Husbands and Home Birth

“You call her [the midwife] right now.  I’ve done a lot of crazy [insert expletive] in my life but I am NOT delivering a baby.”

Guest Post by Alyssa Chirco

This was my husband’s response when I realized that the irregular contractions that I had been experiencing all day were getting stronger and coming routinely every four minutes.  He had agreed to the home birth of our second child, but he was adamant that he would not be the one doing any sort of catching or delivering.  It was obvious that the whole thing still sort of freaked him out.

What is it about husbands and home birth?  Most of the women I know have had to either talk their husbands into home birth, or have compromised their own desires and been talked out of home birth by their skeptical partners.  Why are men so afraid of home birth?  And how do we convince them that, for many families, it can be a safe and viable alternative to birth in a hospital?

My own husband’s journey began with my first pregnancy, when I was planning a hospital birth with an obstetrician, but was also intending to have an unmedicated birth.  I hired a doula, and signed us up for Bradley childbirth education classes.  Most of the information in the classes was not new to me, as my sisters had been born at home and I had already read a lot, but the classes were incredibly eye-opening for my husband.  He learned about how birth really works, and realized why so many hospital policies and procedures are often unnecessary and even detrimental to the birth process.

My first birth experience was not ideal, but as a young, first-time mom giving birth in a hospital, I fared pretty well.  I refused an IV, was allowed to walk and use the shower, and received electronic fetal monitoring only twice during the few hours I labored at the hospital.  Thanks to my doula, I was never offered an epidural, and didn’t have any episiotomy.  And because my entire labor lasted less than eight hours, the obstetrician only made in time to catch a healthy baby girl.

This easy delivery (and lack of hospital interventions) made it a lot easier when it came time to casually mention to my husband that I wanted to have baby #2 at home.  As supportive as he was of my desire for natural childbirth, and as much as he understood the difficulties that come with trying to have a natural birth in a hospital, he wasn’t really comfortable with the idea of having a baby at home.  But I was able to point out to him that the doctors and the nurses at the hospital never really did anything at my first birth.  I never utilized any of the interventions that you need to be in the hospital to get; my body did it all on its own.

My husband agreed to a home birth the second time around because had witnessed a safe, natural birth first-hand and because, ultimately, he trusted that I had done my research and knew what was best for our baby (and, yes, I consider myself extraordinarily lucky that he has this much faith in me).  He also felt more comfortable after meeting with our midwife and hearing first-hand about her experience and how she handles emergency situations.  And when I finally got my hands in a copy of The Business of Being Born and he was able to see the safe and peaceful home births of so many babies for himself, he was more fully convinced that we were doing the right thing.

He still didn’t want to be the one who had to deliver the baby though, and he still had his doubts.  He worried that it would be messy, he worried that something would go wrong, and he worried about what the neighbors would think . . .

My second birth experience was far better than my first.  I labored at home.  I was allowed to eat and drink.  I didn’t have to fight to avoid interventions because my midwife didn’t believe in them in the first place.  When my son’s head emerged but his body didn’t follow, my midwife knew exactly what to do, and within a few minutes she had dislodged what she termed “sticky shoulders” and he slid easily into the world.  From my perspective, it was a great birth.

Overall, my husband found the home birth experience to be a positive one as well.  He particularly enjoyed the fact that he got to sleep in his own bed and not on a hospital couch.  But I also learned afterward that, at one point, he had been afraid that my son and I were going die right there in our bathtub (which was never even close to happening).  If we have another baby, I know that he will support my desire for another home birth.  But I also know that, on some level, he would still feel more comfortable if I chose to go back to the hospital.

As birth activists, it can be hard to see women who have given up on their hopes for a home birth because they can’t convince their husbands.  It’s easy to judge men who are hesitant about home birth, and criticize them for being unsupportive.  But, in fact, I think we are the ones who need to be more supportive and understanding.  Most men aren’t being trying to be difficult, or actively deny their wives and babies a safe and positive birth experience.

They just don’t know any better because no one has told them any better.

We talk a lot about how women in our culture know so little about birth and are rarely exposed to it before they have a baby themselves.  If American women know so little, doesn’t it stand to reason that American men know even less?

