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Birth with passion and without pontification

August 11, 2009

Back when I was an angsty 16-year-old, I made a habit of launching into self-righteous political tirades…oh, about forty-seven times a day with my friends and family members.  I was opening my eyes to the injustices of the world, discovering the hypocrisy of the beast that is humanity, and trying to change people’s minds the best way I knew how:


But I’m not that girl anymore.

(Really, Mom and Dad.  I’m not.)

I’ve grown.  I’ve matured.  And I’ve learned that smacking someone upside the head with LECTURES and SPEECHES and RANTING only has the effect of beating someone further…and further…and further into the position that they already hold.

Seriously.  You can’t beat the “light” (which may or may not be your own point of view) into someone.

And so yesterday, I came across this article, “Pushing Back: Has the Natural Childbirth Movement Gone Too Far?”, and after reading it I thought to myself, “Crap.  CRAP.  Have I recently come across as one of those pro-VBAC or pro-natural childbirth folks who seems to be trying to beat my own position into others?!”

I am not that girl.  I don’t WANT to be that girl.

(If you do read the article, let’s just put aside the last few sentences in which the author casts VBAC as akin to Russian Roulette.  Let’s just put those sentences in a neat little compartment, stow them away, and remember that uterine rupture, while a real risk, only occurs in approximately .6% of all VBAC attempts.  And that the VBAC success rate–which represents the number of VBACs that end in a vaginal birth–is a different concept entirely than the uterine rupture rate.)

Am I swinging my lecturing, heavy-handed sticks?  I hope not…

Because here’s the thing:

I don’t think that it is productive to use a “one-size-fits-all” approach when it comes to a woman’s decision between choosing a VBAC or a repeat cesarean.  And I do not take this approach.  I think that as long as a woman has access to transparent and unexaggerated evidence and information about VBAC and repeat cesarean, and as long as she has the unobstructed opportunity to reflect on what would be best for her and her family, then she has the tools to make a good decision to opt for a VBAC or a repeat cesarean

But I also don’t think that many women are given transparent and unexaggerated evidence and information about VBAC in the United States.  And when care providers continue to deny women the opportunity to choose a VBAC, and when more and more hospitals are instituting VBAC bans (whether formal or “de facto”), then women don’t have a real opportunity to reflect on what is best for them and their families.  Because they only have one option, and that is a repeat cesarean.  And while that may be the right option for some women, it is certainly not the option that all women would choose.

In that same vein, I don’t think that it is productive to be so vehemently pro-natural childbirth that one suggests that women should ignore everything that the medical community tells them.  Or that women who have labor interventions or pain medications during childbirth are somehow “failures.”  Or that women who choose a VBAC or a natural childbirth or breastfeeding are somehow morally better than those who choose a repeat cesarean or pain medication or formula-feeding.  In fact, I find all of these suggestions to be quite appalling.  (For what it’s worth, I don’t think that there are very many natural childbirth-supporters who truly hold these positions.  Oftentimes, I wonder if their/our passion and pride in their/our accomplishments come off as pontification and self-righteousness.  And I, for one, apologize if I’ve ever come off that way.)

But (and it’s a big but) I nonetheless encourage women TO ASK THEIR CARE PROVIDERS QUESTIONS.  Research birth.  Study birth.  Learn about birth.

I’m not at all suggesting that we should not listen to our care providers.  But we have a right and a responsibility to ask them questions about what may happen to our bodies at the time of our children’s births.  Because we’re dealing not only with our uteruses and our vaginas–which, depending on our care provider’s cesarean and episiotomy rates, may be cut unnecessarily–but also with our future reproductive health and with our children’s health and safety.

In addition, I think that we have a right and a responsibility to research the various risks and benefits of the interventions and medications that may be used during labor and delivery.  CervidilPitocinEpiduralsNarcotic pain reliefAmniotomyCesarean section. Episiotomy.  And many others.

There are benefits and appropriate uses and times and places for nearly all medications and interventions during birth, but there are real risks to them as well.  And it is our responsibility as mothers to know these risks before our labors so that we can make an informed decision to use them and so that–as Nursing Birth and Henci Goer point out as their mission to educate child-bearing women–none of us ever has to say “But I didn’t know that was a risk” or “I would never have agreed to that if I knew that could happen.”

Finally, while I would never suggest that all women should attempt intervention and drug-free childbirths, I have suggested that all women should consider them.  And perhaps this came off as being too…you know…angsty-16-year-old-Kristen-y.

Nevertheless, there are practical reasons that one should research non-pharmacological comfort measures for birth.  And these extend beyond the various risks associated with pharmacological pain-relief.  For even if a mom wants to sign up for the epidural as soon as she walks through the hospital doors, she will most likely have to endure a few (and perhaps quite a few) epidural-free contractions until the anesthesiologist is prepared to administer the requested medication.  And if a mom’s partner knows how to apply counterpressure, or if she can reposition herself to relieve the pain of her contractions, or if she can make use of any one of the many, many non-pharmacological comfort measures that are available, then those moments while she waits to the epidural will be much more comfortable than they would be otherwise.

