Many thanks to Empowering Birth blog for posting this:
Perinatal Morbidity and Mortality in a Nationwide Cohort of 529,688 Low-Risk Planned Home and Hospital Births
The results? Read it and rejoice:
"No significant differences were found between planned home and planned hospital birth (adjusted relative risks and 95% confidence intervals: intrapartum death 0.97 (0.69 to 1.37), intrapartum death and neonatal death during the first 24 hours 1.02 (0.77 to 1.36), intrapartum death and neonatal death up to 7 days 1.00 (0.78 to 1.27), admission to neonatal intensive care unit 1.00 (0.86 to 1.16)."
And the conclusion? Read it and rejoice again:
"Conclusions: This study shows that planning a home birth does not increase the risks of perinatal mortality and severe perinatal morbidity among low-risk women, provided the maternity care system facilitates this choice through the availability of well trained midwives and through a good transportation and referral system."
And check out the study size - 529, 688 births!! This is no tiny study... This is major stuff, people.
No doubt the American Medical Association and ACOG (American College of Obstetricians & Gynecologists) will henceforth drop their resistance to and propaganda against homebirth and join wholeheartedly in promoting it as a valid choice for birthing women!
All right, when you've all stopped laughing hystericallyand picked yourselves up off the floor, let's get serious.... We all know that cold, hard evidence has no affect on die-hard beliefs with those who are dedicated to resisting homebirth for the simple reason that it is homebirth.... But maybe mums who are wondering about safety issues can take heart. Of course, this is not the first study proving homebirth's safety - the CPM 2000 study comes to mind. But we can always use more!
Fun stuff!!
Showing posts with label Natural Birth. Show all posts
Showing posts with label Natural Birth. Show all posts
Thursday, April 16, 2009
Monday, April 6, 2009
Lovely Homebirth Story!
I'd like to take this opportunity to introduce a lovely Arizona birth blog which I just found, "Birth Faith." Check out her wonderful blog!
She has just posted her birth story from her birth earlier this week, her first homebirth, and it is great. Check it out here.
I love this quote from her story:
"I don’t think there is any other physical experience that brings a person closer to the veil between earth and heaven than childbirth."
So true!! Congratulations, new mama!
She has just posted her birth story from her birth earlier this week, her first homebirth, and it is great. Check it out here.
I love this quote from her story:
"I don’t think there is any other physical experience that brings a person closer to the veil between earth and heaven than childbirth."
So true!! Congratulations, new mama!
Arizona Mama's Homebirth
The Arizona Republic (online version) published a homebirth story and picture show; here they are:
Story
Slide Show
For the most part, pretty good! I've been really impressed with the Arizona Republic's willingness to publish natural birth articles this week.
A couple of complaints, though...
(1) The pics they show focus somewhat on the sensational - like the mom screaming in pain. Most people are not ready for these pictures. Indeed, most mamas don't print those kind of pictures anyway!!
(2) The scene really has a hippie feel to it, especially the dad, who has long hair and a long beard and is shirtless. For most mainstream birthers, this is going to be a big turnoff.
I think that if I were to advise a re-do on this shoot, I would have them hire a professional photographer to focus more on the beauty of homebirth, and to keep the shots more modest. I personally am completely comfortable with total female nudity in the labor/birth scene, but most people are NOT. I read some of the reader comments on this article, and had to stop reading pretty quickly because they made me so angry. Most were along the lines of, "That is so gross!" "Weird!" "That was disgusting!" etc. I think those of us in the birth world who are accustomed to birth pictures and birth art forget that it is a learned taste. The mainstream public is not going to be able to dive head-first into birth photography and find beauty there. This article has hopefully done some good, but it has likely also done some harm - by driving the idea of homebirth further into the "those stupid hippies who don't care about their babies" niche in the mainstream mind.
Of course, if these pics were taken by a newspaper photographer, then the parents/midwife probably didn't have much say in which pics were chosen - and a newspaper photographer probably would want to focus more on the sensational than the beautiful.
It might also have been nice if the paper had published a more thorough article focusing on explaining what is going on and on the safety and training of midwives and midwife-attended birth.
But still, good job to the paper and to the family! It takes guts to be willing to be willing to publish nude pics in your hometown paper! And I'm very grateful that the paper was willing to publish this material.
Thoughts, anyone? I'd be interested to get input from both those who are used to homebirth pics/stories and those to whom this material is new.
Story
Slide Show
For the most part, pretty good! I've been really impressed with the Arizona Republic's willingness to publish natural birth articles this week.
A couple of complaints, though...
(1) The pics they show focus somewhat on the sensational - like the mom screaming in pain. Most people are not ready for these pictures. Indeed, most mamas don't print those kind of pictures anyway!!
(2) The scene really has a hippie feel to it, especially the dad, who has long hair and a long beard and is shirtless. For most mainstream birthers, this is going to be a big turnoff.
I think that if I were to advise a re-do on this shoot, I would have them hire a professional photographer to focus more on the beauty of homebirth, and to keep the shots more modest. I personally am completely comfortable with total female nudity in the labor/birth scene, but most people are NOT. I read some of the reader comments on this article, and had to stop reading pretty quickly because they made me so angry. Most were along the lines of, "That is so gross!" "Weird!" "That was disgusting!" etc. I think those of us in the birth world who are accustomed to birth pictures and birth art forget that it is a learned taste. The mainstream public is not going to be able to dive head-first into birth photography and find beauty there. This article has hopefully done some good, but it has likely also done some harm - by driving the idea of homebirth further into the "those stupid hippies who don't care about their babies" niche in the mainstream mind.
