A friend of mine (Adrianne, I think it’s safe to say that you are probably not only a friend, but, indeed, my best friend in Oklahoma) has misunderstood a recent post of mine, in a way that I think is hilarious and proves … something.
When I wrote about Unassisted Childbirth (UC), she wrote on her blog about it in a way that made it sound like she thought I meant “unassisted” as in “un-drug-relieved.” Which is understandable, because she might be aware that I rely on caffeine-assistance every day.
But UC refers to a movement (or, as they would say, the natural way things have been done forever) of women who give birth at home, without even the presence of a midwife. (maybe some allow a midwife; this is a club with very stringent restrictions; I’m not entirely sure what is allowed).
This is funny to me, because it shows that Adrianne shares my main paradigm regarding childbirth — it’s something best done in a hospital (or maybe a birthing center next to a hospital), and the only question is if/how much narcotic/anesthetic intervention to use (scream for?).
As Willy Wonka (Gene Wilder) would say, If the Good Lord had wanted us to suffer that much in childbirth, He wouldn’t have invented epidurals.
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Oh, I know…about it meaning everything…at home, no midwife etc. I only commented on the no drugs part. I thought after I published my post that I maybe should have clarified that and changed my title. Maybe I still will…
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dang! i thought it was so meant-to-be, as if to prove that birthing alone at home is almost outside the realm of possibility. (i should have known you knew, but i didn’t know, until recently, that there were people who would want to birth without anyone in attendance. even in the “old days,” i imagine sending my husband off to fetch the wise women of the village (i.e. my mom) to help me).
it’s crazy, because, on the one hand, i am so admiring of at least one UC activist (Rixa–see her blog on my blogroll). she reminds me of thoreau. and i love him!
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There is a lady in my mom’s ward who has her children in her friend’s hot tub. That is creepy. I’ve heard of lots of people that choose to have their baby in water and I think that is fine but a friend’s hot tub is gross to me. I think it is kind of cool to be able to have an unassisted childbirth but I also think it is unwise to recommend everyone have one. And I would ask “At what point to you decide that it is too dangerous and that something is going terribly wrong? How do you make wise decisions about the health and safety of yourself and baby?” I don’t know. I am just so thankful for modern medicine that allows us to have our children with proper medicine (if needed/wanted) and proper care. I wonder how many women that had children in the old days would wish for the same medicines and help from doctors that we enjoy today.
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i agree; also, as i pointed out in my comment to my UC post,
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I never looked up the term “unassisted childbirth” and didn’t realize that it meant no help at all. I thought it was some combination of no drugs, no hospital, whatever.
Hey, one of my friend’s favorite books is Midwives, about a midwife on trial for performing a c-section on a woman–the question of the whole book is whether the woman was dead or not when she performed the c-section to just get the baby out. Very provocative, but I read it when I was pregnant and it scared me a little.
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Well, I’ve had both the standard hospital birth and the UC in my house (which doesn’t make me any sort of expert at all), and I found the UC to be such an uplifting and positive experience.
But as someone said, some diehard UCers might not count mine as unnasisted, my husband was at my beck and call and the midwife was on her way, just a tad late.
As far as whether or not it was hard w/ no drugs: for about 20 minutes I did not want to be doing it at all, but the sense of accomplishment when I was done birthing him was wonderful
That’ll be 2 cents, Shannon. I do take paypal!
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“right in our own little world (Africa, to start) there are women dying all the time as part of non-voluntary UC”
It’s hardly a valid comparison between African women, who may well be malnourished, who have no access to decent pre-natal care, and who have often been subjected to female genital mutilation, which is a huge cause of maternal mortality and morbidity during birth, with well-nourished, unmutilated Western women with access to pre-natal care.
Oranges, apples?
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Hi Rebekka,
you’re absolutely right that most American women have incredible advantages over their African sisters even before they get pregnant or go into labor. (although an interesting article in the nytimes last week discussed a recent rise in infant mortality in our South and the role of (lack of) prenatal care in these deaths.
i see from your blog that you live in Australia (i would love(!) to go to australia someday). have you experienced health care in a third world country or country other than your own? we lived in japan for 3 months and cairo for 2 years. i’ve also travelled in europe, mexico and canada. my husband spent 2 years in venezuela and we’ve both had more intestinal parasites than you’d believe.
while in japan i had a severe (temporarily disfiguring though not life-threatening) allergic reaction. the medical care was substandard. in cairo we visited the ER too often with our toddler (dislocated/nursemaid’s elbow, accidental ingestion of tylenol; she also choked on a peppermint candy and nearly gave me a heart attack–there’s no 911 to call in egypt).
