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Preparation

With the exciting news of your baby, many things begin to quickly change in your life in the first three-month period, but you can still have control of certain aspects of your life. For example, you can slowly begin to ponder what kind of birth you are dreaming of. I say “dream,” because I’ve seen mothers who “plan” every little detail of their births, thinking that they could control the entire process up until the moment of birth. But things don’t always go exactly as planned no matter how hard you try, and the universe just does its own thing.

Having said that, dreaming, creating intentions, visualizing things in our minds certainly bring us closer to the birth we desire, so it’s okay to keep imagining… There are choices we can make, like choosing our doctor or the hospital we’ll give birth at. Or whether we’ll have a doula or a midwife present at the birth and at which stage we’ll go to the hospital.

I chose to do the birth half at home and half at the hospital with a midwife and a doctor. I’m so glad I made that choice… It helped me have the natural birth I’d dreamt of despite all the difficulties. While I was making preparations, I visited several hospitals to talk about my birthing preferences and to understand/figure out whether those prefer-ences would be respected or not. I ruled out the hospitals that ignored personal prefer-ences. I’ve also realized that unless you look out for your rights, hospitals will dictate to you how to do everything. Staying strong and being informed in front of them makes them check their approach. So, what I did was learn everything I could about the pro-cedures about birth and the delivery room from my midwife.

Birth is a Miracle

Birth is not a disease, it’s actually the most normal thing in the world if we’ve managed to create such a large population as human beings. And if it’s not a disease, instead of giving birth in hospitals where lots of disease and sick people exist in the same place, it would be much better to do it in fully-fledged maternity houses. However, we have not yet acquired that level of development. (Yet! I’m sure it will happen if we keep asking for it.)

The possibility of something going wrong during birth is between 10-15% ac-cording to WHO statistics. However, in Turkey, the rate of C-sections is 85% in private hospitals and 53% in state hospitals. The cesarean section is a medical miracle devel-oped as an emergency intervention method. If you are currently pregnant, living in Tur-key, and wanting to have a natural birth, you might have to put up a serious psycholog-ical fight, against both doctors and the people around you. They usually tell you to just have a C-section and get it over with, that you’ll be asleep for 15 minutes tops, and that there is no need for you to endure all that pain.

It’s upsetting to see that this method of medical intervention that’s meant to be used only when it’s absolutely necessary is routinely recommended and often pre-ferred. This practice is based solely on administrative, commercial, and legal concerns rather than reasons relating to the woman who is pregnant or her baby. The reasons are usually as follows: Being able to schedule the birth, allowing doctors to take on more patients, doctors dreading being blamed for faulty treatment, women being en-couraged to make personal choices, rise in childbearing age, increase in IVF and twin births… You can find many notes on this issue in the “Research” chapter, where I try to explain the course of perception of the subject of birth in parallel with historical de-velopments. It’ll be easier for you to recognize any red flags as you read more on the subject.

What I’m trying to say is that the methods of delivery that are imposed upon us are not the absolute truth and the only reality! They have transformed through time and became more and more acceptable and common as women did not object to them. If women take over the responsibility of their own bodies and their own births, there is no reason that these practices should not change back and return to their natural courses.

In societies that are considered to be “modern,” breaks from the actual essence of things are more common. The simplest example of this is the issues we are having with food, which include genetically modified organisms, using too many chemicals on produce, heirloom seeds becoming nearly extinct… As the perception begins to change, it is replaced by what is natural. As time-honored old habits, organic and natu-ral approaches are rediscovered, the world assumes a different order.

Another example would be smoking in common areas. Smoking used to be al-lowed even on planes, whereas now many countries don’t even allow it on the street.

So, perceptions change, and they can be changed. I believe the same can be expected for giving birth.

Let's Get Back To The Preparations…

The first few months are what’s important. Considering, planning, researching many things, deciding on how you’ll move forward in your journey and with whom, it all requires a lot of preparation.

