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Sunday
Sep042011

Suddenly...

… I notice I don’t fit in the Natural Childbirth Community (NBC) anymore. This is probably a “duh” moment for many folks, but it wasn’t until I was invited into a Natural Birth Professionals group in Facebook that I really caught up that I just don’t belong anymore. 

I cannot support the unrealistic and non-evidence-based beliefs of so many of these women. I stuck it out for a couple of days thinking a dissenting opinion could be a good one, but it was obvious peer pressure was the unspoken rule of the road. 

When the topic of the Brewer Diet came up and I said it was pure bunk and could actually cause harm to the kidneys in susceptible women (which I have seen happen first-hand), several women defended it saying so-and-so had preeclampsia in one (or more) pregnancies and then followed the Brewer Diet and miraculously didn’t have preeclampsia in that pregnancy. Another woman said some woman was an “expert” on the Brewer Diet and she was on their faculty. Surprised, I looked to see what college she was the faculty of and it was a non-NARM-accredited “midwifery school.” Can you see me rolling my eyes? I’ve been asked to discuss the Brewer Diet here on several occasions and am sure I’m getting close to expending the time and energy to do so, but that isn’t the purpose of this post. 

This post is to express my dismay at the Natural Birth Advocates (NBAs) and their continued insistence on evidenced-based care and then going completely against what evidence there is! From homeopathy to acupuncture… from not acknowledging anything being too risky to deliver at home to the blasé acceptance of babies dying or being damaged in homebirths… I just can’t take it anymore. 

I may never have another reader again… may be boycotted the way the SOB is, but that’s fine with me. I am not going to tow the party line any more. I don’t know what I would consider myself, but I do need to separate myself from the NBC. 

The Birth Professionals group was one thing, but the cesarean birth my daughter just had was the last piece of patience I had. 

When Meghann got pregnant, we discussed home and hospital birth. I simply did not feel comfortable encouraging a homebirth for my granddaughter and helped her find a wonderful group of CNMs. They were fantastic! Then, on August 31, my daughter went into natural labor and we went to the hospital when it seemed she was in active labor. I’m leaving out a slew of details because I don’t want to tell her story yet, but we were treated like royalty at the hospital, a truly unhindered birth even with tiny bits of technology thrown in (an oxymoron to the NBAs). Meghann and her husband Brian were kind enough to let me chronicle her labor and birth on my Navelgazing Midwife Facebook page and the grand majority of folks were lovely and incredibly supportive. But, when things shifted and it was obvious a cesarean was necessary, a couple of purists felt it was their place to comment… er, judge… what they thought was happening, without the benefit of actually knowing because I wasn’t expressing everything online. 

I paused as things moved to more complicated, thinking, “How will this look to others? A midwife whose UC-born daughter needing a cesarean?” And I hated that I even had to expend an ounce of energy on such a stupid, irrelevant thought. Why should I care one iota what others think? 

Because (too many) others will tear apart her birth story… especially if I wrote her story out, which I am not sure I even want to anymore. Even if I wrote the facts as I know them, her decisions will be picked apart like so much carrion; like I have done to others’ stories myself. 

This acknowledgement that I have dissected other women’s stories is another aspect that lets me know I’ve left the NBC; I am embarrassed and even ashamed that I have hurt other mothers and perhaps tarnished their stories. I pray I won’t ever do that again. 

Just the few negative comments about Meghann’s choosing to have a cesarean after 32 hours of labor and bouts of fetal distress soured me on laying out her birth, knowing criticism will be a side effect of the story here in my blog. 

This morning, I read through the comments and questions on the Natural Birth Professionals page and winced seeing women I simply cannot have civil conversations with anymore. I try to be polite, but their out and out ignorance… and, I’ll just say it… stupidity about what they think birth is supposed to be irks me no end. And the topics? rolling my eyes again How many times can we hear to leave women to labor indefinitely because their body will work it out if left alone? Or that pain relief should be the absolute “last resort” after trying every single idea the judging woman thinks is appropriate? 

I just can’t take it anymore. I’ll have to find a name for myself. I embrace “Medwife” now, but think there’s a place for us middle-of-the-roaders… Realistic Birth Advocates? I kind of like that. It’s taken nearly thirty years to get here, but here I am. And perhaps for the first time, I feel at peace with my place in birth.

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Reader Comments (111)

Funny, I'm working on a blog post right NOW about my journey from one extreme to the middle. I'm with you Barb, I am constantly shaking my head and wondering if the next generation will survive our monumental willingness to close eyes to evidence but squint open only long enough to see what we want to see.

Have you seen the Fed Up With Natural Childbirth page on FB? Lots of disillusioned folks there- if you can stand the vitriol that naturally comes along with it. (I can't.)

September 4, 2011 | Unregistered CommenterKristina

Barb, I think you're wonderful! Truly. I also feel that you are a voice of wisdom in this Childbirth community. I know I've gained a great deal of insight from your observations and research and I just want to say how much I appreciate your perspective and voice. Keep it coming!

September 4, 2011 | Unregistered CommenterJoy

I think I love you. Beautiful post!

September 4, 2011 | Unregistered CommenterSara

This is an awesome post, NGM. Absolutely awesome. Now you must know how it has felt for hard-working OB's, to have to listen to the inanities of the completely-non-evidence-based and non-educated midwives who parrot "trust birth" and "some babies aren't meant to live". And I'm delighted beyond belief that you have come around to the normal point of view that what matters is that your lovely granddaughter is here and your daughter is happy and healthy, not that your daughter needed to prove anything to anybody. Congratulations. This is incredible maturity on your part and it takes incredible guts to admit where you've been. My hat is off to you.

September 4, 2011 | Unregistered CommenterTired of Birth Junkies

While I respect your opinions and experiences (even when I disagree with them)....I hope you read my response with an open mind and heart.

First...
Your daughter's story....i'm sorry that you felt judged. I did not see the comments that hurt you, but I do think that passing judgement without all of the information is inappropriate. Sometimes we ask questions to learn more information and it can come across as judgement when it's not....but regardless of the intent, it hurt your heart in a time that was already both joyous and disappointing for you, and I'm sorry.

Secondly...
I often have the same "Seriously? You're embarrassing our profession by bantering about things that are without research to back it up! STOP IT!!" as you do. HOWEVER, that being said....as critical as you say those in the NCB community are towards the medical community, I think you are slipping into the same unproductive trap - being critical to the NCB community as a whole rather than working to bridge the gap. Medical model claims that midwifery model is ignorant, and midwifery model claims the medical model is dangerous and disrespectful. Neither one is productive nor necessarily true....there are extremely intelligent and safe midwives just as there are some extremely passionate and respectful OB's. To quick-judge either one is unfair and not helpful (yes, my opinion)

THIRDLY....
If you want my opinion on the "Brewer's Diet" along with the research that backs up my opinion - let me know. *wink*

Please don't let the fact that you are disgruntled and hurt cause you to do the very thing you are experiencing from others that is hurting you....lashing out right back doesn't serve obstetrics or birthing families. Education is the key to both sides....

