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Monday
Jun192006

Ecstatic Birth

So, I've been reading in several places/blogs that the natural birth people are kooks who try to brainwash unsuspecting women into believing birth can be empowering and joy-filled. I've read that, for some reason (not explained), natural birth advocates minimize the excruciating, seering, pulling, stabbing, ripping pain of childbirth. I've read that these advocates (myself included, for sure) lure women into homebirth and force them to endure - nay, SUFFER - because of some pain-denying scheme that, in the end, leaves the women bereft of any support when they choose to go to the hospital for an epidural and/or cesarean.

BULLSHIT.

I'm not quite sure why it threatens or offends the medical-minded among us, but the idea of ecstatic birth remains as unreal as a unicorn or Tinker Bell - just ask around.

What I propose is that birth in the hospital as it is presented now could never foster ecstatic birth. No woman could ever find her groove with an IV, a hospital gown baring her ass and monitors wrapping her like a sausage casing. Add to that - complete strangers walking in the room, over and over, without knocking; touching the woman, without permission; barking orders, without requesting help - not so hot. Flip switched lights don't exactly scream "romantic" and even the smallest lights lit might be supplanted with glaring overheads at the whim of a nurse or doctor walking in at any time.

Having been to years of homebirths, I can verify that women who feel they are suffering head right on in to the hospital for an epidural. Women are not kept at home - or should not be kept at home, anyway. (I have been to a few births where the midwife seemed to wield too much control over the direction the birth was needing to go, including whether the mom stayed at home or went to the hospital.)

Women in our area are not dumped at ER doors. All the midwives I know accompany the mom into the hospital and NEVER pass judgement on a woman's pain threshhold and/or desire for medication of any type. While we do tend to keep the statistics of how many transfer to the hospital for pain meds, it isn't any different than a hospital keeping stats on their epidural rates.

We still get paid the same amount of money for transfers (moving to the hospital via the car) or transports (going via ambulance), so economics isn't the issue, either.

What reason in the world would we have for keeping women at home when she wants to have an epidural? None. This is her birth - something medicos all-too-often seem to forget.

I'll speak for myself.

I get no personal satisfaction in a woman's going without pain medication any more than I get personal satisfaction if they do or do not tear.

Early on, I would take credit for a woman's not tearing... that I did perineal "ironing" or massage adequately and "saved" the woman's bottom from tearing. And then I did enough births to see that perineal integrity had very little to do with me and much more with a woman's diet and overall health. Women who catch their own babies tear much less than the women who have strange hands all over their perineums and inside their vaginas. I try hard to keep my hands off women birthing their babies now - and it pays off in fewer tears. Of course, a woman whose ass is hanging off a table can't catch her own baby safely and the perineum is fair game for manipulations, so this slow, gentle, minimal-tearing birthing cannot happen.

Sorry, segue.

The point is, each woman has her own walk and it may or may not include medications. It may or may not include the hospital. It may or may not include physicians from pre-conception until postpartum. None of these concerns me because I work hard to operate in a plenty mentality - there are plenty of women to go around.

(Trying to address the myriad of arguments about how absurd ecstatic birth is compared to the ecstasy of being numb from the nipples down.)

Personal anecdotes:

1. (Birth center) An ultra-conservative woman strips to nothing and has intense foreplay with her husband - to the point of moans and sighs and, what we presume, their sounds of making love. The midwife and I slipped in periodically to listen to heart tones and slipped back out because we felt so incredibly voyeuristic. The woman had a birth orgasm as the baby crowned and she screamed in undeniable joy. Before leaving the birth center, she wrapped herself in her clothes, letting us see only her nose and eyes through her scarves.

2. (Home birth) Woman in kicking labor finds her contractions slowing considerably when the midwives arrive and get things set up. Midwives leave for food or sit downstairs after setting up and labor kicks in again when cuddling and touching bring the contractions back (not necessarily orgasm, nipple stimulation, or intercourse). When mom is within an hour of birth, our presence doesn't seem to affect the labor as much, but there is often a distinct change according to mom and dad when talking afterwards.

