Guest post: Pregnancy, childbirth and parenting gave me an education in feminism

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One of the best things about running this blog is the delight of witnessing women and men discover that they are great writers while engaging with each other in the comments section. Here is a fabulous example, written by thepragmatist in response to my post Natural childbirth, attachment parenting, and policing women’s bodies.

I told my husband that he would be a feminist by the time I was done having our child. He didn’t believe me. I thought I would educate him on the politics of birth… You know, the evils of over-medicalized pregnancy and obstetric interference. Oh boy, it was not him who was going to get the education. No.

What I didn’t know was that I would not be prepared for the loss of agency over my body: that my body would become public property and that I would also feel such despair and horror at the loss. I never realized when I walked into a midwife’s office to plan a home birth (and went home with Birthing From Within that day in my bag to read) that I would end up choosing a MRCS months later, because I realized it was right for me and safe for my baby. That I would meet a female OB/GYN who had utmost respect– more than anyone else– for my agency as a woman, changed my mind about obstetrics forever, and would become a fundamental part of my healing from other trauma. So much for the sexist OB/GYN disabusing the woman of her right to empower herself! Indeed, it was the OB/GYN who was instrumental in helping me understand what it was I really wanted and then manifesting it with me… Certainly not the midwife who told me “not to think about tearing because we have ways to prevent it” or the other midwife, who when I was having strong, regular contractions right before my c-section, told me, smugly, “Well, you can’t always have the birth you want” and refused to attend me and told me to go back to bed. No, midwifery didn’t empower me, science did. Science and reason. Control over my body. A physician with the real power to make that happen.

I learned, on encountering the world of lactivism and attachment parenting that I had assumed would be a good fit for me, as I imagined both feminist, that I was not good enough, not mom enough, not enough, no matter what I did. And that my experience as a woman engaged in the act of mothering was irrelevant to the discussion. I learned that NCB and AP were not only prescriptive but also fundamentally ablest. The final breaking point was when I — disabled by a number of issues — fought my way through many challenges only to be ridiculed for my parenting choices, again and again, some very hard to make. I realized I did not matter as a human being anymore in that context. And that the worse enforcers of this dogma were women themselves. They continue to be. At times derided for such things as “long science-fueled posts” or “normalizing c-sections” and my posts deleted if I dared tried to publicly support a woman in learning to appropriately supplement with formula or enjoy the birth of a child through c-section, for example. Asked to leave our community board for continuing posting “facts” when others would post inflammatory articles like, “Just Say No to Pitocin” and I would go, “Uh, yeah, but wait…” At one point I had 40 grown women devote a thread to informing me that I had completely ruined their forum, when I refused to leave it out of principle, having broken no rules. Later, those women went on to make a different forum where they screen people very carefully for access with intrusive questions to make sure they are sufficiently NCB/AP and topics such as combo feeding or sleep training are off the table, at all times. Sounds feminist to me… Worse yet is knowing that because they pass themselves off as feminist and evidence-based they lure in unsuspecting mothers-to-be who they then fill with misinformation about birth and parenting. Then later, my OB/GYN gets to deal with these women when they show up from home birth a train wreck and be demonized in the process. Avoided interventions but come out of it with perhaps an unnecessary c-section or a needlessly traumatic birth. But who needs to make good sound decisions based on at least a basic understanding of your own physiology, birth, and the interventions involved, and their risks and benefits, when you could sit in an echo chamber all day and blame obstetric intervention and read the same five books to each other?

Indeed, it was MY feminism most altered in its trajectory as I made controversial or unaccepted choices with my body and my baby, meeting my own and my child’s needs, being shamed and derided through out, realizing more and more I had been lied to, that the data was skewed, and that the story was rife with inconsistent, contradictory values, unrealistic (at times, inhumane) expectations and glaring misogyny. Religion, not science. Not safer. Not best practice. Lies. Nefarious too, because the major enforcers of NCB/AP in our community know that they are lies, and have confessed to me in private they know they are lies. Then I fully appreciated the anti-intellectualism but also how corrupt and anti-woman it really was. It wasn’t that my facts were incorrect, but that they were not in line with NCB/AP dominant paradigm. My facts were indeed, not the issue, they were perfectly true: they just did not want them shared.

I was naive, to be honest. I had not ever experienced women en masse, of my own age, in such an environment. Member of many topical message boards over the years, where evidence and argument were critical to discussion, this was so foreign to me that I could not understand it. Why would you not want to know what was going on in your body or how to improve your own medical care? And how could these, the birth duolas and educators, shut me down so completely, when they knew I was correct? Cynically, my husband pointed out I was embarrassing them in front of their client base. “But it’s still a lie!” I would shout. He was right. Correcting the “birth educators” on their misinformation was embarrassing for them, so they demonized me.

My husband did, indeed, become a feminist. He is proud to call himself a feminist. he became a feminist not because I educated him about Spiritual Midwifery. He walked with me through making enormous strides as a woman. From my MRCS came the first time in my life I felt power over my own body, as a sexual abuse survivor, and from there, so much more power came. In the moment that I said no to a vaginal birth and someone actually said, OK! I took new control over my body, my sexuality, my needs as a woman. A pivotal moment in my life. And I am told that I was powerless there. Oh no, not at all. Far from powerless. From there the seeds grew to face ALL the misogyny in my life around me and I stopped accepting anti-feminism from other people. I began to see that other women are the real enforcers in a way I never realized. Or wanted to realize. From there-in everything shifted. When my son was just about a year old, I walked into a police station and filed a report against a charismatic and popular serial sexual predator, thereby stopping him from hurting anyone else again, but risking the same social shunning. Yet I am not good enough for these women, because I fed my baby formula sometimes? I am not powerful? I am ten times braver, indeed. Women who are empowered do not need to empower themselves through their reproductive function or prove their worth through mothering. I learned that bit here.

