Tuesday, June 24, 2014

Why I Give a %*&@ about Birth

A very pregnant me wishing this was a real pina colada. Not a very "earth mama" sentiment, right?

I'm passionate about birth. I'm even taking a workshop this weekend to learn how to be a doula - a person who offers support to the birthing mother and anyone else who's with her during birth. I read every article about birth I can find, I watch every documentary I can find (and my husband laughs as I cry when the baby is born every. single. time.) I love to hear others' birth stories and see others' birth pictures. I can't get enough.

It's funny. As a kid, I found birth SO GROSS. In fact, anything relating to "that area" gave me serious willies. Then, I got pregnant with Stella. I was in awe of the changes in my body, and totally curious about the birth to come. A friend who just had a baby told me to consider looking into natural - or unmedicated or low-intervention - (it seems whichever term I use pisses someone off, so I figure I'll just piss everyone off) birth, because it was so much better for the mother and baby. That seemed like b.s. to me, because I don't like pain. Pain makes me cranky. And I like modern inventions and stuff.

But once I started doing even a tiny bit of research, the facts couldn't be ignored. Interventions like inductions and c-sections can be life-saving when needed, but they are often overused for no evidence-based reason. They are hard on mothers, and they can even be harmful to babies. Although I dreaded the pain, I really wanted to do what I thought was best for that little bean. So I did it. It was crazy and intense and so painful I thought I might die, but I did it. And then I became obsessed with it.

But there's a problem. The problem is that even though I did what I thought was best for my baby, and even though I want to learn more and educate others about how birth doesn't have to be traumatic and can be much healthier for all involved, I'm apparently a "type." In fact, when many people hear that I want to become a doula, they often either cringe or say, "Oh, you're one of THOSE."

I'm a type. So much so, that an article was just written about how people who are passionate about birth are part of a cult. I've never been in a cult in my life, but apparently I am now. And apparently I think that if you don't have an unmedicated birth, you're less of a woman. Or you didn't have a spiritual awakening. Or you suck. Whatever.

Well, for the record, I don't think that. I don't get mad at women at all. Women go to care providers they trust and follow their recommendations. I do that with my doctors, too. Unfortunately, when it comes to birth, many care providers are relying on practices that are simply not evidence-based.

And I don't think birth has to be spiritual. It was for me. It helped me heal from the sexual trauma I suffered as a kid. But for many women, it is something to be endured. That's fine. It still doesn't have to be terrifying for the mother. It doesn't have to be awful. And for so many women and their loved ones, it is.

So. Let me dispel some myths.

