I’ve got no beef with getting more information about the process of labor and delivery. Dads need to be there and they need to be helpful.
My problem with the Birthing Class industry, though, is that it has been hijacked in many cases by a rather extreme cabal of natural-birth boosters. And I’ve got a big problem with them.
Let me start by saying that my wife is a tube jockey, a gas monkey, or whatever else the cool kids call anesthesiologists these days.
See, I’ve lost the argument already, at least for some people.
That’s because, in the minds of the natural-birther crowd, anesthesiologists are among the worse pimps in the labor process.
Not only have they gone through the “character-warping educational methods” of medical school (as natural-birth star Cara Muhlhahn put it in this excellent NY Mag article that Matt linked to in his Tantrum), but they are also the ones offering pain-reducing epidurals that–depending on which batshit, untrained, unregulated and completely unaccountable doula is running your birthing class–either increase your risk of C-section, delay labor interminably, reduce your bond with your child, poison your baby’s blood, run the risk of paralyzing you, or prove that you are a coward.
Each one of those assertions, of course, is demonstrably untrue. And my wife has heard them all, from patients or from friends of ours who learned it in birthing classes.
Unduly harsh on the doulas? Perhaps. There are good doulas and conscientious midwives. But consider this sobering paragraph from the NY Mag article about the presumptive hero of the home-birth movement:
Muhlhahn calls St. Vincent’s her “backup hospital.” About 10 percent of her patients end up transferring there during labor. But her relationship with the hospital is not exactly formal. “St. Vincent’s is her dump,” says one former obstetrics resident who’s treated Muhlhahn’s transfers. “She could say any hospital is her backup, because no hospital is ever going to deny a woman care. She’d bring her patients in, holding their hands, find out we were going to have to do a section, and then she’s out the door. To me, that’s a dump.” Other doctors on the floor have referred to her transferred patients as “train wrecks.”
My wife did her residency at St. Luke’s/Roosevelt on w. 59th Street–the same place where she gave birth to both our babies. St. Luke’s/Roosevelt has both a regular delivery floor and, a floor or two below, a natural birthing center that has attracted plenty of the well-heeled and the famous, including Ricki Lake, who produced the anti-hospital film The Business of Being Born after she had this experience:
During the birth of her first son, Lake was crestfallen to be transferred from the birthing center at St. Luke’s-Roosevelt to the labor and delivery ward after her labor stalled.
My wife wasn’t there when Lake was, but she was there for plenty of other women who went through the same thing. For whatever reason, they aren’t able to deliver in the natural birthing center. So here they come upstairs, about to give birth to their child, the most wonderful thing to happen to them in their lives, and they are absolutely crushed because their birthing plan didn’t turn out the way they wanted. She’d see weeping mothers, angry fathers, deflated midwives, all of whom had been bullied by the natural-birth movement into thinking that they had somehow failed.
This is not just ruining what should be a great arrival. It is, as my wife puts it, anti-feminist. It’s women judging other women for the choices they make. It’s telling women that it’s their responsibility to endure a crucible of pain when the world’s most awesome Advil is just a minute away. You think it’s progressive, but its reactionary as hell.
More than anything, it’s a gross over-correction. No doubt that the old mid-century methods–knocking a woman unconscious with ether and then yanking the kid out with forceps–were barbaric. And I’m no apologist for today’s hospitals, either: I’m sure many of the labor and delivery policies are guided in part by cost and liability concerns. But not at the expense of the health of the mom or the child.
And isn’t that what it’s about–having a healthy child? To have many more specific expectations than that is to fetishize the means at the expense of the end. The goal is to have a healthy baby that you will love and raise right, not to prove your toughness or the correctness of your politics to your neighbors in Park Slope.
By the way, I don’t have a financial interest in this fight–my wife hasn’t done anesthesia for obsterics since she finished residency last year. But she did need tremendous medical intervention after the birth of our son in 2008. What we were expecting would be a low-risk birth–the kind many people would try to do at home–caused her to nearly bleed to death after delivery. The natural-birth crowd would probably find a way to blame what happened on the pitocin–she had to be induced–or the epidural. What actually happened is that she passed an 8-lb child through her cervix, something inherently risky and unpredictable (remember how before there were hospitals lots more women died during childbirth?). When things started to go awry, a phalanx of caring and competent nurses and doctors swept into the room, and as I stood aside with my newborn son and watched helplessly, they saved her life.
They saved her life. Can a doula do that? What if this had happened at home? Would the preciousness of our politics help me raise my children alone? You can see why I have little patience for people like überquack Michel Odent, who asks blithely whether humanity can survive obstretrics.
