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The Ripping Apart of Natural Birth

I keep seeing critiques (more like lashing out) of natural birth, homebirth and the women who make crunchier choices. Gillian Telling’s article “Girl Talk: Don’t Judge Me Because I Had a C-Section” in The Frisky highlights one aspect of the not-natural birth movement: 

“Unfortunately, the first thing people ask you about when you have a new baby is how your labor went. When I mentioned the ‘C’ word, unless the mother had also gone through it and we could commiserate, there was always this little face, like she had smelled something rotten. It was usually followed by a look of pity, an ‘ohhhh…’ and maybe something like ‘I’m sorry,’ ‘That’s too bad,’ or, ‘You can always have a VBAC [Vaginal Birth After Cesarean] on your next one.’ Some would ask if it was an ‘elective C,’ and I got the feeling that had I said yes, they would have felt even more awkward around me, like I’d said I think puppies make for a tasty snack. It got to the point where I lied a few times and just said he was breech, instead of going into the long story and feeling kind of inadequate.” 

It’s startling to me she lied about why she had a cesarean. That really is a sad commentary on the state of affairs in post-birth communication. 

Or really, is it? I’ve listened for years to women who were birth-traumatized (not just by cesareans, but they are certainly part of many women’s picture) say how they lied about their births, putting on plastic smiles and saying, “Everything was fine,” or “It was great!” when, in fact, it was very far from either of those things.  

Women healing from birth trauma often find the telling and re-telling of their stories an integral part on their paths to normalcy (not the old normal, but the new normal). But those around them seem to hit a saturation point and it is a rare woman who has not heard, “Can’t you just get on with your life already?”  

There are other topics that make people uncomfortable… death and illness are two of the most common… but I find anger, pain and disappointment about a woman’s own birth experience all but taboo. When people are in mourning, we’ve been encouraged to listen quietly, not try to fix things, but when a woman says she hated having her baby, rabid judgment and an immediate, “Don’t say that!” meets her feelings. I wish I had a penny for each time I’ve heard, “All that matters is you and the baby are fine.” It isn’t all that matters; ask around. 

And then I came across this article, “Looks Like Nobody Ever Had a Baby Beforeby Daphne Caruana Galizia, written in The Malta Independent Online. Granted, I don’t spend an inordinate amount of time trolling the Internet looking for negative stories. In fact, that’s part of why I’m writing this; they are falling into me unbidden and to me, that means they must be growing in numbers. 

Ms. Galizia spits her words venomously. She states her premise: 

“I get the feeling that life on the maternity ward would be so much easier if childbirth classes were to include one whole session of drumming it into expectant mothers that they are not the first person to have a baby, nor will they be the last.” 

And then to pound the point: 

“Imagine just how much less angst there would be if the breathing trainer, or whatever they’re called, were to say repeatedly: “Remember that trillions of women have had babies throughout history, and that you’re doing nothing special. Even if it feels like you’re the only woman in the world to give birth, you’re not.”

Then they could put it on a banner and hang the banner up at the front of the childbirth class for good measure.”

I know I travel in different circles, but I rarely come in contact with such angry women… angry about childbirth and the way some women choose to traverse the experience. 

Ms. Galizia has had two babies, with CNMs in the hospital, so it isn’t like she is clueless about the kind of care one can get with a midwife, but didn’t she feel special? Did she not feel special having her baby? Unique? How does that not happen? How can a woman who’s, in a sense, birthing "God", not feel amazingly gifted/special/unique? 

But, I stand back and listen to her and try hard to hear her point; it’s just not something I can fathom. Probably the same as she can’t fathom mine/ours. 

Apparently, she has written before about natural childbirth and breastfeeding… and not in a good way. She considers many of us to be involved in “The Cult of Childbirth and its breakaway Cult of Breastfeeding, so (she says) we won’t go into any of that because I really have no time for a sack-load of letters and e-mails from the Queens of Suckling.” 

It’s almost amusing that someone… probably many someones since she’s written about it before… takes this angle on what a pretty vocal group of us feel is equally important, but the polar opposite. 

But, if I think about it longer, maybe she doesn’t feel that birth-breastfeeding is that important after all. Isn’t that the implication (if not all-out snortylaugh)? That we’re navelgazingly obsessed with our biological performances? 

On the heels of reminding us we aren’t so special just because we can make a human being out of two cells, Ms. Galizia launches into the (to me) tiresome argument that hospitals are oh-so-much safer than having a baby at home. 

At the risk of quoting half the article, I’ll just yank out snippets: 

- “The one thing these Cult of Childbirth gurus won’t tell their ‘everything must be perfect’ audience of expectant mothers is just how many women and babies died during or immediately after birth back in those halcyon days when the neighbours milled about downstairs with teapots and towels while the lady of the house screamed, hollered, bawled and strained upstairs.”  