The notion of medical superiority is deeply rooted in American culture.  We tend to believe that doctors, hospitals, and procedures can make everything better, and this thinking is applied to birth as well.  Most Americans assume that interventions always help the birth process, and aren’t familiar with the idea that interventions can actually be harmful.  In many cases, pregnant women don’t even know that they have options and choices when it comes to birth.

Women come to home birth in a variety of ways – disappointment with a prior birth experience, reading books, participating in online forms, talking with other women at mom’s groups or playgroups, just to name a few.  But husbands don’t often share these experiences.  Men don’t have to heal from cesarean scars.  Men rarely participate in chat groups or attend support groups about pregnancy and birth.  Men don’t share intimate details of their birth stories with other women, and don’t hear about the experiences of others.

Instead, men mostly hear the messages from the mainstream media that home birth is dangerous.  Chances are they have never met or even heard of anyone who has had one.  So when husbands hear their wives start to mention the idea of having a baby at home, it’s no wonder that they’re skeptical.  Given what they know, concern and opposition actually seem like perfectly logical responses.

I don’t believe that husbands oppose home birth because they want to be difficult.  In most cases, it’s because they love their wives and they’re unborn children.  It’s because they have only been exposed to the mainstream media message that home birth is dangerous and hospital birth is always a safer alternative.  It’s because they haven’t read the studies and met the women and heard the empowering stories of birth at home.

As birth activists and home birth advocates, we need to change this.

My question to you is how.

If you had a home birth, did you have to convince your husband?  If so, how did you do it?  Or, did you want a home birth but agree to give birth in a hospital or birth center because you couldn’t convince your husband/partner?  How do we help men to be more comfortable with the idea of home birth?

Alyssa Chirco is a stay-at-home mom and freelance writer who lives in St. Louis, Missouri with her husband and two children.  She is active in both birth and breastfeeding education and advocacy, and combines her love of writing with her love of everything parenting-related in her blog St. Louis Smart Mama (www.stlouissmartmama.blogspot.com).

Fearful Fathers.

On this Father’s Day weekend, in addition to all of the celebrating & thanking we’ll do for the fathers in our lives, we also should take a moment to think critically about the power that some fathers exert over the birth of their children. I’m speaking specifically about men who, for whatever reason, don’t believe that the woman they are partnered with is competent to birth her/their child. Now, don’t get me wrong – I don’t think there are very many men out there that would flat out say, “Honey, I just don’t believe you are a competent birther.” Clearly, the message is more subtle – things like, “Oh, but the pain – I don’t think you can handle the pain, remember when you stubbed your toe last week?” or “What if something goes wrong?” or “If it were me, I’d get the epidural.” Well, you know what? IT ISN’T YOU. I totally get that most men, just like most women are overwhelmed by the ‘birth is scary and painful and dangerous (and not much else)‘ message our culture rams down our throats. But almost nothing makes me more angry than a woman who has overcome this cultural hurdle, who wants to make a normal birth a reality for her family, only to be pushed back by her unsupportive spouse.

Let me confess: Right this minute I have a friend who was born at home herself, who had always planned to homebirth, who is currently pregnant and will deliver in a hospital because her husband isn’t comfortable with non-medical birth. Thank the Universe he at least consented to having a doula present (truth be told: she asked me to doula & I declined because of this very issue – which probably makes me a bad person). This type of thing, and I’ve heard it more than once, makes me so sad. It makes me mad at him for being so controlling & selfish, and mad at her for not demanding to birth the way she wants, the way she believes is best. IT IS HER BIRTH, for Pete’s sake (p.s. I never use phrases like ‘for Pete’s Sake’ – I’m much more of an explicative using girl, more on this later, I’m sure). What kind of precedent does this set for the parenting dynamic? I have a guess, and it isn’t pretty.

I know I’m not supposed to feel, much less say, these things. I’m supposed to be all, “Whatever works for them!” It’s just that I can’t help but feel that kind of attitude is part of what perpetuates the interventive, medicalized birth model. Call me crazy, but I just don’t think a fearful father should get the power of veto when it comes to birth choices.