I know, I know, this is a Dad Blog, which means a Dude Blog, and as a Dude I have no right to weigh in on the politics of childbirth. But I doubt my wife is alone in the way she feels. There’s a vast number of women who come into this process not knowing what exactly to think. It’s no small injustice that they emerge from the modern Birthing Class cowed by the braying and irrational voices of the natural-birth extremists.
First, let me recommend Tina Cassidy’s brilliant book “Birth: The Surprising History of How we Are Born” to you. Balanced, personal, funny, carefully researched: must-read for you. She even has the balls to suggest that men should be given the option not to be in a delivery room — she chose an epidural.
We’ve done every flavor, emergency c-section (preemie), VBAC au natural with a midwife in a hospital, ob/gyn delivery with epidural. Of the three, my wife far and away preferred the middle. I kinda liked the last one. The ordeal of the natural birth was hard to watch, but the cert. nurse/midwife was amazing.
So for me that’s the ideal: certified nurse midwife in a hospital setting. Unfortunately liability issues and hospital policy make this very difficult (hence our Ob/gyn delivery).
Bear in mind that most parents can think for themselves, sort out all the information, deal with the loons and extremists, the corporate and financially motivated, and come up with a path that works for them.
Thanks for the book recommendation. I haven’t read it, but will put it on my dead-tree version of a Netflix queue.
I guess you’ve got more optimism than I that parents can sort through the information themselves. Even at Roosevelt’s Birthing Center, there seemed to be misinformation about what OB/GYN’s do on the regular floor. Anesthesia was never asked to come present information down there about what they do, or what will happen if natural birth doesn’t work. But doctors are notoriously bad about communicating their side of things. That’s their fault, by and large: I often think they don’t understand the amount of frustration and skepticism out there.
A great post, and one I wholeheartedly agree with.
Thanks for getting my back, Dan. I checked out your site. The Joseph Salmon Trust story is pretty inspiring. I donated and encourage everyone reading this to do the same: http://allthatcomeswithit.com/
Glad to hear you’ve just gotten into porridge, as well. Have a great walk.
I have a hard time separating the fanatical natural birthers from all of the other anti-science/anti-modern medicine crackpots; to me, they’re no different from parents who refuse to vaccinate their children, or who chose prayer over chemo and radiation.
My wife went through 2 emergency c-sections, which probably saved her life as well as the lives of both my children. A good friend of mine and his wife opted to have their delivery at a natural birthing center. He had to carry his wife (literally) out of there and drive her to a local hospital when complications arose during her labor – the midwives were completely incapable of dealing with emergencies.
As I’m fond of pointing out to natural birth fanatics, there’s a reason that so many American women and babies died during childbirth well into this century. Great post (and yes, until women figure out how to grow their own sperm, partnering dads are entitled to a say in the birthing process.)
Bollocks, anyone with a brain can weigh in on this one, and you are absolutely, 100%, right.
Almost made this lady cry. Like the ridiculous pain of childbirth. And by ridiculous, I remember thinking that if I died that would be okay. That was 8 centimeters into back labor while lying on the backseat of a car driving up the west side highway. I can’t express to you my deep undying love of the most Awesome Advil in the world.
At the risk of turning this into a confessional, I will say that I birthed sans drugs twice, the second time to a 9-lber, and it was great. Not great as in blissful or pleasant but great as climbing Mt Everest or other sublime (in the traditional sense of the word, awe and terror) life experiences. Birth is the least of it, re: having kids, but I do have the memories forever. I was lucky in that both births were relatively quick and uncomplicated, but I think that’s the norm, not the exception.
I did this in hospitals, in case there was a bad turn, and highly recommend the midwife in hospital route as well. The midwife is there with you the whole time, is trained and expert in birth, and doesn’t shout at you, as my doctor did with number one: you better push this out now or you are headed for a c-section! There are lots of tricks that they do know and are graphic enough I won’t relate them here.
I do have to say that I have read legitimate scientific studies that show that some interventions do slow labor which creates its own set of risks. In addition to “Birth”–which is great–I’d recommend “Pushed” by Jennifer Block–guess what perspective it promotes.
On the other hand, I am completely sympathetic to the idea that natural birth is potentially un-feminist, as is the emphasis on breastfeeding for a year. Nothing important is straightforward, and to each their own.
For what it’s worth, the birth center at Roosevelt requires a birth partner–usually dad. When they asked me who my helper would be, I stared and said, the midwife right? Wrong. You need one extra body who you bring on your own. So dads (or dad substitutes, like grandmas or best friends) are fully expected to help in labor.
I am planning a natural childbirth in a midwifery center (attached to the hospital), and NOT because I am a crunchy, tree-hugging, Patchouli-bathing, Subaru-driving nut case (Okay, I do drive a Subaru, but enough of that).
