safe pregnancy birth

A young woman sitting with friends says, “At 24, I was the “can do” woman, in charge of my life and body – Ms. Invincible. Then pregnancy and parenthood gifted me new understanding of what “change” and “flexibility” mean. I was humbled.” Friends smiled and nodded in understanding. Many factors play into life-changing events during the wondrous time around pregnancy and childbirth.

Some local information:
Most of the approximate 2,000 births each year in Maui County are hospital births. In 2011, 78 Maui home births were registered for birth certificates with the Department of Health. Homebirths on Maui are usually attended by trained midwives, also known as Certified Professional Midwives (CPM). As midwives go, there are different levels of training and practice. In Hawaii, the only midwife that is licensed to practice and regulated by the Department of Commerce and Consumer Affairs is the Certified Nurse Midwife (CNM). Statewide they work in clinics, hospitals such as Molokai General Hospital, and some assist with homebirths or at a local birth center such as on Kauai.

The ob/gyn doctors on Maui respect the right of women to make medically-informed decisions about birth. While they believe that hospitals and birthing centers are the safest setting for birth, they will provide prenatal and delivery services any time a patient comes to the hospital requesting medical care. Homebirth midwives who accompany women to the hospital are welcome to provide labor support.

In the spirit of safe passage from womb to world, a focus group of local health care providers including a certified professional midwife, obstetrician, community clinic nurse, local ambulance staff, doula, certified nurse midwife, and hospital maternity unit staff, were brought together and asked, “What is important for women to know?”

Here are their top responses:
1. Learn about pregnancy and childbirth – read about what to expect, attend childbirth classes, talk to your health care provider.

2. Self Care – 4 “biggies” are your responsibility: adequate nutrition (for example, even before you get pregnant, adequate folic acid is important for healthy fetal spinal cord development), avoiding harmful substances such as alcohol and tobacco, doing things that keep you strong and healthy such as walking, swimming, prenatal yoga, and starting regular prenatal care when you find out you’re pregnant.

3. Choice – Whether you opt to have your baby at hospital or home, prenatal care by a doctor or midwife monitors mother and growing baby. This care guides decisions you make for your safety and wellbeing before, during and after baby is born.

4. Awareness – Find out the credentials/licensure and scope of practice of your health care provider. Ask what they do for prenatal care and care during labor. Ask about pain management and emergency interventions. Find out how long it will take to get to the hospital. In a true emergency, minutes are critical.

Be kind to yourself, protect the gifts of understanding and safe childbirth, and may vibrant health be yours!

Image Credit: Janice Fransisco

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Audrey Inaba, RN, was the Maternal and Child Health Coordinator, Maui District Health Office but at the time of writing just recently moved to the Hilo Hawaii District Health Office. Contact: Audrey.inaba@doh.hawaii.gov ; Phone: (808) 974-4292.