Credible evidence demonstrates that choice is so limited that it is probably a myth. Additionally, increasing evidence suggests that autonomy plays an important role in maximizing safety and in decision-making, and that autonomy develops within the context of trusting relationships.
What does this mean for childbirth education?
First, we need to value and respect in more straightforward ways women's inherent ability to give birth and their authoritative knowledge (inner wisdom). The most important goal of childbirth education—indeed, of every encounter with women—is to inspire confidence. Not confidence in science or medicine, but confidence in women's knowledge and ability. We need to trust women, not just birth. We need to have a deeper appreciation of the impossibility of making decisions when one has been stripped of all confidence in a maternity care system that insists it holds the key to safety for women and their babies.
Second, we need to applaud women's knowledge and carefully “pull it out” by questioning them, listening to them, and creating learning environments where women share what they know and can learn from each other, not the experts. Our belief in a woman's inherent ability to be her own and her baby's expert should underpin all our interactions.
Third, we need to make sure that women know they hold the keys to safety for themselves and their babies. What they know, what they feel, and what they wish for are all important in reducing risk and increasing safety. Their confidence, their knowledge of their bodies, and their feelings are vital.
Fourth, we need to focus on developing trusting relationships with the women in our classes. Our relationships are the context for women's autonomy, confidence, and trust.
What does this mean for childbirth education?
First, we need to value and respect in more straightforward ways women's inherent ability to give birth and their authoritative knowledge (inner wisdom). The most important goal of childbirth education—indeed, of every encounter with women—is to inspire confidence. Not confidence in science or medicine, but confidence in women's knowledge and ability. We need to trust women, not just birth. We need to have a deeper appreciation of the impossibility of making decisions when one has been stripped of all confidence in a maternity care system that insists it holds the key to safety for women and their babies.
Second, we need to applaud women's knowledge and carefully “pull it out” by questioning them, listening to them, and creating learning environments where women share what they know and can learn from each other, not the experts. Our belief in a woman's inherent ability to be her own and her baby's expert should underpin all our interactions.
Third, we need to make sure that women know they hold the keys to safety for themselves and their babies. What they know, what they feel, and what they wish for are all important in reducing risk and increasing safety. Their confidence, their knowledge of their bodies, and their feelings are vital.
Fourth, we need to focus on developing trusting relationships with the women in our classes. Our relationships are the context for women's autonomy, confidence, and trust.
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