Cambio #12: Preparémos a Madres y Padres para un nacimiento por cesárea. /Change #12: Prepare Mothers and Fathers for Cesarean Birth
English version at the end
Texto de Pam England
publicado originalmente en : http://birthpeeps.blogspot.com/2010/11/change-12-prepare-mothers-and-fathers.html
Traducido por Dulce Lopez
publicado originalmente en : http://birthpeeps.blogspot.com/2010/11/change-12-prepare-mothers-and-fathers.html
Traducido por Dulce Lopez
Queridos amigos,
Una manera de cambiar la experiencia que las mujeres tienen al parir en nuestra cultura es prepararlas cálida y honestamente para todo tipo de nacimientos en nuestra cultura. Esto incluye el parto por cesárea.
Te has dado cuenta cuántas veces la madre que esta en depresión o deprimida después de una cesárea es aquélla que no leyo o pregunto acerca de ésta porque creyó firmemente qué ésto no le pasaría a ella? (con el incremento de cesáreas actual, le puede suceder incluso si no la necesitaba).
Si le preguntaramos (a ella o al padre) qué hubiera ayudado, ellos responderían: "Me hubiera encantado saber qué esperar de una cesárea. Ha sido un shock inesperado"
No debemos poner total enfoque a la preparación holística a los padres primerizos, por ejemplo: " si ellos no preguntan, no hablaremos de ello" Los padres y madres que no están preparados sufren un shock emocional terrible, no de la cirugía en sí misma, pero también desde su propia inocencia, confusión, auto-juicio, mientras estan abrumados con la experiencia inesperada que se desconectan para atravesarla.
Aún cuando la marea de cesáreas innecesarias nos llega a la mente, algunas mujeres necesitarán cesáreas. Entonces el estar preparados para una cesárea tiene que ser parte de la preparación holística. Todas las madres y padres, otras madres y sus compañeros de nacimiento necesitan estar preparados para dar a luz por cesárea con plena conciencia.
En el trabajo que hago sobre trauma de nacimiento, historias tras historias, no se trata de cesáreas en sí mismas, sino del shock emocional de no saber que esperar, o qué hacer, o que significado le da la cesárea como madre. Por otro lado, las mentoras de Birthing From Within (BFW) han escuchado frecuentemente un Gracias de padres quienes, a causa de la clase "nacimiento por cesárea con plena conciencia" estuvieron realmente preparados y mucho menos traumatizados.
Los padres que se atienden con parteras, doulas, y toman clases, y no escuchan una palabra acerca de "qué hacer durante una cesárea, frecuentemente se sienten traicionados. Extrañamente, el no hablar sobre preparación para una cesárea antes del parto añade un sentimiento de pena porque las personas en quien ellos confiaron (por ej. la gente que "confia en el parto") no habló de cesárea. El silencio envía un meta-mensaje tipo: "las Cesáreas son algo que sucede a mujeres no preparadas, no comprometidas, o mujeres que no tuvieron la protección de información y de una Doula."
Cuando los profesionales de Nacimiento o incluso amigos, hablamos, directa y cálidamente, acerca de nacer por cesárea con plena conciencia, proyectando aceptación y fuerza. Si conectamos con los padres, ellos incorporan nuestra aceptación y fuerza. Imagina esto como una dosis de medicina emocional homeopática en contra de la vergüenza, y retiramos el sentimiento pervertido del fracaso. y si ella llegará a tener una cesárea, sabrá que tiene un aliado en nosotros: ¡nos atrevimos a hablar de cesáreas!
Si tu eres una de esas personas en quien ella confía (una de esas personas que "confian en el parto) y hablaste acerca de la posibilidad de tener una cesárea, incluso si no llegaras a estar con ella en el quirófano, ella sabra que "estas con ella". Ella sabrá que podrá venir contigo a platicar de su experiencia.
No todos los profesionales de nacimiento pueden hablar sobre la cesárea de manera cálida y sin prejuicios. Algunos necesitan primero un período de sanación de sus propios traumas de nacimiento o convicciones en contra de la cesárea
o contra padres que han elegido cesárea. Sólo hasta entonces puden hacerlo.
Existen muchas formas de enseñar sobre cesárea. Algunas formas envían mensajes tácitos de juicios, con razones y formas de evitarla a toda costa. La intención positiva es asustar o motivar a la mujer a "no elegir" una cesárea, pero durante el parto, sabemos que "elegir" y consentimiento informado son zonas nebulosas.
Cuando enseño a parejas acerca del nacimiento por cesárea, siento como si fuera una ceremonia, una iniciación a la autoaceptación y visión de si mismos enfrenando, incluso una cesárea no deseada. La enseñanza es acerca de aceptarse a si mismo, no acerca de evitar o arrepentirse de lo sucedido.
