Filmaker: natural childbirth is anti-feminist propaganda

Macro image of dictionary definition of propaganda

I’m not the only one who has figured out that natural childbirth is profoundly anti-feminist.

The New Inquiry interviewed film professor Irene Lusztig on her new documentary The Motherhood Archives.

Here’s Lusztig on the philosophy of natural childbirth:

I’m a filmmaker; I’ve worked a lot with propaganda and archives—my background is in communist, post­communist stuff… So when I was pregnant it became immediately, abundantly obvious to me that almost everything I was reading or seeing or being exposed to was telling me how to give birth or how to be pregnant or how to mother or look after my child. It was clear to me immediately that all of this is an intense space of propaganda.

On the “right” way to give birth:

I just found it helpful and reassuring to think through the intense ideological space of “the right way to give birth,” “the right way to mother,” “the right way to do this or that with your child.” There’s a constant idea that you’re failing, you’re doing it wrong—so for me I just found it hugely reassuring to ­understand that these things are completely culturally bound, historically bound. There is no wrong way to give birth.

On the misogyny of Grantly Dick-Read:

Grantly Dick-Read is the British obstetrician who coined the term natural childbirth and wrote the first books about it. His writing is a very explicitly Christian appeal to the experience of being inside the pain as a form of spirituality. It’s a Christian thing to do. That history has also been erased. It’s kind of ironic that the space feminists occupy now is a redeployment of this incredibly Christian and misogynist argument about women’s bodies.

On the history of pain relief in childbirth and the fact that women demanded twilight sleep:

… [T]he pain of labor is an abject experience of very intense pain. The language that’s used in these books and articles that feminists wrote advocating twilight sleep is basically human-rights discourse: Society has the obligation to give us women this thing that will take away this devastating pain that we experience. It’s a human-rights discourse of equality for women in the form of pain relief. Which is incredibly interesting set next to ­today’s feminist conversation which is all about natural unmedicated childbirth being the correct, feminist way of giving birth…

On inherently high rates of perinatal and maternal mortality:

People have asked me about the word pathological. People think of that as a very bad word, but it comes directly out of earlier writings about childbirth… It comes out of doctors struggling with incredibly high maternal mortality rates and high infant-mortality rates, incredibly high rates of vaginal tearing and bad maternal side-effects from birth, prolapse and all these things that still happen, actually.

Lusztig has identified the central ironies about contemporary natural childbirth: it is profoundly anti-feminist; it was created by misogynists who wished to control women; it is both ahistorical anti-scientific, denying as it does both the need for pain relief and the inherent dangers of childbirth.

There is one more point about natural childbirth that Lusztig doesn’t mention, although she alludes to it:

Natural childbirth advocates, who claim to be “educated,” appear to be utterly clueless that they are being manipulated by propaganda.

  • twilightsparkle

    I have to share – Five years ago, when I happily got pregnant for the first time, I started reading up on childbirth. My innate distaste of hospitals led to the Business of Being Born, and from there, a downward spiral into everything crunchy.

    At some point I realized that my grandmother was in the right age to have possibly experienced THE HORROR of twilight sleep in childbirth, and I asked her about it. I was floored when she laughed and said “yes, that was AWESOME! Scopolamine and morphine, that was a PARTY!!” She proceeded to relate the scattered memories of the birth of her four kids and how she just loved it, she didn’t feel a thing, or remember much, and it was GREAT. I, being completely indoctrinated in the NCB dogma by that point, assumed that my poor grandmother had been brainwashed. Only now, with a few years, and much more understanding under my belt, can I take her happiness with her births at face value. I can’t believe I bought into that dogma to the extent that I wouldn’t take my own grandmother seriously!

  • Audrey Yarper

    My natural births (one at a birthing center and one at home) were the most empowering experiences of my life. Society had told me that as a woman I was fragile and that my body was flawed and unable to do what it was made to do, with out drugs and surgical interventions. I chose to believe that I was was a strong powerful being and I let my contractions wash over me like the waves of and ocean. I surrendered to the awesome magic and power of birth. I breathed in the pain, I breathed in the ecstacy. I lost time and I was a birthing woman, present, powerful, primordial. In control and in surrender, unafraid. Surrounded by love, support and trust in my ability to birth. I gave birth to my beautifull children and was bathed in the euporia of love induced by my bodies natural oxytocin, uninhibited by drugs. Awake, alert, and joyful. My births, gave me enormous confidince. I have been so much more able to fullfill goals now, because I know what I am capable of. I am not fragile and helpless, and no woman is. I am powerful and amazing. Giviing birth naturally is the most feminist expereince I have ever had. I am sorry if you have never had the opportunity to expereince that.

