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Dear First-Time Moms: If You Do One Thing to Prepare for Birth
Real Honest Advice from a Third Time Mom
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By Shannon Field, Founder and CEO of Soshe
I'm just going to say it:

I wish I could help every first-time mom flip a switch in her brain and say, "Ok. I get it. I get that I really need to PREPARE and TAKE OWNERSHIP of my birth experience - because my health and my baby's health will be better if I do."

And this isn't just for "feel-good" reasons.

It's not just for "natural" moms, and not just for people labeled "high risk". This is for everyone. Low maintenance, low risk, epidural mamas, I'm talking to you too, because I was you.
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But can't I just trust my doctor? Trust my body? Trust the process?

There are so many great doctors and midwives out there. The hard part, especially for first time moms, is knowing if you have one of them! Because being a great medical professional goes beyond bedside manner and likability. It's also about the quality of care delivered, whether or not standard practices and protocols are updated to reflect the latest research, and how good their patients' outcomes are.

The sad truth is that too often, in the U.S. and elsewhere, new and expecting moms are NOT getting medical care that is based on the latest and best research. And this isn't just the optional, extra, "nice-to-have" stuff, although it's that stuff too. These are serious topics that impact the health of you and your baby. 


Let's look at the facts. It really truly makes me sad to tell you this:

Only 2% of laboring moms got five evidence-based best-practices for childbirth. 

Below are the "evidence-based" practices that, according to research, lead to the best outcomes for moms and babies - a list that unfortunately is not the norm.

Important: If you know the list, you can ask for it:
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  1. Labor begins on its own (i.e., not induced, as 25-40+% of pregnancies are)

  2. Freedom to move and change positions (i.e., encouraged to sit up, stand up, leave the bed, and walk around, meaning NOT lying in bed the whole time, as  57% do)

  3. Continuous labor support, with best outcomes from birth doulas (yet doulas attend only 6% of U.S. births, although 27% wish they had one)

  4. Alternative delivery position (i.e., not giving birth on your back, as 91% do in the U.S.)

  5. Mother and baby are not separated after birth (i.e., immediate skin-to-skin, which half still don't get)

  6. Interventions only when medically necessary (note: this was not assessed via LTM III survey)

If these are "best-practice", why aren't they standard?

One possible explanation: It takes an average of 17 years for evidence-based best practice to become standard medical practice.

Also, it's worth saying that there will always be exceptions and circumstances where some of the above are not feasible or advisable. Nonetheless, these should be the default, and the norm, but too often they're not.


More sad facts:

Somewhere between 1 in 3 and 1 in 4 people report that their experience giving birth was traumatic. 

The doctors may not have seen it that way, but the person who gave birth did, and that's what mattered. 

Furthermore, according to numerous research studies, traumatic birth isn't something people just leave behind at the hospital or birth center. Traumatic birth can have a negative impact on mother-baby bonding, breastfeeding, mental health and emotional well being, and the desire to have more children.

A skeptic might say, "But birth is uncontrollable and unpredictable," so there's only so much we can do. But there's a lot more we can do, and lot more YOU can do. For starters, data show that people who prepare for birth have better outcomes, and people who participate in the decision making during labor and delivery and more satisfied with their care (this actually matters more than things like pain levels and how long labor lasted).


And that's not all...

New moms and babies die at a higher rate in the U.S. than in any other developed country. 
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There are also huge disparities between racial and ethnic groups. For example, black women are 3-4 times more likely to die during pregnancy, birth, and postpartum than white women, regardless of other factors like overall health, income, education, and more.

But this is less about dying (or not dying) than it is about the state of maternal health care.

To be clear, chances are really good that you won't die, but what these sad facts tell us is that we have serious problems with our maternal health care system. 

Serious problems including that for every maternal death, there are ten near-deaths. 