Of course, if these pics were taken by a newspaper photographer, then the parents/midwife probably didn't have much say in which pics were chosen - and a newspaper photographer probably would want to focus more on the sensational than the beautiful.
It might also have been nice if the paper had published a more thorough article focusing on explaining what is going on and on the safety and training of midwives and midwife-attended birth.
But still, good job to the paper and to the family! It takes guts to be willing to be willing to publish nude pics in your hometown paper! And I'm very grateful that the paper was willing to publish this material.
Thoughts, anyone? I'd be interested to get input from both those who are used to homebirth pics/stories and those to whom this material is new.
Friday, March 27, 2009
Comfort Measures in Labor
Last night at the East Valley Birth Circle (I'll add the link when my computer stops being annoying), the subject of the evening was "Comfort Measures in Labor." I found the conversation fascinating, as some women brought up things that I hadn't thought of as being "comfort measures" - but which actually were. What were your best comfort measures for labor?
Here are some of mine, in no particular order:
(1) Being at home - If you can be comfortable at a hospital, great! But I needed to be familiar and comfortable and safe and secure in my surroundings, and that - for me - happens at home. Being at home is not a selfish move that a mum makes at the expense of the baby's safety - it is an essential way to ensure that the mother feels safe, which ensures a smoother labor with less chances of stress-related problems arising (arrested labor, etc.)
(2) Knowing my birth team intimately - I didn't have to deal with nurses or doctors I'd never met before. I knew each member of my birth team intimately and personally. That makes a big difference.
(3) Having complete trust in my care provider - I didn't have to fight any battles (i.e. for not having an IV, for not having continuous EFM, for refusing routine vaginal checks, etc.). I knew that they were on my side and that they would honor my wishes. In case anyone out there doesn't know this, labor isn't the time to be fighting battles. Labor requires 100% of your energy - body, mind and soul - and trying to fight for something during labor is either going to be fruitless (because you won't have energy to devote to it) or counterproductive (because it will disrupt your labor and/or your concentration).
(4) Low lights and silence - Big help. No interruptions. Much easier to focus.
(5) Water - I don't know how I could have had a natural birth without water. I spent all of active labor in the tub, shower, or birth pool. Laboring out of water is something that will hopefully never happen with me.
(6) Not being aware of the time - My care providers weren't clock watchers, and most of the time I wasn't aware of the time. There was a clock in the room, however, and whenever I did look at the clock I got discouraged. I think I'll make sure there's no clock next time.
(7) Not having vaginal checks - In case you don't know this yet, vaginal checks are EXCRUCIATINGLY PAINFUL during labor (I learned that during my one and only check). They're really not necessary unless something is going wrong, and they're torture to endure. Thank you, wonderful midwives!!
(8) Not knowing my dilation - Whenever I asked my midwife if we were almost done, she would either say "soon!" or "I'll only know for sure if I check." I refused a check each time, because I knew that to hear something like "3 centimeters" would be absolutely devastating. I think this is probably one reason why so many women get epidurals - hearing constant updates on your status, especially when things are moving slowly (i.e. "3 centimeters!".... two hours later, "3 centimeters!") would be utterly disheartening. This is going in my next birth plan - that under no circumstances am I to be told my dilation unless I specifically ask for it.
(9) Being free to have my needs honored - For example, during labor I learned that I am a "DON'T TOUCH ME!!!" kind of laboring mother. Being touched made me furious and uncomfortable. When I expressed that, it was honored! No one touched me any more. I loved that!!
(10) Being supported by women - I didn't anticipate this, but when I was in labor I wanted to be supported by women. The more the merrier. I wanted to know that they'd been where I was and that they knew what I was going through. Yes, I know there are great male OB's out there.... But for me, it's all about women.
(11) Having hubbie there - I didn't want to be actually supported by my husband, but I needed his presence. The one time he left, about halfway through labor, to get food for our doula and himself, I kind of mini-panicked. I needed him there continuously.
(12) Freedom to move freely - Moving as my body dictated was crucial. I can't imagine being tethered in one spot, or worse, on my back.
That's all I can think of at the moment, though I'm sure there are more. Interesting to think about!
Here are some of mine, in no particular order:
(1) Being at home - If you can be comfortable at a hospital, great! But I needed to be familiar and comfortable and safe and secure in my surroundings, and that - for me - happens at home. Being at home is not a selfish move that a mum makes at the expense of the baby's safety - it is an essential way to ensure that the mother feels safe, which ensures a smoother labor with less chances of stress-related problems arising (arrested labor, etc.)
(2) Knowing my birth team intimately - I didn't have to deal with nurses or doctors I'd never met before. I knew each member of my birth team intimately and personally. That makes a big difference.
(3) Having complete trust in my care provider - I didn't have to fight any battles (i.e. for not having an IV, for not having continuous EFM, for refusing routine vaginal checks, etc.). I knew that they were on my side and that they would honor my wishes. In case anyone out there doesn't know this, labor isn't the time to be fighting battles. Labor requires 100% of your energy - body, mind and soul - and trying to fight for something during labor is either going to be fruitless (because you won't have energy to devote to it) or counterproductive (because it will disrupt your labor and/or your concentration).
(4) Low lights and silence - Big help. No interruptions. Much easier to focus.
