Mad With Power

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AUGUST 19, 2008 12:09PM

Childbirth Choices

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 ~ I hold these truths to be self-evident ~

1. The mind and the body are linked: and a woman's perceptions and needs are never more intimately exposed than in birth. Assuming an absence of risk factors, a labouring mother who is comfortable and in control has removed the most major impediments to birth: herself, and outside interference. Note that paradoxically, it is possible for a woman to be "comfortable and in control" while enduring pain, and letting birth take over.

2. Pregnancy and birth are not medical problems: but complications related to pregnancy and childbirth most certainly are and must be considered mindfully. Prenatal care is key, but need not be invasive or generic.

3. The mother's role in birth is vital: women are important individuals, not negligible vessels. Treat the mother as though her experience of birth does not matter and that illustrates exactly how much weight your experience should be given.

4. The health of the infant is vital: one need not subsume the other.

5. Regional differences vastly affect birth choices:  and even terminology isn't consistent. For example, not only will one hospital's policies vary from another, the word "midwife" means very different things depending on where you are.

6. Strive to empower women, not infantalize them: no one gives birth but the mother. Not her doctor, not her husband, not capital-S Society, whether she births unassisted in a mossy field surrounded by wood nymphs, or has a section in an operating theatre. The mother should be encouraged to learn about her options, and actively participate in birth in the way that is best for her, her pregnancy, and her baby.

7. Interventions can cascade: an uncomplicated, natural birth easily becomes otherwise if it is interfered with.

8. But thank god for 21st century medicine: most of us have had our lives saved by modern medicine - I had my appendix out at the age of 12 - and there is no reason to (cough) throw the baby out with the bathwater. Careful risk and pain management is different than starting at induction and ramping up from there.

~ My first homebirth ~

Monsieur pinks up, freshly born

Attended by midwives with decades of obstetrical nursing experience, I had a spontaneous first labour which totalled 21 hours. 9 of those were active labour, and I gave birth at home in water after about 30-45 minutes of pushing. My son was perfect and shockingly aware. I had no external injury, other than abrasions which healed within days. The birth was virtually bloodless.

I wouldn't recommend it to anyone.

What I mean is: I had the most textbook birth imaginable, and still it was the hardest thing I've ever done in my life. I can't imagine going through that pain and effort if I hadn't been totally committed to it, if I hadn't come to it on my own. I will happily describe my experience to women if prompted, or if there is discussion online, but I always include that information. I always specify that I personally had zero risk factors. I specify that I felt safest and most comfortable in my own space, because hospitals are a source of great anxiety for me, and being loose and open there would be a virtual impossibility. That I fully trusted in my midwives' experience to judge whether a hospital transfer was medically necessary. That my region's lack of support for water birth or even including showers for pain management was another major impediment to my considering them. That even at the peak of transition, when I suddenly became Catholic and called on Mother Mary, I was so grateful that there was no catheter in my spine.

But I know that to a woman who felt most comfortable in the hands of trusted doctors, my experience would have been her hell.  I know that the pain I let work on me was pain I embraced, and if I had been on the run from it, it would have been torture instead of simply very difficult. I know that some women propose marriage to their anaesthetists. Who am I to stand against such a love affair!

So even though I am a homebirther, and even though I am approximately a million months pregnant and I plan to repeat the experience within weeks, I will never tell a woman that homebirth is right for her. I can simply explain how it went for me.

~ Childbirth Choices ~

Feminism isn't about Not Taking His Last Name. It is about having the choice whether or not to take his last name. Birth is a feminist issue, because the rights and voices of women in birth have been stifled by paternalistic medicalization for decades.

Yet similarly, that doesn't mean All Enlightened Women must make a full 180 on medical interventions, leaving hospitals in droves (wood nymphs for everyone!). It means choices, and a woman's role in making those choices for herself and her body.

One of the books recommended to me by my midwives was Birthing From Within, a book that discusses birth options, predominantly unmedicated ones, from the vantage of "rite of passage," not "medical event."

The most stirring thing for me, beyond the art therapy from women who had suffered traumatic births, was that the author herself... had an emergency caesarian. She writes beautifully about her experience and how to mindfully experience birth even at its most necessarily medical.