First of all, if you have the opportunity to work with a midwife or a doula, which I highly recommend, you can start looking into who that will be for you. If there is some-one in your family who does this kind of work or any particular professionals your friends have worked with before, you can talk to them first or you can always consult with your doctor. You can always get in touch with places such as Do-Um, Hamile Okulu, or İstanbul Doğum Akademisi and ask to be put in contact with a midwife or doula who would be suitable for you.

Midwife

Midwifery is a medical profession formed by people who are responsible for diagnosing and supervising pregnancies as well as performing natural deliveries. People in this profession hold the title of midwife. Midwifery is an ancient profession that is chosen only by women in Turkey. Midwives graduate from the schools of nursing affiliated with health colleges of universities and the department of “Midwifery” in vocational health high schools.

Doula

Performing the duties of a doula is both an ancient and brand new service. The word is etymologically Greek, meaning female servant or slave. Today, it means an educated or experienced woman (a friend, relative, or healthcare worker) who provides physical, emotional, and informative support to women giving birth and their families before and during birth as well as the postpartum period.

A doula is not a midwife nor a nurse. Doulas do not offer medical advice or prac-tice any medical procedures, they only work as one part of a team consisting of doctors, nurses, midwives, and other supporting professionals for the well-being of the mother and the baby. 

What is The Difference Between a Midwife and a Doula?

The midwife tracks the pregnancy medically.

The midwife tracks the baby’s heartbeat, the mother’s blood pressure, the dila-tion of the cervix, and other medical matters during the delivery.

The midwife performs postpartum health checks for both the mother and the ba-by.

The midwife can provide emotional and psychological support in line with her education and availability. This is one of the reasons why choosing the “right” midwife is important. My midwife has been hugely supportive in this aspect as well as all others.

The doula only takes care of the mother’s emotional state. She can allocate all her time for the mother as her time is not taken up with other responsibilities.

The doula can provide uninterrupted support during the delivery.

The doula has time to address any needs the father and the family may have.

The doula can provide individual assistance during the postpartum period at home.

Personally, I chose to enlist the services of a midwife, because I had felt that I was emotionally ready for the journey and wanted the person who would walk alongside me to be able to medically intervene if needed. I had thought that I’d feel safer that way, and so I did. Thanks to my midwife, I managed to remain home for a longer amount of time and as I arrived at the hospital at the right time, the risk of being “taken” into a C-section was significantly lowered. Virtually every woman who gives birth in Europe has a doula, but then again, midwives are a regular part of the medical system there.

Another important choice to make is of course choosing your doctor. You can talk to your gynecologist and directly ask them whether your approaches to birth are compatible. You should be clear and honest about your expectations and be persistent about your preferences. This is your baby and your body will be delivering the baby, no one can know what you want better than yourself. If natural birth is important to you but you can’t be sure of your doctor’s approach, you can look into their statistics of natural delivery.

In some European countries, when the rates of cesarean section exceed the upper limit of 15%, the ministry of health launches an investigation on the doctor (and even the hospital). That’s because in social states birth and health services are cov-ered by the states themselves and unnecessary practices and interventions are strictly monitored. Optional cesarean sections are practically prohibited. In order to abide by these regulations and ensure that the doctors have time for everyone, midwives do all the follow-up with pregnant women, and the doctors, of course, are present for the de-livery and important check-ups.

If you feel that your expectations don’t align with your doctor’s practices, you can always consult your midwife (or doula), and most midwives and doulas will be able to inform you with regard to which doctors can patiently wait for natural birth and which ones are of an impatient demeanor and have less time. It never hurts to ask.

In my own experience, I wanted so badly to have a natural birth that my doctor had to go away due to an emergency and I went into delivery with a doctor my midwife had recommended. That new doctor turned out to be an awesome woman, and in all her wisdom, called me back to my essence and deepest desires even when I said I couldn’t keep going. She encouraged me, saying, “You said you wanted to experience birth, and now you’re here, let yourself do it, you’re almost done, you can make it,” and Arven was born.

You should let yourself do it, too, and be well-informed and persistent and go with your gut. What is the one desire that you have beyond all your fears? Surround yourself with doctors, hospitals, doulas, and midwives that support you.

Instructor

Burcu Kutluk

Instructor

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