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.
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.
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.)
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!
- 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?