Monday, January 25, 2010

Welcome Our First 2010 Guest Blogger ~ Vonda Gates

During 2010, I will be having guest bloggers sharing their thoughts about pregnancy, childbirth and breastfeeding. These guest bloggers will maternal child health professional, dedicated to the continuum of care we call birth. If you are a birth professional and would like to be a guest blogger, email me at!

The Birth Class Experience and Informed Decision-Making
by Vonda Gates RN ICCE IAT

(Vonda Gates is a chidlbirth educator trainer and doula trainer living in South Dakota.)

My client and her partner were waiting at their car after I finished cleaning up the Thursday night childbirth class. It was the last night of the series they had attended, so they startled me in the dark as I locked up for the evening. I always enjoy talking with clients but was genuinely surprised when they asked if I would attend their upcoming birth as a doula. They had said almost nothing through the entire class series and I had wondered if I was meeting any of their needs, their silence giving me no clues. Now, however, they were talkative and excited about several changes they had initiated related to this birth.

As their story unfolded over the next month, I learned this was a second birth with a second partner. My client had been hospitalized many times in her life for various mental disorders related to sexual and physical abuse of her first partner. The most recent hospital stay was just six months before the class started and she feared this birth would bring about panic attacks as the first birth was a traumatic memory of pain and isolation. Yet, despite her fears, she wondered if things could go differently this time. As she watched other clients in the class discuss options and make choices she wondered if she could dare to make decisions for herself that would leave the outcome more positive.

Penny Simkin, in her book When Survivors Give Birth (2004) points out that every childbirth class most likely includes survivors of abuse, both male and female. Birth educators should realize that one in every three or four clients have survived some sort of abuse trauma. My client fit one of Simkin’s descriptions of an abuse survivor as the reluctant participant. Other signs include clients that appear bored, sleepy, or even hostile.

I wish I could say I was the enlightened childbirth educator Simkin encourages in her text, realizing that clients with abusive backgrounds have special needs in a class setting.
In this case, I don’t think there was much I did that initiated change. Instead, it was the group process in a safe environment and the example of the other clients modeling informed decision-making that triggered the new beginning for this client. In a letter, my client described her new realization that she could make choices also.

And choices she made. She changed care-providers to one that would allow a doula present at a surgical birth. This required a change to another hospital an hour away. She decided to breastfeed and made arrangements for immediate support in recovery. Her partner’s caring support and their shared commitment to the new plans brought them closer together.

Her desire to not panic at the surgical birth of her second son came to be and it was a happy welcoming with many endearing memories. An unexpected surprise for this doula and educator was when she called the next day to share details of her first night mothering this new child. I did not recognize her voice on the phone. What was so different: a new lilt, a contented tone?

The first sign of many positive changes that followed this birth and of the new beginning she so craved.

Simkin, P. & Klaus, P. (2004). When survivors give birth. Seattle, WA: Classic Day Publishing.

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