It has redefined me. But it also makes me feel like a lone wolf, because I have been ostracized for my choices: from decrying the current parenting paradigm; for actually wanting to talk about the needs of mothers as human beings and not objects; and of course, worse of all, to suggest that women have the right to do what they need to do with their own bodies and have access to accurate information so they know what choices may be right for them. It has resulted in the kind of shaming and shunning usually reserved for promiscuous women or victims of sexual assault. Having also been that woman more than once, it feels the same to me. But never have I been so shamed as when I stood up for mother’s rights! Something you think would be fairly non-controversial, given how much those in the NCB movement promise women such rights in childbirth (and do not deliver), but those rights apparently end there. Because once baby is born, mother has no needs. Huge realization there that I was not actually with feminists. I’m not talking about mothers who “need” to neglect their children, but rather, that it is okay to take into account your own feelings and needs: indeed, it is critical. And indeed, it is the very same kind of shaming, and policing of women’s bodies: through shame and shunning the NCB and AP movement actively silent dissent and enforce prescriptive and gendered parenting roles. At one point, my husband got angry at the continual characterization as men as hapless idiots, incapable of nurturing. He is more of a nurturer, in spirit, than me.

It is really interesting how oppression of women is a continuum and central, always, is reproduction and the reproductive years. So it’s not shocking, really, when a nearby crisis pregnancy center puts on a NCB movie night to raise money to fight abortion and the feminists in the room can’t seem to put it together. Do they say hurrah or get angry? No, they say nothing at all. Eye opening! All around me women call themselves feminist and embrace this movement and they do not know what it is they are subscribing to. This week a film on Ina May is being screened at our local college. Facebook is abuzz. And I want to post, “Did you know she let her premature baby die for lack of medical care? Do you know she doesn’t understand basic female anatomy? Do you know that she judges women’s ability to birth on their emotional state? Why is this feminist? Don’t call it feminist. Call it whatever else you like, but not that.”

I know it would just be deleted.

The disenfranchisement of women’s right to their own bodies is not what I envisioned. I totally bought it: that it was a movement to liberate women. And I think in my mother’s time, maybe it was. They fought for maternity leave, rights in the workplace for mothers, and legalized abortion. But our fight for reproductive freedom has been hijacked and, in a sense, truncated. Misinformation and out right deceit regarding pregnancy and birth is rampant. The real risks of birth rarely discussed. And although we have the right to decide to end a pregnancy, the right to effective pain relief in labour and maternally-requested c-section are tenuous in many Western countries where other feminist principles are often adopted and extolled. The cultural and ideological creep is no longer creeping here in Canada: it is a tsunami, and there is very little push back from my feminist peers. Piggy-backing on the work of a generation of feminists who fought for reproductive rights, inserting itself into discussion on autonomy when it is exactly the opposite, and so many following blindly and unaware of its greater implications.

  • Becca

    Fantastic piece! As a fellow Canadian, I agree this movement has become far too influential. I am tired of being told my body is built for birth when my body has behaved otherwise and without modern obstetrics I would be dead. My first baby died and even modern obstetrics couldn’t save her. Yet according to some I am supposed to ignore the realities and dangers associated with pregnancy and hypertension, Hashimoto’s thyroiditis, gestational diabetes, placental insufficiency, pre-eclampsia and a placenta accreta. Moreover, I have received the message that if I submit or an episiotomy or have an epidural when I deliver in a few weeks then I am allowing myself to be abused and “mutilated” by woman-hating, selfish and emotionally bereft physicians.

    I was actually told that by someone I believed to be a friend, and a feminist, and when it happened I was utterly stunned. The amount of hate and suspicion she harbours towards the medical community seems truly pathological.

    Apparently, I need to trust that my body was “built” to birth babies, and she judges that by the width of my hips. She also believes that natural is always better, and she feels bitter that she had to be induced with one of her children and had an episiotomy.

    And SHE DOES view childbirth as a performance art. This is what she said to me about my upcoming birth: “Don’t worry–you’re going to great!” I don’t care about doing great. I care about outcomes like alive and healthy. Don’t even get me started about her views on breast feeding but let’s just say she got angry at me for buying formula and bottles to have on hand, and she does not even believe in breast pumping. And you know what I can apparently to boost my milk supply? Drink some beer. Yeast helps lactation and so do some teas apparently. Beer and tea should overcome any lactation problems I have even if they’re related to my thyroid. And any other issues should be overcome with persistence and only lazy people give up.

  • I could have written several of these paragraphs that revolve around realizing that all of the NCB, lactivism and AP rhetoric didn’t really stand up to scrutiny. They are fine in and of themselves but the propaganda being produced to promote them as the only viable options is frustratingly lacking in basic reasoning. In the place of reason are ploys to engage in women’s guilt, shame, insecurity and other convenient emotional appeals – whatever gets ‘the message’ across. It’s shameful as well as very difficult to criticize when hard evidence gets p’shawed without consideration.

    Why can’t we have a vast community of mothers that embraces science, evidence and the miracles that medical technology can and does provide?

  • I can’t believe that I was reading this but I actually care about what my wife will be going through. what about natural
    labour pain reliefwhat do you think?

    • Karen in SC

      You didn’t specify what you meant by “natural” pain relief. I can share my experience with two unmedicated births.

      The first one I had triple peak contractions, a doula who was very good at positioning me so at least the mind-numbing pain only lasted about three hours, and a husband who provided counter pressure to my back where most of the pain was. The pain was so intense that I couldn’t speak. The pushing seemed impossible, I could talk then though and begged for the vacuum. I ended up getting an episiotomy. Baby was fine and I did appreciate that afterward I had nothing attached and nothing to get out of my system. The second birth went much better, but most second births do.

      Reading accounts of epidurals here and reading more details from The Adequate Mother’s blog – if I had known then what I know now, I may have made a different decision. It can make labor a calm and peaceful time and allow for controlled pushing.

      Good luck and welcome!

      • thepragmatist

        If natural pain relief works, then that’s great. Some women have easy
        labour and deliveries: it depends on so many variables, just like life.
        Some women have innately high tolerance for pain. Some women dislike
        needles or drugs and just do not want them. Some women might want to see
        what the pain is like before making choices. Others know that they just
        want pain relief and that is it.