Just like you are never, under any circumstances (unless you are a health professional in the employ of the client), allowed to tell a pregnant woman that she looks anything other than perfectly perfect for her gestational stage, a father should support his partner’s choice to birth however she feels is best for her and her baby. Can he voice concern? Absolutely. Can he ask for more information/education. Of course. Should he talk to and get support from other fathers whose partners are making similar choices? By all means. Can he just say no to his partner’s desires for a normal birth? Nope. Not his call.

To all the many fathers who support their partner’s quest for a normal birth: a Big and Happy Father’s Day! To one father in particular, one who looked at his wife minutes after the normal-ish birth of their daughter and said, with eyes completely full of wonder and respect, “The world is a different place now,” and “You are so amazing,” and “I thought she’d be the size of an avacado, but she’s totally the size of a watermelon,” the one who rubbed my legs for hours (and I mean HOURS) without stopping and caught our son in his bare hands, who counts our homebirth at the top of his list of the best things that ever happened to him: You really are the best father on the planet & our family is so lucky to have you.

Wedding Analogy

I woke up the other morning thinking about an experience I had last summer.  I was following a mommy blogger who was preparing to have her first baby.  She was talking about her 36-37 week prenatal visit.  She was hoping that the baby would stay breech so that she could schedule a c-section and be done with it.  Her whole post mad me feel sad.

She had started blogging, as many women do, around her wedding.  She had countless posts with paragraph after paragraph about the intricate details of which flower for which bridal party member and why.  She talked for hours about the flavors of the cakes.  And let’s not forget the wedding dress – that needed the be exactly what she wanted.  It had to be perfect.

To be fair this mom was an event planner.  This was what she did for a living.  She took one day and turned it into something really special for her clients.  She said that a marriage should start out on a perfect note, that it set the stage for the marriage.

So when I heard her talking about how birth was only a day and that it didn’t really matter, I knew she was wrong.  And more than that, her own statements about marriage, when applied to her thoughts about birth were incongruent.  How could she say that how you gave birth didn’t matter?  That it didn’t deserve the same amount of planning that her wedding did.  All she wanted to do was to get it over with…

My heart broke for her.  She is certainly entitled to her opinion and I said nothing to her.  But what I wanted to say was that you could get an amazing sense of empowerment through birth.  That giving birth to your baby was every bit as important and empowering as stepping into the limelight in a beautiful dress as you walked down the aisle towards your husband-to-be. And please note, I’m not saying that you can only achieve this through one type of birth, because that’s not what I believe.

So, if in her world, a marriage that was not carefully planned could start your marriage out on the wrong foot – why couldn’t a birth that wasn’t prepared for also cause similar issues?

In the end her baby turned, much to her dismay.  She decided to “try” a vaginal birth via scheduled induction.  She had an early epidural and what sounds like (via Twitter) a violent instrumental delivery.  She had a really rough recovery and gave up breastfeeding early so that she could rest and heal.  She intends to breastfeed her next baby after her scheduled c-section with baby number two.  I can’t help but thinking if a bit of planning for her birth, like a childbirth class might have helped her a bit.  I think it would have helped her achieve her breastfeeding goals at the least. Her birth certainly impacted her beginning into parenting.

So what I had wanted to say to her before her baby was born, but never posted, was that just because you elope and don’t plan for your wedding, doesn’t mean that your marriage is doomed.  It means you missed out on a beautiful experience, the support, the thrill of planning and the joy of walking down the aisle…

VBAC from a Care Provider’s Perspective

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What is it really like to be a hospital care provider attending VBACs? Janelle from Birth Sense describes it in this post submitted to the ICAN VBAC Blog Carnival.

The whole post provides a very rational, no nonsense description of the actual problems that care providers face without an emotional “WE’RE ALL GOING TO BE SUED AND EVERYONE IS GOING TO DIE AND YOU JUST DON’T UNDERSTAND RISK!” She calls upon providers of modern obstetrics to “speak up on behalf of women who want VBAC and insist that realistic, evidence-based guidelines are instituted.”