Things may not go according to plan during the birth, but I’m a flexible enough person to make those tough choices should they arise.
I am choosing natural childbirth for two reasons:
1)I’m actually looking forward to the experience–pain and all. I’m no masochist, but I personally don’t desire to “numb” myself to the point of paralysis, and succumb to a cascade of medical interventions that may actually increase risk of injury to me or my baby. (My sister had two easy childbirth experiences in a hospital with Pit and epidural, and I think that is wonderful that she had the birth of her desires. But I don’t share her particular desires, and that’s fine).
2)Medico-legal concerns have made childbirth a nightmare for OB’s, and understandably, they are quick to push an intervention if things are not proceeding “perfectly”. But this push for interventions has led to poorer, not better, outcomes for babies and mothers in the United States. Did you know that elective induction with an epidural in primipars (first-time moms) more than doubles the chance of getting a c-section? C-section rates top 30% nationally, and exceed more than 50% in some areas. C-sections are not harmless–they more than double the rate of maternal mortality compared to a spontaneous vaginal delivery. The World Health Organization says optimal c-section rates in a population should not exceed 10-15%. The Netherlands, for example, has a homebirth rate of nearly 34%, and a C-section rate of almost half that, and their maternal and perinatal outcomes far surpass those of the United States.
Yes, please do a little research before you launch on a vitriolic tirade against women who simply want the choice to birth in the way they KNOW is safer and gentler for their situation.
I, for one, never judge another woman’s choice on how to birth–homebirth, epidural, pitocin, c-section, whatever. What I stand up for, and strongly advocate for, is informed CHOICE. Study after study shows that an unmedicated, spontanous vaginal delivery is the safest way to give birth; does that make it the only way…NO! Thank God we have modern hospitals and trained surgeons to assist in the 10-15% of pregnancies that are high-risk. But the sad truth is so many women have felt robbed of their choices in childbirth for too long. This ain’t just “sentimental-intuitive” babble–this is clearly thought, evidence-based reasoning from whence I have made my decision. I am not fetishizing a spa-like birth–I am fiercely protecting my baby’s health, and I have a wealth of scientific literature to back up my logic.
And yes, I will vaccinate.
Katie Gerarge, MPA, PA-C
I believe that babies need to come out. Full stop.
There. That’s been said.
I birthed my first-born with a midwife in attendance, at a hospital. Because all of the birthing rooms were full, and they hospital was not using the “posh” birthing rooms because they don’t staff it (cutbacks and doctors don’t prefer those rooms, though that’s how they sell the hospital to the public), I was put into a room normally used for emergencies. I did most of my labour (now you know I am in Canada) at home, and went to the hospital pre-checked-in because I was with a midwife. (Here, even the homebirths are registered with a hospital when one goes into labour.)
Transferring in a car to get to the hospital (and earlier in the day as my husband wanted to go for a walk by the beach rather in our charming ‘hood!) … stopped my labour, a phenomenon I was not aware of until my next pregnancy. First hitch.
When we arrived, we were put into this emergency labour room, which was incredibly clinical. I pushed for 2 hours, throughout which time I was freezing cold (second hitch). In hard labour. Just as my baby is crowning, the nurses had a shift change. The lovely one that was attending did not want to leave, the senior insisted, and they argued in front of my birthing body until *I* told them to fight somewhere else.
The good nurse left, the nasty one (and she was NASTY) insisted on poking me and prodding me at every turn (third hitch).
Fortunately for her (as I was going to kick her HARD), the baby emerged within a minute of her arriving.
I had said no to the hormone shot one gets in the leg after birth to ensure that one doesn’t hemorrhage, and we were transferred to aftercare: a semi-private room with a woman who had her 4th, had multiple family members (and I mean about 20) coming and going all day long.
Toward the end of the day, a nurse came and freaked out. My baby went from perfect apgar scores to turning blue.
My husband and I had made this birth plan:
– natural unless there is a good reason why not — trust midwives whom we knew well
– interventions to help baby out
– pain meds as needed, but probably not as I have extremely high pain tolerance (okay, a very strong ability to disassociate. don’t ask.)
– if C is required, my guy goes with the baby
– if something goes wrong with me, my guy stays with the baby
– if something goes wrong with baby, my guy stays with the baby
– if baby dies, travel to an island somewhere off the coast, we take time to ourselves to regroup
– if mom dies, sorry guys, you are on your own.
Harsh, I know. But that’s how I think and it meant that our asses were covered, at least figuratively.
So. I have a blue baby that is practically ripped from my arms 12 hours after birth and taken away. I have never seen my guy move so fast.
The evening nurse noticed a heart murmur, which together with the blueness suggests either a hole in the heart or an unclosed valve at transition time from womb to air. My child was put (at 9lbs) into an incubator in the neonatal intensive care.
