Who is the Birth Expert Here?
Does an ‘Expert Position’ serve professionals in the field of birth support?
Do you consider yourself an expert in ‘how to give birth’? If you are a childbirth educator, a birth doula, a midwife or a labor and delivery medical staff member, I’m almost certain that there is a confident voice inside your head saying, “Yes, I know all about giving birth, it’s my profession and what I do for a living”. I believe that since the seventies, with the beginning of birth activism, birth givers have been torn between two types of “experts” – “medical experts” and “natural birth experts.”
Maybe it’s time to rethink our position: Can anyone be an expert and say how another person should give birth?
Birth givers have been torn between two types of “experts” – “medical experts” and “natural birth experts.”
I recently finished reading the book “Childbirth and Authoritative Knowledge; Cross-Cultural Perspectives,” a collection of cross-cultural essays on reproduction and childbirth, edited by R. E. Davis-Floyd and C. F. Sargent, which extends the work of childbirth anthropologist Brigitte Jordan. I was deeply impressed by the authors’ understanding that since the establishment of Obstetric Gynecology in the middle of the nineteenth century, the experience of childbirth has been controlled and shaped by “those who know”; those who are considered an authority of knowledge, and whose ideas about childbirth shape and control our decisions and actions in maternal care, as opposed to the only expert in the room- the birthing mother. “Authoritative knowledge is persuasive because it seems natural, reasonable, and consensually constructed. For the same reason, it also carries the possibility of powerful sanctions, ranging from exclusions from the social group to physical coerciveness” (Jordan and Irwin 1989).
I gave-up my “expert” position and my clients got to be the experts in their own lives
Can we adopt a new position that serves us better?
After practicing from an authoritative position in L&D for so long, no wonder we ended up with a generation of birthing mothers who come to L&D unit and completely hand their lives over to the professionals, fully trusting them to make decisions for them. One would have assumed that birth activists and birth keepers, like childbirth educators and birth doulas, practice from a different position. However, I find that this is not the case. In nearly two decades of practice as both childbirth educator and doula, I admit that only after becoming a life coach, eight years ago, I finally stepped down from the “expert” position, and began seeing my students and birth clients as experts in their own lives, and therefore as experts in designing and achieving their desired birth experience.
Coaching starts from the assumption that the coachee has the answers
Seeing the client as an expert in her own life is a basic principle in coaching and I chose to manifest in The Art of Coaching for Childbirth, a guide introducing birth support coaching and motivating birth professionals of all kinds to integrate the coaching tools and strategies into their practice. This basic principle was first stated by two of the founding fathers of the coaching profession, Sir John Whitmore, who recently passed, and Robert Dilts. According to Dilts, coaching starts from the assumption that people have answers, and the coach’s role is to help them to overcome internal resistance and interference, give feedback on behavior and give tips and guidance (Dilts, 2003). So if the client is the expert and has all the answers, what is the coach’s expertise? Here we can use Whitmore’s observation that: “The effect of coaching is not dependent on “an older, more experienced individual passing down his knowledge. Coaching requires expertise in coaching but not in the subject at hand. That is one of its great strengths” (Whitmore, 2002)
How do you bring out the ‘experts’ in your birth clients?
Here are five steps I suggest we all take:
- Work with questions
- Trust your clients
- Facilitate Clarity
- Elicit accountability with
- No attachment to outcomes
- Work with questions: Instead of telling or teaching, ask expectant individuals more questions about themselves. When they say: “I would like to give birth naturally” try not to assume you know what it means and ask: “Can you clarify for me what is your vision for natural childbirth? How does it look? What happens in natural childbirth? How does it feel? Strive for clarity.
- Trust them as the experts: Even if they currently don’t seem to trust themselves, your trust in them is crucial. As a coach, your most valuable asset is that you believe in their potential. This is true empowerment.
- Facilitate clarity of mind and encourage them to set-up a clear vision: Clairy of mind and vision will help you to provide more accurate support to the particular individual. Ask: “how can I best support you in achieving this vision?” Whether you are a doula holding your first coaching session with your client or an L&D nurse who was just handed your patient’s birth plan, you may initiate a conversation about it beginning with the same question.
- Elicit clients’ accountability to their process: Holding our clients accountable for their own process is a core principle in coaching. When you join the Birth Support Coaching course you’ll learn strategies and techniques that will help you elicit your clients’ accountability levels. Higher commitment to their process will, in turn, result in stronger convictions about their way and will allow them to navigate and advocate better during birth.
- Coach them with no attachment to the outcomes: This is a tough one! But hey, in childbirth, just like in any other area of life, there are no guarantees. What matters is the process. As long as you lead your client to be accountable for her healthy process, it doesn’t matter if in reality there was a deviation from her vision due to medical impositions. clients’ satisfaction level is in correlation to their performance and not the actual unfolding birth, which is unpredictable as we all know.
- Dilts, R. (2003), From Coach to Awakener, Meta Publications, California.
- Irwin S. and Jordan B., (1989) “Cosmopolitan Obstetrics: Some Insights from the Training of Traditional Midwives, Social Science and Medicine, 28(9):925-944
- Whitmore, J. (1992) Coaching for Performance: Growing Human Potential and Purpose – The Principles and Practice of Coaching and Leadership, Nicholas Brealey Publishing, Boston
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