​Serious and risky interventions that are over-used, including unnecessary c-sections, unnecessary episiotomies and Pitocin, unnecessary inductions.  Serious decisions that get in the way of breastfeeding, skin-to-skin, and mother-baby bonding. Serious issues like postpartum depression, anxiety, and PTSD that could have been mitigated with a more evidence-based and positive birth experience. 
Serious issues that can lead to incontinence for new moms, chronic back pain, or pelvic organ prolapse.

Serious complications that most certainly caused some trauma, in-the-moment if not beyond.

There are many amazing doctors and midwives out there who offer care that is evidence-based, respectful, and empowering.

However, it can be hard to find the right provider for you, especially for first time moms. And even if you do find a great doctor or midwife, chances are they're too busy to spend a ton of time educating you on what's ahead (not their fault, that's how our health care payment system works).

So a lot of this research and preparation is on you.

Just ask Serena Williams, who you have to admit, is probably really tuned into her body given her long history of success as a professional athlete. She had to take matters into her own hands just after the birth of her daughter, Olympia.

​Serena recognized the symptoms of a blood clot in her lungs and then pushed the nurses and doctors to do the right tests and interventions asap, even though they initially wondered if she was "confused" by pain medications and doubted that anything serious was wrong. Her birth story was covered by Vogue (scroll halfway down).

​Trust us, she had "the best" doctors, and these doctors were highly motivated to make sure nothing bad happened to Serena. And yet it did. And it was almost really really bad.
This is Not Pointless, Baseless Fear-Mongering

This data is real. I started Soshe to help people prepare for childbirth and the days and weeks postpartum, because being prepared matters, and really knowing what to expect matters (the "real" stuff, not the clickbait).

I thought I was prepared when I had my first baby, but I wasn't. Not at all. I was one of those "I'm low-maintenance, easy pregnancy, trust the system" sorts of first time moms (as many are).

I read the emails and followed the pregnancy app, so I thought I was ready. I was not ready (opinion: most pregnancy apps avoid the "real" stuff and provide a false sense of preparedness).

My epidural was so strong I couldn't feel anything. I didn't know how to push. I figured they just tell me how when it was time. So I pushed too hard (because they told me to "push really hard"!) and I did damage to myself. I also gave birth to my daughter while lying my back, which I now know is generally not the best nor only option, even with an epidural.

I also didn't realize that when I showed up in labor with a lot of bright red blood (not the same as "bloody show"), that was something to be concerned about, something I should have been watching out for. And my daughter had a tongue tie, which made it difficult for her to latch well when breastfeeding, leading to slow weight gain, many trips to the pediatrician, and lots of stress for me. Yet I had never heard of tongue tie, and didn't have it properly diagnosed and treated for weeks.

I could go on, because the list of things I had no idea about is so long. And this is so typical.

The good news is there is something you can do about this: you can prepare and TAKE OWNERSHIP.

How? Take a multi-day childbirth class, ideally not at the hospital (why not?). Read books. Listen to podcasts. Talk to friends about their real experiences, not just their "I'm fine and so lucky and grateful" versions of the story.

And if all of this feels overwhelming, it was for me too. That's why I started Soshe, and built the Soshe app. 


We don't promise to cover every possible surprise you might encounter during childbirth. But we do have tools to get you started, and options to go deeper if you're the type of person who wants to know more.

So yes. There's a lot you can do to get better care, and better outcomes for you and your baby:

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  • Get familiar with what "good care" looks like (so you can ask for it)

  • Talk to your doctor or midwife about getting care based on the latest research (see the list above for starters)

  • Get mentally prepared for the different scenarios that can arise during birth - it's true that you can't totally control or predict birth, but you can and should prepare

Soshe can help with all of this. 
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If this information was new to you, or changed your thinking, Soshe has a lot more content that you won't find in your typical pregnancy app.

If this scared you, know that there are so many things you can do to prepare for a healthy and positive birth experience. Preparation matters. And Soshe can help.

If you feel overwhelmed by the facts, the conflicting information, the overload of information, Soshe has done the research and will guide you through it.

As a mom of three, I founded Soshe, and built the Soshe app, to pay it forward. Soshe can help.

#SoSheCanThrive
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