i had a miscarriage in egypt and had a d&c in a hospital there; i would not recommend that hospital (the history of nursing in egypt is very interesting). i am well-nourished, unmutilated, and i had very good pre-natal care with my next pregnancy (my dr, trained in germany, was extremely responsive and surprisingly deferential). i am glad we came home to the u.s. 4 months before my 2nd daughter was born.
the world is both smaller and larger than we think. i think it’s ok to compare apples to oranges if the point is to highlight the differences in opportunities and choices.
i did try to show my awareness of the difference btw African women who cannot afford the surgery required to remove a dead fetus and American/etc women who, educated and intelligent and independent, choose to give birth unassisted — that’s why i called it “non-voluntary UC.”
i guess what i was trying to get at is that americans should stop criticizing this terrible, awful medical community that wants us to (gasp) give birth in the safest way/place possible that they are aware of. how dare they! how dare they train and learn and dedicate their lives and do their best to deliver healthy babies to healthy moms? this applies equally to the culture of abusive malpractice suits–a big reason c-sections are so prevalent in the u.s. is that dr’s are afraid of being sued, and this is the fault of the sue-ers, not the sue-ees.
Rixa is LUCKY that her birth went so well. i’m glad. i’m glad for every mother who is educated, prepared and lucky enough to give birth in the place and manner of her choosing.
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Hi Shannon,
I don’t believe Rixa is lucky her birth went so well. Rixa educated herself in a way few women do before giving birth – particularly the first time. Luck had little to do with it – preparedness had a lot more.
I know you weren’t saying that it’s the same for African women and Western women – but the implication was there that they die because they have unassisted births – which is not the biggest reason why they die.
I also don’t think this is true – “a big reason c-sections are so prevalent in the u.s. is that dr?s are afraid of being sued, and this is the fault of the sue-ers, not the sue-ees.”
Women who sue doctors largely do so because (1) they have a disabled child who will require life-time care and no other way of providing for them and (2) because they are angry, upset and horrified at the outcome of their birth and have no other way of attaining some sense of justice being done – the channels for complaining about doctors and having something done about those complaints are pretty much non-existent, both in America and Australia. Blaming the women who sue doctors for high c-section rates is blaming the victims IMO. The fault lies not with the individual doctors who are performing c-sections, but rather with a system that does not provide no-fault compensation for women who end up with disabled babies and with a medical profession as a whole that does not deal effectively with complaints and which has a culture of collusion and sweeping bad practice under the carpet to protect doctors.
Just as it’s more complicated that blaming doctors for what goes on during childbirth, so it’s also more complicated than claiming doctors are doing nothing more than doing their best to deliver healthy babies to healthy mothers.
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hi Rebekka,
you don’t think Rixa was lucky to go into labor before her due date? to not watch her due date come and go and wonder if anything was wrong? you don’t think she was lucky to not have a breech presentation or a cord wrapped around a neck or that she didn’t suffer from gestational diabetes or pre-eclampsia, or any of the other complications that pregnant and laboring mothers can experience?
if that’s not luck, what is it? i’m pretty sure you can’t prepare yourself out of cervical incompetence or an ectopic pregnancy or placental abruption or a broken tailbone (or a broken clavicle, as my husband, a 10 lb 8 oz baby suffered coming through the birth canal).
i think it’s lucky (or, i should say, a blessing from God) whenever mother and baby are healthy.
and you’re right — i shouldn’t blame the women who’ve had bad experiences (although i was actually thinking of all malpractice suits, not just maternity ones); better to blame the lawyers, eh?
actually, florida, where i live, does have no-fault compensation… (i know, because i’ve gotten brochures about it both times i’ve given birth here)
(incidentally, i don’t really understand “no-fault” compensation… that means that some group of taxpayers i have never met should give me money because my child is disabled? that would imply that it is their fault, wouldn’t it?)
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Hi Shannon
obviously there is some degree of chance in all things. But there are things you can do while you’re pregnant to minimise your chances of a breech presentation, you can avoid gestational diabetes through diet, there’s quite a bit of evidence that you can avoid pre-eclampsia through diet as well. Avoiding most of these things is not chance – it’s being prepared and healthy and educated. Cord round the neck is not usually an emergency. Whether or not a ten pound baby can fit through the birth canal has a great deal to do with what position the mother is in – my sister-in-law had a 12 pound baby at home, three weeks late, and birthed her with not so much as a graze, standing up.
And yes, ectopic pregnancy is very unlucky – I have a friend who came very close to dying during an ectopic pregnancy that doctors had missed (despite the fact that she had absolutely typical symptoms). But that’s not something that would be suddenly happening to you when you were in labour.
“that means that some group of taxpayers i have never met should give me money because my child is disabled? that would imply that it is their fault, wouldn?t it?”
Actually, it’s not so much that they give you money, as that the community as a whole has an obligation to look after people who can’t look after themselves. And a child who has a permanent disability and will require life-time care would fit into that category.