Furthermore, Janelle points out something that would probably shock the public about hospitals. The “special” mandate that an OB remain in the hospital during the entire VBAC labor with an operating team standing by is hypocritical. If hospitals are so serious about having a team ready to handle VBAC-related emergencies, why would they not want to have the same safety net available to deal with comparable emergency scenarios in “low-risk” women? When I gave birth in a hospital for the first time, I mistakenly assumed that there was an OB and an operating team on hand for those rare emergencies. Why else would I have been in a hospital?

What is most perplexing to me is the mandate that the provider remain in the hospital during a VBAC labor “just in case”, yet other serious causes of perinatal morbidity and mortality are not considered adequate reason to have a surgeon and operating team standing by.  Some examples are:

1. Cord prolapse, with an incidence of 0.14-0.62 percent.  This can cause permanent fetal injury or death.¹
2. Placental abruption, with an incidence of 0.6 percent.  Again, this complication of labor can cause permanent fetal injury or death, as well as potentially life-threatening blood loss for the mother.²
3. Placenta accreta, and its variations (placenta increta and placenta percreta).  With a reported incidence of as many as 1 in 533 births, this is a serious maternal complication which can cause death.³

If we are serious about being able to take immediate action in the event of uterine rupture (approximately 0.5% incidence in low-risk labors VBAC labors), we should be equally serious about being prepared to immediately manage other perinatal emergencies.   The truth is, VBAC is not much riskier than a normal first birth, provided a few criteria are met:

• One low transverse uterine scar
• Normal onset of labor, no cervical ripening or induction
• No use of pitocin augmentation during labor
• Prior vaginal delivery increases chances of successful VBAC
• At least 18 months since cesarean birth

The risk associated with VBAC that concerns hospitals, insurance companies and care providers isn’t just the potential risk to women and babies. They are naturally concerned about the risk to their financial bottom line associated with a potentially predictable obstetric emergency.

The next time you hear anyone try to tell you that patients or laypeople just don’t understand risk, the question should be “The risk to whom?” I would argue that, given accurate information and percentages, most patients understand risk just fine. When you read between the lines, it’s clear that patients are expected to believe that the risk that lies behind scare tactics and lies about necessity of many cesareans and inductions is based on a certain risk to them or their baby. Unfortunately, it often has little or nothing to do with risk to the patient and everything risk to the care provider or institution.

And that’s the risk that most patients do not understand about how decisions are made about their bodies until it’s too late.

Angie’s List Induction-Turned-Cesarean Commercial

Screen cap of laboring woman being rushed to surgery

Transcript of an actual Angie’s List review:

At my 41 week appointment, my OB decided to induce me, but I guess I took longer than he expected because just as I went into hard labor, he told me he was leaving for an important meeting. On his way out, he said goodbye, dressed in his tennis clothes. One hour later, I was getting a c-section… while he was out practicing his serve.

Restriction of Food and Drink in Labor from a Medical Anthropologist’s Perspective

The recent Cochrane review, Restricting oral fluid and food intake during labour, analyzed five studies and concluded that women should be free to eat and drink in labor at will.

Since the evidence shows no benefits or harms, there is no justification for the restriction of fluids and food in labour for women at low risk of complications. No studies looked specifically at women at increased risk of complications, hence there is no evidence to support restrictions in this group of women.

The rationale behind denying laboring women food is that the danger of aspiration and the potentially lethal complication known as Mendelsohn’s syndrome while under general anesthesia is greatly reduced.

Medical anthropologist Robbie Davis-Floyd wrote extensively about the cultural myths about non per os and childbirth in the 1992 book, Birth as an American Rite of Passage. Mendelsohn’s original 1946 article reported several cases of aspiration and subsequent pneumonia, but no deaths. Davis-Floyd cites Baggish’s 1974 study which showed that at most 2 percent of maternal deaths were caused by aspiration under general anesthesia and Scott’s 1978 work that placed the risk of death at 1 in 200,000 women.

So what purpose would denying food and drink to all laboring women serve more than six decades after Mendelsohn’s work and with the great improvements made to regional anesthesia? Davis-Floyd wrote:

According to Feeley-Harnik, “persons undergoing rites of passage are usually prohibited from eating those highly valued foods that would identify them as full members of society” (1981:4). In rites of pregnancy and birth across cultures, food tabus serve the purpose of marking and intensifying the liminal status of the pregnant woman. The pseudo-foods (ice chips and lollipops have no nutritional value) allowed in the hospital are often fed to the laboring woman by her partner as if she herself were the baby, a symbolic process that can heighten her own sense of weakness and dependence.