  • Kelly

    Again, it is so hard to see people who are embodying the very thing they deplore. There certainly are NCB advocates are totally crazy, irresponsible, dangerous, and everything else. Too many people here are equally extreme in their judgments but in the opposite direction. (Also, for the record, there are hospitals and doctors who do terrible, dangerous and irresponsible things too! In maternity care, in every field of care. It is totally legitimate to be informed about what hospitals and doctors do.)
    Natural childbirth at its best is, as this place ought to be, about presenting information (emphasis here) non-judgmentally so that anyone can make an informed choice. I feel lucky that I was well informed and could take charge of my birth (in a hospital I might add). I knew to be skeptical when they said I should schedule a cesarean for a big baby; I said I was willing to give labor a try. When they wanted to induce on my due date, I said I was willing to wait, since there was nothing else wrong. Judgement, condemnation, self-righteousness is wrong on both sides, even if you are relying on science. Science ought to mean given objective information, and ultimately it is always up to the individual to decide what it best for them. Holding science up like a holy relic and condemning anyone who does not follow you blindly is ridiculous and pretty uncharacteristic of science.

    • Sue

      Kelly, you must be reading a different blog to the rest of us. Is it possible that you haven’t read enough here to realise that the term ”NCB” is an abbreviation for the radical anti-obstetric movement? Many people who regularly comment here have had unmedicated vaginal births – mostly in hospital. Like you, they have chosen a safe environment, with medical back-up, and evaluated scientific information.

      The radical anti-obstetric version of your experience would be a rejection of any ante-natal testing, refusal to birth a big baby in hospital, and possibly an emergency transfer shoulder dystocia.

      In contrast, from your post, it appears that you had a hospital care team that gave you objective information about risk and cooperated with your choices (but were prepared to intervene if something went wrong). I imagine that that’s what everyone here would support. What evidence are you seeing to the contrary?

      • Kelly

        I am very simply trying to point out that you are mistaken in thinking all natural childbirth folks are exclusively a radical anti-obstetric movement. It truly is like saying that suicide bombers are indicative of all Muslims. This is why I wish to point out that this blog is damaging to its own cause. This blog is also taking the extremist stance, and is also the suicide bombers in comparison to obstetrics as a whole. It disappoints me because I read a lot of different blogs, mostly because I have found listening and talking to other mothers helps me to become the best, most informed, most validated mother I can be. Mothers helping each other. We are on the same side! Skeptical OB provides a relevant response to radical anti-obstetric natural childbirth folks, it is mean spirited and ultimately a waste of energy because there the true crazies are a small minority, and they never be swayed by this rhetoric anyway. Skeptical OB is preaching to her own choir, to no effect. She is creating minions of preachy bullies who judge and criticize women for trying to do their best.

        And in fairness, the crazies are also judging folks who are doing their best by having whatever medical intervention they choose.

        • The Bofa on the Sofa

          Oh, tone trolling.

          Thank you for your concern.

        • Meerkat

          Kelly, the problem with NCB movement is that it spreads misinformation. They have gotten so good at propaganda that their message has become more or less mainstream. Interestingly enough NCB are using the same propaganda techniques as Soviet Russia and Nazi Germany. They identify an outside enemy (modern medicine/OB-GYNs), proclaim everyone who doesn’t share their opinions as evil or misguided and repeat their message over and over again, from every available platform. Many many women fell for the propaganda and lost their babies or their lives. It’s a serious matter. As far as I know Dr. Amy is the only one who is providing a counter opinion to the NCB propaganda.

  • mydoppleganger

    NCB movies/internet stuff makes it very difficult for me to understand real birth. From what I have read, home births are amazing, empowering, a primal scream or two-and viola. Of course it appealed to my idealism, my hubby being there supporting me as all peacefully happened without a hitch.

    From natural birth facebook pages I read, the statements of “don’t go to a hospital” are frequently said. So it painted my mind with: hospital births hurt more, end badly, and there is nothing nice to them. Also, you don’t get any *points* for going to a hospital, that is not trusting birth.

    It’s like how we tell our kids to avoid strangers. (Of course, reasonable to teach and needed.* However, sometimes a child sees everyone as a potential abductor. This is the flight or fight feeling about OBs after a long period of reading the natural birth forums. Suddenly, 99 percent of the docs only want you to suffer and to take away everything you ideal for. Going to a hospital admits defeat.

    So how can a woman heal from all this false pressure? From believing any medical help is a boogey man? I simply try to: give it all a benefit of a doubt and remember my thoughts on parenting before the NCB thoughts flooded in. How much did all this matter to me before hand? My dreams in life did not include specific birth plans, as I recall.

    I guess the way I will trust birth is to trust that I don’t have to worry about it all myself. To rely on the education of the doctor and nurse teams,and to have a happy spirit about the overall blessing of a baby.:) Why not be thankful for those handy dandy hospitals we have access to?