(5) Water - I don't know how I could have had a natural birth without water. I spent all of active labor in the tub, shower, or birth pool. Laboring out of water is something that will hopefully never happen with me.
(6) Not being aware of the time - My care providers weren't clock watchers, and most of the time I wasn't aware of the time. There was a clock in the room, however, and whenever I did look at the clock I got discouraged. I think I'll make sure there's no clock next time.
(7) Not having vaginal checks - In case you don't know this yet, vaginal checks are EXCRUCIATINGLY PAINFUL during labor (I learned that during my one and only check). They're really not necessary unless something is going wrong, and they're torture to endure. Thank you, wonderful midwives!!
(8) Not knowing my dilation - Whenever I asked my midwife if we were almost done, she would either say "soon!" or "I'll only know for sure if I check." I refused a check each time, because I knew that to hear something like "3 centimeters" would be absolutely devastating. I think this is probably one reason why so many women get epidurals - hearing constant updates on your status, especially when things are moving slowly (i.e. "3 centimeters!".... two hours later, "3 centimeters!") would be utterly disheartening. This is going in my next birth plan - that under no circumstances am I to be told my dilation unless I specifically ask for it.
(9) Being free to have my needs honored - For example, during labor I learned that I am a "DON'T TOUCH ME!!!" kind of laboring mother. Being touched made me furious and uncomfortable. When I expressed that, it was honored! No one touched me any more. I loved that!!
(10) Being supported by women - I didn't anticipate this, but when I was in labor I wanted to be supported by women. The more the merrier. I wanted to know that they'd been where I was and that they knew what I was going through. Yes, I know there are great male OB's out there.... But for me, it's all about women.
(11) Having hubbie there - I didn't want to be actually supported by my husband, but I needed his presence. The one time he left, about halfway through labor, to get food for our doula and himself, I kind of mini-panicked. I needed him there continuously.
(12) Freedom to move freely - Moving as my body dictated was crucial. I can't imagine being tethered in one spot, or worse, on my back.
That's all I can think of at the moment, though I'm sure there are more. Interesting to think about!
Tuesday, March 24, 2009
BMJ Confirms Eating During Labor is Okay!
Many thanks to Jill at Unnecesarean for posting this article from the British Medical Journal reporting on a study confirming that eating and/or drinking during labor does not have a deleterious effect on mother, baby, or neonatal outcomes of birth! I'm going to quote the same segment that she did here:
"EATING while in the throes of childbirth should no longer be a medical taboo, according to a study released today.
"The duration of labour, the need for assisted delivery, and caesarean rates were all unaffected by munching between contractions, found the study, published by the British Medical Journal.
"Doctors the world over have long discouraged women in labour from eating, for fear that it could lead to breathing food into the lungs in the case of an emergency caesarean while under general anaesthetic.
"But such incidents have declined dramatically in recent years, mainly due to the use of local anaesthesia.
"Moreover, some doctors have long argued that fasting while in labour - which can last many, many hours - may be bad for the mother and the baby."
Our childbirth ed teacher prepared us for the hospital protocol of "no eating after admission" and told us, quite frankly, to bring our own food to the hospital.
There is no justification for starving mothers (and babies) for hours on end based on the assumption that the mother just might might might need an emergency section. Hopefully American hospitals will get the message, though it'll probably take a while.
Thankfully our midwives never discouraged eating in labor - they encourage eating and drinking in labor according to the mother's wishes. So I didn't have to fight that battle.
During my own labor.... hmm. Well, my labor started at 4:28 a.m. with my water breaking and immediate labor contractions following. I ate a normal breakfast, and then a snack later in the morning, and then nothing till 11 p.m. that night after the birth - I just wasn't interested. I think I've heard that most women don't want to eat during active labor. I sure didn't! (Though I have heard that some women like to eat in the break between transition and pushing. Wasn't it Ina May Gaskin who said that she needed a tofu salad sandwich at that point in each of her labors?) But I was starved afterwards and devoured two bowls of strawberries and cottage cheese. Yum.
Our midwives did push fluids, though - Gatorade, mostly, which I drank in sips throughout labor.
And so, mothers of the world, eat up! (And drink up!)
"EATING while in the throes of childbirth should no longer be a medical taboo, according to a study released today.
"The duration of labour, the need for assisted delivery, and caesarean rates were all unaffected by munching between contractions, found the study, published by the British Medical Journal.
"Doctors the world over have long discouraged women in labour from eating, for fear that it could lead to breathing food into the lungs in the case of an emergency caesarean while under general anaesthetic.
"But such incidents have declined dramatically in recent years, mainly due to the use of local anaesthesia.
"Moreover, some doctors have long argued that fasting while in labour - which can last many, many hours - may be bad for the mother and the baby."
Our childbirth ed teacher prepared us for the hospital protocol of "no eating after admission" and told us, quite frankly, to bring our own food to the hospital.
There is no justification for starving mothers (and babies) for hours on end based on the assumption that the mother just might might might need an emergency section. Hopefully American hospitals will get the message, though it'll probably take a while.
Thankfully our midwives never discouraged eating in labor - they encourage eating and drinking in labor according to the mother's wishes. So I didn't have to fight that battle.
During my own labor.... hmm. Well, my labor started at 4:28 a.m. with my water breaking and immediate labor contractions following. I ate a normal breakfast, and then a snack later in the morning, and then nothing till 11 p.m. that night after the birth - I just wasn't interested. I think I've heard that most women don't want to eat during active labor. I sure didn't! (Though I have heard that some women like to eat in the break between transition and pushing. Wasn't it Ina May Gaskin who said that she needed a tofu salad sandwich at that point in each of her labors?) But I was starved afterwards and devoured two bowls of strawberries and cottage cheese. Yum.