I am happy for your family and hope for speedy healing for your daughter as well as tons of snuggle time for all of your family with a sweet (and gorgeous!) little baby....

September 4, 2011 | Unregistered CommenterStephanie

Maybe you just need a break. Lamblasting and calling people "stupid" while expressing regret for hurting people by picking apart their birth stories is completely oxymoronic. Is blogging really therapy? Or is it dragging you deeper into frustration over the experiences of the last few days?

You can't be the expert and the grandma to everyone and everything. It's not your job to fix what you "see" as wrong. You've offered to listen and process with other birth professionals before. You know that it takes time. There's no need to make sense of it all right now.

September 4, 2011 | Unregistered CommenterMichelle

I wholeheartedly applaud your navelgaving, as always.

I wish that you would write out the birth story, if you are given the permission to share it with the unforgiving interwebs. It's the real stories, without the gauzy curtain of ideals, that teach women to embrace whatever their own experiences were/are/turn out to be.

With time, I hope that you also feel less angry, but you can erase this part of the comment if you wish, I totally understand.

September 4, 2011 | Unregistered CommenterBenny

Barb, I totally respect every statement you have made - and I utterly agree with where you are coming from! This is precisely why I chose (among other reasons) the RN to CNM route for my education as a midwife. While I am also a big supporter of natural childbirth, I also acknowledge that sometimes interventions are needed. AND - I also am a huge supporter of a woman's right to choose her birth environment and level of intervention - as long as she is fully informed of both the pros and cons of her choices available. Sometimes that means an epidural - or AROM - or an elective c-section. Who am *I* to judge exactly where she is coming from with her choices? It's HER birth - not mine! My role as the RN (soon to be CNM) will be to help ensure that she receives the education regarding her birth choices, and I am there to help gently guide her in her birth. No run the show, not make all of the choices for her - but to help her achieve a safe, healthy birth.

September 4, 2011 | Unregistered Commenteratyourcervix

Don't give up. Don't let the naysayers stop you from telling her story, or letting Meghann tell it herself. I saw the negative comments on facebook and they bothered me and I chose to ignore them. I wanted to make comment, wanted to defend a woman's right to make her own choices about her own body in her own unique situation. Then I felt that acknowledging their voice would only make it worse. I certainly didn't judge Meghann for her choice. I know because I made the same choice. I also knew that her sitaution was her own and she had to decide what was best for her body and her baby. Doctors and midwives and nurses can all give us lay individuals an idea what they think is best for us, but they are not in our body at the time.

I know there are too many cesareans. I also know that my son would not be in this world without one. People judge me for my story too. And often the first thing that NBAs say to me when they hear I had a c-section was "Oh I'm so sorry" and "It's ok to be angry about it." I'm not traumatized by my experience. I tell my story as much as I can to teach NBAs that their first responses should be to find out what my situation was before they assume I was abused and forced to have a c-section.

I personally am A NBA. Or rather, I support that there are too many interventions that are taken with what is a very natural process. I agree there are flaws, and I support women, midwives, doulas and birthing mothers who do their part to bring awareness.

We need middle of the roaders. I just read a beautiful birth story the other day on Bellies & Babies that wonderfully blended natural birthing and the support of technology in a hospital.

So don't let them silence you. If they do, an important story will not be told. The more we talk, the more middle of the roaders can come out of the shadows.

September 4, 2011 | Unregistered Commentertara

I am so sorry anyone thought it appropriate to comment on Meghann's birth that way, or any woman's! I am about where you're at, I think. I loved my homebirth but I recognize that for many women that birth would have been difficult or traumatic, just as many women ARE happy with their hospital, medicated births (not just because society demands it) and I would be NOT happy with their birth. And that's ok. (The actual medical issues you mentioned go without saying, for me.) It's time we stop giving lip service to the unique baby, unique birthing woman, unique BIRTH idea and living it, firstly by not picking apart others births or questioning their decisions in hind sight.
I know this attitude among NBA's has honestly made me ashamed of my first birth at times (a feeling I have blessedly passed) and I find that deplorable. I remember being at a Red Tent and telling an ICAN friend (I was nearing the end of my second pregnancy) that maybe I would share next year when I had "a birth story worth sharing". It struck me hard as soon as I said it and I quickly left the conversation, very deeply troubled by that feeling.
Anyways I'm rambling. I am SO glad you were all treated wonderfully, and so happy you were able to be there with her for the birth. Having my mom right there with me for my births made a world of difference. Blessings on all! <3

September 4, 2011 | Unregistered CommenterStassja

Barb-
I hear your struggle & compassion. Personally I went from natural hospital affiliated birth center labor to iatrogenic (yes I think dr over-reacted.. lots of detail there) emergency c/s to becoming a doula to help empower & inform others, to HBAC to homebirth apprentice, back to doula. I've jumped into the "no intervention should be needed 95% of the time" & backed off again agreeing that if moms are entitled to choose (ie) vbac, then they should be allowed to choose x,y,z intervention... it's all your right, right?
Finally I am settling in with- low intervention- only if *needed* or *wanted* & true *informed* consent! That is the single biggest thing I think we all agree on- whether you are hugely advocating home, hospital or somewhere else, whether you like every blinking, beeping machine ever made, or not a single one... Informed consent & patient choice is huge. And just for fun, there will be less feelings of birth abuse when information & options are given.
No one should have to defend their choices, or justify why they made them or explain 'if we only knew'....
It's an easy trip to get from standing up for women- who often are mistrested or railroaded or experimented on in birth, to shunning all the tools that often are overused. It's easy to forget they have a place, and even more often then they are *needed* they may be wanted by someone.
If ever I were to birth again- it would be at home. But I really believe birth is best where mom feels most comfortable. That is different for each of us. If we believe in informed consent, we share our stories & experiences, and respect the choice they make.
And that is the biggest step toward empowered birth!

September 4, 2011 | Unregistered CommenterSonya

Barbara, I Have lurked and read your blog for a long time now and don't know if I have ever commented before. I want to say that this is absolutely the most honest, raw, and courageous thing I have ever heard you say.

Thank you.

September 4, 2011 | Unregistered CommenterStephanie

Why shouldn't Barb be frustrated and disillusioned? And why shouldn't she call things as they are - some of the"information" being presented by NCB circles is completely erroneous (case in point, the Brewer's diet). This isn't merely a difference of opinion. This is wrong information that can and does kill mothers and babies, and I am sick of it!

I'm one of those ladies on Fed Up, and yes, we are disillusioned. There is vitriol sometimes, and here's why: pregnant women are being given the worst types of misinformation as advice. There's already been at least one dead baby attributed to a woman being advised to stick garlic up her vagina to prevent GBS infection. And that's only one example of many.

