Do Labor-Support Professionals Advance or Repress Women?

First I would like to thank you for reporting on the profession of labor support in the article “Organized Labor” on March 28. The interest, time and effort put into covering one of my client’s births was greatly appreciated. I was pleased with your emphasis on what I feel is the crux of labor support--the constant nurturing, encouragement and guidance of an experienced woman throughout the childbearing process. I was deeply distressed however, by a misunderstanding regarding my personal philosophy toward laboring women’s choices, resultant ramifications of those choices and my role as a labor support professional.

As to the issue of women’s choices in labor, they are not black and white. I do believe there are two basic philosophical approaches to childbirth. In one, the woman eagerly desires medical management of her labor in an effort to achieve an expedient and least-painful means to deliver her baby. The other chooses to have the health care team safeguard herself and the baby, but not interfere in her normal body processes unless complication sets in or she requests assistance.

I do not look upon either woman as valuing her birth or her baby more or less than the other. This is a personal preference, and as long as her choices are safe, no one can tell her what is “right” or “wrong” for her.

The second woman’s philosophy however, shows her preference of giving birth on her own and fully experiencing not just the delivery, but the labor process itself is an important part of her life. She is willing to accept the pain and struggle of labor with the hope that the effort she and her supporters put forth will pay off in less risk for her baby and herself, a decreased chance of an instrument delivery or Cesarean section, and deep satisfaction in reaching her personal goal.

In circumstances where an extremely difficult or complicated labor occurs, I believe appropriate and well-timed medical intervention may offer the best tool at hand to achieve her ultimate goal: the healthy delivery of her baby.

The role of the labor support professional is not to tell the physician how to manage his/her patient, or to interfere in necessary lifesaving interventions. A militant attitude against the medical team benefits no one. Neither is my role to impose any “philosophy” on the laboring couple. Rather, it is to understand the parent’s individual philosophy and desires for the birth experience.

SHERRI ALDEN

San Clemente