Los padres y madres experimientan el nacimiento por cesárea desde perspectivas muy distintas. Necesitan apoyo y prepraración; ellos también podrian sentirse traumatizados por la falta de preparación. si no les deicmos, ellos estarán abrumados por el ambiente quirúrgico. Esta semana trabaje con una adorable pareja que no estaba preparada para un parto por cesárea y tuvieron uno. El bebé nació sano, lo llevaron para el ritual de la mesa de observación para secarlo y arroparlo... después lo entregaron al padre y lo escoltaron hasta el nido. La madre nunca vio al bebé... no hasta horas después en el cuarto de recuperación. Este padre no tenía idea que podía llevar al bebé con la madre...y ayudarla a verlo, abrazarlo, en la misma sala de operación. Pero estaba totalmente abrumado y fue guiado fuera de la sala sin la menor idea de sus opciones. Su experiencia pudo ser muy diferente si tan solo...hubieran estado preparados para una cesárea a conciencia.
Algunos de ustedes seguro ya estarán haciéndolo. y para algunos otros resulta tan opuesto a la intuición que no se imaginan hablando acerca del nacimiento por cesárea sin sonar como que si "aprueban" la cesárea o que estuvieran programando a lso futuros padres para tener una cesárea.
Estas son consideraciones importantes. pero se puede hacer bien. Si tu quieres aprender una forma de hacerlo, toma un taller de introducción para Mentor o contacta Birthing from Within para una clase por teléfono.
Hay muchas fomras de cambiar el nacimiento en nuestra cultura. No sólo es acerca de cambiar los protocolos y rituales médicos, sino también de preparar a los padres para nacer en la cultura en la que realmente estan naciendo. y no en la que deseamos que nazcan.
con amor,
Pam
_________________________
Change #12: Prepare Mothers and Fathers for Cesarean Birth
Dear Peeps,
One way to change the experience women have giving birth in our culture is to warmly, honestly prepare them for all kinds of birth in our culture. That includes cesarean birth.
Have you noticed how many times the mother who is in birth shock or shame after a cesarean is the mother who did not read or ask about it, because she truly believed it would not happen to her? (With the rising cesarean rate, even if it "shouldn't" happen to her, it might.)
If you were to ask her (or the father) what would have helped, she (or he) might say--"I wish I had known what to expect. It was such a shock."
We must not put the onus of holistic preparation on uniniated mothers or fathers, i.e., "if they don't ask, we won't talk about it." Mothers and fathers who are not prepared suffer terrible emotional shock, not from the surgery itself, but from their own innocence, cluelessness, self-judgment, and being so overwhelmed, that they disconnect to get through it.
Even when the tide of unnecessary cesareans turns back, some women will have cesareans. So, cesarean preparation must become part of holistic preparation. All mothers, fathers, other mothers and their birth partners need to be prepared to give birth-in-awareness by cesarean.
In the birth trauma work I do, story after story, is not about the cesarean itself, but the shock of not knowing what to expect, or what to do, or what it means about her as a mother. On the other hand, BFW mentors have often heard thanks from parents who, because of the sensitive role-play class on cesarean birth-in-awareness, were prepared and much less traumatized.
Parents who see midwives, doulas, and take classes--and hear not a word about what to do during cesarean birth--often feel betrayed. Oddly, not talking about cesarean preparation prenatally adds to their feeling of shame because the people they trusted (i.e., the people who 'trust birth') did not talk about it. Silence sends a meta-message something like, "cesareans are something that happens to unprepared, uncommitted women, or women who don't have protection from information and doulas."
When birth peeps (or even friends) talk, straighforwardly and warmly, about giving birth by cesarean in-awareness, we model acceptance and strength. If we have rapport with the parents, they embody our acceptance and strength. Think of this as an emotional homeopathic dose of Medicine against shame, withdrawal, the pervasive feeling of failure. And, if she does have a cesarean birth, she knows she has an ally in us: we dared to talk about it!
If you are one of the people she trusts (one of the people who 'trust birth') and you talked about giving birth by cesarean, even if you are not with her in the operating room, she knows you are "with her." She knows she can come talk to you later.
Not all birth peeps can talk about cesarean birth warmly and without bias. Some need to first go through a period of healing their own birth trauma or agreements against cesareans or cesarean parents. Then, it can be done.
There are many ways of teaching about cesarean. Some send tacit or overt messages of judgment, with reasons and ways to avoid cesarean at all costs. The positive intention is to scare or motivate a woman not to "choose" a cesarean, but in labor, we all know that "choice"and informed consent are nebulous,gray areas.
When I teach couples about cesarean birth, I feel it is a ceremony, an initiation into self-acceptance and envisioning themselves coping--even with an unwished-for cesarean. The teaching is about embracing oneself, not about avoiding and regretting.
Fathers and other mothers experience cesarean birth from an entirely different perspective. They too need support and preparation; they too, can be traumatized by lack of preparation. If we don't tell them, they will be so overwhelmed by the surgery environment. This week I worked with a lovely couple who was unprepared for cesarean birth, but had one. The baby was born healthy, taken to the baby table for the baby dry and wrap ritual... then given to the father and escorted out of the room to the nursery. The mother never saw her baby. ... not until hours later in the recovery room. This father had no idea he could take it to his wife, the mother.... and help her see him, hold him, on the operating table. He was utterly overwhelmed and shepherded out of the operating room without a clue of the options. Their experience would be so different if ...if only.... they had been prepared for cesarean birth-in-awareness.