I just found out that I'm expecting my second child. I already care about this tiny bunch of cells; I fail to understand how other women can be so cavalier about the very real risks of pregnancy and childbirth. It's callous and disturbing. Keep doing what you're doing Barb - I'm grateful for some sanity.

September 4, 2011 | Unregistered Commentermoto_librarian

Welcome to the dark side. Your daughter's birth story would be welcomed on Happy With Hospital Birth (http://hospitalbirth.blogspot.com/), when and if you are ready to write it.

September 4, 2011 | Unregistered CommenterRebecca

My respect grows exponentially with this post. I was hanging on your every word while Meghan was in labor and I DID see the rude comments. The unwanted sympathy and the judgment barely under the surface. That is the kind of sentiment that drove me away from NBA. Along with the blatant disregard for safety and the nonchalant acceptance of preventable deaths. It seems to extend to other aspects of parenting as well. I hope you'll share Meghan's birth story, if she is willing, but I will understand if you don't. I imagine it would be painful to see such a cherished memory picked apart by the vultures. Love to you and your family. {{hugs}}

September 4, 2011 | Unregistered Commentertara

Ultimately the goal is a healthy mom and baby, whatever it takes to get there. Nobody should judge anyone on that IMO as that is a personal path for each individual.

I am a staunch intactivist and I cringe when I see people responding so negatively toward people who circumcise (sadly, this happens over and over online). Although I understand the passion, I feel it makes us look radical not to mention cruel at times. Some natural birth advocates are no different in their beliefs. Those who choose such extreme paths are not helping their cause, I feel.

Congrats on your beautiful AND healthy daughter and granddaughter!

September 4, 2011 | Unregistered CommenterPam

Man, this is a bummer to me. As a NCB advocate I am being lumped in with those you are talking about. It is frustrating because I believe every baby and every mom has their story and I am so supportive of my client's choices. Especially when they choose to to go the hospital (for pain relief usually). I don't judge them for wanting that. And I don't judge people for having hospital births because I believe the safest birth is where mom feels safest. I am sorry people offended you. That sucks. I just hope us midwives and clients can find common ground someday and support choices for women no matter what they are.

September 4, 2011 | Unregistered CommenterBeautiful Moon

I was following along as well and was troubled by the perceived judgement given by some. IMHO, there is NO room for judgement in the birth world. Each and every motherbaby has their own story, their own path to follow and who the hell are we to decide or comment on any of it. Furthermore, the only people who know the true happenings of any event are those who participated in it, and even that can be tainted by their own experiences/perceptions. How can we ever hope to effect change if we're busy picking the other side apart?
While I do have a lot in common with the NCB community, I prefer to think of myself as a birth rights activist or a women's rights activist. Perhaps one of those labels would fit you better? I think many, many people in both camps get so embroiled in the muck that they forget what's truly important/at stake....the mothers and the babies.
Finally, you and I do not always agree, but I am sorry that your joyous event was soured by people too enmeshed in dogma to respect the sacredness of birth. Please keep on speaking your truth. Even when it's difficult to hear, even when some disagree, even when it becomes a battleground, we *must* continually force ourselves to think about the why's, when's and how's of our work.

September 4, 2011 | Unregistered CommenterSummer

Maybe you're an AOICIB -- an Advocate of Informed Choices In Birth. Or an AOFICIB -- Advocate of Free and Informed Choices In Birth.

Human birth is a joyful and natural process, but that doesn't mean it proceeds perfectly without interventions every time. Or even a lot of the time! The AROM that kicked me from piddly prodrome to full active labor (at 6cm!) was an intervention; so was the terbutaline that kept me from delivering at 35 weeks. So was the perineal massage that helped me deliver with no tearing. So was the epidural in my first birth. So was the "sifting" with a rebozo that allowed my nephew to un-wedge in the uterus and finally, finally be born. So much of the time it's an "intervention" if we don't like it and "support" if we do. . .

Inductions save lives. C-sections save lives. They are both desperately over-used, but they are important tools in the warchest of birth. The best birth is the one where mother and baby both emerge healthy, empowered, respected, and honored, whether that's an orgasmic outdoor birth on the forest floor or an elective 35-week C-section.

Much of the birth industry focuses on the "healthy" part, which is great -- but let's not let the pressure off of the other three pillars! Hospital birth has changed, in great part because of NBA advocacy. I don't think your goals have changed; I think that your information has changed, and your environment has changed. If I walk around in a circle holding a compass, the needle will whang around every which way, but it's always pointing north, you know what I mean? "North" here is a respectful, supportive, non-coercive, safe environment for women to have their babies. In Mexico City, with a 50% C-section rate, the journey north will mean one kind of advocacy. In Haiti, with a 3% C-section rate and a maternal mortality of 680/100,000, it will mean a very different kind.

September 4, 2011 | Unregistered CommenterKathryn T.

Amen! I'm a middle of the road person as well. I have people who are shocked to hear that a yoga instructor isn't an uber-crunchy, vegan, NCB advocate, etc. Shocking, truly... My students are surprised to hear their Lamaze instructor say things like "It's OK if you need pain medication." or "Formula isn't poison."

We have a very black and white society with regards to our views on pregnancy, birth and parenting. Either you are crunchy, hippie, all natural, damn it and those other moms are doing it all wrong OR you aren't. I'm also a bit fed up with self righteous folks who feel the need to "correct" other mothers about things which are different choices. Not dangerous, just different choices.

I am happy to know, Barb, that you and I seem to have a similar view on pregnancy and birth - and on a woman's right to choose what is best for her and her baby, free from commentary from the peanut gallery.

Barb, a lurker here - I've been wanting to share my birth story with you, as an example of when interventions are a good idea. I intended to homebirth, being young and healthy. I sought out midwives who have a good relationship with a local hospital -- the CNM who runs the homebirth clinic also teaches and works at the local university hospital. My partner asked about their transfer statistics, and she said, "I transfer about 40% of primips, and about 5% of multips." She went on to explain that she has a higher transfer rate than other local midwives, because she tries to be very cautious, and because it helps her maintain a good relationship with the hospital. She doesn't only ever bring in women in need of emergency c-sections. Plus, her privileges mean that if she transfers with a patient, she can continue to be the primary caregiver.

This turned out to work in our favor. My baby was occiput transverse when I went into labor. My contractions were never regular, and I was in constant pain -- the baby was banging his forehead against my pubic bone, causing pain to resonate throughout my pelvis. I labored at home for 26 hours before we transfered to the hospital. The midwives tried all their tricks, but my pain limited me -- it was hard to walk; moving me took a lot of effort. About 25 hours in, they suggested a hospital transfer. I learned later (they went in the other room to discuss this) that they were primarily concerned about hemorrhage, as I'd been pushing for several hours already.

