Thursday, November 7, 2013

A rant on so-called natural birth.


We're taking classes. Childbirth preparation classes, that is. Yesterday was our first class, and though it mostly went well, I ended up a bit irritated (and had anxious, bad dreams because of it). We are taking this class in part to meet other couples, mostly expats, in a similar situation to ours, and to be well informed and as prepared as we can. The course covers a bit of everything, from the Dutch health care system, to how to register the birth, to breathing, relaxation, the stages of labour, possible medical interventions, breastfeeding, etc...

The first activity was an 'icebreaker' exercise to get to know each other in which we interviewed another couple on basic things like which countries we come from, how long we have been in Holland, if we are planning to give birth at home or at the hospital, if we are being followed by a midwife or a gynaecologist (which is not actually a choice you make, rather a situation that depends on whether or not there are risk factors in the pregnancy), our expectations for birth, if we have thought of using medications...

At some point the teacher made a comment, in a mocking, ironic tone saying how "some people like to say they want a natural birth with painkillers". I tried to shut up, but I could not stop myself from retorting out loud: "but, it is still natural". This "division" and qualification of birth in 'natural' or 'normal' (both words she used at different moments) versus a birth in which pain is managed medically really annoys me, because it implies that if you dare use any pharmacological product you are somehow less valuable, less brave, less a woman??? (And it saddens me to see these discussions all over the place, as if there were camps, as if it was a matter or you're with us or you're the enemy.)

Whatever strategy anyone chooses to cope with labor, whether it is breathing, hypnosis, a hot water tub, gas and air, pethidine or yes, an epidural, if you push the baby out it is a natural birth. I don't see any intrinsic value in enduring pain and I don't think it is something to be particularly glorified or proud of, and specially not something which should be used to make people feel "less" (what?) (But that's just my opinion). Yes, I know my body is perfectly capable of doing this, I trust my body. This does not have to do with that trust, I know there are changes gradually taking place in my body that are preparing me for giving birth. I also know that pain will happen. I know that pain is a very real physiological phenomenon, based on chemistry, and that when my pelvic canal and cervix open and expand I am bound to feel it. I also know that the medical science has ways to counteract pain, and if they are there why should anyone be made to  feel bad about choosing to use them? In the end, it is impossible to predict how things will happen, we can not really plan for (most of) this. So why the harsh judgement and division if sometimes (many times?), it is something we can not control?

Wax model at "La Specola" museum of Zoology and Natural History in Florence

I am not even sure what I want, I know I want to take labor as far as I am able to, I am exercising to strengthen my core, and I want to learn all that I can. I want to be prepared, while acknowledging the unpredictability of the possible outcomes, but I am also very open to the pharmacological options out there. And yes, I will probably want an epidural. I have been there, assisting cows, and they did not seem to be having fun.

I am also thankful of the advances of medicine, and am very well aware that if it were not so, childbirth would still be one of the main causes of death for women or infants. The 19th and 20th century were not so long ago. Sometimes there is not even a choice, and it is thanks to obstetric interventions or surgery that the lives of women and child are preserved.

video

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Like a commenter (Leela) said in response to this post (aptly named: Ugliest, Beautiful Moment, Or, Fuck Ina May)

"I think the main problem is that many women buy into a fantasy that  labor is somehow a magical, painless experience. This is bunk. Natural labor is awesome, very empowering, and can leave a woman feeling a deep sense of pride and accomplishment. But it fucking hurts, and that’s the way it is. I feel that there is too much emphasis on the mistaken notion that we can have birth without pain. That line of thinking is fear-based. It comes from fear of pain. Pain is part of life. You can’t think yourself into escaping it. You can get the pain medication, or you can embrace the pain. Having done both, I can say that both have value and neither is less than the other. You can’t have birth without pain, but you can have pain without fear, and that is where I wish people would focus their energy, not on some bullshit about having an orgasm while you’re pushing out a human being from a tiny canal full of nerves. That shit hurts! Don’t pretend it doesn’t!"