        I don’t have any problem with
        women having unmedicated births, if that works for them. There’s reasons
        to do so and reasons not to do so. What I want to describe here is that
        it’s morally neutral. There is no shame in wanting or needing pain
        relief and there’s not any particular glory in suffering pain beyond
        your capacity to cope– in fact, it can be damaging. So I think it’s
        important to be able to assess your own (or your wife’s pain) without
        MORAL judgment. That’s what I’m talking about here. If your wife
        believes that there is a right way to give birth (NCB drives this
        message), and the information is at best extremely biased and at worse,
        downright misinformation, then what? She may set herself up to not be
        able to accurately assess her pain. She may feel that analgesia will
        hurt the baby and feel pitted against the baby. I have friends tell me
        that during delivery, they wished their child to die in order for the
        pain to stop. And other tell me it was like being in a car accident.
        This is no small pain and this is in a supportive environment with lots
        of duolas, midwives, and good OB/GYNs. The reality is: birth is painful
        and how painful is really not entirely up to your wife. So my suggestion
        if you care about your wife is to help her discuss what she wants and
        needs practically. From a pragmatic point of view. Don’t buy into the
        moralizing of NCB. Remind your wife that her comfort and safety is of
        utmost importance to you and no matter happens in labour and delivery,
        you will be proud of her and support her. Don’t make birth some sort of
        sport or contest she must win: remind her that she is already winning
        and has nothing to prove to you or anyone.

        She should know that
        birth can be difficult and if it is, it’s not her fault, and it is okay
        to trust herself and her feelings related to pain. That there is no
        failure in feeling pain, and the pain of childbirth can be, and often
        is, very hard to deal with. If she feels comfortable with the degree of
        pain she’s experiencing, that’s okay then. If she doesn’t, get her pain
        relief and assure her that it is okay. Read up yourself on the various
        types of anesthesia so that when it comes you have a good idea of what
        is on the table and also what may be side effects: eg. IV narcotics may
        make her feel itchy and sick to her stomach vs. epidural that can cause a
        temporary drop in blood pressure that is usually quickly treated. If
        labour become difficult and lengthy, or scary, remind her that you are
        behind her 100% and that you support whatever she needs. If she feels
        like she need pain relief, remind her that it’s normal to need pain
        relief when things are painful. Remember that the worst outcome of birth
        is NOT a c-section or epidural: the worst outcome is a damaged mom or
        baby, or worse, a dead baby. You don’t ever have to say that (I
        wouldn’t) but it is important to keep it in mind. C-section is not the
        end of the world, and even under the best circumstances your wife has a
        10-20% chance of needing one. It is something to consider and plan for,
        as that is pretty high odds. Do you have a c-section plan? Have one. Be
        prepared for ALL eventualities. I would also look at science-based
        materials so you have a good idea of risks and benefits. I would steer
        clear of faith-based or ideological based materials (like you will find
        on popular NCB sites) and be wary of anyone who tries to scare you by
        expounding the dangers of interventions and who places the outcome of
        birth on a woman. Most things that happen in birth have nothing to do
        with anything a woman has control over. Most things that happen in
        birth, when things go wrong, are just bad luck.

        Stick around
        here and read. One thing I wish I had known long ago is that pain is
        morally neutral, and that suffering pain to prove my worth was a waste
        of time (and damaging psychologically). I’ve gone through enough pain in
        my life. I used to see it as a failure, somehow. I think this is pretty
        common. Even my good friend with cancer felt weak for needing pain
        relief, despite how very painful her cancer is. We see pain as a
        weakness but it’s not. It’s just a bodily function.

        If your wife
        is really committed to an unmedicated delivery, then of course it is
        her choice. You will know if she’s been indoctrinated into NCB if she
        tells you not to offer her pain relief and to actively deny her pain
        relief or if she starts saying things like, “Trust birth.” Encourage her
        not to trust birth, but focus instead on trusting herself. Respect
        birth for its power and its ability to harm if not tended to. No need to
        fear-monger or be overly concerned, just realistic. Never buy into the
        idea that she will ultimately control the outcome. That’s a huge lie we
        tell women and they eventually find themselves terrible disappointed.
        Instead, encourage her to stay open to whatever happens and remind her
        that she can trust her doctors, hospital, and support her to trust
        herself, not birth. Bodies are inherently fallible but our minds are
        strong. Remind her that no matter what happens, you are always proud of
        her and can’t wait to meet your baby. Focus on the baby and be positive!
        I hope this helped.

  • Lori

    Well said, I think too often we are all too ready to fight the good fight for those who agree with us/make the same choices as us, but don’t get up in arms when it comes to someone’s freedom of choice/bodily autonomy who is making different choices. I see this all the time when it comes to breastfeeding.

  • Something From Nothing

    Yes! Thank you for your words, I regard them as very brave and I love, love , love your post! I happen to have attended the screening of the Ina may film in my community. Lets just say there was a lot of uniformity in the room. There was a panel discussion afterwards that consisted of midwives, doulas and one nurse ( who does not work in labor and delivery). There was a woman there who lived on the farm for 10 years and had two babies there. There was absence of any mention of doctors ( unless you count the horrible propaganda videos from the 60’s and 70’s inserted here and there throughout the movie), or maternity nurse, etc… I listened with interest to a doula who advised the audience that she loves her job because she gets to watch women do “what they were created to do”. You can imagine how much I love that crap.

    I thought about many, many things I could add to the discussion. I thought about asking the woman on the panel who had lived on the farm if she was there when Ina May’s baby died. I thought about asking the doula “created by whom? ” or ” what about women who don’t want to have children, or who choose not to birth vaginally? What were they created to do?” The words “birth without fear” were thrown around a lot. There was much talk about empowerment. I thought about pointing out that there are women who, despite not being ‘afraid’ , despite being ‘ empowered’ and, yes, even despite being ‘ in awe of the amazing miracle of birth’, will not be able to birth vaginally no matter what they do. What about those women? How do we empower them? They do not exist in Ina may’s world, and if they do exist, they are certainly not worth talking about.