We arrived at the hospital, with no problems, and we made the decision to use pitocin to help my exhausted uterus get the job done. Per her requirements, my midwife had the on-call OB come in and check me out. Reading the notes about my labor later, I learned that he was pushing for a c-section, but he also considered me a good candidate for a vacuum- or forceps-assisted birth, and because he trusted my midwife and my baby's heart tones were strong, he was willing to let me keep trying for a while before we made that decision.

Then my midwife said, "Look, I know you don't want an epidural, but you haven't slept in about 48 hours, you've been at this for a long time, and you've been in constant pain. How would you feel about having one?" Surprising myself, I said yes. Fortunately it worked well. I was able to sleep for several hours and then get back in the game.

33 hours after I went into labor, 11 hours of which was my second stage, my baby was born vaginally. I do not think it would have been possible for me to have him safely at home, and I am grateful for my midwives' assistance. I was unable to take in many fluids or food, because I was in too much pain. When they catheterized me at the hospital, they removed about a liter of urine, because the pain had made me incapable of peeing.

I am grateful I didn't have a c-section. My recovery was difficult enough, emotionally, without that. I definitely suffered from feeling inadequate from having had an epidural; I can't imagine how a c-section would have made me feel. But overall, it was a good experience. I feel strong. I feel like I made the right decisions in the circumstances.

What made it a good experience? Having caregivers I trust. I was not worried about transferring to the hospital when I needed to, because I knew my midwife wouldn't have any problems when we arrived, and she didn't make me feel bad for needing to go to the hospital. I trusted her with my life, and she lived up to that trust and beyond. My midwives do a 4-6 month postpartum checkup -- emotional, not physical -- and when I went, she was able to reassure me that my experience was a "normal deviation," and that I'd made good decisions. When my partner and I choose to have our next child, I'll choose to try a homebirth again -- with the same midwives!

I learned viscerally that these interventions can be necessary. There are situations where they should not be used, but they exist for a reason. This has made me a more broad-minded doula, and it has refined my philosophy. I am no longer in favor of natural birth at any cost; instead, I firmly believe that my mission is to help women make thoughtful, evidence-based decisions that are appropriate for their circumstances.

What's the point? Point is, you're not alone. I'd love to read your daughter's story, if she's willing to share, and I think your attitude is a smart one.

September 4, 2011 | Unregistered CommenterBeth

i love reading your blog! i became interested in midwifery and health care in general because i saw that midwifery offered a kind of care that went beyond the clinical and supported people emotionally and spiritually. i am however a practical person, and am skeptical of certain NBA positions.
i just started nursing school, so i am still learning, but love reading your opinions, research, information, and find it SO refreshing to see how your mind works!
i hope that i can one day be an RN (possibly birth related, maybe not) that can read research with a critical eye and when appropriate, apply those practices that have enough warrant to improve patient care, even if it goes against my previously held opinions!
i like to read your blog because you are freaking fearless when it comes to standing up for your beliefs, and rights. i don't see why you have to fit into a label, like NBA. information if objectively critiqued should be done outside of the backdrop of any affiliation, so we can truly embrace all sides. human advocate, that's how i'd like to see myself.
i often find myself in positions where i hear people talking about silly superstitious beliefs, imho, and wonder, when is it appropriate to speak up? mostly i think that if someone holds a belief that is pretty harmless, i am in no place to correct them. but when the topic is something more critical, i wonder, how do you tell someone they are wrong, or that the research does not support their opinion? too often people won't change their minds anyhow, but especially when people feel attacked they will hold even dearer to their cause...
i would love to explore the best approach further since i know it will come in handy when i become an RN and am doing patient education.

September 4, 2011 | Unregistered Commenterhbbaggins

Don't worry, Barbara, I'll still read your blog!

It takes a lot of maturity to be able to admit that you have grown professionally and now see things from a different angle. Of course, it really began with you a long time ago, when you realized the limitations of your CPM education.

As for "midwife" vs. "medwife", I don't see the need to change your "job category". I don't think the type of midwife that puts NCB ideology above professionalism and medical knowledge is indeed a midwife at all [and I don't care what initials are after her name]. The professional midwife can care for ALL pregnant women. With some she has more autonomy, with others she has to work with [WITH, not "for" or "under"] more advanced medical practitioners [doctors, in other words]. She can care for the lowest of low-risk patients, and the highest of high-risk; women who are healthy and women who have co-existing medical conditions. When she has a patient who falls within the parameters, she is the sole HCP; when necessary, the necessary specialist[s] and she work together for the desired outcome: the safe delivery of mother and her baby.

Other sorts of birth attendants, IMHO, are not really midwives, they are either missionaries or birth junkies, in it for the "experience", with the child [and sometimes the mother] coming a poor second.

September 4, 2011 | Unregistered CommenterAntigonos

One of the things I hear so often from women who have been turned on to the natural birth scene (sometimes even when they are interviewing me about a homebirth) is "What did women do before there were doctors and hospitals?"
My answer, in short, is "They died. Often. And they are dying all over the world, every minute of every day."
That may be a shocking answer coming from a homebirth midwife, but don't want women thinking that just by choosing a HB and a MW that they will be gauranteed a healthy, happy outcome. I want them to choose homebirth knowing that going to the hospital may have to happen, and if it does, to go without fear knowing that the hospital doctors, and nurses are going to do what they can to keep her and her baby alive and well. And that the pitocin, and IV drips, and antibiotics, and maybe the epidural and maybe the cesarean section just might be necessary to keep her and her baby safe. I want them to know that sometimes, things DO go wrong and if it does, a hospital is a fine and dandy place to have a baby, too. I am NOT going to transfer a train wreck when it can be avoided...I want Mama come out of birthing her baby with both of them strong and healthy enough to enjoy their first days together.

Realistic Birth Advocates? You know I am standing shoulder to shoulder with you on that front. I'd like to think of myself as a "Practical Midwife".

It doesn't matter if you choose to share Meghann's birth with us.....any one of us who comes to birth with a realistic approach knows that after 32 hours of labour things aren't going so hot and it's time to have a baby on the outside, already. Remember that good, old fashioned piece of midwifery advice, "Never let the sun rise on a labouring woman twice"? So much more sensible than thinking if she just had more time/less fear/more trust/a different birth team/whatever whatever whatever the baby will come. At what cost? An exhausted mama? A distressed baby? Worse?

Anyway.....I totally feel ya, Barb. I remember sharing my 5th birth on an NBC forum....and was totally lambasted because I talked about how difficult it was..."Do you think it was so hard because you weren't prepared? Or maybe because you had fear about the birth? Blah blah blah about how it was probably my lack of trust or my fears. Um, No, it was because I had a 9lb 8 oz, posterior, military presenting post-dates baby with a compound hand AND a 15 inch head. Duh! I probably SHOULD have had a cesarean....instead of pushing for 5 1/2 hours and suffering a fractured coccyx, a baby who refused to nurse, and so much trauma I had severe, debilitating anxiety attacks through out the following pregnancy. I have no problem with admitting, hard core home birther that I am, that that particular birth was not sunshine, lollipops and fine imported cheese.

