I Had A 'Hands Off' Birth And This Is What It Was Like

by Wendy Wisner
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Did you know it was possible to give birth without a doctor or midwife checking your dilation constantly – or even at all? Or that you could give birth without someone telling you, “It’s time to push”? That you could do it without continuous electronic fetal monitoring, in any position you choose, and essentially without anyone even touching you unless absolutely necessary?

Obviously, this scenario is not for everyone – nor is it possible if you end up having a medically complicated birth. But this is how both of my births went down – by choice – and I wouldn’t have traded the experience for the world.

I don’t think I fully realized at the time how unusual my experience was, or that there was even a name for it. But scrolling through Facebook the other day, I found a viral post that described my experience to down to every detail. Deb Fiore, a certified nurse midwife (CNM) from North Carolina, wrote a post on her Facebook page describing a low-intervention type of birth like the one I had.

She calls this kind of birth a “hands off” birth, which I think is brilliant. Check it out here.

This is how Fiore describes the “hands off” birth:

“I rarely touch a woman during her labor/birth,” she says. “I don’t ‘check her cervix’ unless needed (which is rare and typically only needed with first time mums). I don’t tell a woman that ‘it’s time to push’ or that she needs to start pushing. I don’t ‘massage the perineum.’ I don’t ‘catch’ the baby (unless requested to by mum).”

Fiore, who has 18 years of experience – including in high risks hospital settings – has attended over 1,200 births (wow!). She explains that in her experience, most moms really have all it takes to birth their babies themselves and it is rare that she needs to intervene.

“[W]e do not need our hands on perineums [sic] or babies when they enter the world except in the rare scenario where they are having trouble with the journey (shoulder dystocia, tight nuchal cord, ect [sic]),” she writes.

Fiore ponders why birth practitioners are always taught to use their hands and to intervene at every birth, even when it isn’t medically necessary.

And what does she think the reason is for this? CONTROL.

“It gives US a sense of control and the root of control is FEAR of the ‘what if??’” Fiore writes. “We don’t respect the process as being physiologic, we can’t accept that it can happen without our intervention, therefore, we fear it and attempt to control it.”

Now, I know at this point many of you are thinking, “But isn’t it a medical professional’s job to have some control over the details of a woman’s birth, even if there isn’t a medical emergency unfolding?” Or you might be thinking, “You do you. But I wanted my doctor/midwife by my side at all times, heavily monitoring what was going on.”

Both of those perspectives have merit, for sure. But I think that what Fiore is saying is that events like birth – which is medical in nature, but also a natural physiological process that humans have been doing for millions of years, and can often unfold on its own without help – tends to be overly monitored these days.

The way birth typically goes down often leaves mothers feeling powerless, like they can’t trust their bodies to birth their babies, and that doctors should always have the upper hand when it comes to decisions mothers make during labor and birth.

“Folks, despite what you have been told by your physician, nurse, nurse-midwife, certified professional midwife or lay midwife, WE are not the ones ‘delivering’ your babies nor do I believe we should be the ones ‘catching’ your babies,” Fiore writes. “Birth is a physiological event that belongs to the woman and her family. My role as the attendant/midwife is to quietly safeguard the process and space, and to intervene should the process require my skills (which is a rare event).”

To that I say, HELL YES. Yes, medical advances in birth are amazing, have saved lives, and absolutely should be utilized when necessary. But even major medical organizations like the American Congress of Obstetricians and Gynecologists (ACOG) have put out guidelines stating that for low-risk women, doctors should err on the side of staying out of the birthing process and should only intervene when medically necessary.

As for my own births, there was never a moment where I didn’t feel totally safe and taken care of despite the fact that my midwives were very hands off. For example, although they didn’t require me to wear an electronic fetal monitoring device continually during labor, they checked my baby’s heartbeat throughout the birth with a hand-held monitor. And although my dilation wasn’t checked, they monitored my contractions and progression carefully (though sometimes in the other room or over the phone).

And they most certainly used their hands when my first son’s cord was around his neck as he came out of the birth canal. Same goes for when my second son had a slight case of shoulder dystocia.

My midwives intervened when they needed to, but otherwise stayed the heck out of the process. The result was that I felt empowered in my body. I felt in charge of what was happening. And I emerged from the experiences feeling like a badass superhero birthing mama.

Too many of us aren’t listened to during birth – and we are often poked and prodded when a more “hands off” approach would be appropriate. We are told that our intuition doesn’t mean anything or that only medical professionals know what is happening with our bodies. This leaves us feeling vulnerable and disempowered – and that needs to change.

However birth goes down for you, I believe there is a way for us all to feel strong and validated. And it starts with how our providers treat us. We birthing moms deserve respect and autonomy, and to feel that we have a clear and important voice when it comes to decisions about what happens our bodies and our babies. Amen.

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