In a recent article in Birth, Broach and Newton (1988) address the question of why laboring women are still prohibited from eating and drinking in labor in spite of mounting evidence that such prohibitions are medically contraindicated. Pointing out that this custom started in the 1940’s when general anesthesia was widely used for childbirth and the danger from aspiration was therefore higher, they posit that its continuance is the result of “culture lag”—that is, of “culturally patterned behavior that continues to be practiced long after the reasons for doing so have disappeared” (1988:84).

Davis-Floyd views denying food in labor as indicative of the confirmation of a woman’s initiate status as a dependent of the institution.

On the contrary, I would suggest that this custom forms an integral part of the technocratic tapestry of birth in the United States, continuing as routine procedure not because of culture lag but because it serves so well to legitimate and further necessitate the technocratic interventions we investigate here as transformative rituals. To deny a laboring woman access to her own choice of food and drink in the hospital is to confirm her initiatory status and consequent loss of autonomy, to increase the chances that she will require interventions, and to tell her that only the institution can provide the nourishment she needs—a message that is most forcefully conveyed through the “IV.”

Restriction of food and liquids in labor was the subject of many discussions last year following the American Congress of Obstetricians and Gynecologists’ press release that women should be allowed “modest amounts” of water and clear liquids in labor, with physicians defending IV use and telling women to calm down their rhetoric and fight for things that matter.

Cesarean Recovery

With the number of cesarean sections increasing in our country annually, many women do not really understand or know that recovering from a cesarean section is much different from a vaginal delivery. After my first cesarean section I learned this the hard way and wish I had a couple tips on making recovery more bearable.  But we often forget that the recovery after a cesarean birth is not just physical, but it is also emotional for a large portion of cesarean section mothers.

The different types of healing to be considered are in the hospital, long term, when you return home with your new baby, and also things you should be aware of such as when to call your health care provider post cesarean. (I also want to thank ICAN and their Recovering from a Cesarean White Paper in aiding to my post today)

While in the hospital :

• Get as much help as you can from family members, your partner, nurses, and other hospital staff. That is what they are there for and during the hours, and days immediately after your surgery, you will need it even if you do not want it.
• Stay hydrated and eat. You may not want to eat, but working on eating a well balanced and healthy diet, as well as staying hydrated (stay away from sugary drinks such as fruit juice and soda) will help to make you start to feel semi human again.
• If private rooms are available opt for one so someone (family member or friend) can stay with you to help you during this time.
• Use a pillow between your legs, and/or on your side to help sleep to be more comfortable. In the days, and even weeks following your cesarean it will not be easy to get comfortable. This is completely normal.  It took me almost a full 2 months to even get comfortable in my own bed at home after my second c-section.
• Take pain medication that is being offered if you are in pain. With my first child, I was breastfeeding and was overly concerned about any of the medications being transfused though my milk so I opted for over the counter pain medication such as motrin instead. But it certainly made my recovery longer, and made taking care of my son harder. (As ICAN recommends, ask your provider about a stool softener, as narcotic pain medication can cause constipation.)
• Get up and walk around.  It may hurt like hell, but it will help to get you back on your feet sooner rather than later. The longer you wait, the more painful it will get up, and the harder it will be.
• The use of a pillow to protect your stomach while coughing, standing up, nursing or moving around in bed is a smart idea.
• Do not hesitate to ask for a lactation consultant in the hospital. Breastfeeding after a cesarean section is more difficult not just for mom because of her incision, but also for baby. Check out the ICAN white paper on Breastfeeding After a Cesarean.

The first couple days in the hospital may feel like you are dying, I know because I have been there, but in most cases, you will only get better. When you get home, there are some more great tips for healing, although your housework may suffer for the first couple weeks, I am sure no one will mind too much.