But, Barb, learning, growing, changing, re-evaluating....it's all a good thing. It's something I truly admire about you....how candid you are when you feel you have been wrong. That is an inspiration to the many who read your blog, and who are beginning their journey into the birth world. And it's how we should be....open, and honest, with our clients, the community at large, and most importantly, ourselves.

September 4, 2011 | Unregistered CommenterColleen

I'm right there with you, Barb, and I apologize for several of my ridiculous beliefs I truly believed when I was thick in the middle of the haze that is the NCB Cult...i.e. woman on depressants and painkillers shouldn't be breastfeeding and that epis are terrible. I was wrong, wrong, wrong! When I started realizing how serious my fertility issues are suddenly everything inside of me sifted and I realized if my husband and I are ever blessed enough to become pregnant there's no way I would be taking any risks at a home birth with a DEM or CPM or a UC all on my own. Uh oh, wait that means I must not really think it's as safe as I have superficially believed my whole life. Then I really started paying attention to the attitudes and misinformation that permeates every aspect of the NCB and my eyes were soon wide open. It's unsafe & it's demeaning and judgmental of women. Not all women can or want to have natural childbirths at home, not all doctors are running assembly lines and don't care about their patients. Why should any woman have to endure days & days of painful, labor in this day and age? They shouldn't! Some women have "easy" uncomplicated births and going natural is just fine for them, but all women and all labors and all babies are different! NCB treats all women the same and shames them for "giving up". Also, they are completely okay with a few dead babies here and there even if there deaths were completely preventable because these midwives care more about the "birth experience" than the baby's life. The saddest part is women get pulled into this disillusion and believe these things themselves. I have no problem with natural, med-free childbirth in a hospital or at home with a trained professional and yes many hospitals in our country could improve, but it's still a whole lot of a heck safer then giving birth at home with a lay midwife who dismisses meconium in the waters as normal and let's a woman labor in distress and again for days until her baby dies! I don't know what to call myself anymore either, Barb. I support a woman's choices in birth and I support natural birth, but I am no longer a NCB supporter and I find it said that even when I was the best experience I had as a doula was in a hospital where myself and my clients were treated with respect and given choices and listen to and respected and my worst experience as a doula was with a CPM who was unrealistic, delusional and dangerous and who is extremely lucky my ex-client's baby survived after a mismanaged 24 hours labor, followed by 4 hours plus of pushing and a 3rd degree tear! Yes I no longer belong in the NCB community either. It's a dangerous place to be for women and babies. I apologize for arguing on your page on the day your granddaughter was born, but those women were pissing me off! I couldn't stand their thinly veiled insults. Also, no midwife should be allowed to deliver high risk pregnancies at home...period. The midwives in this country are DANGEROUS! I understand doctors may be quick to push for unnecessary interventions but they're only unnecessary in hindsight...they just don't know which women and baby will be okay and which ones will not. They unlike many home birth midwives do not think it's okay for a baby to die here or there for the cause.

September 4, 2011 | Unregistered CommenterRain

Hi, I wrote something similar to this on a FB page recently, that it is not always enough to 'trust birth' and 'trust our bodies', that sometimes babies do die during homebirths - perhaps deaths that could have been avoided (especially if the mother was 'high risk' anyway). I had a homebirth and am now a trainee doula and I love the NCB thing, but I agree with you that it is not always correct to believe that 'everything in birth will be fine as long as we don't intervene with the process'. And it is dangerous to think so. Just one question though please: why didn't you want your daughter to have a homebirth? Do you believe that even with low-risk pregnancies homebirth is not safe? If so, why do you think that? Thanks.

September 4, 2011 | Unregistered CommenterNina

When I was doing my doula training, I already knew I was more middle-of-the-road. It bothered me that my colleagues were mostly focused on making sure women had unmedicated births, and talking women out of medicated births. I think of it as my job to help women have the best birth they can, letting THEM decide what "best" means, and knowing that shit happens. Probably because I went to med school for 2 years before I decided to change and go for a CNM, I do believe that most people involved in women's care DO have good intentions and that they all do have a legitimate role in birth (some women DO need surgeons).

September 4, 2011 | Unregistered CommenterChe

Barb,

I often follow your blog and your links, because I really do feel a kindred spirit has finally entered my world! I feel like the waves we've landed on within this world seems to rise and fall within a recognizable rhythm.

I work with the ICAN organization, and let me say that listening to birth stories has really affected my perceptions of what a birth advocate can be. It all comes back to a feminist point of view in my little world. I want womyn/wombyn/women/ladies/chicks/etc to all feel empowered in their decision making and move from there. I was sitting with some women I don't know very well yesterday and it came up that every woman should have an epidural, yada yada so on and so forth. I feel like busting out like superwoman and baring my milky breasts and hairy vag and saying "I AM SUPERADVOCATE HERE TO SAVE THE DAY!" and yet I just can't do it. There is a gentle way to plant the seed. It was more of a moment of - if you want to talk, here's my email address and we can go for coffee (one of the women was newly pregnant).

Even though I look up to you as a birth professional, I don't see you with superstar status. I see you as a fellow person who cares about people. There is nothing wrong with being ordinary, and I won't drool all over you - but I think our world is lucky to know you are here, and that you will consider helping people versus baring your badges. It's not a one-size fits all world, why do we have to resign our vaginas into the same hell hole?

I think what has happened is that as an oppressed society we're turning to infighting. I say - stop spending your time on fucking facebook "badges of honor" groups like NCB, etc and spend a little more time writing letters and caring for women who need true, simple, honest support. The women I know are fearful of coming to our groups because of the connotations. We are just there for support and advocacy, that is it. The more it gets blown up the less effective any of our work is.

To evidence-based practice... I say that people need to be better at scrutinizing the evidence. If I want to find evidence for something, I can find it. End of story. Good/bad/and otherwise. Even if it's 100% the best evidence in the world, people are going to take the other path anyways. What do I care? I do care, though, when it affects a whole lotta people. So, things like decisions by governments to keep funding of midwifery low... women who don't get a choice, or don't know their choices because they don't have access to the internet - these kinds of things.

Say something nice to a woman you know today. Pay it forward. If people want to be like that - let them expend their energy. Eventually it will burn out... and then the next thing will come along.

Love you! Keep up the good work woman.

September 4, 2011 | Unregistered CommenterRhonda

I work in a hospital with a 28% CS Rate, I suspect the hospital your daughter gave birth may be higher. 1/4 of babies are delivered this way because for what ever reason they need it. It does not make me any less a midwife for the path to delivery my ladies may take. In fact these women need midwives to advocate for them even more. CS is not the outcome we wish for, but is sometimes necessary and we shouldn't be surprised when it happens.


