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Monday
Jun052006

Many Approaches Taken to Childbirth (article rebuttle)

http://www.tribune-chronicle.com/News/articles.asp?articleID=4687

Interesting how an article that sounds so great in the beginning - discussing a woman who chose to go medication-free for her birth and believed in herself - can go far, far downhill as medwife after medwife is quoted about how flexible women HAVE to be in order to get along with the hospital protocols.

"Rigidity has no place in the (birth) plan."

"Some women insist on no medical interventions at all, no matter how small. That’s an example of rigidity. ... Women who are inflexible are setting themselves up for failure instead of setting themselves up for success."

Why would a midwife say something like that?

In talking about birth plans, I teach that they are really not the best thing for a hospital birth at all. I believe birth plans are great for fostering communication between the parents and doula/birth team, but I know that most docs and nurses roll their eyes at them.

Still the patient’s decisions aren’t always welcomed with open arms by practitioners.

That's an understatement.

Let's all state the obvious one more time:

You pay for the hospital ticket, you go for the hospital ride.

Again?

You pay for the hospital ticket, you go for the hospital ride.

So, if you are trying to create a homebirth in a hospital - THINK AGAIN.

Just by setting foot in the hospital, you are stepping into The System that runs without a conductor. If you want something different than what they have to offer, be prepared for some serious uphill hiking. (Way too many analogies in the last few sentences.)

‘‘We are getting used to new ideas in labor and delivery,’’ said Patty Fusselman, nurse-manager of labor and delivery at the mother-baby unit at St. Elizabeth. ‘‘Before, women were permitted only ice chips; now, they can have water. We almost fainted when one of the midwives asked us to feed her patient — it’s just something that was never done.’’

Just the language is so condescending it breaks my heart. Why aren't the women seen as WOMEN!? For goodness sakes, what do women around the world do? Yeah, I know... women have to be prepared for a general anesthesia cesarean, right? Because no one EVER has major surgery on a full stomach? (As if laboring women eat full meals and a couple of bottles of wine.) "Now, they can have water." Isn't that so generous of them?

Still, what hospitals want to do and what mothers want for themselves and their babies sometimes seem to be at odds.‘‘I did have to tell the nurses once that they weren’t going to bathe my baby just then,’’ said Martin. ‘‘It was 2 a.m. He’d just gotten to sleep.’’

Martin suggested the bath might be more appropriate in a few hours, she said, and the nurses were willing to return once her son awoke.

It is so sad to me that routine is more important to everyone in hospitals than individuals and their needs. I don't even know the answer to it... hiring more nurses wouldn't do it because compassion must accompany the intent.

I know... I KNOW! I know there are wonderful, compassionate nurses. I work with them all the time. (Some are clients - many read this, actually.) But, the language of superiority and the belief that protocol is the Be All and End All to a woman's birth experience must end. I do know nurses have to work under the standing orders of the physician. I do know they do operate under the hospitals protocols. But, I still have seen a bending of the rules, a removing of the barrier of authority in order to humanize the laboring woman's experience. It certainly takes some energy to connect with clients, but does it take that much more energy to see her as a woman and not "the primip in 4?"

‘‘In this area, the rate is in the 50 to 60 percent range,’’ said Dr. Anthony DeSalvo, Warren obstetrician/gynecologist and president of the Trumbull County Medical Association. The rate differs from region to region, he said. When at a private hospital in New York, Dr. DeSalvo said epidurals there were administered in 90 percent of all births.

Dr. Amy makes snide comments about how natural birth advocates claim epidural rates are upwards of 90% in some hospitals. She thinks we are full of crap. Well, here is an article that verifies what we have all been saying.

Diane Simcox, a long-time labor and delivery nurse at St. Elizabeth and a self-described advocate of epidurals, said pain management options have improved over the years.

‘‘You don’t get a gold star for going through the pain,’’ Simcox said.

Martin, whose three children were born with the help of a midwife, and all without pain medication, disagrees.

‘I have my own gold star,’’ she said. ‘‘I am so proud of myself.’’

Why do nurses have to say such mean stuff to women? "There isn't a prize for taking all that pain, you know." "What kind of prize are you trying to win anyway?"

Don't y'all think maybe we should devise a prize? What would we call it?

I work hard to help women who choose to have epidurals not feel badly about their choices (or any other meds). Epidurals are valid for certain situations, that's for sure. But, women walking into their labors not wanting meds and choosing them rarely say they are glad they did. Whereas women who are enticed to accept meds and choose not to are ECSTATIC that they didn't choose meds afterwards. I have yet to hear a woman say, "I wish I'd have had that epidural." I have often heard, "I wish I hadn't had the epidural."

Let's think of a name for the prize, eh?

Some articles beg for commentary. Share yours, too, everyone!

Reader Comments (11)

Ohhhh I love this. I have to run with this one..... On that favourite OB of yours and mine (SNORT) Dr. Amy, she started in on "boasting" about "natural childbirth"
*note to self must learn those HTML tag thingies*
Anyway, my big prize was
I got to avoid un necessary surgery twice more! Woo Hoo for me!
I'm going to find more... I will be creative! I will find prize names!!!!!
Interestingly enough, I had a birth plan for #1. I did not want one for either of the last two, felt like I might jinx the birth or something... I wrote them, just never printed them out or showed them to anyone. Guess I'm too "rigid"... snorting and guffaw-ing now.
SO happy to read all those words you are putting out here!!! SO HAPPY!