At this point, as this is being explained to us, my inlaws arrive. We are in this horrible room with a depressed new mom who hasn’t nursed, changed, or looked at her screaming newborn, with extended family coming and going and specialists trying to explain the problem to us when in walk my inlaws.
Ha!
I told the employees of the hospital that I required to be moved to the next available private room (there are 20 privates and 2 semi-privates, luck of the draw). Really? I should have had to at that point. I had the insurance to pay for it and I was willing to pay cash instead if it suited them. When they looked dubious, I got somewhat vicious.
Oops. Here’s a private room here! Never mind that the posh birthing rooms are empty, save for 2 (they have to use 2 rooms to justify selling the hospital on that feature), on the next floor up.
The diagnosis was the valve in the heart. Do you know what that is often caused by? A poor squeeze on the way out of the birthing canal can do it. (Remember the nurses arguing? That was right at the point when the baby should have been squeezed.) An ice cold birthing room can also squash that first breath that the baby takes, which is integral to the transition from womb (not) breathing to air breathing.
Ultimately, my trip to the hospital caused them to have to keep my full term, otherwise healthy baby away from me. I scraped every drop of colostrum (that essential early honey-like substance before one’s milk comes in) from my breasts and bottle fed it to her. I was not allowed to keep constant vigil for those long three days (in fact, they tried to send me home, but I had a midwife who fought for me and the need to bond and nurse as I wanted and could breastfeed), but if I ever had another child incubated, they would have to arrest me and take me to jail before I would leave her/his side in that cold (warm) plastic box again.
At the risk of this getting long(er), I will stop it there. Suffice it to say that my guy was so traumatised by the turn of events, that it took weeks to get him back to the bliss of those first 12 hours.
I had my second and third at home. The first homebirth, I hemorrhaged badly, but my midwives had the appropriate meds and skills to arrest the problem quickly. The second went off without a hitch. The births were amazing, my kids did not witness but were thrilled to be at our side as soon as it seemed right for them to be there, and my recovery was … well … lovely.
I am for women having the right to choose a safe birth. In most cases, midwives can see trouble coming like headlights on a train on a clear dark night, and will advocate for a transfer to the hospital. We too have a maverick midwife who is unregistered in Vancouver. Certain people are very much attracted to her beliefs and her practices. Why must these people be vilified, for the sake of those who don’t do sufficient homework in advance and go with the trendy “on video” choice and have it get “scary”, as the writer and his wife in the New York magazine article? Why must those who choose, or by default have, a C section, be vilified?
Each time, I was happy the baby came out all right. Seriously. I would have been just as grateful (or more) if I needed and got a C-section as I was with my (by luck and choice) all natural birth.
Good post Nathan. First let me say how glad I am that you guys took on this topic for this week’s tantrum. This isn’t just a woman’s issue and men shouldn’t be crucified for sharing their points-of-view about birth. As I’ve mentioned before, I’m all for birth classes, but I think an overhaul is needed to make Dads feel like an equal partner and not a sidekick just along for the ride.
My wife wanted a natural birth too and I saw the pressure she put herself under and how crestfallen she was when her doctor recommended a planned C-section because it was pretty late in the game and the baby still hadn’t dropped. She consulted every website she could find and called so many people in the attempt to question the doctor’s recommendation. I totally supported my wife but I finally had to just ask: “Why are we not listening to our doctor?”
She ended up scheduling the planned C-section but for at least two months, she was hung up on not having a natural birth. This was incredibly frustrating because it seemed to taint what otherwise was the best thing to ever happen to us.
This is not about individual women’s choices and putting down those who choose differently. This is about the system of industrialized birth that undermines women’s natural ability to birth and then claims the credit for rescuing them. Now THAT’S anti-feminist.
Nathan: the hospital saved your wife’s life? Maybe. But maybe they stabbed her first. And you’re grateful to them?
Natural birth advocates know what the research bears out (and what you unaccountably left out of your analysis): BABIES BORN THE NATURAL WAY HAVE BETTER HEALTH OUTCOMES (AS DO THEIR MOTHERS) THAN THOSE BORN SURGICALLY. (How did you manage to leave this paramount issue out of your argument?) It is hospital practices that create the very circumstances that they then purport to rescue you from via surgery. These practices greatly increase the odds of surgery and adverse health outcomes for infants and mothers. When a woman is asked to labor in the presence of strangers, flat on her back, without food or water, on the hospital’s timetable instead of her own, with fear instead of confidence in her heart and in those around her, her labor stalls. Then she’s told she needs pitocin for augmentation, a drug that is known to increase the likelihood of uterine rupture and hemorrhage, not to mention unnaturally excruciating pain and panic that leads to surgery (which is dangerous, any way you slice it). A hospital is NOT the safest place to give birth.