    First time pregnant women, please hear me out…I wasted too much time pining for the perfect birth that hit all the movement’s ideals. Just don’t be so hard on yourself. :) *That advice would have saved me a ton of emotional soul searching and I would have been happier overall.*:)

    • MichelleJo

      Problem is that any truthful site like this one, is hated by the NCB crowd before they even read or consider what is being said. If a piece of information comes from Dr Amy, it’s automatically discounted because she’s just a [insert whatever description you want]. Rarely do they honestly argue a point, and a lot of them are just plain too stupid to. Unfortunately, woo sites outnumber logical/true sites about 100 to 1.

  • http://Www.awaitingjuno.blogspot.com/ Mrs. W

    I feel like sending that filmmaker a big bunch of flowers as a thank-you for hopefully being one of the first in a collection of BOBB push back materials (I would also include P. McDonagh-Hull and Dr. Murphy’s book “Choosing Cesarean as a pioneer in the push against NCB)….

  • Karen in SC

    OT: to Bofa

    Sheldon “I informed you thusly” is a quote from the episode when the guys planned to go to a special showing of Indiana Jones, only to get there too late for seats. To rub salt in the wound, Wesley Crusher got to cut in line “and it’s not even your franchise.”

    Of course, that quote = CEU for my PCM

    • Karen in SC

      Didn’t see your query before as I’ve been knitting all weekend!!

    • Box of Salt

      Karen, minor correction: Wil Wheaton. No I didn’t look it up, and I’ve only watched Big Bang Theory once, and as Wheaton played himself in that episode I’m assuming he did so in the one you’re quoting, too.

      Do I get CEU too?

      • LynnetteHafkenIBCLC

        Why not? I’m awarding myself a CEU just for reading that.

    • The Bofa on the Sofa

      I know that. But, as I asked, WHEN was “thusly”?

      Apparently, I do not recall your information.

      • Karen in SC

        If you are asking to what I was saying “I told you so” about, I can’t remember either LOL

        • The Bofa on the Sofa

          No, I am asking WHEN you told me so.

          It was about my comment on how birth centers made no sense to me, being basically a homebirth without the comfort of home. All you said is, “I informed you thusly”

          • Vanessa Robertson

            Your home is likely not equipped with a giant soaking tub nor an industrial sized water heater. You may have pets or others in the home that you don’t want to have to worry about. You might not want to dispose of the placenta or have to supply sheets, towels, etc., you may not feel comfortable “hosting” the people on your “birth team” (my BC was going to send a midwife, a student, and a birth attendent). Your BC may be closer to a hospital or a closer to a better hospital than your home is. If I had to do it again I would skip the BC (see above comments) and just go to the hospital but those are the reasons we chose the BC over a homebirth.

          • The Bofa on the Sofa

            Yes, why not just skip the BC and use the hospital then?

            It makes no sense. A homebirth without the comforts of home, or a hospital birth without the safety of being in a hospital.

          • Vanessa Robertson

            Um…because these people want to have their babies OUTSIDE the hospital. You asked why BC and not home. Those are some reasons. Hospital vs not in the hospital is a whole other issue. A BC is nothing like a hospital.

  • kira fox

    I’m sorry but what?!?!?!?! Natural Childbirth is a decision. Why would anybody think otherwise?
    http://www.natural-labour-relief.com/2013/07/natural-childbirth-methods.html

    • Captain Obvious

      You obviously got sucked in by the propaganda.
      “Home birth is a wonderful experience for many expecting mothers. Hospitals can be terrifying places, and when one is being constantly poked and prodded with needles and other machines, it can be difficult to relax. The most important thing for any expecting mother is comfort; delivery is not an easy process, but when a woman is distressed, it becomes that much harder for her to handle.” Typical 1/8 women transfer to this scary hospital because of pain. They are in fear of not getting to the hospital fast enough for pain relieve or to make sure their baby is still on. Any person injured OOH are brought to this scary hospital by ambulance. Have you ever had an ambulance rush you home for the comforts of home to treat your broken leg, myocardial infarction, or stroke?
      “Because the water is so similar to the amniotic fluid that a baby is already encompassed in inside the womb, the birth is not so harsh on the newborn.” Water is hypotonic any from so many water birth accounts cooler than body temperature by the time setup and delivery occurs. AF is isotonic with enough natural salts and anti microbial characteristics. There are enough cases of umbilical cords avulsing, near drowning and fatal drowning, and infection from delivering in the water. Laboring in the water is fine, delivering in the water has risks. And that dive reflex that the NCB talks about babies not able to breath until out of water only occurs in cold water drownings, not warm tub deliveries. Babies have drowned.
      So good to see your post supports the blog thread premise.

      • Box of Salt

        “Because the water is so similar to the amniotic fluid that a baby is already encompassed in inside the womb”

        I’m guessing the Laboraide lady (no background information about her qualifications easily found on her website) doesn’t understood chemistry and doesn’t even know what “hypotonic” and “isotonic” mean.