When you get home :

• Focus on yourself, and your baby. You just had major surgery and your baby needs you.
• Have your partner help/do the household chores. Laundry, dishes, cooking, or anything else that needs to be done. Don’t worry, you can put off the dusting, cleaning the bathroom, mopping, and all the big chores for a couple weeks, your house won’t be mad at you!
• Do not lift anything that is heavier than your baby for at least 4-6 weeks. Those infant carriers/carseats are tempting to pick up, especially when going to an appointment for you or your baby, but stay away from it. You do not want to hurt yourself, or have an extended recovery.
• Ask others for help. If you have older children it may be helpful for your partner to take some time off from work, or have an available family member come over to help you. During the first weeks after my second cesarean section my toddler not only got the flu, but I was the only person he wanted making it difficult on me because I could not pick him up.
• Take it slow!  Get back into your normal household routine over a long period of time. You do not want to over do it because you will certainly pay for it later on.
• Have access to baby stuff such as diapers, bottles, burp cloths, wipes, or whatever you and your baby need for a couple hours in several places around the house. If your bed is the only place you are comfortable, make sure you can set yourself up to be able to hang out with baby, change diapers, and everything else you need right there.
• Co-Sleep!  Room in with your baby, so when it comes time for midnight feedings, you do not need to get up or go far to take care of your little one.
• If you have school age children, have others help to prepare their lunches, lay out clothes for the next day and anything else that needs to be done. To spend quality time, sit on the couch, or someplace comfortable and assist them with their home work, or read a book. Find ways to spend time other than anything that may put a physical strain on you.
• Considering hiring a post partum doula. They can really be heaven sent in a post cesarean situation!
• Don’t push yourself. If you want to take a shower and get dressed for the day, make that your only goal for the day.
• Pajamas are your best friend. They are comfortable, and help to remind others you are still recovering from major surgery.
• Remember how important it is to continue to remain well hydrated, and eating healthy.

Many do not think of the long term or emotional recovery of a cesarean section. I personally did not even encounter the emotional recovery until my cesarean baby was 3 months old. Be gentle on yourself, you aren’t the first to go through this, but many people around you may treat your feelings like nothing because cesarean sections have become so common. I can’t tell you how the phrase “a healthy baby is all that matters” feels to me still today.  Do not let others discount your feelings on your experience.

For your long term recovery…

• Contact your local ICAN (International Cesarean Awareness Network) chapter. These are women who have been there, and done that and know how you feel and what you are going through. They are an excellent support system internationally and are such a huge blessing for many mothers. I know they were to me!
• Write out a birth story, express your feelings on paper, or on a blog, get it out. Keeping your feelings inside may be harder in the long run.
• Keep your baby as close to you as possible for as long as you can.

If you experience any of the following symtoms or problems, you should contact your care provider immediately.

• Any type of bleeding from your incision.
• Leaking, redness, or any type of fluids coming from your incision.
• If your pain does not decrease over time.
• Symptoms of post partum depression such as anxiety, fear, problems sleeping, depression, or anything else you may equate with something more than just the baby blues.
• Cramping or pain in your arms or legs that will not go away.
• Continuous headaches, migraines, or backaches.

Over all, be gentle on yourself.
You just went through major surgery!

Loyally Devoted to Doctor

I recently read the book The Highly Sensitive Person by Elaine N Aron, Ph.D. In the chapter called Medics, Medication, and Highly Sensitive People, the author states:

“Keep in mind, too, that it is common to feel an attachment to anyone you have been with during an arousing experience, especially if it was a truly painful or emotionally significant ordeal. In the medical realm you hear these sorts of extra feelings when people describe their surgeon or women talk about the person who delivered their child, which is perfectly normal. The solution is simply to know why it happens and compensate for it appropriately.”

In the chapter about relationships, she talks about studies that were done that showed people are far more likely to fall in love under stressful circumstances. She applied this phenomenon to attachment in all relationships, not just romantic relationships. Later when I read the above statement in the medical chapter, so many things started to make sense to me.

