in labor are not emergent. For instance, when was the decision for labor augmentation made emergent? And, if this was posed to them by their provider, that they could ask for alternatives to pitocin, not to mention a few minutes to think about their options. Ultimately, the discussed turned into their rights as patients and informed consent. Even one woman said, “So if we are being told we need something, we can say no if we disagree?”