We recently watched “The Business of Being Born” and since we are in this business, (I am now 37 weeks pregnant so I’m considered full-term! Bring it on baby!) We enjoyed all the questions and issues it brought up. Mostly, I think it is interesting how we are taught by our culture to fear birth and to mistrust our bodies, when the majority of births are normal. Yes, birth is unpredictable and can be extremely frightening, but our culture is obsessed with this fear when childbirth is a very normal part of most woman’s lives. (My heart does ache for friends who have struggled with infertility or lack a proper sperm donor.)

I have some strong opinions about childbirth since it is a field I have been active in, even years before my own child bearing. I trained as a doula (labor assistant, see http://www.dona.org/ for more info) in 2000. I have always been amazed with birth. I feel it is a miraculous and spiritual process where the power of God moves through a woman’s body to bring new life. Before I was trained as a doula and assisted other women through childbirth, I just kind of assumed I would deliver my future children the way most American women do: in a hospital, with an OB and medical interventions. The film discusses the current crisis in American maternity care. Just watch the film to find out what I’m talking about as there is too much to mention. (The documentary is available thought Netflix and your local library). Suffice it to say that Cuba and Poland have better infant mortality rates than the USA. I read another article recently that stated “the maternal death rate in the USA is four times higher than it should be and why is no one talking about this?”* . There are many very alarming trends that hurt our women and children, many of which come from cultural/medical perceptions which treat birth as a pathology and not a normal, healthy, state of being. I am very grateful for the medical advances that are available and that save women and children everyday. However, in the majority of women, birth is a normal process. With proper preparation, a belief in the birth process, and confronting the fear of childbirth instead of giving into it, I believe women could have more options in the process of birth. Many more problems can arise when unnecessary medical interventions are introduced. (I am not judging people who choose a medical birth, but I do think if women really looked at what is going on in maternal/child health and knew what questions to ask that some different choices would be made.) Here is a local example from Utah. Utah has an 80% induction rate, which directly corresponds to a nearly 40% cesarean rate since induction greatly increases the probability of a surgical outcome. Many OB/GYNs insist that pitocin creates the exact same physical effect as oxytocin, the body’s natural hormone. Not so. This assumption ignores the many other dynamics taking place in the body of a woman who is coming into labor naturally. Pitocin contractions tend to be much more intense and less manageable without pain medications and can put the baby through unnecessary stress. In normal circumstances, about 15% of pregnancies will have a medical reason to end in a cesarean, which again, is wonderful and saves lives. But C- sections are major surgery and carry all the attending risks of major surgery. When they are happening over twice as often as they should, it is time to ask some questions.

Many women feel technology is giving them more options but it is actually taking choices away. What happens with an epidural is a good example. Epidurals are great in relieving pain, but everything that comes with an epidural (urinary catheter, continuous fetal monitoring, IVs, the epidural needle itself, etc) make it necessary for a woman to labor in bed. There are few positions less helpful to the labor process (and birth) then being flat on one’s back. It negates the help of gravity and impedes the woman’s ability to move freely, all of which can help the baby descend and get into a good position for birth. For pain relief and management, laboring in a bath or shower or using different pressure points and positions are also very helpful but are no longer an option. I been present for multiple epidurals and I have seen good and bad examples of the effects they have on a laboring woman. (Good example, a mom with a very, very long labor and was exhausted, chose an epidural, was able to rest and finish dilating, got to 10 cm and successfully brought her beautiful baby into the world. Bad example, the baby’s heart rate slowed down dramatically after the epidural, which necessitated more interventions, not to mention frightening the new parents. Prior to the epidural the baby was tolerating labor without any complications.) As a personal irony, my mom, who gave birth to my six older siblings naturally, had an epidural for my birth and loved it!