Why do women love their maternity care provider, even when they may have done unnecessary procedures on them and not allowed them to make their own choices? Why do many providers use scare tactics? Why do women hold so adamantly to the belief that their provider “saved their life” or “saved their baby” or “was a great doctor” or “really took good care of me”, even when evidence to the contrary is right in front of them? Why do they fail to make important connections, such as that their c-section may have been one of the many unnecessary ones, or that there may not have been a true evidence based need for their induction? Why is childbirth treated like a major emergency with so much fear and anxiety around it? Why aren’t all women who give birth in this system severely traumatized from it, and instead defend and adore their doctors? The answer is simple: the culture of fear that surrounds childbirth actually endears women to their doctors. It cements the relationship between women, their doctors, and the hospitals their doctors practice at. It ensures that the women will keep coming back, and will recommend their providers to all their friends as they speak about them in glowing heroic terms. It is quite brilliant really, providers and hospitals have found the key to running a very successful business, and it has nothing to do with allowing women to make their own choices. They simply have to give the illusion prenatally that the woman can make her own choices for her birth, and then make sure that the actual experience of birth is one filled with fear, anxiety, and of course a healthy baby, and then the narcissistic provider will come out looking like roses to the woman who must endure the “horrors of childbirth”.

Of course, I am not really giving the doctors the benefit of the doubt here. They likely don’t know on a conscious level what they are really doing. They have been trained to act this way, by people who were also trained to act this way, and it is reinforced for them every time a woman profusely thanks her doctor for a job well done, and every time a woman tells her birth horror story where the good doctor makes an appearance as the hero who delivers her baby to her despite all the dangers that presented at the last minute. Both the woman and the doctor seem ignorant of the psychological effects that framing every average birth as a medical emergency creates.

In the statement above, the author states: “it is common to feel an attachment to anyone you have been with during an arousing experience, especially if it was a truly painful or emotionally significant ordeal.” This describes childbirth perfectly. The word “arousing” here is referring to sensory levels. That can mean physically, emotionally, sexually, or any other assault to the senses, good or bad, that can be had. We know childbirth can be described as “arousing” in many ways. It is also inherently “painful” and “emotionally significant”. Even when women use drugs, there is still some level of pain before she took them, and depending on what type of drugs she took, she may still experience pain while she is taking them. So really, all births fit this criteria. Births in a hospital, or at home, or in a birth center all have these same basic elements. It seems women are wired to form an attachment to the people who were with her and helped her through the event. This could be her partner, her doula, her midwife, her doctor, her nurse, or her friend or relative. I think this type of attachment likely had an evolutionary purpose at one time. It would be ideal to attach to an older, wiser woman who assisted with the delivery of babies who would have been there to care for the mom postpartum, and to slowly help her to bond and form an attachment to the baby. This wise woman would then help the mother learn to breastfeed and care for her new infant, while slowly pulling back her own attentions from the situation. This is what we have in homebirth midwives today. How would our ancestors have fared if a man had shown up in the tribe to deliver a baby, and then disappeared immediately afterward? The woman would be left adoring him, yet not having help from him to form an attachment to her infant. Never learning how to breastfeed or other infant care skills. What would have become of humanity? What is becoming of humanity?

Midwives and doulas seem to understand this phenomenon. Doulas usually visit a woman once or twice postpartum and are available if she needs to talk or has questions about the baby, breastfeeding, or the birth. Midwives start seeing a woman more and more as the birth approaches, and then once the baby is born, they start to taper off again, seeing her less and less until she is no longer needed at all. This is a much more natural and appropriate response to caring for a woman during such a pivotal transition in her life. What happens when women see doctors or CNM’s in hospitals though? They are likely seeing a practice, not a specific provider. They will likely not give birth with the same doctor or CNM they saw prenatally. They may never see the same doctor or CNM again after they give birth, or perhaps just once at the six week checkup. How does this affect women emotionally, or in her relationship with her baby, when instead of having a slow winding away from her provider, there is just an abrupt ending to the relationship? Does this interfere with breastfeeding, or affect feelings of trauma related to the birth, or feelings of depression related to her new role as mother? It is ingrained in our psyche to attach to these people who help us through such a major event in our life. How will the people we choose handle this responsibility? Are we choosing someone who will corrupt our experience and force an unnatural attachment to them by creating more anxiety around the experience? Are we choosing someone who will be there for us days, weeks, and months later to answer our questions about the baby or to offer us emotional support? Will the person we choose even be available for the birth, and will we ever see them again afterward?