OBs are surgeons – they have little incentive to promote practices that help women birth without their assistance. Most OBs have never even seen an unassisted, intervention-free birth! How on earth could they be entrusted with routine prenatal and birth care? This is like bringing in the cops any time your kids fight. Cops are great for some things, sure, but they’re really not great for most of life’s routine hiccups. And that’s what birth can be when women feel confident and supported: routine.
We have a c-section rate in the USA around 30%. This is far higher than any other industrialized country and yet we have higher infant and maternal mortality. And yet no couple ever thinks that their own c-section was anything but absolutely necessary and life-saving. You do the math.
I highly recommend the book “Ina May’s Guide to Childbirth” to you. There are also many informative articles about this broken system at her website: http://www.inamay.com.
I have had 3 children with midwives attending, one in my own home. Yes, I thought I might split in half and die. Something intangible and indescribable happens when you give birth wholly on your own efforts, and it’s worth it. On the other hand, if I were ever told I needed a c-section, I would do it gladly. And I would feel happy to have my baby healthy and whole. And I would feel grateful for the advances of modern medicine. But that’s because if my lay (unregulated, unrecognized, no hospital privileges) midwife says I need one, I believe her. That’s not how I feel about OBs and hospitals.
It bothers me that women who desire an unmedicated and natural birth as possible and talk openly about it, are considered fanatical. We are criticized for sharing our viewpoint and our concerns about interventions are discounted despite the evidence in favor of unmedicated birth.
We constantly need to sensor our conversations and temper our passion about unmedicated birth when talking with other mothers so as to not make them feel bad for their choices, and yet… countless times while I was pregnant I was belittled by other women saying, “you can’t do it, just wait until you’re in labor, you’ll change your mind once it comes down to it, just take the drugs, you don’t need to be a hero.”
Why can we not realize that there is more than one way to birth and support each other as women and families. Why must we belittle each others choices? Can we not learn to support and respect each other’s decisions instead? Seems more productive to me!
Maybe it was unclear (as often happens) in my post, but I’m not telling everybody to get an epidural. Nor am I saying that every woman who prefers home birth is an extremist. If you think you should have a natural birth, that’s great. If you tell every woman they should have a natural birth, that’s not great. I’m in favor of free choice, which means freedom to have a baby in your whirlpool in the woods, but also freedom from guilt-trips about following the clinical standard of care.
Some of you have gotten to this page from MyBestBirth.com, which is apparently Ricky Lake’s community site. Welcome to DadWagon. May I point out that even the name of the MyBestBirth site suggests that Lake has it all figured out and the rest of us have a “not-best” approach to birth?
@Karen, I am very sorry to hear about your first labor experience in hospital. I was going to cheer for the Canadian curling team, but now I am not so sure. Seriously, though, that sucks, and it sounds like you did the right thing by having the next two kids in an environment that made you much more comfortable the next two times. Yay. And I love your birth plan, by the way, doomsday scenarios and all. Also: your point about the NY Mag writer rather guilelessly picking out the “scary” midwife is the smartest thing anyone here, including me, has pointed out.
@Audrey I don’t see what the studies you mention comparing outcomes of natural babies vs. C-section prove. Maybe I’m not understanding this right, but isn’t it obvious that natural babies have better outcomes than C-section babies? If everything goes right, you get to have a natural birth. If something goes wrong, you may have a C-section. So what’s at fault: the C-section or the underlying condition that caused the C-section? That’s called a confounding variable. People on either sides can cite studies that don’t actually prove much.
I am NOT defending elective c-sections done for the comfort or convenience of the mom or the doctor. That strikes me as poor choice.
A woman whose medical knowledge I trust very highly decided to have her baby at home. She’s an RN and she HATES hospitals and the unbending and sometimes uncaring hospital rules that kept @Karen from being by her baby’s side. But how can I not be critical of midwifery when my cousin wife’s midwife told the her keep her baby THREE weeks after her due date last year, when it was done developing and was just getting fat and dangerous in there? Guess what? The baby weighed over 10 lbs, she needed a c-section, and as @audrey pointed out, that’s not optimal. Some pitocin and some freaking common sense could have solved that situation in a very different way.
My modest proposal: Make sure whoever is helping with your birth adheres to a uniform standard of care. Then use them if you want to; no judging or being judge.
I agree with L-A. But let’s be clear: Birth center/natural birth classes, at the least the one I had to take at Roosevelt, do often vilify (in dulcet voices) the ignorant masses who claim they want drugs. The educators told us things like ‘you are a special group, you have made a special choice’ –which is just mean, since so often that ‘choice’ is medical luck. (You could get kicked out of the birth center, for instance, merely by being more than 7 days past your due date.) True choice means being able to scream give me the epi and not feel bad–and of course to know all one’s options and hear that drug-free birth isn’t that bad either. It can feel like a form of torture, sure, but to an end, and that makes all the difference.