    What about women who think their value lies in more than their breasts and vagina? What about survivors of sexual abuse? What about women who’s mothers suffer incontinence and prolapse who feel they would like to try to avoid the same fate? Couldn’t we just go on and on? I thought about saying that Ina may empowers women who think like her and who make choices that she endorses. Otherwise, you don’t deserve a mention. That is NOT feminism in my book. It is misogyny enforced by women.

    So I thought of saying all of those things, but in the end, I was silent. I chose to be silent, because I looked around the room, and I knew that speaking my thoughts out loud would be like going to church and standing up after the sermon and asking people in the room if they realized that a lot of what they are told to believe is made up fairy tales, made up by men with a desire for power and control, and expecting people to slap their foreheads and say” gee, I never thought of it like that!” It would never, ever happen.

    I was silenced by the thought that my words would fall on deaf ears, and worse, that my words would get contorted and twisted, as so often happens with people who drink the kool-aid, and I would be discussed as the “obstetrician in the community who is anti vaginal birth”. I decided not to stick my neck out on that particular night. There is already some antagonism between physicians and midwives/doulas in this community, and for my own sanity, I do not care to widen the gap further. However, I was inspired to find my voice in other ways and to start to push back against the tsunami that is coming. Obstetricians can no longer sit on their hands while women blindly go forth and “take back birth”, whatever that expression even means.

    Thank you, pragmatist , for your post. And thank you, Dr. Tuteur, for all the hard work your do.

    • thepragmatist

      The characterization of it as a church is apt. Maybe Dr. Tuteur would let you write a review of the film here! Ha! I can’t believe you went!!!

  • sarah

    This post is THE SHIT. Thank you for writing this!!!!

  • PrincessDoc

    This is brilliant. In another setting this is just how I was treated.

  • Great post. Thank you for sharing your story.

  • Frequent Guest

    Thank you, thepragmatist, for writing this, and to Dr. Amy, for sharing!

  • fearlessformulafeeder

    This is beautiful. And scary. And brave. And NECESSARY READING for every self-proclaimed feminist. Thank you for giving The Pragmatist a safe home and platform, Dr. Amy (and for the record, Pragmatist, I’d be honored to have you hanging out over on FFF as well…;) )

    • thepragmatist

      Thanks so much, FFF. I do post over at your page sometimes, just under a different name. You helped me so very much when I was figuring out how to appropriately combination feed! 🙂 Also, I really appreciate the work you’ve done dismantling many of the myths of breastfeeding vs. formula feeding. You’re a reference I’ve sent many a friend to when breast-feeding doesn’t work out.

    • Rebecca

      “And brave.” Yes. That’s exactly the word I was searching for. As I read this post, I kept feeling like I wanted to hug its author, not in a sense of victory but in a sense of protectiveness and reassurance.

  • WhatPaleBlueDot

    BRILLIANT!

    The terrible reality is that the feminist movement became so divorced from birth and parenting (I refuse to use that m word) that the first voice to step up and say “OH I THINK I’M A FEMINIST AND THIS IS WHAT I SAY!” was listened to. And what spewed from that mouth is so vile and antifeminist that no one has the daring to admit they’ve got it completely assbackwards and that they were so fooled. The feminist movement is not divorced from the women who create the next generation any longer, and it most certainly cannot afford to be. We need to uncover this for the broader feminist culture, and we are behind the curve. Before women reach these milestones, they need to know about this insidious culture and what it wants to take from them while convincing them that the most feminist thing they can do is stay at home from birth until their children are grown. It’s not too late, but we have a lot of catching up to do.

  • DaisyGrrl

    Thank you for this post. While I am not a mother, my sister recently had her first child and I have found many of the issues in this blog to be intensely interesting as I watched her navigate pregnancy and childbirth (and now, motherhood). I consider myself a feminist, and have found the comments on this site to be insightful and informative. Like thepragmatist, I did not expect the dialogue surrounding NCB to be so intensely anti-woman in nature. The posts of the last few days, and especially this post, have given voice to the misgivings that have been percolating in my mind over the last few months.

    To me, feminism is about agency and ensuring that women are free to make decisions that work for themselves, their families, and their communities. In order for them to make these choices, women need access to accurate information that enables them rather than misinformation that takes away their ability to make an informed choice.

    I’m still learning about some of the misinformation that my sister got from her midwife and it makes me angry that she wasn’t given the chance to make decisions based on facts. It’s condescending in the extreme and is completely unacceptable. What really makes me angry is that we live in Canada, where the midwives are well educated and should know better.

    Thepragmatist, thank you also for reminding me also that regardless of the choices that my sister makes as a mother, it is my role to provide support and respect her decisions. Her choices are her choices and nobody else’s business as long as they work for her and her family.

  • Eddie

    I just wanted to chime in to say what an awesome post this was.

  • JenniferG

    Awesome post. Thank you.

  • Such a great post. a lot of it feels like what I’m going through in my recovery from sexual assault and gaining control over my own body. Having cerebral palsy and severe chronic pain, meaning my body usually isn’t ever under my control, throws a wrench into the gears.

  • Guest

    That’s supposed to read: I am a feminist (not liberated) because I choose…

  • Guest

    I find the sentiments and comments to be somewhat extreme. All of this “oppressive pressure” on mothers is largely self-imposed. The guilt to breast-fed and have a drug-less delivery is also self-imposed. I am liberated because I choose to nurse my babies and I choose to have elective c-section after my first delivery being an emergency section. I don’t feel guilty but I don’t feel liberated about it.

    • thepragmatist

      Ah, missing the point… I’m not talking about guilt. No, I am not guilty: I’m angry.

      I’m addressing the claim that NCB and AP is feminist, when indeed, its greatest proponents are fundamentally anti-feminist in deed and in word. Lying to women? Check. Misinforming women of the care they can expect? Check. Using the tactics of shame and shunning to apply social pressure to women who do not conform to the standard? Check. What makes you think my critique of this makes me less liberated than you? Indeed, my shock came when I realized that a movement I had believed feminist turned out to be anti-woman to the core and indeed, it was the OB/GYN who I was told to fear who presented the most feminist care I’ve ever received!