What’s more, these sorts of pain-relief options can even be helpful for a mom who is recovering from a cesarean section!  (I know that I was using my hypnobirthing visualizations in the recovery room as the spinal began to wear off and the nurse began applying manual pressure to my uterus.  OUCH!)

But as I also mentioned in one of my previous posts, I think that a birth in which the mother has researched her options and has chosen her options and owns her birth choices can be one that is utterly transformative and amazing and inspiring.  I’ve had this sort of experience.  I had it with A’s birth.  And let me tell you, one of the reasons I am so passionate about birth and birthing women now is that I want all women to experience the gift that his birth gave to me.  It was just that powerful.  Just that beautiful.

And my friend Ren said it best when she wrote (in response to Heather Armstrong’s recently-posted birth story):

Armstrong makes a big pile of money off of her blog because tons of people read it, and I couldn’t be happier for her right now, because I love that she just told all those thousands of women: YOU HAVE OPTIONS.   You should study.  You should prepare.  You should make the decisions yourself.  Your birth should be your own.  Not a doctor’s.  Not a midwife’s.  Not a doula’s.  Those people can support you and help you in many ways, but you should not turn over the birth of your child to someone else, no matter what degrees or certifications they may have.  And if you choose to have interventions (induction, drugs, whatever), you should choose them based on the research you have done for yourself. I don’t think women hear this enough.  No, I know women don’t hear this enough.  So I am grateful and glad for people like Armstrong who are saying it, loudly.

Because, as Armstrong relates and as I can personally attest, if you do the preparation work and do what you can to own your birth experience, it can be a miracle in your life.  Religious.  Spiritual.  Utterly transformative.  And not just because now you have this kid to contend with.  The kid is a separate miracle. The birth experience is something different.  Something extra.  Something for you (and hopefully your partner, as well).  If you choose to make it so.

And I hope you do.

In a non-pontificating, non-self-righteous sort of way, of course.

4 Comments leave one →
  1. renbeth permalink
    August 12, 2009 11:10 am

    I read the article you linked to. And I do agree that natural childbirth advocates do more harm than good when they get all preachy and righteous – behavior which I have never seen from you, by the way.


    I feel like the article is still focused solely on the question of “health.” Now, naturally I agree that the health and safety of the mother and the baby is paramount in any pregnancy/childbirth experience. But from my perspective – and I think yours, as you’ve written and spoken about here and elsewhere – childbirth is not just a medical and/or physical process. Davis writes about being confused about what is actually “safe” or “healthy” – she barely mentions the *emotional* and *psychological* experience of giving birth.

    I guess the thing is that I think the natural childbirth movement hasn’t gone far enough – not in this country. Or rather, I think the *informed childbirth* movement hasn’t gone far enough.

  2. BirthingBeautifulIdeas permalink*
    August 12, 2009 12:30 pm

    You make an excellent point about the article’s focus. It seemed to me as if the author has some general idea that the medicalization of birth is jeopardizing both the physical and the psychological-emotional aspects of birth, but I don’t think the latter was loud in clear in her essay.

    What I should have also included in this post is that many of the reader comments on the essay seemed to respond to concerns about the *attitudes* of natural childbirth advocates. As if this advocacy is at the *expense* of women’s and babies’ health. And this affected me more than the essay itself. Because if people are *interpreting* current birth advocacy as being at the expense of maternal and infant health, and as preachy, self-righteous pontification, then that makes me very, very worried. (I also think the author was conflating *individuals’* asinine comments about natural childbirth with the natural childbirth “movement” itself. But that’s another worrisome issue entirely…)

    And might I add that I love casting the conversation in terms of *informed* childbirth. Because that’s what has one of the greatest potentials to make a birth empowering, I do believe.

  3. August 27, 2009 3:47 pm

    I often worry about sounding self-righteous when posting links and info in facebook. I don’t get upset about women who choose to give birth a certain way, but it upsets me when they make a decision with no consideration of other options. Now to be fair, I didn’t consider hospital birth when I found out I was pregnant. But thanks to being the oldest of 4 home or birth center delivered babies I had already known about natural birth. In high school I researched c-sections because it seemed like most of the people I knew were born via c-section that worn born naturally. I was the weird one for being born outside of a hospital. I researched these facts because I wanted to know why it was so weird to give birth at home. I realized before I ever got pregnant that I’m glad I’m “weird” and the product of natural birth.

  4. BirthingBeautifulIdeas permalink*
    August 27, 2009 5:20 pm

    That’s great that had your own mother and birth as a good example of what birth can be like, Clarissa! It is my hope that more and more daughters (and sons, for that matter) will see or at least know that their mothers–and aunts, sisters, and girlfriends–have taken charge of their birth and their bodies by researching their options and standing up for what they want for the birth of their child(ren). In my humble opinion, these sorts of personal experiences can have the most lasting effect on people.

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