>  -----Original Message-----
> From:         Susan Majoris  
> Sent: Tuesday, October 28, 2003 9:38 AM
> To:   [log in to unmask]
> Subject:      Re: Changing Practices
> 
> If everyone had one goal for creating change and accomplished it - wow!
> Take the pregnant mom - if she is attending Lamaze or Bradley etc...classes during pregnancy,  she may be set up for a bad experience.  Why?  The system does not support the wellness model of care in labor/birth.  The medical model prevails.   Often, care-givers, prepare moms for what "might happen", instilling fear and the need for monitoring in their care.  We could call it the "Fear Factor".  Think about a most recent discussion on Lactnet and the result of birth plans that evolve out of fear - not a real birth plan.
> Because of time factors and the lack of broad based options ;   we induce, augment,  eliminate pain, assist delivery with instruments, do episiotomies, discourage V-BAC and  do cesareans.  Mom's are in our hands - instead of us being at their disposal.  What a great birth when a mom tells us what she needs from us.
> Ironically, very nice labor and birth units have surfaced - that would facilitate many options to support women respecting their individual needs - we just have no comfort level with those options or possibly the staffing seems to not support the use of non-pharm optiions too - so encouraging doulas might help.  Doctors are right - they live in the doctors world.  Nurses are right - they live in the nurses world. Childbirth Educators are right - they live in world of lamaze, bradley, doulas, midwives, and lactation consultants are right too!  We are all indoctrinated in our own worlds. How do we bring all of that together.   BY MAKING MOM AND BABY THE CENTERPIECE.  
> Women do not believe they can make it through labor and birth.  The fear level is incredibly high at times.   Re-education of women/families on birth options and how they impact baby, mom, parenting, breastfeeding, and life....is in order - so informed choices can be made. Re-education of professionals too in their own worlds.   In some areas it could be another Lone Ranger job   People do not understand the effect this is all having on morbidity and mortality in our country.  
> It is a bold move to stand firm with research and facts and work to remind professionals we are tampering...   Birth is a normal process.  Women can give birth without alot of intervention.  If we have tubs, birth balls, massage opportunities,  oral fluids and nourishment, warm and nurturing environments and people who believe that women can give birth we might make some progress - Providing all options is the wellness model of care - not excluding medical options but enhancing will all the non-pharm. comfort 
> A professional blueprint to help facilitate change is the MotherFriendly Childbirth Initiative.  - check it out at motherfriendly.org.  -  IRMC is working on it.  Email me - if you want to know more.  Sue Majoris

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