It’s funny, the birth ed classes actually leave out the worst parts–post-partum effects on mom, and I’m not talking depression. Google mastitis, diastasis and prolapse, preferably via google image. That kind of stuff happens, at higher rates than anyone wants to talk about, no matter how they come out. If they talked about it ahead of time, who knows what would happen to our replacement rate.
@Nathan: I think the issue for the natural birthers re C-sections is that many doctors/hospitals are too eager to do them even if it only appears that something may be going slightly wrong (a drop in the infant’s heart rate, for example, which may actually be natural/normal — or may not).
Which is why, when my wife and I were getting ready to go through all of this, we asked the hospital what it’s C-section rate was. I don’t remember the actual figure, but it was lower than average, or at least low enough not to be worrying. I think I may even have learned to ask that question at birthing class!
(FWIW, we also checked episiotomy rates, which is less of a big deal here, but in Jean’s home country of Taiwan, the rate is nearly 100% — which, ick.)
I always feel weird when I read something that judges me for feeling something I never felt. I transferred to the birth unit/birthing center of my local hospital during my first labor. I was glad to do it, my baby needed it. But still, I was a little disappointed I couldn’t finish at home. Why is that wrong?
I admit my disappointment, but I don’t let it cloud my experience. Plus, who said I felt judged by NCB’ers. I didn’t. I never felt the need to justify what happened. And I really hate that medico-birthers feel so threatened by my little bit of disappointment.
I mean come on, if you plan a wonderful homebirth, complete with candles during early labor, slow dancing with your partner during transition, champagne and cake for after the birth, and a lovely long snuggle with your new baby, why is it wrong to be disappointed if you have to get a c-section for some reason? It’s not exactly the wonderful day you planned.
If you planned an amazing wedding just the way you wanted, flowers, candles, romance, then ended up having to get married in a dingy town hall with two strangers as witnesses, you’d still be happy you were married to the guy you love, but you’d have a bit of disappointment for what you missed out on. You process, you get over it.
Same idea right, you love your baby, you embrace your new experience, but you still have a bit of sadness for what you missed.
Then this guy, and people like him, turn that feeling into, “you ungrateful wench, you should be glad your baby is alive…” Just back off dude, we are complex beings, capable of being happy and sad in the same situation. Capable of rejecting and embracing at the same time. So stop judging us as guilty people who push our guilt on others, it’s just not the way it is.
@Nathan:
It amazes me, how you can feel so confident in your position when you are clearly unaware of the most basic research summaries that are readily available online with a simple google search!
About your friend with the 10-pound c-section that you think was so obviously necessary: I personally know in my own social circle two women who have birthed vaginally, without medication, 11-pound baby boys, perfectly healthy, births without a hitch. One did it at home with a lay midwife. The other, who went on to have a 2nd 11-pound baby boy vaginally, was a double VBAC (i.e. she had had 2 c-sections before her 2 vaginal births and the first 11-pounder was the first baby to emerge through her vaginal canal). The human body is amazing – do not let OBs tell you that you can’t do it, because YOU CAN. As Ina May Gaskin likes to tell her moms: Your body will not grow a baby that you cannot birth. And here are her birth statistics to back it up: http://www.inamay.com/?page_id=28
I am a petite Asian 4’ 11” woman who weighs 115 pounds. I birthed a 8 pound 6 oz baby (my 2nd) without even a tear. It’s all a load of crap, Nathan. We CAN do it. Again from Ina May Gaskin: Your body is not a lemon! (Your wife’s body isn’t either.)
Have you really watched Ricki Lake’s movie? You refer to it, but you seem unaware of the important points she makes.
As for the confounding variable thing, Nathan, I take it you mean firstly that we can’t tell whether the worse outcomes from c-section come from the surgery itself or from the pre-existing conditions or emergency situation of the birth itself, and secondly, that those conditions and situations would have resulted, without a c-section, in far worse outcomes for mom and baby. Do I have that right?
I think you are wrong. Firstly, there is no doubt in even the medical community and research literature that c-sections are THEMSELVES THE CAUSE of increased risk for both baby and mother. No matter what the underlying medical condition, babies born via c-section have an increased likelihood of being cut (by a scalpel), of respiratory infection (they don’t get that last squeeze coming out of the birth canal that empties their lungs of fluid), and of prematurity (when the c-section is performed before the mother is in labor) which is a tremendous risk factor itself: http://en.wikipedia.org/wiki/Preterm_birth#Specific_risks_for_the_preterm_neonate
These are not risks that existed because the baby’s heart rate was depressing during contractions (which, as Matt says, is not even clearly abnormal or dangerous, let alone a pre-existing condition). These are complications from the surgery itself, of leap-frogging over nature’s way. This is not controversial, Nathan.