Providing for people who are incapable of looking after themselves in no way implies that it’s our fault that they can’t look after themselves. If I feed someone who’s hungry, does that make it my fault they didn’t have enough food?
I personally don’t want to live in a community that thinks it’s okay for disabled children not to get the best opportunities and care that they can get, if their parents happen to not have the money to pay for it, because it’s not our FAULT that they’re disabled. I’d rather live in a community where people are looked after – and I’d rather my taxes went towards that than towards a whole lot of things they currently pay for.
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“if that?s not luck, what is it? i?m pretty sure you can?t prepare yourself out of cervical incompetence or an ectopic pregnancy or placental abruption or a broken tailbone (or a broken clavicle, as my husband, a 10 lb 8 oz baby suffered coming through the birth canal) ”
hmm. sorry to hear of your fear of childbirth. ” Lucky” is being able to drive a vehicle everyday and go to bed safe once again, every night. Lol, but we are so much a mobile society…that we are quite comfortable taking the risk of injury and death in order to reap the benefit in the ease of mobility. ~Life has risks. What we get accustomed to is revealing.
As there is not further detail (contracted pelvis involved bvery rare in USA) I will take the 10# 8 oz birth weight and tell you squarely : the broken clavicle was very likely due to the lack of mobility of his mother’s pelvis. Yep, we set mothers on their tailbobones in the USA when babies are coming through. It really is not too bright an idea, this confining of women, if we expect mothers to experience normal progression of labor and normal, successful birth of their child. Too few people have any experience with noramalacy in childbirth. There is a confusion of medical delivery care with giving birth. ChildDelivery is wellknown~ ChildBIRTH is not, and many are misled by the cultural norms/rituals. Fortunately, physiological childbirth is still accomplished in the USA by very determined, careful mothers and midwives. I believe midwifery care (following MIDWIFERY protocols~ not MEDICAL protocols) provides the lost key for that secret garden~ Normalcy in Childbirth. The state I live in is in a maternity care crisis. The practice of ‘9-5 obstetrics’ is very real and has grown to be common and ordinary. What drugs and surgery can accomplish ! My local hospital has a 40 % surgical delivery rate. Anyone intelligent enough to find maternal and neonatal morbidity and mortality rates for this has something to chew on.
fear-based ? Let’s see……many now just line-up their surgery date ? How many intend “to have their baby” at the local hospital with a surgical delivery rate of 25, 30, 35, 40 % ? We have become a childbearing culture that doesn’t have any critical thinking skills.
Gentle Birth, Gentle Mothering by Dr. Sarah J. Buckley as well as many other excellent resources are available for gaining a knowledge of childBirth.
well…Lol, with all the easy access to evidence-based informative sites, as well as sites that share authoritative knowledge gained through many years of midwifery~ what can there be for excuses ? I hopw not laziness, stubborn adherence to attitudes, and/or fear.
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hmmm, thanks Rebekka and Sandra, you’ve given me a lot to think about. it seems like you both have very strong feelings about what could be. … a vision of a better world where all women are educated and prepared and, yes, also lucky. a world where the collective knowledge of midwives and women who’ve experienced birth would be imparted to every woman and we would all make good, informed choices about how and where and in what manner to give birth. i can’t argue with that.
This better world would also include communities who voluntarily give to those less fortunate. I can?t argue with that either. My husband and I tithe; we voluntarily give 10% of our income (we are the opposite of rich) to our church, which does incredible humanitarian and other work with the money. What I quibble with is the coercive nature of taxation. Of course it would be better for our tax dollars to go to feeding the hungry and clothing the naked ? rather than for almost anything else. Can?t argue with that, either.
we all admire Rixa. but she is doing her dissertation on unassisted childbirth. obviously, there is a lot to learn to prepare to have a miraculous, yet not lucky, birth. is it surprising, then, that some women might want to leave some of it to the ?experts,? and accept guidance from medical personnel who have spent time learning something about birth rather than turning over years of their lives to the proper study that informed home/alone birth would require?
i know that Rixa had several years to prepare for her birth. Does my being a woman and desirous of having children mean that I should devote years of my life to preparation and study for an event that will take up around 24 hours of my entire life? (this sounds very anti-feminist to me). Of course I should have learned and prepared more. Should I have gotten a Ph.D before attempting birth?