      When a woman asks a government paid-for midwife if she can access a MRCS and she is told they do not exist here, when that is far from the truth, how can she be “liberated” in her choices? The paternalism is rife. When a midwife who has nearly lost hospital privileges and couldn’t tell an obstructed labour to save her life continues to practice, promising she is a safe provider while not acknowledging that she has been sanctioned by her own College, when really she is actively continuing to lie to women and they pay with their bodies, how is that feminist? When the government scales back and cannot recruit physicians to deliver babies, and instead encourages women to home birth, is that feminist? And when women can’t speak up about their own experiences without having their comments and experiences deleted, how is that feminist? I am not oppressed but rather have been liberated and freed through rejecting the movement, and the women who enforce it. Meanwhile, it’s dominating public health policy where I live. In some well-resourced, Western countries, epidurals are not accessible (the Netherdlands), and MRCS are not permitted, or if permitted require the same kind of paternalistic oversight that was once applied to abortion (the UK). So, it’s great that you can make those choices, but others can’t. What if you were pressured to have a TOLAC against your will? We have a woman who posted here who could not have access an MRCS for which she had very sound reasons: but indeed, was lied to, and ended up delivering without sufficient pain medication. So if we are liberated, indeed, then where are the choices? Emancipation in word alone means nothing. Meanwhile, proponents of NCB dismiss any critique as anti-woman and skew scientific data so that even those who wish to be informed must wade through the information until they get the source data, take a crash course in statistics, and learn to interpret the research themselves.

      Indeed, there are choices. You are correct. But we are at a crossroads. Do we educate women honestly, or continue to ignore and minimize the risk of vaginal delivery and promote care that is substandard? Do we push back against the patent lies promoted in a massive public relations campaign that promotes the midwifery standard of care while demonizing medicine and science? Is women’s health somehow outside all other health issues, where agency and informed consent are otherwise paramount?

      • anonomom_LLLL_IBCLC

        I do find it distressing that so many people, me included, feel the need to be anonymous when visiting this site and in criticizing the NCB movement. It just goes to show how there is such an anti-debate, anti-scrutiny atmosphere. I was recently at a lactation conference, and I suggested in an anonymous venue that next year we should discuss the prevalence of non-evidence based treatments like craniosacral therapy. I expected the suggestion to be booed or greeted with stony silence, given how no one seems to question it openly. Instead many people voted for it as a good topic. It’s so very regressive.

        • KarenJJ

          The need for anonymity is definitely regressive, but I like that there are likely others that are wanting to improve the maternity care they provide are might be questioning some of the things they recommend.

          • thepragmatist

            The need for anonymity is telling, no? I am not understating the pressure here… for me, it is to protect my family in a small community from further bullying. If suggesting things like the better treatment of new mothers and that technology is, at face, neutral, is so revolutionary as to get me bullied and threatened, I can’t imagine how this would be received. And the hit list that someone in the NCB community developed to “out” posters here and at Fed Up is so intrusive and threatening to someone like me… I fight enough battles, and I really don’t need more. So for now, I will contribute here. Maybe I will start my own blog. I don’t know. But anonymity is requisite on many levels for me as it is for many others posting here. When I started posting here I was afraid to even discuss MRCS anywhere! I have become braver. When I become no longer anonymous it is because I have decided the appropriate time to take a stand, in the meantime I serve a better purpose just the way I am.

          • KarenJJ

            My hope is that there’s enough of those sitting anonymously thinking about how they feel after being treated in hospital and finding it wanting. And not wanting in the way NCB like to say it is. My issue was largely with the care post-birth from the midwives. I felt like a naughty child for requesting pain relief, for asking for formula to help feed my baby and being denied. As someone that was used to being heard and used to being able to make decisions, I was taken aback at how I couldn’t ask for formula for my baby and couldn’t request pain relief.

            I don’t see how directives such as Hannah Dahlen’s “towards normal birth”
            http://www0.health.nsw.gov.au/policies/pd/2010/pdf/PD2010_045.pdf

            is going to help women. It seems to be removing choice from women.

          • Sue

            – Again with the “woman friendly” but not “baby friendly”

    • KarenJJ

      “All of this “oppressive pressure” on mothers is largely self-imposed.”

      It’s not. It’s a part of health policy and health directives.

      http://www0.health.nsw.gov.au/policies/pd/2010/pdf/PD2010_045.pdf

    • lacrima

      When a practice is “self-imposed” by an enormous number of people, when dissenting voices are silenced, when contrary evidence is suppressed, explained away or ignored, when a practice is advertised and encouraged as being the ideal or best or only option, at what point does the imposition change from internal to external? Then, of course, there’s those instances where these practices are forced on to women…
      I never bought into the NCB/lactivist position, but I encountered plenty of external opposition to my request for pain relief during labor, to the point where I was forced into enduring an extended back labor with no drugs, which is not uncommon in the public health system in Australia. I had to fight to receive prescription formula for my sick daughter, since the attending nurse didn’t believe that I’d breastfed my starving baby for enough time. I couldn’t get to it, it was in a locked cupboard. I was told that she would get it when I’d breastfed for another 20 minutes.
      There was nothing self-imposed about the pressure I faced, and I am not an unusual case, at least, not around here.

      • thepragmatist

        That is horrifying.

  • anonymous

    Brava, thepragmatist!

  • Dr Kitty

    That was a great post. Well said.

  • jessiebird

    Thank you, thepragmatist. It’s brave of you to share your most personal experience with everyone for the sake of protecting and reassuring other women. I have a very different background to you, but the evolution of my thinking is similar. And I haven’t felt so liberated as when I let go of the self-doubt and recriminations after how my children’s births transpired. With much thanks to this blog.