I'm trying so hard to think about any hospital birth that comes anywhere close to these types of births... and I can't. Perhaps an L&D nurse might, but I would suspect it would be a rare exception instead of fairly normal as it is in a homebirth.

So, why would a woman want a birth that more mimics love-making instead of a scene out of ER? I can't imagine there is any reason to answer that question.

Another common argument is that women are selfish for wanting the experience at the expense of the child, but psychologists and other scientists can surely explain how vital it is for the mother to remain at peace so her child has optimal hormones and blood supply for a healthy labor and birth. Even when a change of course occurs, remaining calm and peaceful does wonders for everyone involved, baby included.

I wonder why it has to be all or nothing. If the medical folk feel safety is being compromised, but women want more ecstasy in their birth experiences, then for crying in a bucket, let's figure out a way to foster it!

I propose:

- obstetricians welcome birth plans and acknowledge the work that goes into them

- nurses (including Certified Nurse-Midwives) and hospital staff do the same regarding birth plans

- doctors, CNMs, nurses and anyone else ask permission before touching a woman unless imminent health and life prohibits that one second request

- medical/midwifery personnel remain scarce during labor, attempting to foster privacy for the laboring couple

- nurses learn how to use Dopplers and minimize fetal heart monitors so women are better able to move away from the bed

- make the bed, if there is one at all, one that two or three people can climb into for cuddling

- medical personnel learn how to deliver/catch babies in a wide variety of positions including standing and in tubs so women are able to be much less inhibited (one of the most oft disgusted comment from women is how they were ordered to move when their babies were about to be born)

- medical personnel be instructed to STOP YELLING as women are pushing their babies out, most especially when they do not have an epidural

- medical personnel call the woman by her name and not "mommy" or "mama" or any other anonymous blanket nickname

- make sure the cd players work in each of the rooms and have a supply of donated music for laboring couples

- when making suggestions to augment labor, be gentle and respectful of culture/religion and not be crass or vulgar when suggesting even a seemingly benign recommendation such as nipple stimulation

- nurse managers flag natural birth advocates - perhaps they have had extra training in hypnobirthing or the Bradley Method (no groaning allowed in this wish list!) - and assign the nurses as needed

- get hospitals into the 90's and GET SOME AQUADOULAS! For goodness sake, there's enough research out there showing that waterbirth is perfectly fine. Let's do it already. So you get a little wet leaning over to take heart tones - so what.

- quit giving women hideous gowns/johnnies - let them be naked! Quit trying to cover our women up; when they say they don't want a gown or a sheet, they mean it. It's your shame issue, not theirs. Deal with it. (Yes, there are cultures that require covering up... that isn't ever an issue in the hospital, there are always plenty of cover-up clothes and sheets and blankets)

- quit draping women as the baby is being born - the reality of a sterile field has been disproven, so let women, without their asses hanging off the bed, catch their own babies... or their partners catch the babies with them. Draping remains a shame issue as well. (Again, depending on the culture, of course.)

- figure out a way to foster a VBAC, vaginal twin, and vaginal breech births in the hospital. Until you do, women are going to leave in droves to have homebirths. If you are so adamant about homebirth being so dangerous, then figure out a way to have what you would consider a safer birth inside the hospital while still allowing a woman her own choice and autonomy.

- medical/midwifery personnel obtain extra training in customer service - Disney can help lots in this area

- medical/midwifery personnel learn to accept individual choices (hand-in-hand with the birth plan note at the top of this list) and not manipulate, guilt-trip, or humiliate a woman or her partner in order to get them to do "standard protocols." People before things... including protocols.

- nurse managers and admin remove misogynistic physicians and nurses and report abuses when they occur to get the cruel and sick providers out of the system as soon as possible. There is no tenure in medicine.

I believe if medical care could do a fraction of the things on this list, birth in the hospital would be much more satisfying and much more ecstatic for a huge number of women.