Or do you honestly think I could peruse a few websites and come out properly prepared for a successful home/alone birth? Or would I, as a young, about-to-be-a-first-time-mother, have emerged confused, scared and worried that the choices I have made are wrong?
education on childbirth (rather than childdelivery, as you say), if we are serious about it, would need to begin in highschool; maybe this is the answer to teenage pregnancy!! one thing i do like about this line of thinking is that it requires an acknowledgment of the biological differences between boys and girls (which logically morphs into a consideration of differing gender roles), if we were to say that girls (alone) need this intensive education and preparation. can you imagine getting this kind of curriculum approved by state legislatures trying to appear “gender-blind”?
i think it’s great that the 12 lb baby was born so easily. was that her first? i know of a 7 lb baby whose delivery broke the mother’s tailbone; and, from what you say, it’s tragic that this happened solely due to delivery position. I?ll be emailing my mil for further details as to her delivery of my husband.
i don’t know that i have a fear of birth ? now (I certainly did before the first one; a certain amount of fear is pretty healthy, don?t you think?). i’ve had three kids, and plan to have 1-2 more. i will definitely be approaching those deliveries with a different set of possibilities, and i thank you for that.
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Hi Shannon, sorry it’s taken a couple of days to come back to this – been very busy!
I think you sum it up well when you say we have a vision of a better world!
I guess there is an element of coercion to taxation – but that’s true of all taxation, not just tax for social benefits. Most people would agree there are some things we all need to pay for and shouldn’t get an option about, like defending our country against an invading army, for example. Or paying for a police force. Or public schools. I guess if I put myself in the shoes of someone who has a severely disabled child, would I want them to have to rely on people’s charity after I died and couldn’t look after them any more? Or would I want to know that they would be fed and clothed and housed and taken to the doctor when they needed it, regardless of whether people in the community were feeling generous that month or could afford to give money that month or not? I would want to know that my child will always be looked after – and if there’s no choice but to rely on charity, you could never be sure of that. I think looking after the disabled should be something that there is an obligation for us to do as a society, not a choice for some of us to do if we are generous.
I don’t think you need a PhD before giving birth. Nor do I think unassisted birth is for everyone – I would certainly want a midwife. And I certainly don’t think you can just read a few websites and be prepared for an unassisted birth! (Actually, I don’t think you can peruse a few websites and be prepared for birth, full stop!). But so much of the information out there is geared towards medicalised birth, and a lot of medical personnel are so immersed in the medical model that you’re not going to get good information about natural birth from them – I had a friend Robbie who was a med student (sadly he died a few years ago), and I remember him being terribly upset by his obstetric rounds – he was at the hospital for six weeks, and in that time he saw plenty of c-sections, but did not see a single un-medicated, normal birth. He would have graduated as a doctor without seeing one birth that happened the way our bodies are designed for it to happen. Educating yourself means looking beyond the medical model to find out what physiological birth looks like, and looking at the facts and figures to see how you can best and most safely achieve that. For some people, that may be unassisted birth. For me, it’s a home birth with a trusted, hands-off midwife. Unlike a doctor, a home birth midwife IS highly educated about normal birth (and also, of course, about how to tell if things are going wrong and what to do in an emergency). I also would probably not feel comfortable without knowing I can reach the hospital pretty quickly if something did go wrong. And for some women, giving birth in a hospital is the option they should pick.
I do think women should take the time to educate themselves, and by that I mean more than perusing websites and reading that dreadful book “What to expect when you’re expecting”, but less than several years of study, and I also think your idea of education about birth starting in high school is a great idea.
The thing about delivery position is vital – lying down, a woman’s pelvis is 30% smaller than in an upright position. Put women in the lithotomy position, and it’s no wonder they can’t birth their babies without help! Babies are supposed to come out with the assistance of gravity!
And my SIL’s baby wasn’t her first – but she sure was a HUGE baby! She didn’t look like a newborn. My SIL is positive that if she’d been in hospital she would have ended up with a c-section.
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Hi Rebekka,
i appreciate your comments. this whole discussion reminds me of learning about the women’s suffrage movement in the u.s. I remember being in awe of the personal sacrifices those women made in order to be activists, in order to make something so obviously right a reality for us. i wondered if i would be willing to give up so much of what i wanted out of life–time for a family and children and lots of different interests, if i believed that strongly in something, and if i saw that there was such a need for that activism.
i think we need activists. i’m glad, perversely perhaps, that i don’t feel called to be an activist–i’m too selfish to give up that much of my life. perhaps for activists, it is just part of life.
(some of what you took exception to in my last comment was aimed at Sandra’s comment rather than yours–the perusing website thing and others)
what you say about your friend in medical school is horrifying, of course. i’ve mentioned elsewhere on this blog that my father is a dr, a DO, and my brother starts med school this fall. my father delivered about a 1000 babies before he gave that part of his practice up. my mom had her first 3 kids unmedicated, and then 2 emergency c-sections; my father assisted on the c-sections.
in my mind, the more education, and the more options, the better, for women.
your approach–optimistic, yet reasonable (having a midwife present, and being close to a hospital), educated and prepared, makes a lot of sense to me. the militant UC “drs and hospitals are evil” approach does not.
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