BLOGGER TEMPLATES AND TWITTER BACKGROUNDS »

Sunday, May 16, 2010

What is 'interference'?

I'm having a nice discussion with some Trust Birth folk on my blog which is much easier here in my own territory, where I'm not misunderstood and have a chance to clarify. Facebook is too frustrating which is why I gave up trying there. Too much 'cheerleading'.

I AM questioning interference, but at this point I'm trying to understand how Trust Birth defines it, and it is also causing me to explore it for myself. I was reading about the Matrona and they share a lot of the interference messages which I thought was interesting. I'm looking at this concept from two perspectives:

1. Who defines interference? Can you know you're interfering until after the fact? What does intention matter, really?

2. What do I personally feel is 'interference' - I'd say unnecessary distraction of the parents (because I do not believe it is just about the mother), whether medical or social or whatever. If there isn't a good medical reason to be fussing with the parents, then don't. If there isn't a benefit to the parents for the social interference (guests, phones ringing, excessive conversation, etc.), then don't. Seems pretty simple to me.

What I get stuck on in this conversation (and I am thoroughly enjoying it!) is that I experience a black and white view of what 'should' and 'should not'. I see comments around what the TB person views as interference but that maybe the client wouldn't at all. Maybe the withdrawal of the support person (if it is unexpected) is an interference, too. I know that generally, women hire people with an idea in mind of what they're going to get. Sometimes they are surprised. If you are high risk and can only deliver with an obstetrician in a hospital setting and require intervention to make that happen- is that interference?

I am struggling to understand where the line is drawn. I love the idea of assessing newborn health without fussing with the mama and baby, which the Matrona promotes. I won't even pretend to say it doesn't scare ME, the idea of something going south and having to take records to a hospital where there is no charting of anything at all.

I don't think it's as simple as surrendering to a philosophy, not in this culture. We're very into records and defensibility. I think that each provider has to design this way of functioning for themselves. I have seen beautiful midwife Pamela Hines-Powell delve into her beliefs time and again and come out changed, with a new shift, with a new way of practicing. I've seen her pull back more and more and have been excited about what seems like a shifting faith and belief and trust, something we desperately lack in our culture. I have learned a lot from the journey's she's shared about simple things like hats, and major things like the birth bubble.

I want to end by saying that I feel very strongly that one message I take away from the TB discussions I've seen (and I've seen MANY) is that there seems to be only one *right* way to be present at a birth. This goes against my fundamental beliefs and it's probably one of the reasons why I just don't connect, despite the many areas we are in agreement. I am concerned about the idea of ANY organization telling ANY group of people that there is one way to be 'correct'. I have met many women and attended many births and each client wanted something a little different. She needed something specific to her to feel safe and feel connected. Let's not forget the fathers who are equally important and have their own set of needs- there's just no way we can ask midwives to subscribe to one set of beliefs and then serve such a wide population.

Let me explain:

One client might want a more hands on midwife because while she is excited about birthing at home, she needs the reassurance of the heart tones checking/vitals, verbal encouragement, etc. Another client might not want any of this. Both clients might not know this until they're in labor and this is often the case.

I suppose this means that the provider needs to discern for themselves in every moment what is 'interfering' and what is not. What worries me is that people might come out of their training thinking that they "will" or "won't" do things (which is fine and great), but until the mother in labor meets this boundary, there's no way to know whether it's interference or not. Maybe that sounds abstract, I don't know. I'm very obviously still plucking at this and working through it.

What is the 'right' way to midwife?

I don't have any idea. I don't know who I will be as a midwife, I don't know what I will value. I don't know what my learning experiences will teach me. I'm questioning NOW, I'm opening my heart NOW to things I do feel pretty resistant to, but I'm doing it anyway. How will I know what fits if I am not willing to really try it on?

2 comments:

Pamela said...

the "right" way to midwife is to be flexible, to meet each family where they are, and discuss expectations, needs, desires.

I think it's never a good idea to practice in one mode. I work hard to find out what couples have in mind and then to walk right up there and hold that particular space, no matter what it looks like.

SheGotHipsLikeCinderella said...

"Who defines interference?"
Personally, I think there is only one definition of interference, the actual definition. It is this: The act or an instance of hindering, obstructing, or impeding that prevents a natural or desired outcome. Interference is meddling; involvement in something without a justification. It's causing an uninvited and unwarranted disturbance of some body's peace and privacy, a deliberate entry into a situation in order to influence events. Interference has a known distorting or inhibiting effect on normal behavior. Some interference relates to deterrence - the act or process of discouraging actions or preventing occurrences by instilling fear or doubt or anxiety.
"I see comments around what the TB person views as interference but that maybe the client wouldn't at all."
I am a so-called "TB person" and I personally view interference exactly as it is defined, just because someone does not view something as interference doesn't make it not an interference.
"Maybe the withdrawal of the support person (if it is unexpected) is an interference, too."
I suppose it would be, however if a woman hires a midwife who trusts birth, you can be sure she has been informed fully as to what to expect. It isn't a withdrawal of support, its just care that isn't inventive in the process her body is undergoing.
"If you are high risk and can only deliver with an obstetrician in a hospital setting and require intervention to make that happen- is that interference?"
Yes, and it is risky. A necessary risk? Maybe. Is it worth it? Only the family can answer that.
"I feel very strongly that one message I take away from the TB discussions I've seen (and I've seen MANY) is that there seems to be only one *right* way to be present at a birth."
The only right way to be present at a birth is the way that best serves a mama, baby and family as a whole. It isn't about us. The Trust Birth Initiative is all about what is best for the mother, baby and their family. If that is against your fundamental beliefs, than I think you might want to re-evaluate why you want to pursue this.
"One client might want a more hands on midwife because while she is excited about birthing at home, she needs the reassurance of the heart tones checking/vitals, verbal encouragement, etc."
A midwife who trusts birth would probably strive to find out why the mama feels the need to have reassurance, and help the mama there first- and if she feels she needs somenting, she will get it... might it open a can of worms? Maybe, but if mama is willing to accept that potential then it is her choice.
"What is the 'right' way to midwife?"
Put babies and mamas first.