I just wanted to say congratulations on the birth of your granddaughter. I wish her a speedy recovery. Enjoy her!

September 4, 2011 | Unregistered CommenterCanuGess

Barb, there is a budding and growing movement for Safe and Respectful birth. There are many of us, and we have different ideals, but we all agree one a few things. We agree that care providers should be highly trained and held to high ethical and practice standards. We agree that women should be able to hire a licensed professional and know without great effort that that licensed professional is highly trained and achieves quality outcomes while maintaining a strict set of transfer standards. We agree that medical care improves outcomes when it is necessary. We agree that women should be treated with great respect when seeking medical care. We agree that women should be truthfully informed of the risks and benefits of all intervention and nonintervention. We believe that women should be listened to both in labor and not in labor. We believe that women should be encouraged to trust these highly qualified and highly ethical providers to give expert and responsible advice. We believe that those care providers should carry adequate insurance and maintain quality continuing education. And, finally, we believe that because of that education and a strong ethical drive, those care providers should be trustworthy and should take responsibility when outcomes are suboptimal or poor and endeavor to learn from those outcomes and improve services instead of denying those outcomes, blaming them on mothers, and skirting the law and professional oversight.

There are improvements to be made in all sectors of healthcare. But we can improve women's and pregnancy care by pushing for high standards in all modes of service delivery.

And, Barb, we'd love to have you.

September 4, 2011 | Unregistered CommenterWhatPaleBlueDot

First, Congratulations!!!
Second, 'realistic birth advocate' sounds great. It puts into words the reason why I consult your site over and over again.

On to something a bit more delicate. I come from a world way less polarized than the birth world in the US. Maybe that explains my lack of awareness.
When I read about your daughter's cesarean birth, I didn't comment, but I feared. Certainly not out of judgment, but out of care. The same happens when my friends give birth. I had a traumatic cesarean birth. I am well aware that this doesn't mean that all cesarean births are traumatic. I have friends who had beautiful cesarean births and oh how I am happy for them (and envious).
But statistically, a cesarean birth is more difficult to process.

I feared, hoping for the best. Your daughter is probably more mentally stable than I was when I gave birth. It looks like she was treated better. Perhaps you made sure of that. In any case, she is lucky to have you, who helped with nursing when she couldn't (to my knowledge hospital staff don't offer that).

Another thing. Grandparents tend to be overjoyed about the arrival of a grandchild. Especially the first. It's normal. But their joy might override everything else. My mother's joy certainly did. Writing this, I am not assuming that it is the case for you. It can be hard (and I am not assuming it was for your daughter) to have your parents rejoice over your baby while you're passed out from surgery. It was for me. And for many women I know and don't know.

I do realize that this is an anxious response that has nothing to do with the birth as it took place. But it doesn't come from nowhere. It's difficult for me to talk about these things. It's also difficult not to. I am offering these words in case you hadn't considered this aspect of things.
Had somebody made room for the difficulties, along with the joy, when my son was born (and long after, as it has been taking years for me to process the events), it would have made things easier for us. I certainly hope none of this applies to the birth of your granddaugther. But in case it does, please be gentle.

(My comments have nothing to do with debating whether the c-section was necessary or not. What I know is that even a life saving c-section can be hard to process. Or not. Same for elective. For the mother, it takes time to know where she falls. Such a discovery is very personal. I do not think that, in most cases, it is triggered by natural birth advocates. I know it wasn't for me.)

September 4, 2011 | Unregistered Commenter'Away from your crazy mom'

Resourceful Midwife. I think that has a nice ring. And that's the kind of midwife I want. One who uses her resources wisely. Maybe it's that homebirth and all the different methods for helping a baby move down and into the right place for a lovely uncomplicated birth. Maybe it's knowing when to move to the hospital. Maybe it's support for a mom who has chosen the hospital upfront and knowing what interventions are needed and what are not. Maybe it's using a sonogram machine because mom doesn't want VE's due to a traumatic previous birth, and you find an OP baby early enough to try what you can to move it. Maybe it's knowing mom needs support for deciding to get an epidural because she cannot relax. Maybe it's catching the baby sitting on the hospital floor because mom's still trying to move that baby and she feels naturally comfortable in the captain Morgan stance. Maybe it's time for a c-section, and mom needs to not feel guilty, needs to know she's done what she could do. Maybe it's having the meds available for home or hospital when mom bleeds too much. That's using your resources wisely. That's a resourceful midwife not one stuck in her beliefs. A resourceful midwife wants to combine mom's wishes, dad's support, with the safety of the baby. All together, and you have the best birth possible. Even knowing grief counseling because we all know birth can go wrong and babies do die in the best places with the smartest people who have been highly educated. Life cannot be pushed into our beliefs. We should be making our beliefs from the things we have learned wisely. It makes me feel better to know you are out there bringing a balance. Seriously.

I think women also need to give themselves a break. I had a CNM my last birth but spent a few months fretting that I had gotten my water broken by her. I let her do it, there was no coersion. I was in labor and I usually nod my head a lot and say, "sure." Well, then I felt like I let myself down. This all with an OP baby with an asynclitic (sp?) head who was a full pound bigger than my other babies. An OP baby who also was having very bad decels at the last minute AND who had a very tight cord (not just wrapped). I had labored without meds, labored on foot, my midwife was awesome, my husband was awesome. But I questioned that AROM in the last hour. Really? We were already at like 9cm. Seriously. No water even came out because the head was fixed down there. I got to hold my baby right away and I gave her a bath, I nursed her. I got everything I wanted, and yet regretted one small non-natural birth decision. No IV...nothing. I wore my own clothes until the last two hours. I ate and drank. I got everything I wanted. Oh brother. There is no perfect birth for a nit picker.

Blessings!

September 4, 2011 | Unregistered CommenterDawn

Barb,

I'm just curious about which version of the "Brewer Diet" you are referring to. There are so many different versions being passed around the internet which are misinformed and inaccurate and can indeed be harmful. It can be easy for people to think that they are all talking about the same diet, when they say "Brewer Diet", but that's just not something that we can assume any more. So which version of the "Brewer Diet" are you referring to?

Joy Jones, RN

September 4, 2011 | Unregistered CommenterJoy Jones

Barb,
It is so appalling that people used the delivery of good news to advance their agendas and uncharitable opinions.

I was so looking forward to the birth story because what you did share sounds so much like my own labor with my first. However, I don't blame you for wanting to protect what was a beautiful experience where you witnessed your daughter display such strength and perseverance, and her husband display such love and support, be judged by people who try to reduce the hallowedness of that experience in any way.

Your balanced approach that has always seemed mindful of varying points of view has been so helpful to me since I've been following your blog. It is unfortunate something as beautiful as the work of bringing children into the world is marred by people who behave so inconsiderately towards others.

