Creating 'Luck' in Your Maternity Care

A sentence that should not exisit: "I got so lucky with my midwife..."

Why is the standard of care so abysmal that we feel "lucky" when we find a midwife that is women centered in the care that she offers.

Why is it akin to finding a gold nugget, to not be dismissed, talked down to, or have our autonomy overridden in our antenatal care and birth experiences?

In conversations I've had with women in my community, the overwhelming refrain from anybody who did not experience birth trauma, is that they felt lucky to have received the care they did.

Yet is it not our right, to recieve thoughtful, compassionate, aligned care, during this life changing experience of pregnancy and birth??

It seems unfortunate to me, that there is such a divide between those who received care that was aligned with their wishes, and those who we bulldozed and pigeonholed into things that in hindsight, they wish they had a better understanding of at the time. And this is not about so called "good" births versus "bad" births. There are plenty of women who chose to have an in-labour-emergency-cesarean, that also feel like they made an informed and aligned choice.

The point being, it was their choice. It shouldn't be "luck" to draw a public health midwife that respects another woman's choices, even if it is different than what she would have chosen for herself. That should be the minimum standard.

This seemingly almost 50-50 split was a big part of my choice to freebirth for my first baby. When you have no control over which midwives are on staff when you go into labour - those odds of drawing someone who would not respect my birth choices was just not a risk I was willing to take. This risk can be mitigated through a continuity of care model such as a privately practicing midwife who has admitting rights at the hospital you intend to birth at, or through hiring a doula, so you can feel confident that there is someone in the room that is on the same page as you and is willing to listen to and respect your wishes, regardless of hospital staff. But unfortunately, the current MGP programs in Australia, just don't offer that continuity of the same trusted midwife for your case - instead, the cases of multiple pregnant and birthing women in the community are shared amongst a "group" of midwives (hence, Midwifery Group Practice), with the premise that this offers continuity of care. And for some women, that may be the level of continuity that they are seeking. But for me it just doesn't cut it.

And so it comes down to "luck."

So how can you create your own luck when it comes to having your needs met during pregnancy, birth, and postpartum?

1. If you choose to engage in the public system, feel your way into the midwives in your MGP, and figure out if it feels aligned for how you want your birth to look and feel.

2. Research private midwives in your area and reach out to any you feel might be the right support person for you. Choosing your own midwife is a great way to ensure you get the continuity of care that you want.

3. Think about hiring a doula. A doula can help you navigate the medical jargon and assess your options. They can help you understand the risks and benefits of what is being offered and provide the emotional support that is often missing from the midwife-woman relationship. A doula can be an alternative source of birth education and often specialise in physiological birth, so conversations with your doula can help build your belief in birth and grow your confidence in what you want your birth to feel like, as well as giving you one known and familiar face at your birth and that continuity into postpartum care.

Exploring these options will help you feel lucky in your birth. When you feel safe to say no; when you feel supported in your choices; when your emotional state is respected just as much as your physical state.

Anecdotal evidence is showing that it's less about the actual birth outcomes, and more about the way women FEEL, that dictates whether a pregnancy and birth experience feels "good." And that feeling comes from feeling seen, heard, and respected. So if you can focus more on finding that feeling with your care providers, rather than actual outcomes (sometimes, medical things are actually out of our control and we may need to make choices we thought we would never make).

But if we can feel seen and heard, like we MATTER, that's what's most important. So, is it really about luck??