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Let and Allow Are Not In My Vocabulary

10/1/2023

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Recently, a client decided during labor to transfer to hospital care for birth.  Shortly after we got there, the OB asked me why I "let" my client continue to labor. That got me thinking about what I see as the biggest difference between midwifery care and obstretric care.

There was nothing happening with the labor I was at that would indicate an immediate trip to the hospital was needed.  As I've written before, hospital transfers can happen for benign reasons like a client wanting pain medication, or because the client is tired and wants the tools hospitals offer to get contractions stronger to get finished. The client is in charge and if they want to go to the hospital, it's my job to facilitate and support them in that.

In the past the American College of Obstetrics and Gynecology has had wording to include "allow a trial of labor after cesarean"  as well as "allowed to push" in their provider guidelines. I was asked why I "let" someone continue to labor at home. The connotations those words have is the difference between midwifery and obstetrical care. 

To allow or let means someone is in charge, or has control over what another person is doing. My clients are adults who have taken the time to educate themselves on the risks and benefits of home birth, and they have also educated themselves on the risks and benefits of hospital births and interventions that are offered at hospitals.  

My clients are the ones making decisions regarding their care. My role is to facilitate and offer education so they understand what is happening and understand fully the risks and benefits of the options so they can decide what is best for the individual situation and for them. I don't "let" or "allow" my clients to do anything!!  My clients are fully capable of making decisions without my permission and I wouldn't want it any other way.


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    Author

    Gail Webster, CPM

    Gail is a Certified Professional Midwife serving Manhattan, Junction City, Fort Riley and other areas in Kansas.  


    When Gail is not occupied with birth work, she enjoys reading, quilting, baking, riding her motorcycle and spending time with family.
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