- “It is thanks to hospitals and advanced medical care that we have been divorced from the biological fact that childbirth kills. Yes, it kills.” 

I’ll counter with it isn’t just medical care that has removed maternal deaths from an every day experience, but improved care overall. We know much more about the healthy pregnant and postpartum woman. We (in the west, anyway), for the most part, find information and education a valuable tool in keeping ourselves healthy during the childbearing year (and beyond). It is absolutely true that prenatal care is what happens between appointments, but we also know there are experts who can help us if we wander out of the range of normal. While women who’ve been insulted/assaulted by The Medical System may choose to birth outside of that Establishment, it would be a rare woman indeed who would stay home allowing herself and/or her baby to die if they needed the help a hospital can offer.

I couldn’t resist adding this quote from Ms. Galizia: “Hospitals and advanced medical care are artificial, yes, if you want to put it that way. But this is precisely why they are so wonderful. Nature, red in tooth and claw, is often hideous and cruel, and childbirth is one of the most obvious examples. Even when all goes according to plan, even when there is no ripping, cutting or slicing, it is gruesome. In their beautiful artificiality, doctors and hospitals have conquered nature, which seems determined to kill off a sizeable percentage of women and babies.” 

Sometimes, no response speaks volumes. 

The latest assault on natural birth came this week from The Guardian; “Torn Apart by Childbirth.” How’s that for a title?

“Vikki Dutton, who lives in Essex and has three children aged eight, five and one, had a fourth- degree tear when she gave birth to her first child. ‘For a few hours after the birth, I had one hole instead of two. I spent two hours in surgery, and left hospital with more than 100 stitches. It was incredibly, unbelievably painful – like getting a paper cut in the most intimate part of your body, only 1,000 times worse.’

And there are more stories like these – lots more. Two years ago a poster called Cyee started a thread on ‘birth injuries’ on Mumsnet while she was lying in bed after surgical repair for a fistula. More than 1,395 posts have since been added. Under the veil of anonymity that web-chat allows, women pour out the pain, and tragedies, that they have hitherto suffered in silence: some tell how they can't bear to be touched, let alone have sex, a year and more on from the birth. Yet more tell of how they wouldn't – couldn't – contemplate a second child, so terrible was the physical fallout from the first.”

The piece spells out the gory details of urinary and rectal incontinence and the isolation that comes with smelling like poop all day long. The women are unable to tell even their spouses of the physical damage that occurred because they are so ashamed. It can take years for women to learn there are ways to be repaired; probably too many women never know they can be.

“Her (Michelle Thornton, consultant colorectal surgeon for NHS Lanarkshire) bugbear… is that women aren't being told there are risks to vaginal delivery just as there are risks to caesarean delivery. ‘We know that certain circumstances make birth injury more likely,’ she says. ‘Big babies are a definite risk factor; a rapid second stage of labour is a risk factor. Having torn in a previous delivery is a major risk factor; augmentation is a risk factor, and so too is a forceps delivery.’

Uh, what about a woman’s position during second stage? Valsalva pushing? (Which is shown to increase pelvic floor dysfunction/damage.) The ghastly “help” doctors and some nurses do… the “perineal massage”? (It isn’t perineal massage, it’s perineal pulling and vaginal pressing. I’ve seen horrid outcomes of that sort of un-help; torn vaginal floors, swollen nearly shut vulvas and ripped perineums, all from another person’s fingers.) What about the effect of multi-hour’d immobility on a woman’s vulva, vagina and rectum? The effect of a catheter going in and out throughout labor? How might pitocin alter the expulsive process? What happens to the perineum when an epidural’d woman is being coached to push? How might the vagina respond to repeated vaginal exams? What if those exams are aggressive? What if, in addition to fingers, the vagina has had an IUPC inserted? An internal monitor screwed onto the baby’s head that’s deep inside the body? None of these issues are taken into account in such an inflammatory article. 

internal fetal scalp electrode 

But, you and I both know that whole slews of pregnant women reading the article are going to beg their doctors for cesareans so they can avoid the horrors they read about. If we wrote a thousand articles about the ways women’s genitals can be damaged during birth and how to avoid them, they couldn’t come close to the emotional impact this one article will have had. We need to try anyway. 

Those of us that write need to get louder, more aggressive in our countering articles such as those mentioned above. I challenge natural birth-oriented bloggers (myself, included!) to attack these overt slams against our birthing choices word for word. I’m certainly not wanting to give them more air-time, but if someone Googles “4th degree tear childbirth,” I want them to be able to find many other articles/blog posts countering the original piece. 

I can’t do it alone.