Forceps, Museum Boerhave in Leiden

16 comments:

  1. Ah I've been wanting to write a similar post for so long, but you said it better. I'm choosing a birth with intervention in the form of pain relief because I WANT to. I understand the associated risks, and in all honesty only know 2 people who actually got the completely intervention free birth they wanted. I get REALLY angry with the 'we need to empower women to know they can do it' line of argument too. As if somehow I'm just too stupid and ignorant to know how a 'real' woman should behave. Stick to your guns- we'll have natural, pain-management births together!

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    1. Yeah, exactly, it's that assumption about how real women should behave that gets me. We'll see what happens but yes, information and being open is key.

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  2. I have always been of the opinion that as long as that baby gets out of the mom, one way or another (given everyone is alive and healthy at the end of the process), then it was a successful birth and that's all that matters. I am so glad that science allows us to have these options that quite literally save lives.

    Funny enough, though, in the US, I feel like the opposite agenda is being pushed on women. If you want a birth without meds, people tell you that you don't have to be a hero. This line of thinking leads to many unnecessary medical interventions and a high C section rate in this country.

    Yes, giving birth is painful! I think that as long as we educate ourselves on the available pain management options, and understand the risks and benefits, we can make the decision that is right for us, individually.

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    1. You are so right, as long as the baby gets out, and everyone is safe and happy and healthy, then it is a success.

      In Mexico too, the rate of C-sections is extremely high (around 40%), and it has to do with the "convenience" of being able to schedule it and with the fact that it is simpler for doctors (and more profitable ??? ). It is very scary when you think about it as a whole and I think that's another extreme that should change (system-wise). C-sections should be available when medically indicated, with no hesitations, but I am not sure that is what's happening. Of course, every case is particular.

      And yes, understanding the risks and benefits is very important.

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  3. As someone who was planning an intervention-free birth, I can say that the problem isn't what you want or why you want it, it's the pressure that there is a RIGHT way, and therefore, a wrong way to do it. I ended up having my baby with no pain meds and would definitely do this again. But I DID have unplanned interventions and was happy to take them and utilize them when they were clearly needed. To me, the problem is with blind stubbornness without thinking through what you, as an individual and a woman, need for YOUR birth. There should not be judgment from others involved in this decision. Birth is freaking hard. The hardest thing I've ever done, and we need to make our way through however possible.

    Prior to giving birth, Lorna and I had a conversation in which I said the only way I judged women was in regards to a planned cesarean. Now I no longer judge that. I get it. I get all of it. Do what you need to do. It's freaking terrible and amazing all at once.

    What is not fair is the judgment we (and others) inflict on ourselves. I am still trying to write my own birth experience out, but am having a hard time because I am wrestling with my own judgements of myself.

    Whew! I could say more, but I won't. I must care a lot about this because I came out of my postpartum-no-commenting-hibernation to leave you a comment (and with my iPhone no less!).

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    1. Yes, the "right" and "wrong" approaches are problematic, because they leave people feeling inadequate. Every situation is particular, and we really can not know what will happen, how things will go. So we should try to be open and informed, and aware that things might go differently to what we have in mind, it's just the way it is, and we can not really plan or control. And yes, the judgement should go, every case is different and we should be able to evaluate our needs and, within what is possible, decide accordingly.
      I am looking forward to reading your story, don't be too hard on yourself, like Anna said, Owen is here, and he looks so happy, so you did good.

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  4. This idea like it's failure to accept help when giving birth has gotten crazy. Anything else in life we ENCOURAGE people to accept help, and find ways to do things with more ease and less pain but when it comes to the decisions women make about having babies it's all judgment, all the time and it's just not fair.

    You've said it all, really.

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    1. Yeah, I hope by talking about it and by realizing that we are "all in the same boat" even when all kinds of decisions and approaches and philosophies are out there.

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  5. Child birth before medical intervention has always carried risks. Yes, our bodies are designed to go through the labour process, but that doesn't not mean it was been safe and risk free since time began. In countries where there is less medical involvement I would hazard an educated guess that there are more complications. Pain relief can help the mother feel less distressed or anxious, and can therefore make the birth easier on the baby, no?

    People, perhaps women in particular, need to be much more respectful of what decisions women make when pregnant/in labour/while rearing. It seems like you're damned if you do, and damned if you don't. We need to stop being so judgemental about peoples choices. Choose pain relief, don't choose pain relief. Breast feed or don't breastfeed.