June 5, 2006 | Unregistered Commentermm

mm: great story! I'm glad you wrote out the things you wanted - it doesn't need to be printed out, but considered.

Thank you for your kind words about all my writing. It's flowing and flowing and flowing right now. Thanks for reading.

June 6, 2006 | Unregistered CommenterNavelgazing Midwife

Can you post the original article? The link does not work.

June 6, 2006 | Unregistered CommenterAnonymous

I read this from Marsden Wagner just before I came to your site today:

"making certain that the woman’s experience while giving birth is fulfilling and empowering is not just a nice extra, it is absolutely essential as it makes the woman strong and therefore makes society strong."

I hadn't considered this before. I have ranted about the need for women to understand themselves and their capabilities and have ways to deal with difficulty, but never thought to extend that into society.

I know, I'm slow to put the pieces together!

My jaw dropped at the progression from ice chips to water - that's astonishing ("we've come a long way, girls!!").

Water instead of ice chips is such a small thing, but it's an illustration of how much of birth we have to take back. We are fighting battles over ice chips because laboring women are so powerless in hospitals.

June 6, 2006 | Unregistered Commenterjenn

Thank you, thank you for saying all this! I am so sick of being told "You do not get a medal for having a natural birth". I had a wonderful unmedicated birth with my daughter, and I was so proud of myself. But, I learned when she was only a week old that this is a taboo subject, no matter how nonjudgmental I try to be towards other women and their choices. Now, I only discuss her birth with other women who have also had unmedicated births, because I have learned that this is the only way to avoid offending someone, at least in my very conservative state. People seem to assume that by making the choices I made during her birth, I was criticizing the choices they themselves made.

June 6, 2006 | Unregistered CommenterK.

Anon: I checked the link in several ways on different computers and it always worked for me and others. Perhaps you have a pop-up blocker on? (Click while holding down CTRL takes care of that.)

I don't re-print the whole article without written permission from the author of newspaper because it is illegal and is a major bone of contention amongst published writers and amongst those that publish them/us. Hope the pop-up is the issue. Please let me know!

June 6, 2006 | Unregistered CommenterNavelgazing Midwife

Jenn: You are right. The micro-leap from ice chips to water seems like so much nothing, yet the medical folks see it as a humongous flying leap in progress. Yet another example of the gulf between the medicalized and the more natural type folks.

Again, so sad.

K: Maybe we SHOULD talk about our natural births outloud and filled with joy and excitement.

Maybe we SHOULD brag our heads off about how great it was and how we would do it again that way in a heartbeat.

Maybe we should offer tones of pity to the women who whine about how awful their pain was until the epidural and how they proposed marriage to the anesthesiologist.

Maybe we should find a way to make it as socially unacceptable to have an epidural as it is to smoke.

Maybe we should have Natural Birth Days where the "pain" of birth is celebrated and honored.

Maybe natural birth advocates could talk about having an epidural in the same tone as we talk about having a cesarean - thank god they are there, but in the masses of numbers being done, perhaps that is the error.

I went and bought gold stars today.

June 6, 2006 | Unregistered CommenterNavelgazing Midwife

After a somewhat traumatic week of births, I lay in my DH arms and reminisced the birth of my own two children. I realized that the circumstance that I was provided in which to birth was exactly like the way Michel Odent describes in "Birth Reborn"...no outside distractions, no VEs (that I remember), I don't even remember FHTs being taken but think they must've been, no one telling me what to do or when to do it, only a gentle suggestion from MW with my first that I might want to try the tub. So I think that women not only get a gold star for not getting pain meds, they get a gold star for being able to birth at all in a hospital setting!!!

June 6, 2006 | Unregistered CommenterAnonymous

Anon: How wonderful for you! What a beautiful way to have babies. So lucky are your women that you have that history inside your being. Just great.

*laughing about the gold stars*

My cesarean moms are being unusually quiet in all this discussion. I am worried I am alienating them. I am not meaning to, but if you all have something to add, please do.

Am I not being sensitive enough? Do you not know I believe your cesareans were warranted? (Except for the forced cesarean client who also reads here.)

June 7, 2006 | Unregistered CommenterNavelgazing Midwife

Barb,

I keep meaning to say I love your voice since you've come back from that break in blogging. You seem to have unshackled yourself from that horrible limiting fear of causing offence and are just telling it as it is these days in all its festering ugliness, injustice, tragedy and potential beauty.

Keep it up; it's a wonderfully powerful voice.

Penny

June 9, 2006 | Unregistered CommenterAnonymous

Here is one cesarean mom who totally agrees with your comment:

"Maybe natural birth advocates could talk about having an epidural in the same tone as we talk about having a cesarean - thank god they are there, but in the masses of numbers being done, perhaps that is the error."

I did not have a natural vaginal birth (in fact, I consider myself to not have given birth yet), but I am always so proud of my friends who have. I love hearing their birth stories as a way to envision my future births and plan for them, and for the chance to say, "That's the way to do it!"

Avoiding complications was the reason why I planned a natural homebirth the first time around, and why I will do so again in future pregnancies.

Tangentially, how sad is it that birth plans are scoffed at? What other business would tell their clients, "That's nice and all, but we know your needs better than you do." And still stay in business? I agree, it's a miracle anyone can birth in a hospital, much less without unwelcome interventions.

June 9, 2006 | Unregistered CommenterRG

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