September 4, 2011 | Unregistered CommenterKim

I don't know if you get my comments because I never see them published, but I just want to say that this is the WHOLE REASON I read your blog! I loved my natural birth but I refuse to be a NCB advocate because of all the non-evidence based crap I hear. Its hard to take seriously people who criticize OB's for not practicing evidence based medicine when so many are pushing homeopathy and wholesale rejection of vaccines. ::eyeroll::

I love you because you consider all sides of things, discuss evidence, and put such a high value on women's own choices.

Don't be afraid to reject the NCB partyline. I will certainly join you in the Realistic Biirth Advocacy movement and do all the research I can with my MPH. :)

Congrats again on your granddaughter. Enjoy!!

September 4, 2011 | Unregistered CommenterLarissa

i like your blog more and more each day. i have loved watching your daughter's belly grow and watching her birth unfold over facebook. i am so very glad Meghann had a c section available to ensure safe delivery of her baby. c sections save babies. i am so tried of NCBs towing the party line that they are evil- baby/mother-bonding destruction machines. my only regret in my life was my decision to homebirth with an ill trained under-educated CPM. knowing a simple surgery could have saved her, but now she is buried is something i live with forever. a small scar on my bikini line would have been nothing compared.

September 4, 2011 | Unregistered Commenterliz p

For many of us in this new safe birth movement, it started with a personal experience. For some it was as devastating as a severe birth injury or loss, but for many of us it was something less dramatic. For me the wake-up call was the sudden nastiness flung at me by my own midwife when I was 28 weeks pregnant and dared to question decisions she made at my first birth. I was hugely pregnant with all the vulnerability that implies and she freaked out on me, shouted at me, called me names all because I didn't "trust birth" and her goddess-like self-image and wanted an actively managed 3rd stage. She fired me and I found other homebirth midwives...ultimately, complications took me to the hospital and I had a c-section I was happy and relieved to have. And even the second group of midwives then shunned me. (These stories can be read on my blog for anyone who wants a roller coaster ride of weirdness to occupy their afternoon.)

It was at that point the wheels started turning for me that maybe this wasn't really about MY empowerment, as a birthing woman, but something for them, some sense of superiority, some need to feel powerful, some kind of emotional needs based on dominance...And when I started questioning everything it all fell apart. I still feel incredibly sad and angry about how cheaply I was treated by this group of people who claimed to have my best interests in mind. How quickly they turned from sister friend mentality to calling me crazy, gaslighting, mocking, and other nasty behaviors. All over what? The fact that I chose safety over "experience" and wasn't devastated about it.

I would actually discourage you from putting your daughter's birth story out there right now. Maybe in a year or more, when she's well into motherhood and it isn't so raw and fresh. But these people can be amazingly vicious, and I wouldn't want her to be hurt the way I have been hurt.

September 4, 2011 | Unregistered CommenterAnonoregonian

Larissa: I don't censor you! I publish all but the most vile comments (and even those usually make it through), so know that isn't you. I'm sorry the Net Gods eat your comments... you can always co-email them to me so I can publish them if they don't make it here.

Joy: The Brewer Diet that says 80-100 grams of protein a day. Some even suggest 120 grams is better yet.

You all who understand where I am... and even commiserate with me... it's nice to not be alone over here. I'm really surprised at the comments... wondering when the detractors are coming.

September 4, 2011 | Registered CommenterNavelgazing Midwife

I'm 13 weeks pregnant with my first child and don't really talk about my birth plans because I know people will think I'm being wishy-washy about the whole thing. Yes, I plan to prepare for an unmedicated birth, but realize that things may happen where drugs and interventions are warranted and necessary.

I know a doula who until recently, didn't think that epidurals could EVER be necessary. Then she attended a birth where the epidural kept her client from needing a c-section. I couldn't believe that it took her so long to realize this!

Oh, and there was also the time on the Unnecesarean facebook page where a woman got picked apart for getting a c-section after 60 HOURS OF HARD LABOR! Oh my gosh, I was so angry!

September 4, 2011 | Unregistered CommenterLaura--The Sushi Snob

Barb, it feels great to hear someone espousing this middle-of-the road attitude! When I tell my birth story to people, I always feel like I have to justify my decisions. To some I have to justify why I felt safe about trying for a homebirth; to others I feel the need to justify why the way events played out was sufficient that I stopped feeling good about it, and transferred to hospital. I wish I didn't feel this need. It seems to me that advocating homebirth at any cost is just as dangerous as advocating excessive medical intervention (such as early elective c-secs). I love the pragmatic and safe attitude you are expressing here.

September 4, 2011 | Unregistered CommenterAli

YES! I am right there with you, Barb. I don't know what to call me anymore. It seems I am shunned from many sides, which is so ironic as I stand firmly in acceptance in all beliefs. I am not a natural birth advocate. I am a WOMAN advocate. In fact, someday I want to write, or put an anthology of stories and essays from our point of view. You are not alone, and it helps to hear that I am not either. Thank you for speaking our truth!

September 4, 2011 | Unregistered CommenterKristina F

I just want to say that my mother is barely alive without a caeserean, my aunt also. My sister and cousin too in this generation. Myself well I hope and cross my finger but generationally it doesn't look good. We are perfectly designed for death

Sod the critics: choose life

When I see my child... well oh I hope... to see

Enjoy your grand child

September 4, 2011 | Unregistered CommenterGuest

Congratulations on becoming a Granny! I am SO happy everyone is healthy and happy. It's not acceptable to comment on someone else's birth, even criticizing what's going on, especially when the whole story is unnknown. Questions, okay, but not "questionning". Women need SUPPORT. Their choices need to be respected. And they need to feel safe. Everyone has different levels of what feels safe and good to them, and it's not our business to judge what should feel safe and right to another. Childbirth is SO personal. One simply cannot create a "gold standard" and hold everyone to it, believing those who don't follow the same philosophy or "live up to the standard" because they were too emotionally "blocked" or "untrusting" or "miseducated" to give birth "properly", are somehow unworthy of our compassion and support.
I find much to value in the NBA philosophy, as I also find value in obstrics. I also find much to object to in both camps, most of it having to do with the backbiting and assuming of righteousness. There is healing to be done on both ends. More and more, I don't find I have a philosophy except for moms and babes coming through birth safely, happily, feeling great about the work they did, feeling powerful, and respected. I pray your daughter felt like the rock star she is. Love to you all three generations.

September 4, 2011 | Unregistered CommenterMotherWit Doula

Congrats on being a Grandma! And congrats to your daughter and her husband for their beautiful, sweet baby!

Kid's lucky to have a grandmother that has a TON of integrity, is intelligent and also comes equipped with a spine that's made of the finest steel: flexible but unbreakable. ^_^

Being "right" is easy. Having been "wrong" and LEARNING from that experience, adapting to new evidence...THAT takes some serious courage. ^_^

September 4, 2011 | Unregistered CommenterAnda

I think there should be a place for every caregiver who is skilled, knowledgable, compassionate, and aware. Whether that is home or hospital, CPM, CNM or *gasp* MD. We all need to be available for all women - to inform them, help them have real choices, and be in the place that is right for them.