Our midwives did push fluids, though - Gatorade, mostly, which I drank in sips throughout labor.
And so, mothers of the world, eat up! (And drink up!)
Monday, March 23, 2009
Birth Activism: Where Is It?
I found this quote on the blog "Musings of an OB Nurse in Transition" and found it interesting. Her question, basically, is "Where did all the birth activism of the '70's go?"
"First day out of the gate (in her new job), I went into a total state of shock.
"This was the late Nineties...I had "come of age" in the Seventies, in the era of "Our Bodies Ourselves", Ina May Gaskin, fighting for our rights in the hospital to have our partners at our side, to birth our babies naturally, without the fog of Scopalamine or Demerol, of immediate bonding and breastfeeding, of Bradley, Lamaze, and VBAC. Although I didn't give birth myself until nearly fifteen years later, I totally absorbed that mind set. I had pretty much gotten what I wanted when I gave birth for the first time in the late Eighties. I had no idea how much things had changed (read that regressed) in the "Self Empowerment in Birthing" school of thought. I was stunned at all the planned inductions, the "epidural as norm" attitude, and the relative ease with which the decision to perform a Cesarean Section was made. Honest to God, I even remember a physician sitting on the edge of the bed of a newly admitted, beautifully laboring multip, with a history of two vaginal births , then a c/section, and finally a successful VBAC, trying with all her might to convince the mother that it was too dangerous to "attempt" another VBAC, and that she should immediately prepare for surgery! She didn't, thank God, despite what was essentially a temper tantrum by her physician...the same physician who had attended her VBAC!!!!!
"Needless to say, things didn't go well for me. I was simply aghast that mother's seemed to just accept drivel like this, few if any took childbirth preparation classes, or if they did, they managed to squeeze them in during an 8-hour marathon Saturday class, and that most of them wanted to "stop being pregnant" by 39 weeks, so they gladly scheduled their inductions, and the first question out of their mouths upon arrival was not "How soon can I breastfeed my baby", but "How soon can I get my epidural"?"
Being that I am new to the birth world, I only have a hazy sense of how things have changed over the past 30 years. Have things regressed or progressed? Or perhaps both at once? And if the birth scene is more bleak than it was 20-30 years ago (in terms of high c-section rate, high induction rate, lack of preparation for childbirth by parents, lack of independent thought/action by parents) why is that so?
I can think of a couple of possibilities:
- Perhaps the natural birth world of the '70's was just as tiny as the natural birth/homebirth movement nowadays - it just seems bigger when you're involved in it.
- Could lack of true preparation for labor/birth have caused mass turn-off to natural birth? A lot of childbirth classes seem to try to cover up the reality of birth (read: "pain") by using euphemisms like "hard work" and etc. Experiencing the pain of childbirth after being prepared only for 'hard work' could definitely be a turn-off.
- Could it be that natural birth has been abandoned as a vestige of the hippie movement, which most people don't want to be associated with? Or could it be that society is tired of militant feminism, which natural birth can sometimes also be associated with?
I'd be interested if anyone out there had any thoughts on this. It's a very interesting question.
Regardless of whether the birthing scene in America has progressed or regressed, it's a certainty that American women are, at this time in history, very compliant and obedient to the medical authorities. I constantly hear women saying, "My doctor decided to induce me..." "My doctor decided on a cesarean...." "My doctor wouldn't allow me to go into labor...." "My doctor wouldn't let me labor more than 12 hours..."etc. etc. ad infinitum (or ad nauseum). One rarely hears of a woman telling her doctor "No" when a bad medical decision is made on her behalf, or of a woman making her own decision against her doctor's advice.
Part of this is, I think, simply because doctors have the ultimate trump card - the "dead baby card." As in, "Yes, you can go against my authority, but you'll have a dead baby if you don't do what I say." That's the way to get a mother to fold before the fight even starts. A friend of mine had this happen to her this year. They were trying to coerce her into an induction which seemed pretty unnecessary (her labor process had already started), and she was questioning the reasoning behind it - so the doctor pulled the dead baby card. It worked. It would have worked on me too. Thankfully my wonderful midwife doesn't play that game!
Part of it is also the hierarchy. When I'm with my midwife, I'm with a friend. We're on the same level. She advises me, but it's friend-to-friend. I don't feel the need to bow down or obey. Independent thought is openly encouraged. But when I visit an OB, there's the instant hierarchy. The white coat, the stethoscope, the chart, the clinical atmosphere, the coolly professional tones with lack of much eye contact, having to conduct one's entire conversation while seated on an exam table. Even though I don't believe in medical hierarchy ("believe in" as in "support"), I immediately feel the need to obey, to avoid questioning, to comply. It's just part of the system.
I'm wandering.... Back to the subject.
Anyhow, though, aside from that, American women are definitely on the whole apathetic about natural birth. Generally the plan is, "Don't want to take childbirth classes because I don't want to think about it; going to hospital to get an epidural." That's not the greatest plan in the world. It's not that epidurals are evil, but that uninformed medical choice (or lack thereof) is foolish. If you go into an epidural knowing all the risks, fine! But if you're just showing up at the hospital and accepting all advice and all interventions suggested, most likely you'll end up with a cascade of unnecessary interventions, which affect both mum and baby, and quite likely (in today's climate) a cesarean.