Some of you may already be doing this. And for some, it is so counter-intuitive, you can't imagine how to talk about cesarean birth without sounding like you are "approving" it or hypnotizing them to give birth by cesarean. These are important considerations. It can be done though. If you want to learn one way to do this, take an introduction to mentoring workshop, or contact Birthing From Within for a phone class.
There are many ways to change birth in our culture. It's not only about changing the medical protocols and rituals, but in preparing parents to birth in the culture they are actually birthing in, and not the one we wish they were birthing in.
In-Love,
Pam
One way to change the experience women have giving birth in our culture is to warmly, honestly prepare them for all kinds of birth in our culture. That includes cesarean birth.
Have you noticed how many times the mother who is in birth shock or shame after a cesarean is the mother who did not read or ask about it, because she truly believed it would not happen to her? (With the rising cesarean rate, even if it "shouldn't" happen to her, it might.)
If you were to ask her (or the father) what would have helped, she (or he) might say--"I wish I had known what to expect. It was such a shock."
We must not put the onus of holistic preparation on uniniated mothers or fathers, i.e., "if they don't ask, we won't talk about it." Mothers and fathers who are not prepared suffer terrible emotional shock, not from the surgery itself, but from their own innocence, cluelessness, self-judgment, and being so overwhelmed, that they disconnect to get through it.
Even when the tide of unnecessary cesareans turns back, some women will have cesareans. So, cesarean preparation must become part of holistic preparation. All mothers, fathers, other mothers and their birth partners need to be prepared to give birth-in-awareness by cesarean.
In the birth trauma work I do, story after story, is not about the cesarean itself, but the shock of not knowing what to expect, or what to do, or what it means about her as a mother. On the other hand, BFW mentors have often heard thanks from parents who, because of the sensitive role-play class on cesarean birth-in-awareness, were prepared and much less traumatized.
Parents who see midwives, doulas, and take classes--and hear not a word about what to do during cesarean birth--often feel betrayed. Oddly, not talking about cesarean preparation prenatally adds to their feeling of shame because the people they trusted (i.e., the people who 'trust birth') did not talk about it. Silence sends a meta-message something like, "cesareans are something that happens to unprepared, uncommitted women, or women who don't have protection from information and doulas."
When birth peeps (or even friends) talk, straighforwardly and warmly, about giving birth by cesarean in-awareness, we model acceptance and strength. If we have rapport with the parents, they embody our acceptance and strength. Think of this as an emotional homeopathic dose of Medicine against shame, withdrawal, the pervasive feeling of failure. And, if she does have a cesarean birth, she knows she has an ally in us: we dared to talk about it!
If you are one of the people she trusts (one of the people who 'trust birth') and you talked about giving birth by cesarean, even if you are not with her in the operating room, she knows you are "with her." She knows she can come talk to you later.
Not all birth peeps can talk about cesarean birth warmly and without bias. Some need to first go through a period of healing their own birth trauma or agreements against cesareans or cesarean parents. Then, it can be done.
There are many ways of teaching about cesarean. Some send tacit or overt messages of judgment, with reasons and ways to avoid cesarean at all costs. The positive intention is to scare or motivate a woman not to "choose" a cesarean, but in labor, we all know that "choice"and informed consent are nebulous,gray areas.
When I teach couples about cesarean birth, I feel it is a ceremony, an initiation into self-acceptance and envisioning themselves coping--even with an unwished-for cesarean. The teaching is about embracing oneself, not about avoiding and regretting.
Fathers and other mothers experience cesarean birth from an entirely different perspective. They too need support and preparation; they too, can be traumatized by lack of preparation. If we don't tell them, they will be so overwhelmed by the surgery environment. This week I worked with a lovely couple who was unprepared for cesarean birth, but had one. The baby was born healthy, taken to the baby table for the baby dry and wrap ritual... then given to the father and escorted out of the room to the nursery. The mother never saw her baby. ... not until hours later in the recovery room. This father had no idea he could take it to his wife, the mother.... and help her see him, hold him, on the operating table. He was utterly overwhelmed and shepherded out of the operating room without a clue of the options. Their experience would be so different if ...if only.... they had been prepared for cesarean birth-in-awareness.
Some of you may already be doing this. And for some, it is so counter-intuitive, you can't imagine how to talk about cesarean birth without sounding like you are "approving" it or hypnotizing them to give birth by cesarean. These are important considerations. It can be done though. If you want to learn one way to do this, take an introduction to mentoring workshop, or contact Birthing From Within for a phone class.
There are many ways to change birth in our culture. It's not only about changing the medical protocols and rituals, but in preparing parents to birth in the culture they are actually birthing in, and not the one we wish they were birthing in.
In-Love,
Pam