    Just the other day, I ran into my first NCB person in public. I think I’m lucky not to have met many others–well, one other who said that if the placenta previa didn’t resolve (but it usually does) I’d have to have a c-section, which is PRETTY BAD. Anyway, this recent woman was older, a grandmother’s age, with her baby granddaughter. She asked about my daughter, who is at the 1st percentile at nearly age 2 because of severe IUGR. I told her the story of the placenta previa and the IUGR, the seven-week NICU stay in Japan, commuting to the hospital with a bag of milk on public transportion after the c-section…she commiserated that it sounded like a hard time. I shrugged and said,”Well, if the alternative was disability or death, I could deal with it, gratefully and cheerfully even. I think about what women had to go through before these technologies, losing babies, getting injured, dying themselves….”

    She replied,”Well, they didn’t wash their hands, you know.”

    I kind of stuttered, taken aback,”Oh, well, uh, I guess yeah, the fevers…”

    How is hand washing related to placenta previa, hemorrhage, IUGR….

    It was such a disconnect and confusing because I didn’t know where to take the conversation. Fortunately, we had to depart at that moment.

    🙂

    • Rebecca

      This is where you cock your head, smile sweetly, and say “Well, bless your heart.”

  • Allie P

    BRAVA!

    For my money, the “unnecessary” C-Sections are not the mother-requested ones, but the ones where patients have refused far less intrusive interventions (pitocin to augment labor, pain relief to allow mom to rest for pushing, etc.) and wind up with emergency transfers and c-sections they might have otherwise avoided.

    I was induced post dates and had a vaginal birth — in a world without drugs that allowed my cervix to ripen and open, I would have had a c-section. That was made unnecessary by those “evil interventions” the NCB folk demonize.

    • Karen in SC

      This is so true! How can NCBers not see that?

      • The Bofa on the Sofa

        They do not understand that the point of interventions is to prevent problems, not solve them.

        • Bombshellrisa

          Thank you! And this totally explains why they think having the hospital “10 minutes away” is good and why they think it’s perfectly acceptable to try and show up in the ER crowning so they can avoid another section and get their “healing VBAC”

    • Alicia

      Exactly! I had back labor that radiated through my hips and was making me exhausted as I tried to manage it without medication. It was my husband that helped me ‘see the light’ and realize that an epidural would *help* me more than hurt me. I wanted to try for a vaginal birth, and I wanted the strength to push my baby out, and I knew exhaustion could hinder both of those things, so I asked for an epidural and it was the best thing I did! The pain went away, I could rest and relax, and things progressed on their own. When it came time to push I had the strength for the two hours it took (he was sunny-side up, so had to maneuver around my pelvic bone), and in the end he came out calm and fine, and I was calm and happy. I wouldn’t mind having another epidural if I have another kid at all!

  • GiddyUpGo123

    Wow, nicely written and very thought-provoking … I really think this needs to be published to a broader audience, but I think the mainstream markets would turn their noses up at it, because almost all of them have already jumped on the NCB/AP bandwagon. I’d love to see this change some hearts and minds and I think it could if you found the right place for it. Slate maybe? You ought to look into it.

    • Certified Hamster Midwife

      I’m sure XOJane would accept it in a minute, as would Jezebel. Not sure that’s the ideal audience, though. Comment is Free at the Guardian would be a good venue.

      • Disgusted

        Oh no no, Jezebel is highly woo friendly. Or at least the commenters are.

  • Box of Salt

    Thank you, both thepramatist and Dr Amy.

  • “sit in an echo chamber all day and blame _______”
    “I was embarrassing them in front of their client base.”
    “At one point I had 40 grown women devote a thread to informing me that I had completely ruined their forum, when I refused to leave it out of principle”

    • Mrs. W

      Alan, this isn’t about you, it may be hard for you to believe, being a twin-spirit to TFB and all.

      • Captain Obvious

        I don’t entirely agree. I have read several of the threads since Alan has been antagonizing. Many of them could easily have been about Alan. I think he does too, which is probably the motivation for many of his ludicrous posts.

    • ratiomom

      No-one is banning you here, Alan. No-one is embarrassed either. You can even say whatever you want. You just have to stick to the subject of the post. Go ahead, give your opinion, we’re listening! The only rule is that you can’t divert the conversation to SAT scores, circumcision or any other random subject.

      • You are not the one who decides that. My comment that was deleted yesterday was short and referred to none of that stuff but rather to subjects central to this blog: HB risk research and MRCS.

      • “Go ahead, give your opinion, we’re listening!”

        Okay, let’s try it.

        My opinion about thepragmatist’s guest post:

        My opinion is that she was treated unfairly by that board; that they wrongly gathered together to throw virtual stones at her and accused her of ruining the board; that they were unwilling to have their paradigms questioned by somebody who brought facts and logic to the table; that she should not have had posts deleted if they brought a scientific approach to questioning the arguments advanced within that community.

    • theadequatemother

      Oh I am breaking my new year’s resolution…but what the hell.

      This is not an echo chamber. Lively discussion is welcomed…especially when it is based on educated viewpoints that are supported by science.

      So far you haven’t manged to say anything that embarresses me, as an anesthesiologist, in front of my potential “client” base. Nor have I read anything you’ve written where you’ve been able put the OBs, the family docs, a pediatric emergency specialist, a pediatric gastroenterologist, or any of the engineers lawyers, scientists or other professionals on this site “in their place” or scored a point against them or otherwise been able to embarress them. Sorry. It hasn’t happened yet, and I doubt it will in the future.

      You can stick around here and comment according to the limitations that Dr Amy as the moderator has placed on you, but you won’t ever have the power to ruin this forum.

      • thepragmatist

        Wait, how can anyone post here and embarrass a “Doctor” who isn’t even practicing? Am I missing something, Alan?

  • FormerPhysicist

    Powerful. Thank you.

  • Renee Martin

    Thank you!
    It hurts so much to see something so dear to me (feminism) be misused, misrepresented and exploited by those who wish to oppress us. Nothing bugs me more than seeing biological essentialists (Ina) and straight up religious misogynist’s (Dr. Sears), gain the trust of women, and use it to push their retrograde beliefs. I think we need some real feminist push back, but what we get is a few (often apologetic) posts here and there, at best.

    I guess licensing CPMs is now part of the republican platform, and is showing up in NC, SC, VA. This does not surprise me one bit: that those who champion a total regression of womens rights, and place all fetuses above both women and living children, would push for substandard, dangerous, ideologically driven maternity services instead of proper health care for women. NOT a shock.

