How women make decisions during labor and birth

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As doulas, it is important that we understand why women make the decisions they do.  Understanding how women make decisions during labor and birth helps us to move away from our own biases during birth, and move into the world of the women we serve.  One of our assignments for certification is to look at decisions that are being made in two particular scenarios and decide why they were made.  By doing this, our students learn to understand different ways of thinking and understanding.  Below is an example of this assignment:

“Homebirth In The Hospital-

  1. Pamela and Chloe-Pam had a poorly managed medical birth for her first child. The experience left her unhappy and disappointed with her experience. Due to this, Pam made an intuitive thinking-based decision to integrate noninvasive birth model into her next experience. She did this because she felt disappointment with her experience the first time and wanted a positive experience this time.
  2. Pam and Chloe-Pam asked for pain relief during labor. This was also an intuitive decision based on the level of discomfort she was feeling at that time. Pam was feeling pain-was asked in between contractions if she was sure about pain medication and was able to feel out her decision.
  3. Sueli and Marcus-Sueli made the decision to stay home after her water broke. This was an intuitive decision based on her feeling of relaxation at home and her feeling that she would still have at least 6 hours until baby. Sueli was so comfortable at home that she didn’t feel that she needed hospital right away.

Case Study 3

  1. MD made decision to augment labor with Pitocin due to length between contractions and level of effacement/dilation. This decision was based on scientific thinking and critical thinking.
  2. Megan was turned during labor due to fetal decelerations. This was an evidence-based critical thinking decision based on it’s effectiveness during past births.
  3. Megan’s Pitocin was slowed to assist in reducing fetal stress/decelerations. This was also a critical thinking or scientific decision based on past experiences by MD and research he had encountered.”

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