This entry has been all over the place. But really, my question: Why the apathy among American women? Why the unquestioning compliance to one's OB? Why? Especially when American society is otherwise rife with independently-thinking, feminist-oriented women? Why did birth get left out of the philosophical equation for 95% of American women?
Interesting to ponder.
"First day out of the gate (in her new job), I went into a total state of shock.
"This was the late Nineties...I had "come of age" in the Seventies, in the era of "Our Bodies Ourselves", Ina May Gaskin, fighting for our rights in the hospital to have our partners at our side, to birth our babies naturally, without the fog of Scopalamine or Demerol, of immediate bonding and breastfeeding, of Bradley, Lamaze, and VBAC. Although I didn't give birth myself until nearly fifteen years later, I totally absorbed that mind set. I had pretty much gotten what I wanted when I gave birth for the first time in the late Eighties. I had no idea how much things had changed (read that regressed) in the "Self Empowerment in Birthing" school of thought. I was stunned at all the planned inductions, the "epidural as norm" attitude, and the relative ease with which the decision to perform a Cesarean Section was made. Honest to God, I even remember a physician sitting on the edge of the bed of a newly admitted, beautifully laboring multip, with a history of two vaginal births , then a c/section, and finally a successful VBAC, trying with all her might to convince the mother that it was too dangerous to "attempt" another VBAC, and that she should immediately prepare for surgery! She didn't, thank God, despite what was essentially a temper tantrum by her physician...the same physician who had attended her VBAC!!!!!
"Needless to say, things didn't go well for me. I was simply aghast that mother's seemed to just accept drivel like this, few if any took childbirth preparation classes, or if they did, they managed to squeeze them in during an 8-hour marathon Saturday class, and that most of them wanted to "stop being pregnant" by 39 weeks, so they gladly scheduled their inductions, and the first question out of their mouths upon arrival was not "How soon can I breastfeed my baby", but "How soon can I get my epidural"?"
Being that I am new to the birth world, I only have a hazy sense of how things have changed over the past 30 years. Have things regressed or progressed? Or perhaps both at once? And if the birth scene is more bleak than it was 20-30 years ago (in terms of high c-section rate, high induction rate, lack of preparation for childbirth by parents, lack of independent thought/action by parents) why is that so?
I can think of a couple of possibilities:
- Perhaps the natural birth world of the '70's was just as tiny as the natural birth/homebirth movement nowadays - it just seems bigger when you're involved in it.
- Could lack of true preparation for labor/birth have caused mass turn-off to natural birth? A lot of childbirth classes seem to try to cover up the reality of birth (read: "pain") by using euphemisms like "hard work" and etc. Experiencing the pain of childbirth after being prepared only for 'hard work' could definitely be a turn-off.
- Could it be that natural birth has been abandoned as a vestige of the hippie movement, which most people don't want to be associated with? Or could it be that society is tired of militant feminism, which natural birth can sometimes also be associated with?
I'd be interested if anyone out there had any thoughts on this. It's a very interesting question.
Regardless of whether the birthing scene in America has progressed or regressed, it's a certainty that American women are, at this time in history, very compliant and obedient to the medical authorities. I constantly hear women saying, "My doctor decided to induce me..." "My doctor decided on a cesarean...." "My doctor wouldn't allow me to go into labor...." "My doctor wouldn't let me labor more than 12 hours..."etc. etc. ad infinitum (or ad nauseum). One rarely hears of a woman telling her doctor "No" when a bad medical decision is made on her behalf, or of a woman making her own decision against her doctor's advice.
Part of this is, I think, simply because doctors have the ultimate trump card - the "dead baby card." As in, "Yes, you can go against my authority, but you'll have a dead baby if you don't do what I say." That's the way to get a mother to fold before the fight even starts. A friend of mine had this happen to her this year. They were trying to coerce her into an induction which seemed pretty unnecessary (her labor process had already started), and she was questioning the reasoning behind it - so the doctor pulled the dead baby card. It worked. It would have worked on me too. Thankfully my wonderful midwife doesn't play that game!
Part of it is also the hierarchy. When I'm with my midwife, I'm with a friend. We're on the same level. She advises me, but it's friend-to-friend. I don't feel the need to bow down or obey. Independent thought is openly encouraged. But when I visit an OB, there's the instant hierarchy. The white coat, the stethoscope, the chart, the clinical atmosphere, the coolly professional tones with lack of much eye contact, having to conduct one's entire conversation while seated on an exam table. Even though I don't believe in medical hierarchy ("believe in" as in "support"), I immediately feel the need to obey, to avoid questioning, to comply. It's just part of the system.
I'm wandering.... Back to the subject.
Anyhow, though, aside from that, American women are definitely on the whole apathetic about natural birth. Generally the plan is, "Don't want to take childbirth classes because I don't want to think about it; going to hospital to get an epidural." That's not the greatest plan in the world. It's not that epidurals are evil, but that uninformed medical choice (or lack thereof) is foolish. If you go into an epidural knowing all the risks, fine! But if you're just showing up at the hospital and accepting all advice and all interventions suggested, most likely you'll end up with a cascade of unnecessary interventions, which affect both mum and baby, and quite likely (in today's climate) a cesarean.
This entry has been all over the place. But really, my question: Why the apathy among American women? Why the unquestioning compliance to one's OB? Why? Especially when American society is otherwise rife with independently-thinking, feminist-oriented women? Why did birth get left out of the philosophical equation for 95% of American women?
