Birth Day - International Childbirth Education Association

Are unexpected outcomes
in childbirth normal and should
they be presented in all classes?
By Sherokee Ilse
The answer to both, I believe, is
‘yes.’ Allow me to explain.
“Just remember, at the end of
this pregnancy and labor, you will
have your prize, your joy, your baby.”
These words, spoken by the assistant
childbirth educator, still ring in my ears
decades later. Sadly, our ‘prize’ was a
baby boy who died a day or two before
birth. We named him Brennan William,
and from that day forward our
whole world changed. And we are by
far not the only ones.
Setting the Stage
In the US alone, close to 30,000
babies die prior to birth in what is
technically called stillbirth. If you add
in neonatal death and even Sudden
Infant Death Syndrome, the numbers
of families who will experience the
death of a baby is staggering in the
21st century in the United States. In
addition, there are so many unexpected
outcomes that occur during pregnancy
short of death. How are parents to
face the many common disappointments
and tragedies that occur in most
pregnancies or even their fears about
them if they are not even discussed by
childbirth educators?
Preparing for birth and parenting...
the dreams, the hopes, and the plans...
is something every parent does. The
hopes are high and the expectations
about the experience, while unique
for every person, are vivid to most. As
young children, most wannabe parents
planned their dream childbirth journey,
seeds planted as they played ‘mommy,
daddy, and baby.’ Over the years, the
dream grew as they watched adults
parent and prepared for their own
family. Pregnancy tests, ultrasounds,
books, videos, and meeting friends’
babies made it come alive. The picture
became more clear of what their
pregnancy would be like (easy, glowing)
how the birth would, or would not go
(short, natural, and pain-free labor) and
what the baby would look like ( Gerber
baby maybe?).
On top of that, today parents
often believe that if they follow the
rules and do everything right they
will control their destiny; they will get
and deserve to have only natural and
‘expected’ outcomes. In most people’s
minds the worst that can happen is a
Cesarean or a long labor.
Are these dreams helpful to cling
to? Does life really fulfill every dream?
Are things fair? Should childbirth
educators allow these parents to stay
naïve and uninformed? And what if all
does not go as planned? What if they
need more pain medication or medical
intervention than planned? What
if their boy turns out to be a girl? How
do people handle change, disappointment,
and yes, even the occasional
tragedy? If the unexpected does occur,
which it does probably close to 90% of
the time, will they wonder if they did
something wrong, blame their medical
caregiver or their childbirth educator,
and will they know what to do and how
to cope?
Until recently, few childbirth educator’s
or medical careproviders wanted
to challenge these perfect dreams or
openly discuss the unexpected. This
once taboo subject is rising from the
darkness. Those who make a commitment
to touch upon this in class and
who learn ways to do it well (it can be
done well, albeit challenging at first),
find much satisfaction and even positive
feedback, after the baby is born
in particular. They often find honest
discussions promote self-reliance in
families rather than a victim mentality.
Parents who have a sense they can
control and face their fears are more
confident and adaptable.
Unexpected outcomes don’t always
have to be negative experiences that
everyone must avoid. Though there
is always some loss when part of the
dream changes, with a good attitude,
support, coping skills, and resources,
losses can become a positive, growing
experience in time.
continued on next page
16 | International Journal of Childbirth Education | Volume 24 Number 4 December 2009