Dear Dad-What I Wish You Knew

People think midwives love our work because of the babies. Babies are cute, but I love the moms. I love helping them craft and execute the vision for the birth of their dreams. In a totally different way, I love dads, too. 

There are two types of dads I run into: There are the dads who are all for a community based birth either because they defer to their partner’s desires or they have researched and agree that a home birth can be an excellent choice for a families. The other camp of dads respect and love their partners but aren’t sure about this crazy idea of a home birth. The best way to show their love, in their minds, is to protect them from a dangerous choice.

I am so glad dads are protectors. It’s how they’re wired and most women appreciate knowing their man has their back. However, in the current American maternity climate, it may be more protective for men to urge their women to birth in the safety of their own home. 

Is that crazy? 

I don’t think so. What is crazy to me is that in the US, we spend more money on maternity care but we are coming in last in maternal mortality when compared to all other developed nations. Let me say that another way: It’s safer to give birth in Saudi Arabia, Turkey, Iran, or Chili than the USA. 

The countries that are keeping the most women alive in/after childbirth? They’re the ones using midwives for their low risk pregnancies. OBs are used where they shine-in complicated situations. Some countries even mandate that if a woman in a low risk pregnancy wants a surgeon for her birth, she must pay for it herself. 

 Why is the USA doing so poorly? The reasons are not known for sure but obesity is blamed. It may certainly be part of it. Many of us think that our interventions and medicalization of birth play a large part in the problem. It’s well known that a cascade of interventions takes women down a path they may not have needed to go on. An elective induction for “big baby” (common but not a true medical need) brings a woman into the hospital to ripen her cervix (which means it’s not ready), start artificial contractions, while withholding food, limiting mobility, increasing infection risk with cervical exams and artificial rupturing of membranes. All of this in a brightly lit room staffed with strangers-no wonder she asks for pain relief, which often causes her body to relax so much her baby may become mal-positioned and her contractions to become weak. The situation is remedied with increasing pitocin (drug that increases contractions) sometimes to the point of causing fetal distress. A cesarean saves the day and the mother tells everyone she’s so glad she didn’t birth at home since her baby needed that lifesaving surgery to be born. 

I am thankful for each tool the hospital offers. I’ve benefitted from them personally, I’ve gut-wrenchingly explained the reasons a client needed to consider a C-section after a long try at a vaginal birth.  At my 100th doula birth, I cried from the bathroom while texting my OB friend that I just suggested his client get an epidural-a first for me. 

But we don’t need interventions routinely. The Cesarean rate should be no higher than 14% according to the WHO. It’s well more than double that in the best hospitals. If more than half of the patients giving birth in the OR are receiving an unnecessary surgery, we should all pay attention. If every other man with an enlarged prostrate received an unnecessary surgery from a certain practice in town, wouldn’t it be a problem? If you were hesitant about seeing a doctor from that practice, wouldn’t you want your wife/girlfriend’s support in finding another option?

So men, please consider studying about the cascade of interventions, about birth trauma, home birth safety, midwifery, and doulas. Help your woman find the best OB or midwife for her needs (Pro tip: the doulas know who this is. Asking on social media for the best OB brings a list of doctors submitted by women who didn’t know they didn’t need that C-section. Midwives need to be a good fit, too-there are a LOT of styles of midwifery). 

If you’re with a woman giving birth vaginally for the first time, hire a doula. She’s worth every penny and more. 

Take a childbirth class by someone who teaches about physiological birth, not “how to be a good patient” which the nurses who used to teach the hospital class tell me should be the real name. 

If your partner says she wants to interview a midwife, go for it-you’ll learn more than you think. 

Dads, you’re a key to this whole birth going smoothly. You know her better than we do. You know what that wrinkle across her brow means. You probably know how best to encourage her. She needs you to walk with her through this pregnancy and birth, she needs your super powers and your protection. Help her choose a place of birth and practitioner that matches what she needs. Low risk pregnancies can safely be conducted at home and her (and your!) satisfaction will much likely be higher in your own home. Don’t let your protective nature lock you into the standard American birth with all of its potential pitfalls.