That taught me the best lesson I learned about birth: anyone who tells you there's only one right way to do it is not talking to you any more. They are using you, either to make a point or to try and recruit you to one "side."

Me? I'm nobody's soldier. Here's to living in this moment in time, in nations with this quality of care available, where we can still march to the beat of our own drum. We shouldn't take that freedom for granted.

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Great post, Madeleine!

I ended up have a C-section after laboring 14 hours and although, in hindsight, I wish I had taken more control over what was happening to me (I was at the hospital taking a childbirth class when my water broke, and they gave me pitocin immediately), I was still "present" and still felt extreme joy at the birth of my son.

I totally agree that the mind and body are connected and that everybody has different levels of comfort, particularly regarding their birthplan (such as it is a "plan", since things rarely go as you expect!).

Here's wishing you another smooth delivery with Baby Two!
An astonishing manifesto. I am delighted to see you posting, Mme Powers!
Great post. So completely true.

And your son is beautiful.
J.P.: Thank you for the good wishes! I am definitely looking forward to the apparent respite of second births. Still hard work, but work your body knows, apparently.

Redstocking: aha, a sign that this "homebirth thing" is not just a passing fad! Would love to hear more about your experience.

M.Chariot: ma petite taureau, you raised the bar impossibly high, but it's a joy to be blogging alongside you.

odetteroulette: I have found your posts on this subject to be refreshingly sane and I greatly appreciate your endorsement.

Urban Dad: Yo.
Thank you for this post. I was so bugged by the one I read this morning from the OB who claimed it was more feminist to hand your body over to the doctors and take their drugs without question. It followed me all day like a bowl of Cream of Wheat over my head.

The fact that the Dick-Read fellow was a misogynist doesn't mean that much of what goes on in ob/gyn practice is feminist. There's room for lots of misguided sexist thought under the red tent.

Here's to choice.
Wonderfully well-thought out. No matter how it happens, childbirth is an amazing process.
Oh, thanks so much for posting this. I agree with your manifesto. Bravo.

Childbirth is a particular interest of mine; I am a strong advocate of whatever you want to call it...mom's making informed choices I think is the best way to say it.
Women are fucking amazing. I could never do that.
Fantastic! I'm so glad you wrote this -- we need some contrast to the lovely doctor who has been so enlightening. Your son is beautiful. I'm giving birth to my second baby in January. My first was natural with a nurse midwife in a hospital. I agree with everything you say -- it's all about women's choices, and the mother and the baby are really the only important people in the room.
Well said. Choice is the thing!


Kirsten
Get to know me and get current at: http://www.relevantmom.blogspot.com/
Lydieth: Lots of room for misguided sexist thought -- indeed. Not to mention, a man born in 1890 may be expected to have a certain distance from the conventional wisdoms of modernity.

Alexandria: How true it is. And "pain free" childbirth, managed or not, is vanishingly rare, besides -- if you don't feel your contractions, chances are you'll feel your recovery, etc. They don't call labour "walk in the park," and there's a reason!

The Buzz: Informed choice is a great way to put it. The only thing that ever gets my back up is when a mother deliberately puts her head in the sand, but that's not really birth-specific. I just dislike learned helplessness period.

Black Bart: Ah, that's kind, but I don't think men are incapable of endurance by any stretch. You just don't have the requisite parts! Some quantum reality there's a "Black Brit" and she's one mean mama, I'd wager...

AmyFuji: Congratulations on your pregnancy! Here's to an easy and healthy birth for you and your second.

Kirsten: Choice is the thing -- not quite as catchy as "bird is the word" but I'd go for it!

And everyone who has complimented my freshly born boy (now almost three, mercy), heartfelt thanks. He's so different in his birth photos, all bent out of shape, but still amazingly himself.
Thanks for this, MP. I had a waterbirth with my third at a freestanding birth center, and attended by certified midwives. My labor was 3 hours, pushing was 15 minutes, and I caught my own Thing Three--who weighed 11lbs. It was an amazing experience. Choice is key, and feeling like I had the power to make those decisions was wonderful.
I have but one truth to offer on childbirth -- if, when it is all over, the mother is breathing, the baby is breathing, and the baby is on the OUTSIDE, then it has been a good birth.