As I was taught as a doula, when considering medical procedures we should consider the risks, benefits, and alternatives available. (Even here, there is question as to whether hospitals provide full disclosure as to the risks entailed with certain procedures. If this were not an issue, I don’t believe that purely elective C-sections for healthy pregnancies would ever take place).Women are typically not taught to think like this about childbirth and the medical establishment is certainly not forthcoming with any options other then those which fit their model (a model which is typically geared toward artificial timelines in labor progress and aggressive management). Many first time moms I have spoken to did not even know they had other options in childbirth outside of the typical interventions. And even if a woman is aware of other options, the power disparity that typically exists between a laboring woman and her OB/GYN makes choice illusory.

* from “Masking Maternal Mortality” by Ina May Gaskin in the March/April 2008 issue of the magazine “Mothering”.
More reading about the cultural fear of birth:
http://www.davis-floyd.com/userfiles/Culture%20and%20Birth.pdf
Robbie Davis-Floyd is a Cultural Anthropologist and has many interesting articles about childbirth here: http://www.davis-floyd.com/ShowPage.asp?id=158

On a personal note:
Colin was born in a hospital, and the birth itself was a wonderful and empowering experience. I had Brian laboring with me and could not have done it without him. He has become a great advocate for natural childbirth as he is among a minority of people who have witnessed how labor can proceed naturally (only about 14% of American women give birth naturally). We also had a great nurse, midwife, and two very supportive friends who came to welcome Colin into the world. The hospital never pressured me to receive pain medication or unnecessary interventions, and I was very, very happy to not have an IV, continuous fetal monitoring (Doppler yes but I was not strapped to the bed). However, I had a very quick labor (8 hours total, about 5 hours in the hospital) and things may have been different if I had been hanging out there for 24+ hours. I trusted my body. I trusted the birth process, and visualized every contraction bringing me closer to holding my baby. I was able to totally relax, not fight against the process but completely give into it. The only time I felt uncomfortable in the whole process was when the nurse made me stay still or in a position I did not want to be in to take my blood pressure. I was free to move around and naturally and innately found ways to be comfortable. We had a situation with Colin after he was born where we felt that hospital policy took precedence over what would have been best for our situation, and this is why we are choosing to give birth in a birth center instead of a hospital this time. The birth center is amazingly peaceful and lovely, and has a 3% cesarean rate (which is partially due to the fact that higher risk pregnancies are referred out to OBs and hospitals, as they should be.) All other outcome statistics are also better than average at the birth center. I do understand that if there is anything threatening my life or the life of my baby, we will head to a hospital, and I completely trust my midwife to make that judgment call. I am almost more nervous for this birth experience than I was the first time around since Colin was so easy and since if I develop complications I will need to go to a hospital. But knowing all that I know, and that birth is unpredictable, I know it will be ok however things happen. I simply hope for a healthy baby and a healthy me.

Baby Colin just born.

11 Comments:

  1. Dawngirl said...
    Hi Ann--Dawn here. Coincidentally, Chris and I watched the documentary recently and we both felt very surprised and enlightened. We will not have kids for a little while yet, but it has definitely made me think about the options. I hope that I can be as courageous as you and do everything naturally!! Anyway, we're looking forward to seeing you and Brian and Colin (and hopefully the new baby) in June--we can't wait!
    stuckihouse said...
    Dawn, you let a comment! How great. Glad you and Chris saw the film. I also hope you meet the baby in June. Since Colin came early, I do not know how to be much more pregnant than this! See you soon!
    andi said...
    Have you read "Misconceptions" by Naomi Wolf? She is the same person who wrote "The Beauty Myth". It's a good read but she kind of acts like she invented natural childbirth.

    BTW - I have a friend who just had her third baby at home in a kiddy-pool. She would NOT let ANYONE (including her husband) touch her until she caught her own baby. I will have to find the link to her blog post about it. It puts Naomi Wolf to shame!
    andi said...
    Found the link: http://chazandginger.blogspot.com/search/label/birth

    Great story and yes, ginger is mormon and covered in tattoos.
    stuckihouse said...
    Dawn, there was an f left out of the word "let" in my response to you. Sorry!
    Leah Ward said...
    Hey Ann

    I have to say I really agree with you! Having had both of my children in the UK, in a birthing centre, never even seeing a doctor only midwives, the US, especially Utah, system always sounds so ridiculous to me. I birthed Katya sitting up and was encouraged to try any position I wanted. Then I had Oliver standing up, which I highly reccomend, I only pushed 3 times and he was out! I was really amazed when my sister, in Utah, told me that the doctor offered to induce her 3 weeks before her due date? I also had totally natural births. I figure it hurts that bad anyway that no amount of gas and air or cocodamol is going to touch that pain so better to get on with the job at hand and focus on the prize. We wish you all the best and a safe and beautiful birth!

