A while ago, I had a discussion with an OB. That discussion led me to have an even keener clarity of how different the range of focus is between birth support workers and primary health care providers (in this instance obstetricians).
Theirs is a long range of focus with an eye tightly fixed on the end. Doulas have a much more roving eye, pulling out this, questioning that as we move towards the 'end'. During this discussion, he stated firmly (several times) that his objective always is to have a healthy mom and a healthy baby. Well guess what? So is mine! It was a little bewildering to have him insist so adamantly about something so obvious. It made me wonder if he thought that *I* didn't agree with that ultimate outcome.
Huh? To be clear...We all agree on the destination. A healthy mother and child at the end of any birth experience is what we are all aiming for. In my mind, that is a given and obstetricians have the awesome job of making sure that outcome is preserved. They are Life Savers and we all are infinitely grateful that they exist.
At the same time...for the birthing person...the journey matters.
The journey always matters. Have you ever travelled before? Naturally, your ultimate goal is to arrive at your designated location in one piece, whole and unscathed. But diversions, detours and delays along the way can make your journey a whole lot less pleasant. Ever dealt with incompetent airlines, lost luggage, rude passengers, mix ups in bookings or any myriad of things that can go wrong while travelling? All of those unplanned happenings can ruin the start of what is supposed to be a relaxing holiday. Yet, there you are; alive at the very least. The birth experience should not be just about survival- being alive at the end of it. While realistically, due to things going unexpectedly and sometimes tragically wrong, it can be reduced to that singular goal for some people. This is sadly true but this is not anyone's wish.
Expectant parents want to feel a measure of control and participation in their pregnancy care, with the understanding that:
1. healthy mom and baby are the ultimate goals.. but that
2. the journey matters.
This is why people take childbirth preparation classes, read books, investigate topics on the internet and hire doulas; to help them have a clear map of where they are going. To help them navigate the often confusing waters of birth. To help them avoid pitfalls where possible. To arm them with information so they can ask good questions. To do what they can to have a positive birth EXPERIENCE. This journey mattering business is borne out by the existence of a plethora of groups, forums and organizations founded and established solely for the purpose of helping people process their birth experiences, indeed in many instances- their birth trauma. Such a huge, life long undertaking (giving birth and the start of parenting) is deserving of preparation before hand and processing afterward.
OBs are not in the business of being Journey Helpers and this is appropriate. Their job is to navigate us to the desired destination. When things go wrong, they have the skills to bring things back on track. Their range of focus NEEDS to be narrow. But, just as airplane pilots don't fly alone neither do doctors. There is always a crew of support staff and together they work to bring people safely AND pleasantly to the desired destination.
For birthing people, in decades to come, the memories from their experience can run the gamut of eliciting positive feelings to triggering PTSD. A lot of that is based on how the journey went. My wish is for birth workers to get the recognition and appreciation we deserve for the work we do in making the journey better for birthing people and families. And I'm talking about official recognition- by the hospitals we work in, the primary care providers we work alongside and the governments that financially support our health care and make the policies that influence birth. Those entities are an essential part of this process but they do not render unnecessary the deep support provided by us; the kind of support that makes the path smoother and the way clear. We all have the same outcome in mind but birth support workers also know that birthing people are more than just survivors of a biological process; they are travelers on the trip of a life time and we work with the double vision of preserving both the journey and the destination.