1. I think that women who don't have unmedicated births are less than. I don't. You had a baby. I think you're a mom, and I think that's incredible. I hope you felt supported and healthy and not terrified during your pregnancy and birth, because I like and care about women. That's why I call myself a feminist. Proudly.
2. I don't think c-sections and inductions are ever necessary. Ha. No. I've been lucky that I didn't require either, but I know they're life-saving. My sister had preeclamsia with my nephew, so an induction saved both their lives. There was a time when babies and mothers routinely died, all because we didn't perform c-sections. I think both are amazing. I also think they're overused for purposes that make no sense.
3. Epidurals are the devil. Nope. I asked for one each time, but my birth crew reminded me that I wanted to do it without one. (My main fear was of the headaches some women suffer from them, because I'm prone to headaches anyway.) From what I've read, if an epidural is placed after a woman has begun actively dilating, and she continues moving after its placement, epidurals can be fine. They can slow down labor to the point that other interventions are necessary if used too early or if the woman is not allowed to move around; that's my main beef with them.
4. Birth is wonderful and you are an idiot to miss out on that. It's too bad there are no videos of me giving birth. I'm not the serene woman singing during her contractions, I'm not the smiling woman floating in a pool. I'm the woman shouting expletives and telling my husband to get out of my face and screaming at my midwife, "WHY AREN'T YOU DOING ANYTHING?" Yes, the intense experience of birth was, in fact, spiritual for me, because it helped me to love and trust and revere my body. And the surge of endorphins afterward was, in fact, amazing. But the process itself did not feel great. And I think that if you never experience that in your whole life, that's OK. I'll never run a marathon, and I think I'm still pretty cool.
5. I think doctors are quacks and not to be trusted. No. I love my doctor. I love my friends who are doctors. Modern medicine is a marvel. However, I prefer midwives for birth. They are lower stress, lower intervention, more woman-centered. There are amazing obstetricians out there, I've heard. And if I got pregnant a third time and had some complications, you better believe I'd go to one.
6. Home is the only place to give birth. Home births are actually illegal in some states. Which is stupid. There's no reason why a healthy pregancy can't end in a healthy birth at home, and home births are considered quite normal in many parts of the world - like Scotland. (You can read more about that in Brigid Kaelin's fantastic blog, by the way.) In Kentucky, you can only have a home birth if it's performed by a certified nurse midwife, not a certified professional midwife. But in Louisville, where I live, there are no area CNM who perform home births. So, in essence, if you want to have a legal home birth in Louisville, you have to travel to an out-of-town certified nurse midwife and expect her to travel to you on the big day. Which is why many people opt for "illegal" home births in Louisville, overseen by CPM. (Yes, this is confusing. And it really shouldn't be.) Regardless, I gave birth in hospitals - both times. It was a compromise. I wanted a home birth, but Dave liked the assurance that came with a hospital. I really don't care where people give birth, but I do wish that every woman who gave birth in a hospital had the experience I had at Clark Memorial Hospital. It was so calm and nurturing. Birth centers are a wonderful compromise, but they are few and far between. So give birth where you feel comfortable. If you don't get arrested, that is.
7. The birth experience for the mom trumps the health of the baby. This is, by far, the most hurtful piece of b.s. propaganda about birth enthusiasts out there. I did not start down this path for my own "experience." In fact, I endured the pain for the health of my babies. Those interventions that can save lives can also have side effects for the baby. It has been proven that babies born by c-section are at a higher risk for asthma and allergies. Additionally, a recent study found "that induction and augmentation of labor with oxytocin [Pitocin] was an independent risk factor for unexpected admission to the NICU lasting more than 24 hours for full-term infants. Augmentation also correlated with Apgar scores of fewer than seven at five minutes." Plus, I recently wrote how new evidence shows that many interventions can make breastfeeding more complicated than it has to be. So, no, I didn't put myself ahead of my baby, nor do I think anyone should. In fact, I see it the other way around. Interventions that save lives = wonderful. Interventions that are not necessary can be harmful to babies as well as moms. This is how I see it.

So, there. I'm not in a cult. I didn't drink placenta-flavored Kool-Aid. (Sorry? Too much?) So why do I care? I care because I don't like how many women feel scared of birth. Birth is natural and amazing and can be very empowering (whether it ends in a vaginal birth in a rose garden or a c-section in a hospital). When women feel afraid of their bodies and bullied into procedures about which they haven't been properly educated about risks and side effects, I see that as a feminist issue. One that I'm excited to fight for. No matter how much propaganda is thrown my way.


Magic Mama said...

I love this article and I hate the one that you wrote this in response to. Women were designed to give birth without intervention so I hate it when people say that natural birth is somehow "dangerous". It isn't. Interventions are sometimes necessary, but the key word is "sometimes". If birth was really that dangerous then humans would have died out long ago.

ElleMura said...

I want to love this post because you're one of the few NCB proponents posting who is truly not judgmental of those who opt for pain relief (or at the very least, subtlely elitist).

But you lose me when you claim that home birth can be done safely. Even if home birth in the U.S. were actually well-regulated and well-integrated with hospital systems, there are unforeseeable situations in which the transfer time absolutely does matter, rarely but surely to the life of the baby, and far more often to the baby's long-term health. And regarldess of that, it's *not* well-regulated here; far from "integrated," home birth practitioners often see themselves at odds with hospitals, making them overly hesitant to timely transfer - in the cases in which the practitioner is educated enough to recognize an urgent need to transfer.

If you "do your own research" and you peruse only legitimate sources, this conclusion will be inescapable. My blog entry on this topic cites to 30+ such sources, when both parts are considered.

All that said, I appreciate that you love and are passionate about childbirth, without inflating the benefits of NUCB, as so many prideful mothers do, at the expense of those who take the courses, and buy into the pseudoscience therein propagated, and then feel inadequate or even that they have harmed their baby when they opt for pain relief.


Randi Skaggs said...

Thank you, Magic Mama! And thanks for your comment, ElleMura. Like I said, I love to read everything I can on this topic, so I look forward to reading your blog as well as the research you cite. I'm new to this topic and certainly humble enough to admit that I have lots to learn. My research has caused me to feel that home births can be very safe, when performed with trained practitioners on women with low-risk pregnancies. But this informed and civil dialogue is what I crave most of all. You and I might never agree on the safety and legality of home births, but we can discuss it without negative and hurtful language. And that, my friend, is fantastic! Thank you both for reading!