Interesting to ponder.
Tuesday, October 14, 2008
Why Natural Childbirth?
I wanted to share a few thoughts on this topic - in other words, why would any sane woman in the 21st century choose natural childbirth when there are so many chemical methods for pain relief?
(This is separate from an upcoming entry, "Why Homebirth?" which is related but separate. One can have natural birth at home or in hospital (although it's much tougher in hospital), but the benefits of homebirth aren't transferable to a hospital - so I'll write on those later.)
What is natural birth? Most obviously it is birth that is untainted by artificial chemicals, either in the form of induction/augmentation agents (pitocin, misoprostol, etc.), or chemical pain relief (epidural, spinal, narcotics, etc.). Actually, I should correct myself... There are different definitions, depending on who you ask. In the mainstream birth world, "natural birth" generally just means birth without chemical pain relief, regardless of whether or not the mother was artificially induced or had an artificially augmented labor. "Pure birth," which I experienced and which I highly recommend, is the technical term for birth which is completely free from any chemical interference (and generally other externals such as an IV or continuous fetal monitoring).
There are deeper facets to natural childbirth, which would include things like natural birth positions (squatting, standing, etc.), immediate skin-to-skin contact with baby, delayed cord clamping, continuous labor support, no directed pushing, etc.). However, for the purpose of this entry I am going to focus on the "chemical" parts - I will define natural birth as birth in which the mother receives no pain medication, and ideally no labor induction or labor augmentation drugs. (With a national cesarean rate of about 32% and a national induction rate of around 40%, you can bet that any of the above is pretty stinking rare.)
First, let's get the obvious out of the way. Natural birth is way better for baby and mother. This is not hard to understand or to prove. Fewer cesareans (a first-time mother with an epidural is roughly four times as likely to end up with a cesarean as is an unmedicated mother), fewer long-term health effects on mom and baby, better bonding, you name it. The health benefits of natural birth for mother and baby are endless. This point isn't even up for debate, it's been so well-proven. Period. End of story.
But there's a bigger story.
Let me tell you my own experience, briefly.
I hated childbirth. Every minute of it. It started out uncomfortable, and worked up to excruciating - and stayed there. I basically screamed for the last six hours of it. It was hell on earth. In fact, as soon as it was over, I turned to my husband and told him that childbirth should be a Christian missionary's best friend, because there is no closer analogy to hell on earth. I didn't even experience the classical "birth ecstasy" of the unmedicated mother - the "my baby, my baby!" moment. I just wanted to crawl in a hole and die. I felt awful, birthing the placenta was also excruciating, and I immediately had afterpains so badly that I couldn't stand to nurse (and they hung around for over six weeks, dang it!!). If you look at my birth pictures, I am not even smiling because I was exhausted and in pain.
I'm not saying this to be discouraging - I just want the reader to know that I DO know how bad childbirth hurts. It hurts big-time. For me it was eighteen hours of torture. If I had been in the hospital I would have requested an epidural about ten hours before our son was born (another reason I'm glad I wasn't in the hospital!). Many women say that they experience childbirth as spiritual, that that they find "their rhythm," etc. I didn't. It was horrible start-to-finish.
Then, the intelligent reader asks, why are you now a proponent of natural childbirth/homebirth with a blog devoted exclusively to the subject? Are you stark, raving mad?
Let me continue with my story.
It is hard to explain this, but in the days after my birth I experienced the most amazing spiritual transformation. Next to Christian salvation, it has been the most amazing life-change - one that I could not have anticipated, and one that I cannot even fully describe. I will say this, though - Who I was before natural childbirth was not who I was after experiencing natural childbirth. It was a complete transformation, one which still awes and amazes me and which is completely beyond my understanding.
For one thing, I am now much more self-confident. I know that I am competent and able to do whatever I need, because I have done the most difficult thing that any human being can do. My body is amazing, and frankly, so am I! I withstood that tremendous pain and got through it - and I can do ANYTHING now. I have lost all amazement for athletic feats. Someone climbed Mt. Everest? Ran a 3-minute mile? GIVE ME A BREAK!!! I came through natural childbirth!!!!!
For another thing, natural childbirth also greatly healed my self-image. I, like the other 99.99% of American women who have been brainwashed into only seeing beauty in quasi-anorexia, definitely had issues with seeing my body as anything but flawed. But natural childbirth showed me the brilliant complexity and functionality of my body in ways that I could never have imagined. My body is "wonderfully and marvelously made," and I gained immense respect for it and for myself. Now, post-pregnancy, my body has way more issues than it did before - stretch marks galore, ten extra pounds and proportions so radically different I probably wouldn't recognize myself from before. But my self-image is much more positive and affirming, and I have learned to be grateful for the amazing things that my body can do - regardless of whether or not I look like a supermodel.
For another thing, I feel that in many ways that natural childbirth was truly my "coming of age." This was truly that transformation point for me. It wasn't puberty, high school graduation, sweet 16 (or 18 or 21), first date, first kiss, marriage, sex, pregnancy - no way. Not even close. It was natural childbirth. It was truly the coming of age for me. I can't say how or why, and I certainly didn't expect it. It just was. Some part of me just matured and ripened over that 24-hour period and emerged as a woman. I believe that there is some part of woman's soul that is tied to the experience of childbirth. If you ask almost any woman who has experienced natural birth, she will generally agree with this without even thinking about it (and will often go into detail about it!).