    • Mac Sherbert

      Why would licensing CPMs be a part of the republican platform???????

      • MaineJen

        Well, they want to take us back 100 years in every other aspect of our lives (“us” meaning women). Why not this, too?

        • AmyP

          Really? Do you think that Republicans want to take away your washer, dryer, dishwasher, electric stove, vacuum cleaner, cell phone, car, battery-operated baby swing, umbrella stroller, vibrating bassinet, Crockpot, toaster, hand mixer, rice cooker and central HVAC? Honestly? Also, haven’t we thoroughly established that homebirth is most dangerous for the baby, rather than for the mother?

          Isn’t it rather more likely that legislators have been hoodwinked by midwives’ organizations that talk a good game about freedom, limited government and the evils of excessive regulation? Those organizations are similarly adept at dressing themselves up in language about choice, autonomy and female empowerment when talking to liberal audiences.

          When talking to conservatives about homebirth issues, I would suggest canning that kind of talk (“you people hate women”) both because it’s untrue and uncharitable and also because it doesn’t get you a single step closer to shutting down the homebirth movement. I think conservatives would be very friendly to the idea that if somebody is practicing medicine and is state-licensed, they need to be carrying malpractice insurance, just like OBs do, so that if there is a wrongful death or injury through their incompetence, that the family will be compensated. For heaven’s sake, we expect even tradesmen to be bonded.

          • ratiomom

            The religious right does have a legitimate interest in stimulating the NCB and lactivist movement.

            If they can keep women’s minds and their days filled to capacity with things like obsessing over from which orifice babies emerge, breastfeeding, washing cotton diapers, homemade babyfood and babywearing, they won’t be using that time to gain economic independence, defend their reproductive rights or engage in politics.

            In every choice that a parent needs to make, the NCB/lactivist approved option is invariably the one that is the hardest and most time consuming for the mother. Birthing without pain relief, breastfeeding, bedsharing, babywearing, cotton diapering, homeschooling,…. They only have one thing in common and that is that they are hard on the mom and take a lot of time.

            It’s even more effective if they can enlist women to harrass other women about their choices in these matters.

          • Durango

            Can we agree that NCB spans the political spectrum? Every single NCB-er I know is as liberal as they come, despite the profoundly anti-woman beliefs at the core of NCB and AP.

          • Certified Hamster Midwife

            It spans all political and religious beliefs! That’s what fascinates me so much about it and why I follow this issue even though I am what my old username on this board was: “Barren Spinster.” It’s very strange to see an issue that unites fundamentalists and atheists like this. Although maybe not on the same message boards, necessarily, unless they’re locally-focused.

          • thepragmatist

            It is fascinating to watch as liberal feminists must reconcile the fact that religious fundamentalists support the very same platform in my local community and see how they try to reconcile such differences.

            Recently, the Leaky Boob featured a photograph of the Pope blessing a nursing mother, and the LB stifled any criticism. Posters said, “Who cares who is doing it, it’s about breastfeeding!” and “Breast-feeding is more important than who is in the photograph!” and other such things. Pope or not, my feelings about the Pope or not, the fact that the lactivist movement does not care WHO is endorsing breastfeeding (just that it is endorsed) or denies what valid criticism exists about the person, shows a disturbing fundamentalism. At least, I find it so. Not to start an argument about the Pope: it’s not the Pope, it’s the principle. No, lactivism is not more important than who is endorsing breast-feeding, nor should it make that person immune from criticism, nor will I ever accept someone anti-woman simply because they may agree with me on one point.

          • Amy

            What was their issue with the Pope? As a Catholic mom from arguably the Catholic capitol of the US (meaning I know lots of other Catholic families) most are pretty big into breastfeeding, some AP type parenting things, homeschooling, etc. I am surprised that the Lactivist movement would be poopy about the Pope endorsing it?! Weird!

          • thepragmatist

            Sorry, I wasn’t clear. No, they were not. They silenced criticism of the Pope that I don’t really want to get into here as I don’t want to start a debate related to the merits of Catholicism. The issue was that there were some who are critical of the Catholic Church for a number of valid reasons. I was saying that putting lactivism over a whole score of other social issues shows a certain fundamentalism in itself. When people spoke critically of the Pope and policies THEY felt were more anti-woman than not, it was silenced in favour of lactivism over all else.

            Maybe I am not being clear in the point I am trying to make. It is not about the Pope: it was about the response being basically that we don’t care who it is, if it’s an endorsement for breastfeeding, it is acceptable. I have an issue with that, personally.

          • I don’t have a creative name

            THANK YOU!!!

      • theadequatemother

        I would assume its an attempt to gain the female vote not a conspiracy to keep them women in the home.

    • thepragmatist

      I thought what Dr. Amy had to say about Ina May being relegated in her community/cult to deal with “woman issues” as especially pertinent in that respect. And again, it seems that anti-feminist would relegate women’s healthcare to “woman’s work” and women are more than happy to follow along. Indeed, it should not matter the sex of the care provider, but the quality of care, and the evidence behind it. Science itself is neutral.

      • KarenJJ

        “But taking birth back from paternalism would be to empower women with science and reason, not to relegate women’s health care to non science-based “ways of knowing”. ”

        And this is the most important thing I’ve learned since I started reading Skeptical Ob.

        Knowing how to save a woman’s and a baby’s life via a c-section is something for women to learn to. And they are in a high proportion. If they are being done unnecessarily on women that don’t want one then we need to learn to pinpoint better which ones are being done unnecessarily – not eschew them completely. It will take more research and we should be learning more, not turning our backs on science.

        • thepragmatist

          I’m beginning to feel it is not even possible to have that conversation, though: it is too obscured by politics. Imagine if this applied to say, heart research, with a militant lobby obscuring adequate research and drawing public health officials down the path to “other ways of knowing” about the heart?