Nor is it controversial that surgery has its own risks, again, wholly unrelated to any pre-existing condition that causes the so-called “need” for c-section. It is major abdominal surgery, and that has risks that far outweigh the risks of natural childbirth. http://www.americanpregnancy.org/labornbirth/cesareanrisks.html
Even having established that c-section ITSELF presents very real and increased risks for mom and baby, I don’t think anyone (even them most ardent natural birth advocates there are) would disagree with the fact that there is some small percentage (say 5% or lower) of birth situations where a c-section is truly a necessity, without which the baby or mom would suffer harm greater than any of the above increased risks from surgery. And I don’t think that ANYONE thinks that a woman in this situation should decline a c-section.
But that still leaves the majority of c-sections in this country being medically unnecessary, in my view. Whereas you seem to think most c-sections done are medically necessary. (Like I said before, no one thinks theirs was unnecessary, right?) But how do you reconcile this with the fact that there are many other countries with fewer c-sections and yet still far better maternal and fetal outcomes than ours: the Scandinavian countries, the Nederlands, all of Europe, and Japan? http://www.icanofnj.com/usbirthstatistics.htm
And as Ina May Gaskin writes, were are probably losing even more mothers than we think we are to complications from surgical child birth because we don’t report maternal deaths properly. If a woman hemorrhages to death or dies of infection a month or even a week after her baby is born, it wouldn’t be recorded as pregnancy-related! See http://www.inamay.com/?page_id=12
In Europe and Japan, midwives attend over 75% of the births, and OBs are called in where there are high-risk situations like multiples, breech, maternal health factors, etc. Why do we need midwives? Ina May Gaskin again: “To start a pregnancy, you need a woman and a man; their functions are different, but everybody will hope that they will love one another, respect and admire one another. To care for pregnancy and childbirth, you need a midwife and a doctor. I hope that they will love one another, respect and admire one another and will know that they are both needed and complementary.” http://www.inamay.com/?page_id=249
Finally, Nathan, why is elective c-section for a woman’s convenience a poor choice? Is that not judging moms who have simply made a different choice than you have? If you can say that, I don’t know why you have a problem with the natural birth advocates who you so despise saying that starting down the slippery slope of hospital interventions is a poor choice that often ends unnecessarily in c-section. Which is it?
Nathan, can you say more about the uniform standard of care? You make it sound so simple and so obviously right, and as if no one would ever disagree with that. But what if those who care about a uniform standard of care (OBs) provide care that is entirely more risky than those who don’t care (lay midwives)? What if treating birth as a medical event (in hospitals) leads to standardization that actually has worse outcomes than when birth is handled as a family event (as in homebirth)? And if you read Atul Gawande’s piece about why c-sections are necessary, it’s not because they’re safer. It’s because they’re the safest way to have babies *in hospitals*, where things need to be uniform (like no one leaves a scalpel inside your wife) in order to be safe. But if you avoid the hospital (and their uniform standard of care) entirely, your wife and baby have better odds. How’s that for radical?
This probably sounds crazy to you but I no longer consider my births to be medical affairs. For me they are mostly spiritual events, and to that end, I don’t want standardization and shift changes, I want someone who connects deeply with me and believes in my body. Yes, my midwife brings sutures and oxygen tanks and pitocin in case I hemorrhage, and yes, it is important there is a hospital nearby in case we need it. (And if I ever go into surgery, just for you I will smile at the anesthesiologist, okay?) But really there is this entire element of a woman’s spirit during birth that is entirely overlooked here. It’s not that women who have c-sections couldn’t birth or that they or their babies were in any danger. It’s that they put themselves into a situation (hospital) that greatly impeded their innate ability to birth their babies and created in them the false sensation of danger or worse yet circumstances that actually created real danger (pitocin leading to hemorrhage or rupture), and that they were (and continue to be) ignorant of what those impediments were. You think your wife would have died without the hospital OBs. Whereas I think that most women in her situation would never have hemorrhaged had they not gone to the hospital and been given pitocin for augmenting a labor that would have proceeded just fine on its own if we were patient and supportive and didn’t have a system that tries to cram as many paying patients into beds as quickly as they can. Read that book I recommended to you! (As a teaser, I will tell you that one of the chapters is titled, Sphinter Law. It is the most basic tenet natural childbirth and yet you’ve never heard of it, right?)
