Cesarean sections. Epidurals. Natural childbirth. Induced labor.
Expectant mothers have many options when it comes to their maternity care.
A group of Tri-City women don't want to tell mothers what choice is best, because they've been there and recognize that each situation is different. What they do want is for mothers, obstetricians and midwives to be educated on all labor and birth options so informed decisions will be made through the process.
These women have joined a national movement using Labor Day as its springboard to spread the message. They organized Monday's "National Rally for Change" in Richland and want to make it clear it's not a protest, but a public awareness event.
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The rally will be from 10 a.m. to noon in John Dam Plaza, with men, women and children encouraged to attend. It is one of four organized in Washington -- the others in Yakima, Spokane and Seattle -- and among more than 100 nationwide.
The coordinators have been preparing signs with messages like: "Your Body, Your Way," "Informed Consent and Refusal" and "Empowered Birth."
"This is all about supporting birth and women," Lisa Campbell of Richland told the Herald. "The end we all want is a healthy mom and healthy baby."
She said it is OK if a woman chooses to have a home birth or to schedule a C-section or anything in between, as long as they know all the risks and benefits. However, women should not be forced to feel like they have to do what every other mother does, she said.
The first rally was held in Southern California last December, and has grown to this national movement coordinated by ImprovingBirth.org. The organization, which has filed for nonprofit status, wants to reduce the number of unnecessary inductions and C-sections in the United States by educating birthing families, birth workers and hospital administrators.
Founder Dawn Thompson has set out through the organization to encourage hospital administrators to review their birth-specific policies and procedures, and doctors and nurses to stay updated with the most current care practices. ImprovingBirth.org says the United States outspends every country in the world for maternity care, but ranks 49th for maternal mortality rates.
Susan Brady, whose son Ethan was born a year ago, said she became passionate about things like birth once she was a mother.
"I had a great experience as a mother with my birth. I want every mom that I talk to to feel that she was listened to," she said.
The Richland woman had read some Facebook postings by friends about Labor Day rallies in other states and said the cause resonated with her, so she decided to plan the Richland event with help from friend Kseniya Deryckx.
The Facebook group for the local event is www.facebook.com/ImprovingBirthNationalRallyForChangeRichlandWa.
"The rally is not home birth vs. hospital birth. We're not saying you have to do things naturally or get an epidural," Brady said. "This is just about birth and saying, 'Moms, know your options. And health care providers, please listen and have a discussion with women.' I think that is so, so important."
The group supports "evidence-based maternity care," meaning that the care chosen is based on reliable research beneficial to mothers and babies, reducing the incidences of complications, injury and death. They believe the standard of care is outdated, with too many doctors rushing to induce a mother or to skip a vaginal birth and go forward with a C-section when there is no medical reason to speed up the process.
However, the group also knows that inductions and C-sections can be life-saving interventions when needed, and overall just wants a mother to be able to make an informed choice.
"We are making really great strides in the hospitals," said Brady, noting that the Tri-City area has been at the forefront, advancing in that direction. "But still across the state we're seeing tremendous variability in care."
Brady points to the Bree Collaborative, which each year is tasked with researching up to three health care services in the state and making recommendations to the Washington State Health Care Authority.
Obstetrics care was chosen as the first research topic and a report was completed Aug. 2. The 33-page report can be found at www.hta.hca.wa.gov/bree.html.
The state collaborative found "that substantial variation in OB care practice patterns (labor and delivery) and services exists across providers and facilities in Washington state, despite local and national quality improvement efforts. Variation is disconcerting because it may signal unfavorable outcomes for both mothers and infants, as well as higher costs."
There were 85,494 births in Washington in 2011.
The report said there should be no "elective deliveries" before the 39th week, elective inductions of labor between 39 and up to 41 weeks should be decreased, along with primary C-sections to lower the rate of repeat cesareans with additional births.
Deryckx said she understands that as humans we like to hurry with all our technology. But through that technology, we also learn what works and what doesn't, and the same could be applied to best practices for childbirth.
Deryckx said she'd like to see the community step up and "empower everyone to speak up because it is often that women have bad experiences, they don't say anything about it. It is often that people feel they could have had a very different outcome, and don't feel they have room to talk about it."
"I just hope that people will come and not be afraid," she added. "This is not a negative event, and we really hope the community won't see it as such. We want to overcome this kind of fear of voicing your opinion or expressing concerns about what is going on."
Brady said she does not want to attack our health care system, but to bring awareness to moms who are unhappy with their birth experience and to thank those health care providers who listened and had discussions with expectant parents.
"It's about birth, not how you did it or didn't do it," she said. "It's about how would you like your birth to be, and having the voice to say that and the ears to hear that, and having that flexibility."
Deryckx is listed on the national website as the Richland event contact. For more information, she can be reached at 360-510-3475 or email@example.com.