Who wants to start?

Reader Comments (12)

On the med student boards I've been visiting there I am doing what I can to raise the questions of patient care when itcomes to L&D and what it means. I'm trying to get the paradigm recognized so that hopefully it will start to shift. I have received PMs from people who agree with me and are grateful that I am speaking up, against waves of misogynistic care, to the very people who are undergoing the training to *become* those doctors.

You are everything I want to be for women birthing in the hospital. Your words keep me grounded and present. I plan to make a mighty big stink for my clients. What is another word for pregnant woman, that I can use? I hate the word 'patient', it is so distant and cold... give me something warm and juicy, succulent! It starts with words, nothing is trivial.

We can do it. :) I'm going at it from the inside out! I'm thinking about majoring in non-profit so that I can work more effectively for change once I am through school, maybe start an organization or contribute more effectively to an existing one.

This is my life's work. :)

June 19, 2006 | Unregistered CommenterKristina

yes, yes-- it is funny- we had a fairly modest couple - and she got into the bath tub and wanted to stay but couldn't find anything to recline on - I said to her husband how about you we'll put towels behind you-- and he stood in indecision- and I said we can leave the room and you can climb in shorts or we have even had dad's in tubs sans shorts- well he stripped to nothing- and climbed in - and even though she was a little concerned about modesty- she also relaxed more and her contractions really picked up- and it wasn't long till we had the baby-

I love your list for hospitals..... I love it

June 19, 2006 | Unregistered CommenterAnonymous

I believe the first quote I was given was... to go out for dinner and a movie if I wanted an "experience"... neo-natal doc and his cohorts have been deleted from my bookmarks as of this afternoon.
k

June 19, 2006 | Unregistered Commentermm

Thank you, Kristina. I pray you are able to stay strong through the medical school process and are able to make even small changes in obstetric care. It could certainly use an advocate.

I've been trying to find a proper word for the medical "patient" - they would never use "client" because that changes the dynamics completely. Hospitals expect to contain patients, but laboring women are normal and merely birthing and are not patients until they have been cut - and then, rightly so, they have been made into patients. Let's keep looking and thinking.

Anon: Thanks so very much! I'm sure there are things I've forgotten (and depend on my readers to fill-in-the-blanks!), but these things have been on my mind for years. It felt good to write them down.

MM: I hesitate to go read neonatal doc! But, perhaps some of us need to say something. More things. Different things. Saying the same thing isn't going to make a difference; we have to find new ways of explaining. Demonstrating.

I so wish we could get labor and birth-long videotapes they might actually sit down to watch over a weekend. Not that it will change their complete opinions, but at least they might have a clue of what we speak about. For goodness' sake, we see both sides of birth! They do not. How can they speak with authority if they don't even know what they are talking about?

Hard-headed and arrogant. Too many doctors and nurses remain so.

June 20, 2006 | Unregistered CommenterNavelgazing Midwife

What a fantistic blog. It's amazing how many women I know are convinced they couldn't of done it without medical intervention. It's a totally different mindset. Thank you for your words of wisdom.

June 20, 2006 | Unregistered Commenterflarin_erin

Instead of "patient", how about

Woman
Mother
Goddess

Incredible article. I read it twice, and am sending the link to my friends.

Donna, the apprentice. :^)

June 20, 2006 | Unregistered CommenterDonna

Here here to those suggestions I completely agree that if the medical model took only even half of them on it would be a vast improvement to the system so many of us are shying away from! You are truly an inspiration and reading your blog is showing me more and more where I would like to see myself in the coming years so thank you for putting it all out there and helping me to keep my passion for birthing women and womens issues in general alive while I raise my children and dream about the future :D Truth be told I am actually scared to work in the hospital setting when the time comes!