Now I realize why other women feel the way they do about their provider. I did not attach to my provider, I was instead extremely traumatized by her actions. I still wonder why some women are traumatized, and others fall in love with their providers, given the same set of circumstances. I wonder if it is actually more natural, and thus common, to attach to a provider even when (or perhaps especially when) that provider creates an atmosphere of fear. It makes sense then why so few of us are speaking up about the system and the way women are treated. It makes sense that women are extremely loyal to their providers, even when many aspects of their births were disappointing or upsetting to them. It makes sense that many women are reluctant to accept that there is anything wrong with maternity care. It makes sense why the maternity care system is so hard to change and is met with so much resistance from every side.

What can birth activists do to help women form healthy attachments during this transitional time in her life? It may be tempting to try to convince all women to have a homebirth with a midwife since we know that they are probably the best option for healthy attachments and a healthy weaning away as well, however, if a woman has already formed a strong attachment to a certain provider, it may be more realistic to recommend having a doula. A doula will be there prenatally, for the birth, and postpartum, and therefore can provide much of the physical and emotional support that new moms need and deserve. Some moms may hire a doula, yet keep her same provider that she has formed an attachment to, and others may find that a doula is a stepping stone to having a homebirth the next time. One day I hope that maternity care shifts to being centered around the mother again, and not around the provider and his schedule or routine.

Why Our Women are Afraid of Birth

Deliver Me

It is Tuesday, at 10pm while I settle in after getting my little ones to bed. I flip through the channels and settle on discovery healthy which is a personal favorite of mine, but it really has only recently become a favorite because of shows like I didn’t know I was pregnant. It fascinates me that women could make it though a full term pregnancy and not know they were pregnant, but that is just me, and the experiences that I had with my children is what makes me wonder how the heck women could not know they were pregnant.  But that is completely besides my point today.
So as I watch this show, I am noticing a trend. High risk, high risk, high risk, previous cesarean section, scheduled cesarean section, high risk, healthy first time mother, scheduled cesarean, high risk. Well I mean, that is how it is in Los Angeles right?  You would think so!  But apparently because only these crazy, scary, uncommon births make something called ratings, that is all they are going to feature on TV. Because in reality, no one wants to watch a natural birth or a home birth because no one is running around with a scalpel screaming about the emergency that childbirth is. Nor is the mother screaming for her epidural because she just cant deal with the pain of the 3 hours of labor so far.
But what we should be thinking about most importantly is the message this is sending. What is this teaching first time mothers or even young women that may not be planning on having children soon but will some day?  It is teaching them how scary, dangerous, and medical birth is supposed to be. But is that really how birth is? Of course not. Anyone who has taken the time to read the studies, and just not follow what mainstream society thinks is the right way to handle pregnancy will know that birth is not scary or dangerous or a huge emergency. While it can be in some cases, in most cases it can and will be beautiful when just left alone.

When a woman becomes pregnant today, if they do not already have an Obstetrician they have been seeing for well women care since 16, or whatever age their parent decided it was the right them for them, what is the first thing that they do? They ask around their circle of female friends for the best Doctor out there because isn’t that what we all want? We want the one who is the BMW of pre natal care. Little do women know that they are really going to end up with the 1990 Dodge Dynasty when they take this route because hands off is better.
But because our society has told us this is the way things should be, they run off like lemmings right off the cliff of medical interventions landing in the valley of cesarean sections.

Maybe if the television channels like Discovery health followed a dozen home births or even aired The Business of Being Born they could get a popular, and controversial other side to what they are constantly airing. Maybe it will boost their ratings even more, maybe not?  But what it will do is give the other side of the whole issue. Let’s get Marsden Wagner to do a half hour special on Birth in The United States and see how many women run off to the midwives.  Instead they air these disgustingly inaccurate “Freebirthing” shows. They find the one idiot who is going to make women who choose unassisted birth look like a bunch of uneducated yokels.  Which is exactly what they did with their special on Unassisted birth.

I guess in the end, like anything else the television airs, it is biased and we shouldn’t expect much different.

Healthy Baby Bounty Bag

Photo (c) Lansinoh

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