@L-A: I personally find the balance between advocacy and non-judgment really tricky. The crucial difference seems to be whether we are talking about public health or talking about a person’s choices. In terms of public health, there is no question that natural birth is safer for all concerned, and to that end, routine use of labor-augmenting drugs and pain-killers is to the detriment not just to us, but to our unborn children. (And the same goes for breastfeeding – in public health terms, all babies benefit tremendously from being breastfed for at least a year.) There is a time for sympathy – no one would say that in response to a friend’s c-section story it would be helpful to start sharing European statistics. But without advocacy there is no education, and without education there is no change. It’s a timeless conundrum, I’m afraid, how to advocate for change without stepping on others’ toes. Perhaps mothers should stop confusing public health advocacy with attacks on their choices. (Do we get upset with anti-smoking or bike-helmet-wearing campaigns?) Perhaps mothers should stop putting responsibility for their feelings of guilt and inadequacy on others. It can be disturbing to learn things that make us question our choices, or that we were ignorant or misinformed – but is it sensible, fair, or productive to attack the source of the information? Is it so important to avoid bad feelings that we should muzzle ourselves or others from improving things for those who come behind us? And furthermore, isn’t it rather puzzling that feelings of guilt can be blamed on others at all? If in fact natural birth and breastfeeding advocates are wrong, then those mothers shouldn’t feel bad at all. And if in fact they’re right, those bad feelings are productive ones – they can inspire each of us to educate ourselves and choose better the next time around.
@Emily: You GO GIRL!
I am a first-time husband and dad.
My wife however already had 2 (wonderful) kids and had been married previously.
So the bottom line is this: I could have just received the Nobel Prize in Medicine for Knowing All There is to Know About Pregnancy and Childbirth and the net outcome will be that things will go exactly the way my wife says, and I will do as I am told.
Example:
Parents: “Are you going to ‘find out’?”
Me: “I want to be surprised.”
Wife: “You’ll be surprised 12 weeks. There’s planning to be done.”
There you have it folks. So far my responsibilities in the birthing room consist of “Don’t pass out.”
Got it. Check.
its become a such a business – the stay at home deliveries are Trendy (either by culture pushing back on the medical business model or the drugs or the lost of control that happens in a hospital – I dont know)… I say to each their own.
I can only speak for me and my family when I say I’m very happy at the choices we made at the time we made them.
Great post!
I thought this was a good post and you definitely have a right to weigh in:) I do take issue with the fact that you seem to imply that all that matters in the end is that you have a healthy baby. Yes that is important, but out emotions and how they are reacted too can play a huge part in our well being. Some women come away from the birth experience with PTSD. And they have to live with this for a very long time.
In my experience(as a L&D RN), this happens because a women has felt like her choices had been stripped from her. I think this can happen with natural births as well. Not only are we expecting women to keep their emotions under control, but we are expecting them to answer questions and process information right in the middle of one of the most intense times of their lives. It really is unfair to suggest that if things don’t go as planned that they just bottle their previous plans and deal with it.
I of course feel like there are extremists out there, but I feel like a lot of these women have had horrible birth experiences. This does not mean that what happened to them was the worst thing in the world, but in their mind, they were stripped, beaten, and told to be quiet at one of the most vulnerable times of their lives. Most women I know that choose natural birth do so because 1) they are afraid of big epidural needles:) 2) they don’t like putting medications in them if they don’t have to 3) they want to be able to freely move around for birth 4) they have a hope and desire that they can do something for which they feel their bodies are made for 5) they had a bad experience previously where they felt like their choices were taken away. I don’t think these are bad reasons.
But you are right, being judgmental about other people and their choices is wrong. And just because you had a wonderful experience doesn’t mean someone else wants the same thing. All in all this is a tricky topic for women to discuss because it involves way more than just the physical, and we are all a little bit insecure anyways:)
look at this:
http://www.nytimes.com/2010/03/07/health/07birth.html
“until women figure out how to grow their own sperm, partnering dads are entitled to a say in the birthing process”.
And until men start enduring the massive physiological stress that is carrying a pregnancy and birthing the child, partnering dads are not entitled to a say in the birthing process. I love the way you think contributing a sperm( completely effortless) somehow gives you entitlement to influence the way a woman labours.. Yuck!
By all means guys, assist your partner when she’s deciding how SHE wishes to give birth and help her in making informed choices ; but please don’t assume that your input is something you’re entitled to put across because you contributed a sperm. How a woman labours and delivers the baby is entirely up to her because it is her body that is doing the labouring.
birth is a process females have been doing for thousands of years and humans are the only species who invites the male to be present, you are there by the woman’s invitation, not because you are entitled. Until men start carrying pregnancies and birthing the child, it is entirely, 100% a woman’s decision in how that process should happen and whether her partner will be there for that matter.