Another word I would always lean towards is 'client' because as birthing women and families we employ the services of a midwife or hospital or OB. Although I know it isn't seen as this in the system but hopefully the pendulum will swing and soon enough medical professionals will realise that it is their care and respect for their clients that keeps them in business their skills come second to that!
Congrats to the VBAC mumma too hope she is enjoying her babymoon:D
Cheers
Loz

June 20, 2006 | Unregistered Commenterloz

Erin - Thank you so much! I'm glad you are enjoying reading here. I have some strong opinions that happened to be shared by many of us, but aren't always voiced. I'm glad you are here. I will be sure to read your blog, too. Doing that today. Thanks so much for your belief in women. We need as much help as we can get!

Donna - Using Goddess in the hospital? I don't think so. I can hear the snickers now.

What we need is a word that will represent a birthing woman in the hospital instead of "patient." While I like "client," too, it just wouldn't fly there. I wonder, too, if anything we fringe thinkers consider would be scoffed at simply because of the messenger.

Maybe what we should do is take the word and empower ourselves with it - like lesbians did with the word "dyke" - and blacks did with the "n" word. Not sure if that is possible, but an idea.

loz - I am so glad you feel empowered by my words! No fear on working in the hospital. There will be hard and painful days there just like there are in homebirth.

One of my clients (I've written about her before) is an L&D Nurse and she cries because of the pain she sees most days - the number of cesareans is more than the vaginal births sometimes. She HAS to be there. She HAS to stand as a witness to the pain and butchering women are experiencing in today's obstetrics. She also has to be an example of a medical person believing in birth so much she has had 4 homebirths herself. She has so much to offer her patients; no one else there has as much to offer.

You can do it. You have to.

I brought my VBAC mama home yesterday afternoon and she is tucked in with her new daughter this very moment. Nursing is going splendidly and she is supremely happy - even though her bottom is still seriously swollen. I have her using the herbal sitz bath frozen maxi pads and it is helping tremendously. She's also using the herbal tea diluted with warm water as her peri-wash after peeing. Her vagina went through a lot, so it's to be expected to be so sore - although swollen this long is a tad unusual. She will heal well - she's extremely healthy.

Thanks so much for asking after her. Everyone's love and energy is so welcome.

June 21, 2006 | Unregistered CommenterNavelgazing Midwife

Here are the synonyms of "patient" from dictoinary.com's thesearus;

Definition: sick person
Synonyms: case, convalescent, emergency, inmate, invalid, outpatient, shut-in, sick person, subject, sufferer, victim

Yikes! Someone, please think of another word.

-Jennifer Z.

June 21, 2006 | Unregistered CommenterAnonymous

I have just found your site. I am ecstatic myself to have done so.

June 21, 2006 | Unregistered CommenterHollyRhea

this may not relate at all, but let me try anyway...today I received the latest module on Midwifery and Research. We are to learn all about research methodologies etc and then review several research papers in "respected OB journals" It just didn't make sense to me. Nothing about these "studies" is real! They are all staged in some way, even if minor. Birth cannot be researched. It can be observed and tons and tons of anecdotal information can be gleened, but I truly, truly do not believe that a process that in itself is miraculous and is as varied as snowflakes or thumbprints, can ever, ever be controlled and can thereby not be "studied" There will always be exceptions to the rules...thank the goddess. The downside is that unless something is supported by a "controlled study" it seems to have no validity in the scientific world, which we are more and more becoming. I'm just one of the odd ducks that believes in the mystery of life and tired of arguing about it. So I have gradually stopped trying to convince others so hard and just hope that they stumble on the beauty of it all inspite of the many obstacles thrown in the way.

June 21, 2006 | Unregistered CommenterAnonymous

I've written myself about hating the word "patient" for pregnant women.

I most often used client (as a doula/childbirth educator and now student nurse, too.)

http://dictionary.reference.com/browse/client

I like some of the connotations of the word, but not others.

Some of the synonyms work and some don't:

http://thesaurus.reference.com/browse/client

I know a midwife who calls her clients (when giving birth in her free-standing birth center) "guests."

Hh

Hh

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