    Love

    Leah, Martin, Katya, and Ollie
    Leah said...
    Ann, well said! My opinions are strong in this area, we share the same vibe. I wonder what would happen if this were the required watching in prenatal classes, along with a few great reads like Ina May's books, The Woman's Guide to a Better Birth, and even Baby Love by Rebecca Walker.
    We did it with a midwife and doula in a hospital, and unfortunately i was forced by policy after 20 hours there to accept pitocin which put Om in distress and caused other unpleasant interventions. But we avoided an epidural and a section and the event was life-changing overall.
    Thanks for sharing, I will definitely promote the film!
    Leah said...
    Ann,
    Well said! I wonder what would happen if this were required watching along with great reading such as Ina May's writing, The Woman's Guide to a Better Birth, and even Rebecca Walker's Baby Love.
    Birthing with a doula in a hospital, we avoided an epidural and consequently a section, but policy forced me to accept pitocin throwing Om into distress and putting me in a temporary panic. This caused further unpleasant interventions, however, overall the experience was of course life-changing with a happy outcome. I do wish women wouldn't have to fight so hard for peaceful births in a hospital.
    Thanks for sharing, I will highly recommend the film to friends!
    Cheers, Leah
    jungleprincess said...
    I just read your post again since I didn't get to comment when I read it before. Such great thoughts, and so important to share with others! I love the way each experience with birth gives you more confidence in your body's abilities. I know everything will go great for you!
    Paris Soul Mate said...
    Ann-

    Felicitations! Your daughter Jane is lovely.

    I recently watched this movie as well and think that every pregnant woman in America should watch it to get a better perspective on labor and deliver.

    My first pregnancy was a c-section, and in retrospect I recognize it was for the convenience of the doctor and medical staff. I wish I hadn't been so afraid of the birth process, and had made myself informed it is such a beautiful life experience.

    Best,
    Sina (from Paris)
    rusted sun said...
    Ann,

    I know my comment is a little late, but I just read this post after Alisa suggested I read it. I enjoyed hearing your perspective, and we're so happy your birthing experiences have gone as you have planned and prepared.

    Alisa and I watched this documentary about a week or so before our twins were born, and we found it to be very interesting. I thought it was fascinating to see the home births because the birth class we went to showed birth videos that were very different. In preparation of the twins' birth, the documentary kind of got me excited for the labor process. Then the labor process ended up being more like the last one with Abby Epstein going in for an emergency C-section. I'm really glad they had the emergency C-section in the documentary because it showed how a home birth with a midwife can be backed up by the hospital.

    Unfortunately, we ended up having a delivery where we could relate more to the emergency C-section than the other deliveries shown in the documentary. Ours definitely was a "car wreck"-like experience, as described by Abby in the movie. Of course, we knew with twins we were already a high risk pregnancy. Then neither one of the twins was positioned vertex when Alisa's water broke. Fortunately, the C-section went well, both babies have progressed very well since birth, and Alisa has recovered remarkably well. Even so, Alisa has felt disappointment that she wasn't able to experience labor and vaginal delivery. Hopefully, we'll get another shot at it down the road...

    A couple of interesting notes we heard before and after the delivery of our twins...at the birthing class we attended at the hospital, the instructor straight up told us that an epidural poses no risk. We were shocked that she not only didn't mention the risks but claimed there were none....during our hospital stay, a post-partum nurse told us that there were 22 women in the hospital and 12 had had C-sections. Those kind of numbers aren't very comforting.

    Hopefully, the documentary and experiences like yours and others who are going to birthing centers will encourage many to consider their options.
    -Lonnie

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