I need to add something here: It's hard writing the above, because there are some women who can't give birth, due to singleness or infertility. One of my close friends is dealing with longterm infertility right now, and it is a heart-wrenching process (another proof that birth is important to women!). I believe that that things are different spiritually for women who cannot physically give birth - that God provides other methods of maturation and self-discovery and spiritual growth. God is a God of individuals - no one is left out of spiritual growth opportunities in the economy of God. But speaking for myself, I know that there was a depth to my soul that could only be reached with unmedicated birth. And that's something I never would have guessed before my birth experience.
Some might say, "All of the above was just from childbirth - not natural childbirth." Nope, not at all. The pain of labor and birth was inextricably wrapped up in transformative effects of both. For me, childbirth was a "baptism of pain." It taught me to reach out to other women, my midwives and doula, and to see how much true love and friendship there can be among female friends, and how comforting women can be to one another during birth. It taught me compassion for other birthing women and for people who must endure pain. It taught me the great kinship that I experience with women throughout the ages of history who have endured the same thing to bring the human race into existence. It taught me to value my baby greatly, because he was birthed through my pain - and is unutterably precious.
From a Christian perspective, experiencing natural childbirth gave me a deeper understanding into the meaning of the Bible passage, "But women will be saved through childbearing" (I Tim 2:15) This is not referring to salvation from eternal death, but to something quite different. There are many different interpretations and lines of thought on this passage. But to me it has become clear that God has used the "curse" of the Fall (for man, hard and unproductive labor in their lifework, for women, pain in childbirth) to also be our greatest blessings. Who would deny that men find some of their greatest blessings and self-identity through hard work and discovery/industry/building/etc.? And I know now that women can find some of their deepest grounding, meaning, and self-identity in the pain of childbirth. Our curse has become our blessing.
But frankly, there is just so much to this transformation that I just can't describe it. If anyone would like to write a comment and give me a hint as to what I ought to be writing, I would appreciate it and will add it in! I can only say that natural, drug-free childbirth was an earth-shattering, life-changing transformation that will be with me for the rest of my life. I am even eager to go through it again, just because of that. And I have the deepest sorrow for all the women who do not get to experience this transformation because they have been cut open or drugged. I want every woman to experience this tremendous blessing and transformation - and that's one of the main reasons this blog is here.
Having a baby is more than a messy, unpleasant process that one must endure to get a baby. When people hear a horrible birth story and say, "Well, at least you have a healthy baby! That's what matters!" they completely miss the point. A woman's birth stories are part of her identity and will affect her profoundly for the rest of her life. Many women spend years and subsequent births trying to heal from cruel and demeaning treatment during previous births, or births that were in one way or another traumatic. Yes, the baby is the most important thing, but a mother's birth experience is a close second. There is nothing like it in the world, and I hope to spend the rest of my life promoting natural birth for this reason.
Email me with comments and questions!
Love,
Diana
(This is separate from an upcoming entry, "Why Homebirth?" which is related but separate. One can have natural birth at home or in hospital (although it's much tougher in hospital), but the benefits of homebirth aren't transferable to a hospital - so I'll write on those later.)
What is natural birth? Most obviously it is birth that is untainted by artificial chemicals, either in the form of induction/augmentation agents (pitocin, misoprostol, etc.), or chemical pain relief (epidural, spinal, narcotics, etc.). Actually, I should correct myself... There are different definitions, depending on who you ask. In the mainstream birth world, "natural birth" generally just means birth without chemical pain relief, regardless of whether or not the mother was artificially induced or had an artificially augmented labor. "Pure birth," which I experienced and which I highly recommend, is the technical term for birth which is completely free from any chemical interference (and generally other externals such as an IV or continuous fetal monitoring).
There are deeper facets to natural childbirth, which would include things like natural birth positions (squatting, standing, etc.), immediate skin-to-skin contact with baby, delayed cord clamping, continuous labor support, no directed pushing, etc.). However, for the purpose of this entry I am going to focus on the "chemical" parts - I will define natural birth as birth in which the mother receives no pain medication, and ideally no labor induction or labor augmentation drugs. (With a national cesarean rate of about 32% and a national induction rate of around 40%, you can bet that any of the above is pretty stinking rare.)
First, let's get the obvious out of the way. Natural birth is way better for baby and mother. This is not hard to understand or to prove. Fewer cesareans (a first-time mother with an epidural is roughly four times as likely to end up with a cesarean as is an unmedicated mother), fewer long-term health effects on mom and baby, better bonding, you name it. The health benefits of natural birth for mother and baby are endless. This point isn't even up for debate, it's been so well-proven. Period. End of story.
But there's a bigger story.
Let me tell you my own experience, briefly.
I hated childbirth. Every minute of it. It started out uncomfortable, and worked up to excruciating - and stayed there. I basically screamed for the last six hours of it. It was hell on earth. In fact, as soon as it was over, I turned to my husband and told him that childbirth should be a Christian missionary's best friend, because there is no closer analogy to hell on earth. I didn't even experience the classical "birth ecstasy" of the unmedicated mother - the "my baby, my baby!" moment. I just wanted to crawl in a hole and die. I felt awful, birthing the placenta was also excruciating, and I immediately had afterpains so badly that I couldn't stand to nurse (and they hung around for over six weeks, dang it!!). If you look at my birth pictures, I am not even smiling because I was exhausted and in pain.
