When it comes to birth, we like to talk about the choices that women and families have to decide how and when the bring their precious new life into the world – but many women are in situations where the choice is not all theirs. In this piece, doula Sandra Maurer sheds light on the reality in which mothers on active duty military live, and gives five useful pointers for how we as doulas and midwives can best support them through their birth experiences.
As doulas and midwives we teach women that their bodies belong to them, to make their own choices, and to remember that they can always refuse a treatment. But none of that is necessarily true if you are an active duty military mama. While it may be true in theory, it is certainly not true in practice.
Active duty women are required to birth at military hospitals and to follow medical advice as an order. Going against medical advice is technically “allowed” but the ramifications of doing so could result in something as drastic as a dishonorable discharge for disobeying direct orders.
My first active-duty client, Crystal, was a shy but determined woman, who was preparing to have her first child. She was strong, healthy, confident in her body’s ability to birth unmedicated and uninterrupted. But Crystal was also active duty so, technically, she was the property of the government. This created a troublesome grey area for Crystal and her unborn child – can an active duty mother really make decisions for herself? Although Crystal wanted a natural birth, she was pressured to the point of tears by her nurses in her 38th week of pregnancy to be induced, and ultimately, she ended up with a very-unwanted C-section.
Though this mama ended up with a surgical birth, her spirit remained strong, knowing she did everything she could. Ultimately, as doulas and midwives, our job is to set mothers up for motherhood in a positive, empowering way, regardless of what happens in the birth room. It is our responsibility to make sure they are informed, encouraged and reassured with each step. Making confident birthing decisions, even as active duty personnel, will usher them into confident mothering decisions.
How can we best support an active duty mama?
1. Make sure mom knows her options. They may be limited, but they do exist. You should understand where mom is in the chain of command within the military, and then find options that will work for her.
“Knowing what mom is willing to do and who she is willing to stand up to is important to know ahead of time. Birth workers may get frustrated as active duty moms go against their own (the mom’s) wishes out of fear of going against “orders” from the doctors. It is not the mom’s fault, it is drilled into her head that if she says no to someone who outranks her, she will be punished, even if that person is telling her something that she feels is not accurate or something she doesn’t want. She can delay appointments though she can’t cancel them. This can be a good tactic!” ~Krysten, Military Mama and Doula
2. Talk through everything. Discuss every last detail, and in the process work to counteract any negativity from care providers about mom’s body or ability to birth her way. Encourage mom feel comfortable with you so that she expresses all the fears she is experiencing to you. Help mom to really decide what kind of birth she wants and write out a thorough birth plan to be looked over with the OB or midwife. It may be helpful for a birth worker to attend a prenatal visit, as an observer only, to get the idea of what kind of place mom will be birthing in.
3. Help her find her voice. Mom may be in the military but she is still a woman, still has a voice, and still needs to use it. I think the reason why Crystal was so positive after her experience, despite the challenges, was that she constantly made her feelings clear. This allowed her to avoid any guilt or shame later. Help mom to vocalize her needs and be able to explain why; to think like a consumer and not a subordinate.
4. Don’t be angry for her, but do feel anger or sadness with her, just as you share in her joy and elation over the healthy child she holds at the end of the process. Being angry for her, or interceding for her in a negative way, can add to her stress. She already feels surrounded; help her to instead feel supported.
5. Remind her she’s a good mom. She may not remember this if/when she is made to feel that her decisions aren’t safe for her or baby. Repeating this to her will hopefully inspire her to find the place in her heart where she knows it’s true and not give into fear.
Sandra Maurer, CD, RYT is a wife, blogger, certified Birth Arts International birth doula, certified yoga instructor, nanny and owner of WholeBeginnings Etsy shop for postpartum and pregnancy products. In love with all things mothers, she aims to support, empower and love women through pregnancy and parenthood. You can find her at http://wholebeginnings.com.