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Authority, intuition and informed choices in pregnancy and birth

Does your birth plan and preparation include tapping into your own infinite source of personal wisdom that lives in your body?

Everyone has it, often laying at the bottom of the bog of our patriarchal consciousness.

It is intuition, instinct. It is that feeling in your gut when you know something is wrong. It is also the feeling in your gut when you "just know" something is right.

Pregnancy ignites access to our mammalian, biological intuition. Your instinct to protect your body and baby is the reason that our species has evolved to the extent it has. Your maternal instinct is the foundation of human survival. You know better than anyone else what is right for you and your baby.

Pregnancy is the perfect time to get in touch with your feminine, intuitive genius. Your intuition will inform your motherhood and lead you into living in your power, and your most aligned life. You are faced with so many decisions during pregnancy, perhaps that feel more important than most decisions you have ever had to make. What if you listened to your intuition, and valued your insight into these decisions more highly than that of any external "expert"?

The culture of prenatal "care" in the paternalistic model of health care has diminished the value and validity of our intuitive maternal instincts; pushing them out of consciousness of what is considered true, safe and right. That model has made way for the father-doctor-god complex to take over the realm of pregnancy and birth.

What if you were the expert on your body, and your baby? What would it feel like to put your own intuition over external "expert's" opinions?

It is easy and normal to give your power away in this science, technology, and expert obsessed world. Consider the rituals that take place upon finding out you are pregnant. You pee on a stick to tell you if you are pregnant. The norm is to then seek "prenatal care" from someone else, a doctor or a midwife. You hand over your care to the expert that you choose. Often it is not even apparent that there is a choice, if there is just one OB office near you or just one midwife, you go there. From then on, your care provider becomes the authority over you. Let’s consider the mainstream language around prenatal appointments, testing and intervention. I often hear women say things like "they had me come in for an ultrasound" or "they scheduled me for this test". The mainstream model is a hierarchical power structure, where the actual pregnant woman, is at the bottom, and the language I hear in casual grocery store conversations clearly reflects that. The word for prenatal care in spanish, by the way, is control de embarazo; literally, control of pregnancy. The word for a pregnancy without prenatal care from a doctor or midwife is autogestionado; as in, gestated by the woman herself. As if someone else can gestate your baby for you? The culture of pregnancy care and birth in spanish speaking countries like latin America (I live in Mexico most of the year) is just as, if not more, paternalistic and hierarchical as here in the U.S.. but I digress.

The truth is, you have to consent to everything, and you have the right to refuse everything. Prenatal care is indeed a la carte. You pick and choose what tests or ultrasounds or exams you want. You actually can refuse everything. Everything down to having a care provider in the first place.

The current health-care system was founded on a paternalistic model in which the physician maintained complete and unquestionable authority over all health-related decisions and information (Mallardi, 2005). The patient was seen as an object and recipient of the physician's medical expertise. The physician acted as the authoritarian benefactor who took care of the patient (Mallardi, 2005). This relationship between patient and physician prevailed, uninterrupted for centuries. In fact, many argue that the paternalistic model not only still exists, but thrives in today's health-care systems (Arslanian-Engoren, 2002; Cody, 2003; Wittmann-Price, 2004). The American College of Obstetricians and Gynecologists recognizes the problematic existence of the paternalistic model in current obstetric care as a “historical imbalance of power in gender relations [that constrains] individual choice posed by complex medical technology, and the intersection of gender bias with race and class bias in the attitudes and actions of individuals and institutions” (ACOG Committee on Ethics, 2004, p. 13).... Federal acts and regulations, as well as professional guidelines, clearly demonstrate that every pregnant woman has the right to base her maternity care decisions on accurate, up-to-date, comprehensible information.

- Informed Decision Making in Maternity Care

The imbalance of power in gender relations that this model of maternity care creates is not limited to male doctor female patient relations. It is just as present in the relationship between a female doctor and female patient, because every doctor is trained in the paternalistic model of care. Regardless of gender, the doctor represents the masculine authority, because of her training in this model.

Fertility, pregnancy and birth has changed from an occult and magical world of knowledge of all women, to a realm of the experts; knowledge withheld from the common woman by the cult of the professionals.

But there is an in between; a beautiful balance of the science and the sacred; a model of prenatal care where a woman feels like she is truly in power and is the expert on her own body, and uses the information available from current science to make decisions on how she wants to engage with that system.

Reclaiming authority over your pregnancy and birth decisions, and all health care for that matter, is the first step to manifesting a powerful birth experience, and LIFE. It is crucial to our continual process of liberation to claim our right to informed consent. Though it is legally mandated, informed consent is an ever more elusive aspect of prenatal care.

I teach the BRAIN acronym, from childbirth international, to all of my clients as a guide to decision making in pregnancy. But I switch it up so it is actually IBRAN; here is why

I - Intuition What does my body say? Ask yourself about the question at hand, for example, whether or not you need another ultra sound for whatever concern. Without thinking with your logical mind about it, what is the first answer that pops into your mind? Now check in with your heart. Imagine going to get the ultra sound and not, and how do both options feel in your heart? Now with your gut. What do the options feel like in your gut? I put intuition first, because I think it is time we begin valuing feelings and instincts over "science". Science is ever changing, and things that were routine ten years ago are now considered dangerous. But our instincts and intuition never changes, because it is our body's truth. It is the only thing that is true for us.

B - Benefits What are the benefits of the options? Using the ultra sound example, what are the benefits of the information I could discover by getting this ultra sound? Would that information put me at ease? Would that information improve my outcome? What are the true benefits?

R - Risks What are the risks associated with this option? What are the risks and dangers of ultra sound? What is the risk of what I will discover in the ultra sound?

A - Alternatives What are the alternatives to the proposed option? Is there a different way to find out about the thing that they have suggested to look for in the ultra sound? Do I really need to know? What if I didn't know? N - Nothing What if I did nothing? What if I just waited it out?

This method of decision making combines getting in touch with our feminine, intuitive knowing, the sacred and ceremonial side of pregnancy and birth, with the more scientific and masculine side of our mind by balancing risks and benefits. It is a beautiful idea to have a truly intuitive pregnancy, and not consider the more masculine and scientific side of things and I think that is a valid, beautiful and safe option for some people who have worked hard to surrender their mind to that way of existing intuitively. But for most of us, our brain is conditioned to think in a scientific, logical and perhaps more triangular, masculine way. The IBRAN method of decision making provides a method that puts the woman at the top of the power structure, reclaiming her authority while listening to her intuition first, but still considering the science. I view it as a step toward reclamation of the feminine and intuitive magical ways of pregnancy and birth, while quelling the fears and questions of the logical, paternally conditioned mind of modern women. If it feels good for you, it is enough to just stop after I . Just checking in with your intuition, is enough.

At any moment that something doesn't feel right, you can say no. You can get up and walk out and never walk back in. You don't have to show up for that test. You can switch your care provider to someone who is aligned with your values, and most importantly, respects your intuition.

It is enough to just not feel right about something. Your intuition is more intelligent to your needs than any expert. What would it feel like to put your intuition on the top of the power structure? What would your prenatal care look like if your intuition was the expert? What would your birth plan look like if following your intuition was number one?

In my coaching work, I provide tools and practices for women to get in tune with their intuition. I value the mother's instinct as the number one authority. I trust women. I trust their own expertise on their body, and I hold the space and provide resources for them to step into alignment with their intuitive genius. I ask the questions that guide women into their own undeniable truth, and allow for the uncomfortable feelings that may arise as we clear that path to power.

Women own their birth, and the birthing woman taking back her authority is the core of the birth and feminist revolution.

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