I'm not saying this to be discouraging - I just want the reader to know that I DO know how bad childbirth hurts. It hurts big-time. For me it was eighteen hours of torture. If I had been in the hospital I would have requested an epidural about ten hours before our son was born (another reason I'm glad I wasn't in the hospital!). Many women say that they experience childbirth as spiritual, that that they find "their rhythm," etc. I didn't. It was horrible start-to-finish.
Then, the intelligent reader asks, why are you now a proponent of natural childbirth/homebirth with a blog devoted exclusively to the subject? Are you stark, raving mad?
Let me continue with my story.
It is hard to explain this, but in the days after my birth I experienced the most amazing spiritual transformation. Next to Christian salvation, it has been the most amazing life-change - one that I could not have anticipated, and one that I cannot even fully describe. I will say this, though - Who I was before natural childbirth was not who I was after experiencing natural childbirth. It was a complete transformation, one which still awes and amazes me and which is completely beyond my understanding.
For one thing, I am now much more self-confident. I know that I am competent and able to do whatever I need, because I have done the most difficult thing that any human being can do. My body is amazing, and frankly, so am I! I withstood that tremendous pain and got through it - and I can do ANYTHING now. I have lost all amazement for athletic feats. Someone climbed Mt. Everest? Ran a 3-minute mile? GIVE ME A BREAK!!! I came through natural childbirth!!!!!
For another thing, natural childbirth also greatly healed my self-image. I, like the other 99.99% of American women who have been brainwashed into only seeing beauty in quasi-anorexia, definitely had issues with seeing my body as anything but flawed. But natural childbirth showed me the brilliant complexity and functionality of my body in ways that I could never have imagined. My body is "wonderfully and marvelously made," and I gained immense respect for it and for myself. Now, post-pregnancy, my body has way more issues than it did before - stretch marks galore, ten extra pounds and proportions so radically different I probably wouldn't recognize myself from before. But my self-image is much more positive and affirming, and I have learned to be grateful for the amazing things that my body can do - regardless of whether or not I look like a supermodel.
For another thing, I feel that in many ways that natural childbirth was truly my "coming of age." This was truly that transformation point for me. It wasn't puberty, high school graduation, sweet 16 (or 18 or 21), first date, first kiss, marriage, sex, pregnancy - no way. Not even close. It was natural childbirth. It was truly the coming of age for me. I can't say how or why, and I certainly didn't expect it. It just was. Some part of me just matured and ripened over that 24-hour period and emerged as a woman. I believe that there is some part of woman's soul that is tied to the experience of childbirth. If you ask almost any woman who has experienced natural birth, she will generally agree with this without even thinking about it (and will often go into detail about it!).
I need to add something here: It's hard writing the above, because there are some women who can't give birth, due to singleness or infertility. One of my close friends is dealing with longterm infertility right now, and it is a heart-wrenching process (another proof that birth is important to women!). I believe that that things are different spiritually for women who cannot physically give birth - that God provides other methods of maturation and self-discovery and spiritual growth. God is a God of individuals - no one is left out of spiritual growth opportunities in the economy of God. But speaking for myself, I know that there was a depth to my soul that could only be reached with unmedicated birth. And that's something I never would have guessed before my birth experience.
Some might say, "All of the above was just from childbirth - not natural childbirth." Nope, not at all. The pain of labor and birth was inextricably wrapped up in transformative effects of both. For me, childbirth was a "baptism of pain." It taught me to reach out to other women, my midwives and doula, and to see how much true love and friendship there can be among female friends, and how comforting women can be to one another during birth. It taught me compassion for other birthing women and for people who must endure pain. It taught me the great kinship that I experience with women throughout the ages of history who have endured the same thing to bring the human race into existence. It taught me to value my baby greatly, because he was birthed through my pain - and is unutterably precious.
From a Christian perspective, experiencing natural childbirth gave me a deeper understanding into the meaning of the Bible passage, "But women will be saved through childbearing" (I Tim 2:15) This is not referring to salvation from eternal death, but to something quite different. There are many different interpretations and lines of thought on this passage. But to me it has become clear that God has used the "curse" of the Fall (for man, hard and unproductive labor in their lifework, for women, pain in childbirth) to also be our greatest blessings. Who would deny that men find some of their greatest blessings and self-identity through hard work and discovery/industry/building/etc.? And I know now that women can find some of their deepest grounding, meaning, and self-identity in the pain of childbirth. Our curse has become our blessing.
But frankly, there is just so much to this transformation that I just can't describe it. If anyone would like to write a comment and give me a hint as to what I ought to be writing, I would appreciate it and will add it in! I can only say that natural, drug-free childbirth was an earth-shattering, life-changing transformation that will be with me for the rest of my life. I am even eager to go through it again, just because of that. And I have the deepest sorrow for all the women who do not get to experience this transformation because they have been cut open or drugged. I want every woman to experience this tremendous blessing and transformation - and that's one of the main reasons this blog is here.
Having a baby is more than a messy, unpleasant process that one must endure to get a baby. When people hear a horrible birth story and say, "Well, at least you have a healthy baby! That's what matters!" they completely miss the point. A woman's birth stories are part of her identity and will affect her profoundly for the rest of her life. Many women spend years and subsequent births trying to heal from cruel and demeaning treatment during previous births, or births that were in one way or another traumatic. Yes, the baby is the most important thing, but a mother's birth experience is a close second. There is nothing like it in the world, and I hope to spend the rest of my life promoting natural birth for this reason.
Email me with comments and questions!
Love,
Diana
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