I suspect that interventions have become the standard and have slipped into
what we call normal physiologic birth far more than we consciously notice.

One way to bring normal (physiologic birth as it has worked beautifully for
thousands of years) back to childbirth preparation classes is to save all
the discussion and questions about intervention for one class. " We will
discuss that in class five. Keep that question for class five. " One class.
And devote the entire class to interventions.

Assign each couple an intervention to research the benefits and risks of and
assign the opposite of the person's inclination. Give Natural Ned and Nelly
the benefits of the epidural and give Technological Tess and Ted the risks.
Have each couple share their findings when you get to that point in the
cascade of interventions.

A wonderful midwife and educator named Ann Fuller trained me to teach
childbirth education like this and it has worked for me for many years.

I begin the intervention class with a scenario describing a post dates
situation and cascade through the possible interventions to caesarian
section birth with clear explanations and descriptions. I show diagrams,
illustrations and pass around and amnihook and internal fetal scalp monitor
when I discuss them and what they do. With every intervention, I explain
what it does to help the process, how it might impede the process, what it
sets up for the process (introduction of the clock, risk of infection, need
for further intervention, restriction of movement) what are the risks, what
are the alternatives and what if one says no to this one? I teach this
mnemotic device for remembering, use your brain:

b benefits
r risks
a alternatives
i intuition says yea or nay?
n what if I say no?

The information speaks for itself and the clients have the opportunity to
ask plenty of questions. The great benefit is that the rest of the series is
full of positive images and explanations of how birth works and normal
physiologic birth is not entangled with interventions.

Sincerely,

Lisa Boisvert-Mackenzie, Midwife
Saipan, Northern Mariana Islands

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