          I know I am preaching to the choir here but why should we listen to “other ways of knowing” that border on the obscene in their ridiculousness? The midwife who claims she can “see” a woman’s dilation is a midwife who is deluded with her own religious beliefs. The midwife who breathes on a dead baby’s face and tells the mother to sing to her baby to bring it back to life is delusional. Those “other ways of knowing” equate to religious belief. No different than shaman/midwives in other areas who rub dirt into vaginal lacerations while praying over the woman and then when she dies, blames witch craft (oh yes, it happens!).

          Traditional care equals a 1/8- 1/16 lifetime chance of dying in childbirth. Magic has no place in health services. Call it magic but don’t call it medicine. And the day you can prove to me that your magic exists, do tell, please.

          IMO: “Other ways of knowing” is an offense to all rational, intellectual women everywhere who have worked their way into the sciences. There ARE other ways of knowing but they are called magic, superstition, etc. Do not call it science. Do not equate the scientific method with delusional superstition and call it evidence-based.

          Meanwhile, WHERE is the skeptical community in all of this? the silence on women’s health issues to me is just another sign of the inherent sexism existing still in society. Where is the outcry from science-based medicine and the skeptical community? I see the same thing: publicly, they embrace this movement for fear of being labelled anti-woman, and privately, will lean in and whisper, “But that’s not the truth…” Then tell the truth! Because the silence shapes public policy.

          • The Bofa on the Sofa

            Those “other ways of knowing” equate to religious belief. No different
            than shaman/midwives in other areas who rub dirt into vaginal
            lacerations while praying over the woman and then when she dies, blames
            witch craft (oh yes, it happens!).

            This is similar to the topic I mentioned the other day, about why in the blazes anyone would want to use TCM considering how terrible its track record has been in China.

            Again, it is the reverence that people tend to put on “other” cultures and their methods. Despite the fact that those methods have generally been awful. Ooooo, Ina May brought the “Gaskin maneuver” back from India (or wherever). Um, we’ll gladly use whatever works (that’s what medicine does), but I would suggest we shouldn’t be looking to India for best practices in childbirth.

            It’s all an application of the Noble Savage belief. Shaman’s have been rubbing dirt on vaginas for hundreds of years. Who are we to criticize it? No, it just shows their wisdom.

            Besides, everyone knows they only do that when there isn’t any cinnamon around to blow on them.

          • Sue

            “Other ways of knowing” is for people who don’t know enough through the standard way – using their intellect.

  • Victoria

    Congratulations Comrade! Fantastic post, thank you!
    Thank you Dr Amy for highlighting thepragmatist’s words.

  • Mrs. W

    Brava – it is rather shocking, particularly in our neck of the woods how oppressive birth and mothering are, in ways that before I was a mother I never would have imagined.

  • TiffanyEpiphany

    Thank you, thepragmatist, for sharing your heart with us. You are an inspiration an a perfect example of everything good and right, behind the veil of feminist illusion.

  • anonomom_LLLL_IBCLC

    Wow. Powerful.

  • CDNGuest

    This: “Women who are empowered do not need to empower themselves through their reproductive function or prove their worth through mothering.”

    She should publish this.

    • Mrs. W

      True, but it nice not to be ostracized for those things.

      • CDNGuest

        Mrs. W. I couldn’t agree with you more. I wanted to highlight the above statement as I found it to be particularly reflective, relevant to feminism as a topic, and critical to redefining women as more than just their bodies or their functions. Hope your weekend is uplifting!

        • thepragmatist

          It also relates significantly to being sexually assaulted. Because as a woman, and victim of sexual assault, my body was the focus and object, and my worth decided by somebody else. And it was my sex that defined me, not my personhood. I am not suggesting it is the same action, but similar thought.

  • mamaellie

    I love this post. It was just the perfect thing to read this morning. This site has done so much more for me than I could have imagined. My children are safer now than they have been in years because they are vaccinated, my son (unlike his sisters) was born in a hospital, my homeschooled olders are headed to school this fall, and their mama is remembering she had other dreams. Thank you thepragmatist, for your words today. They were very inspiring.

    • Certified Hamster Midwife

      And for some parents, having a bunch of kids and homeschooling them is their dream. That’s cool. But it doesn’t have to be *your* dream for you to be allowed to reproduce.

    • Dr Kitty

      Good for you.
      I hope your kids enjoy school, and that you fulfil your dreams.

    • Alenushka

      Good luck in school! My older son has very very special needs and so many people urged us to HS. We did not. I know it is right for many people but it was not right for our son. Public school services made him blossom and helped us to cope as well.

  • Durango

    Beautiful.

  • Sunandstarshinemommy

    Huge standing ovation!

  • Charlotte

    I love this! The willful blindness and oppression of the NCB movement are more than I can stand, and I sincerely hope this movement wanes before my own children give birth. Somehow, someway, a backlash has got to be forming. At some point the house of cards has to collapse.

    • Awesomemom

      That is one of the reasons I keep coming back here, I want to keep tabs on things in the hopes that when my daughter is of child bearing age she will not be dealing with this and if it is still around I want to know how best to help her through all this.

    • mamaellie

      We are the backlash. It feels good to be a part of it.

  • ratiomom

    This!
    There really is a whole movement devoted to denying the very existence of a mother’s rights and needs.It’s time for us to push back, or get thrown back into the dark middle ages.

    We shouldn’t accept that pain relief during labour is considered an indulgence instead of a right.

    We shouldn’t accept that women for whom vaginal childbirth would inflict physical or psychological damage are being forced to suffer through it because the hospital approaches its cesarean quotum.
    We shouldn’t accept that postpartum women are treated like milk machines for the primary patient instead of human beings.

    When I look at my little girl I worry in what circumstances she’ll be giving birth to her children.

    • Eddie

      I worry about my teenage daughter and the world in which she’ll give birth, but when I look at my littlest, I do believe that fact will ultimately win out over superstition. It just takes (too much) time sometimes. But when you look at history, science always wins over superstition.

      Let’s be clear that science has gotten misdirected by its own superstitions at times. Scientists are people too, subject to all the same foibles as everyone else. The difference is that science is by nature (did I just say “nature”?) self-correcting in the long-run.