    But then you've said it all really. I'm just in total agreement with you.

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    1. Yeah, I do not know the numbers, but I would tend to agree about the complications. It is a small percentage of births that will require assistance, but you can not know in advance whether or not that will be your case.

      I hope we can learn to be more respectful with one another.

      BTW; Amy. I have been trying to comment in your blog, but I don't seem to be able to do so unless I set up a login / password account, even when trying to use Google is that the case?

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  6. You know, I kept reading all over the place how Dutch women preferred natural births AND doing it at home and it always baffled me. There was so much emphasis on it that I thought that if I ever moved there I wasn't really going to have a choice as to how I wanted to have my babies. I think it's ridiculous for someone to try to decide for someone else how they should handle such a momentous situation! Just as getting pregnant in the first place is a choice (a lot of the time at least), whether they have painkillers or not is *also* their choice, only they can decide how they want to go about it and everyone else should stay out of it!

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    1. Yes, giving birth at home is a part of the culture here, people seem to be wary of hospitals. That said, you *do* have the choice, and you can give birth at the hospital if you prefer it for whatever reason (you feel safer, there are risk factors, etc). I was also mistrustful of the fact that if your pregnancy is low-risk, you are followed by midwifes all throughout (you do not even get the choice to be followed by a gynaecologist). If something is odd ot needs extra medical attention, then they will send you to the ob/gyn. But, it turns out, midwives here are highly professional, they study at least 4 years and are very similar to a nurse, plus, they specialize in pregnancy + birth, so I have come to trust them. And if a doctor is needed he will be called.
      It also depends per midwife center I guess, they each have their own approach / philosophy. We specifically chose a center that was attached to the hospital (so that in case anything happens, we are already there), and that had very good reviews. In any case they give you the choice of whether you want pain management options or not (though you can not get those at home, if that is your choice), and explain you the risks, pros and cons. It is all very personal, and many times, the situation at birth out of our control.
      It's just a society thing that brings up the debate / judgement (that lady was just the one giving the childbirth preparation classes and I think her comment was rather unnecessary) . Regardless the opinions on what is better or worse, right or wrong are all over the place, and I think it should remain something where nobody is judged for their choices.

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  7. Guuaaauuu vi esas fotos y me dio miedo. Te digo lo què se escuchado Por que catalogar que es bueno y Que No, cuando al fin y al cabo lo Importante es tu salud y la de tu bebe si la necesitas la cesaria o no es Algo Que solo la Naturaleza debe decidir.
    SABES me PARECE muy chevere Eso que Hacen en holanda, aca en italia MUCHOS no SABEN COMO funcionan Tantas Cosas Relacionadas con el Embarazo y el parto ni si Quiera MUCHOS de los Italianos y Esto Es Un Punto negativo.
    Te He Pensado Mucho ESTOY muy contenta por ti. Un saludo

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    1. Si, es verdad, a veces las cesareas son necesarias por varias razones médicas (el bebé necesita oxígeno ya, historia de cicatrices internas / otras operaciones etc...), pero como tu dices no me parece que sea una elección como si se tratara de papas con mayonesa o con catsup. Y aun así, cada situación es particular.
      Muchas gracias por el apoyo y muchos saludos.

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  8. Ahh! I'd missed the note about you being pregnant, cutie! Congrats to both of you.

    And you're right, there is absolutely nothing wrong with giving birth however you and your healthcare providers see fit. Even if you have c-section. After two hours of pushing, my doctor wanted to do that with my son but I stubbornly ended up pushing him out anyway -- and injuring myself severely.

    I've learned a bit since then. Forget about the petty arguments over how to be a mom -- you will run into plenty. Motherhood is a miracle, no matter how you go about it. Always remember your best is enough.

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    1. Thank you so much Velda, and yes ou are so right, all those how-to,and "this is the way" arguments can only be damaging... we are all different and so are our children, what works for a family might not for another. I think that while staying as informed as we can is good, following our instincts when it comes to parenting is also important at least to some extent.
      Thanks for the advice though (I will probably ask you tips later!) So many questions...

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