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Trust In Practice

By Justin Ohm, DC

What if we stopped trying to save women?

I can’t take credit for that line—I think it originated with the Free Birth Society— but I do resonate with its meaning. I am a practicing chiropractor, and I specialize in perinatal and pediatric care. I feel chiropractic care is essential during pregnancy, but if there is one thing I have learned over the years, it’s that providing an adjustment to the pelvis and spine is not enough—or at least we could be offering so much more.

Let me explain. I feel like one of the biggest issues facing pregnant women is the fear-based narrative that they are subjected to by most of their providers. Every day in practice I have a decision to make: Am I going to be part of that narrative, or am I going to consciously foster a trust-based narrative?

If I choose to explain chiropractic as a solution to a problem, then my focus of care is inevitably on “the problem.” If, however, I remind the mother-to-be of the amazing adaptation her body is conducting all on its own, and that chiropractic care is simply supporting the function of her body, then I have shifted the focus toward the solution. And guess what? That solution, that power, and that intelligence is internal to that woman, rather than externally provided by a member of her birth team. Knowing that—and trusting that—is a skill that can bolster the confidence we carry into birth.

Fear is insidious. It is endemic to the medical system in most circumstances. It is also much easier to be fearful of something you have no experience with, or minimal preparation for. Think about the big unknown that a first-time pregnancy could instill if the mother doesn’t feel prepared for birth. Birth preparation in the United States, if it occurs at all, typically consists of a birth class. In a hospital setting, the purpose of the class is to familiarize you with the facility and the protocols they follow. In a private setting, “natural” birth classes can offer a more in-depth understanding of what to expect in labor, but they often fall victim to an oversimplified concept that birth is “natural,” and you will know how to do it already.

There are a lot of things that are natural for the body to do that you would never consider doing without practicing for it first. It is natural for the body to be able to run, but I wouldn’t sign up for a marathon without training and preparation. Interestingly, birth has often been described as a marathon. So how do we prepare for birth? The same way we prepare for any challenging task: by developing skills that will help us accomplish it. Having choices in birth is great, but without skills that we can carry into that event, we can often be let down by the outcome.

I’m not saying that who you pick as your provider and how you craft your birth plan doesn’t matter. Your choices and desires for your birth are absolutely your right, and it’s your responsibility to make those choices. Finding a provider who supports your choices is valuable, but it doesn’t give us any additional skill set to better complete the task of birthing your baby. If we feel prepared, and if we feel skilled, we have far less fear. We become confident and self-empowered.

It is time for a shift in birth preparation. Couples need to search for skills-based approaches to childbirth. Those classes and programs are out there. Regardless of what type of birth you want or may end up with, birth skills support our ability to complete that task. Providers need to go beyond simply providing care. They need to explain the value of birth preparation and birth skills, and encourage families to become self-empowered for birth. This allows women and their partners to take full responsibility for their birth—which is the only way to shift the power from an external authority to the individual.