Most everything else is noise.
There has been a lot of posting and commenting on this topic here at OS in the past several days, but I believe your statement is the most intelligent, compassionate, wise and understandable of them all. Way to put it out there.

And a great photo, too!
I found Amy's article, "Ricki Lake: Please stop lying about homebirth!" to be strident and accusatory in tone, and boy did it get my juices flowing. I spent a long time working on a post, googling various things, and gathering data for my rebuttal (my four children were born at home and I taught Bradley method childbirth classes some years ago, so I am fairly knowledgeable on the topic). Of course, I imagined all sorts of things about this woman, who would have the gall to essentially accuse me of being a bad mother! Guess what? - I inadvertently lost the post! And faced with having to write it all again, I took a deep breath and when sanity returned to my mind :) , I was able to feel empathy for a woman who, in her world-view, believes that children are being endangered. Once I was able to see that, all the animus in support of posting was gone, and I did not rewrite my post.
However, I would share here that my home birth experiences were positive for me and my babies. They were personally empowering for me, as I learned a lot about myself that I hadn't known before, which have helped me enormously over the nearly 30 years since. My sisters, following my example, also planned mid-wife assisted home births. Of our 12 children, one could not be born at home as my sister developed polyhydramnios, which was linked to suspected fetal anomalies. My sister had a C-Section, my niece spent three weeks in neonatal ICU, but is now a lovely 18-year-old. The other eleven children were born safely and healthily at home.
Clearly, I believe that homebirth with skilled assistance is a safe alternative for low-risk mothers.
Here's are links to some of the sites I found while googling http://www.gentlebirth.org/ronnie/homesafe.html
http://www.birthnet.org/services/home.php
http://www.homemakerscottage.com/motherhood_homebirtharticle.html
I found Amy's article, "Ricki Lake: Please stop lying about homebirth!" to be strident and accusatory in tone, and boy did it get my juices flowing. I spent a long time working on a post, googling various things, and gathering data for my rebuttal (my four children were born at home and I taught Bradley method childbirth classes some years ago, so I am fairly knowledgeable on the topic). Of course, I imagined all sorts of things about this woman, who would have the gall to essentially accuse me of being a bad mother! Guess what? - I inadvertently lost the post! And faced with having to write it all again, I took a deep breath and when sanity returned to my mind :) , I was able to feel empathy for a woman who, in her world-view, believes that children are being endangered. Once I was able to see that, all the animus in support of posting was gone, and I did not rewrite my post.
However, I would share here that my home birth experiences were positive for me and my babies. They were personally empowering for me, as I learned a lot about myself that I hadn't known before, which have helped me enormously over the nearly 30 years since. My sisters, following my example, also planned mid-wife assisted home births. Of our 12 children, one could not be born at home as my sister developed polyhydramnios, which was linked to suspected fetal anomalies. My sister had a C-Section, my niece spent three weeks in neonatal ICU, but is now a lovely 18-year-old. The other eleven children were born safely and healthily at home.
Clearly, I believe that homebirth with skilled assistance is a safe alternative for low-risk mothers.
Here's are links to some of the sites I found while googling http://www.gentlebirth.org/ronnie/homesafe.html
http://www.birthnet.org/services/home.php
http://www.homemakerscottage.com/motherhood_homebirtharticle.html
Late arrival to this love fest. But I also want to sing some praises. This is a wonderfully balanced and sane-spirited piece. Thank you for standing up for me and my choices. I chose a hospital birth for the reasons you chose a home birth. It made me a lot more comfortable. And I chose to change my name because I want to share a name with my family not my dad and siblings. But it was always about having choice. Which, AS YOU PUT IT SO WELL, is the true feminist battle. And it seems we're getting somewhere when we have the choice as feminists to defend our rights and needs as mothers and wives in and out of hospitals. Here here, thanks again.
Flawless, just flawles!

And an adorable babe to boot! Congrats and good luck with your new arrival.

This should be required reading for med students.

Liz, you know, it is very possible to ensure safety during a birth while at the same time, treating the woman with dignity, compassion and respecting her autonomy.
Aww, look at that baby!

I have not had a home birth, (Close a couple of times, though. My four labors, in order, were 12 hours; 30 minutes; 7 hours; 45 minutes. Looks like I'd better stop, I'm due for another long labor!)

I fully support home birthers!