I agree with an above commentator - perhaps taking time off of the internet would be a good break. Sometimes the opinions of other are just not constructive. Good luck.

September 4, 2011 | Unregistered CommenterMeg

Hi Barb,

I've been reading your blog for a while and I had to delurk to comment on this post. I had a (mostly) natural hospital birth when I had my second baby four months ago. My first child's birth was a little bit precipitous; he had to be intubated for meconium aspiration. Throughout labor he experience fetal distress and I was tethered to be the bed for continual fetal monitoring. I'd planned an intervention-free birth and was extremely disappointed in myself when I decided to have an epidural. I reasoned though that since I couldn't move around I should try and get a little relief. Anyway. He ended up being fine, despite the dramatics right at birth.

So, anyway when my second baby was born I was hellbent to try again with minimal interventions. I got to the hospital, got checked in and the nurse told me she needed to run an IV port. I hesitated and she explained that it was hospital policy. They didn't have to actually run anything but they needed to have access in case of an emergency. Because of my experience with my son I didn't need much convincing that an IV might be good idea. I ended up getting a little bit of anti-nausea medication and fluids and that was it. I didn't need continual monitoring but if I had I would have had portable monitors so I would still be able to move around. My CNM sat with me the majority of my labor and was with me the whole time when I went into transition. The nurses were amazing. No one offered me pain meds, or ridiculed me or made me feel stupid. One nurse even said, "Yeah, it's a little easier when the moms get epidurals but I really like working with moms that don't." My baby was born after two pushed over an intact perineum. I was so proud of myself! But I also realized a few things: first, I'd been pretty stridently pro-NBC. I still am; I do think most women can have a baby with minimal interventions and I do think that it makes for a shorter recovery time (I could be wrong about that but it was definitely my experience). I think it's better for the baby. But, BUT...maybe I had an easy labor. Not everyone labors like me, I wasn't in agony. All but the last 90 minutes were extremely manageable. I read lots of pro-NCB blogs prior to giving birth and it made me view my CNM, who I've seen as a provider for ELEVEN YEARS and trusted implicitly until then, as an enemy. It made me fear and dread going through the hospital doors in labor. It shouldn't be like that. I imagine that there are a lot of hospitals that are like the one I had my baby in, and a lot of nurses that are supportive of natural birth moms, and a lot of CNMs (and maybe OBs) who have the best interest of moms at heart and WANT to give them the birth they want so long as everyone's healthy.

I know that I might be a little idealistic but I think that one of the big problems with the NCB movement is an antagonism that is almost encouraged between women and providers, even CNMs.

The other thing, if you look at books about the history of childbirth, midwives have never sat back and just watched a woman labor when things were going south. They've always helped manage birth in one way or another when the need arose. It's a fallacy to think that childbirth never needs to be managed in one way or another.

Sorry for the long, rambling post. But I wish there was a little more trust. Sure, midwives and doctors should respect women but women should also trust that if an intervention is recommended it's not because they're being railroaded but because it might be medically necessary. I really, really respect you for writing this. If you were going to be there while I was giving birth, this would make me trust you even more because I would know that you would use good judgment if I needed a higher level of care. It isn't--it can't be--so black and white. Thank god for your appeal to common sense.

September 4, 2011 | Unregistered CommenterMaggie

to Rain: I'm dismayed to read that after apologizing for the sparring on facebook, you chose to end your post here with this comment: "They unlike many home birth midwives do not think it's okay for a baby to die here or there for the cause."

Assuming that *anyone* thinks it's okay for a baby to die perpetuates the arguing. Honestly!

September 4, 2011 | Unregistered CommenterAdrienne

Congratulations!

I know the trepidation you feel about posting the story. I dont know the details of what occurred, but it sounds so much like my son's birth - for me, it was an induction for GDM on my due date - 29 hours of pit, 19 of which were unmedicated, failed epidurals, malpositioned baby, failure to progress, all ending in a c-section.

My doula basically gave up on us when we agreed to the induction.

I was heavily into a "birthing naturally" online community at the time. I was scared to post my story, as it was the classic "cascade of interventions" story. When I did, some ripped it to shreds, but most of the ladies just... never responded. It was almost like being shunned.

The thing is, while I DO think that a lot of interventions arent necessary, I am also a physician and I had the conversations with my OB about the induction in the first place. I only push so far against recommendations - for a REASON. (we compromised at a 40 week induction instead of 38 weeks like she wanted...with biweekly NSTs). I would NEVER deliver at home or in a birth center. I need the emergency backup available for me to feel comfortable. I have seen WAY too many "perfect pregnancy, perfect labor, dead baby" situations in my career. And I take a lot of flack for that as well.

All in all the birth itself was pretty traumatic - mostly because of failed anesthesia (yes, I felt the c-section). It has made me terrified this time around (which is coming SOON, Im 38+1 today).

I am not in the "give me every intervention in the book because we can" camp - I am with CNMs, TOLACing with hopes for VBAC in a hospital this time around. I see a chiropractor (who has kept me walking) and a few other "crunchy" things. My birth plan has dwindled from all kinds of details to "just DISCUSS THINGS WITH ME BEFORE YOU DO THEM" because in reality, that's what I care about.

I agree...safe and respectful birth is what Im after. NOT the assembly line "everyone should get an epidural etc" and DEFINITELY not in the "trust birth/babies" camp.

Middle of the road. Sometimes interventions are needed. Sometimes they're overused. Sometimes they arent. As long as Mama and Baby are alive, happy, and healthy, isnt that the point????

September 4, 2011 | Unregistered CommenterDrStar

Thank you. Thank you for posting this and helping me to heal and accept my own non-medicated, low intervention turned emergency c-section birth.

I hope that your daughter comes to accept her labor and birth. I was fine with it for weeks and then the pain killers and endorphins wore off and the visitors stopped coming and it hit me like a freight train. I had failed. I had done everything wrong. The only way I have been able to accept my decisions from my birth were to talk it out over and over again with my doula and husband. Be and ear and just keep telling her that she made the best decisions given the information she had.

The c-section I had saved my baby boy, however I still hold the guilt that I "did it wrong" and "my body failed me".

Congratulations on your wonderful addition!

September 4, 2011 | Unregistered CommenterSamantha W

I *still* don't view you as a "medwife".

I've met "medwives", they're the kind that if they had "MD" behind their name instead of "CNM", they'd permanently have a scalpel in their hand.

That's all I really had to say. I applaud Meghann for her decisions made. Because they were HER decisions. I'm sure she's wise enough to know her options and be educated on risks/benefits.

September 4, 2011 | Unregistered Commentermommymichael

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