        • Sue

          Or even the meaning of ”oxymoron” – as in ”one can always have a natural water birth”

    • MichelleJo

      Disregarding the fact that natural childbirth is an industry,
      what is taught in “childbirth classes”, taught by “childbirth educators” is just to scare you off the very things that will give you an easier time, so yeah, you “choose” natural childbirth.

      It’s one thing to want a tour of the hospital you’ll give birth in and get some sort of idea of what to expect, but to pay out good money for a series of classes is daylight robbery. What don’t you know, where the baby comes out of? All you need to know is that about nine months after conception you’re going to start getting pains that get progressively stronger and closer together until they so strong and close together that they become unbearable and will stay unbearable for a while. Then, feeling like are going to burst, you will push the baby out of you (if you’ve been to the toilet, you know how to do this, you don’t need any affirmations). Oh yeah, if you don’t like the pain, there are a few safe, good options that the hospital will offer you. They are yours to take or leave. And if there are any medical problems with your birth, the hospital is staffed and equipped to deal with it. There. How much will you pay me for educating you?

    • I don’t have a creative name

      Let’s be clear –

      Natural childbirth, when referring to forego the decision to have any pain relief during labor, is a personal decision, and no one else’ business.

      Natural childbirth, when referring to the movement often discussed on this site, is a set of beliefs that a women is less of a woman and less of a mother if she chooses anything other than a completely natural labor. C-sections, pain relief, and even inducing labor when continuing the pregnancy would be less than safe are all verboten for the nuttiest of these nuts. They will risk their own and their child’s life to be “natural”. This is not a “decision”, this is a cult-like ideology that chooses the “sisterhood” of “natural” over their own children and sometimes over their own lives.

      • Antigonos CNM

        Natural childbirth, when referring to forego the decision to have any pain relief during labor, is a personal decision, and no one else’ business.

        I agree with this statement, except that I would choose to use the term “unmedicated childbirth”. That gets rid of the confusion between an individual decision and a movement whose goals go far beyond simply not using any form of medication for analgesia in childbirth.

        • I don’t have a creative name

          True.

          And when I clicked on her name now, I see that almost all of her posts are pushing this “laboraide” product. I think this is actually spam, rather than someone who was confused about what we’re doing here.

        • Poogles

          “I would choose to use the term “unmedicated childbirth”. That gets rid of the confusion between an individual decision and a movement whose goals go far beyond simply not using any form of medication for analgesia in childbirth.”

          Though now there is a growing tendency among NCB-types to only use “unmedicated childbirth” to describe births that didn’t use ANY medications, so it you had a little pitocin to help things along but no epidural, you stil didn’t have an “unmedicated childbirth”.

  • drmoss

    Talking of Grantly Dick-Read, here’s a quote from him that doesn’t fit too well with modern ideas:
    “Woman fails when she ceases to desire the children for which she was primarily made. Her true emancipation lies in freedom to fulfil her biological purposes.”

    There! Get back in the kitchen! We’re back in the first scene of Monty Python’s Meaning of Life – ‘Get that, would you, Dierdre?’

    Chris

    • Vanessa Robertson

      Bleh! I remember reading that and just writing it off as a product of his times. He was very old when he wrote that book in the 1940′s.

    • Sue

      At least Monty Python promoted the gender-neutral Right to Have Babies!

  • yentavegan

    OT.. My son wore a hoodie everyday in high school. My son was briefly suspended from school. My son walked to a local store to purchase snacks and an ice tea. My son is alive perhaps because of his skin colour or perhaps because where we live idiot cop wanna be’s can’t carry guns. Who knows. Today I weep for Trayvon Martin.

    • AmyP

      Also OT:

      Not smashing up a stranger’s face and head goes a long, long way in avoiding winding up like Trayvon Martin.

      Brain injuries are serious. Hitting anybody in the head is serious. Zimmerman had no way of knowing when Trayvon Martin was going to figure he was done pounding his head on the sidewalk or when help was going to arrive. Either brain damage or death were very likely possibilities for Zimmerman if he allowed Martin to continue attacking him.

      • Therese

        If Martin did anything like that then wouldn’t Zimmerman have needed medical attention? That’s what I don’t get.

        • AmyP

          He did get medical attention. There were EMTs. I haven’t watched the video myself, but an EMT testified during the trial as to the nature of Zimmerman’s injuries.

          Look at the photos of Zimmerman after the shooting on the Wikipedia page on the case, particularly comparing the photo of Zimmerman’s face after the struggle and his normal photographs (the nose in particular looks terrible).

          http://en.wikipedia.org/wiki/Shooting_of_Trayvon_Martin

          • Antigonos CNM

            What do all these posts about the Zimmerman trial have to do with birth? Let’s leave it, folks, for another, more appropriate forum.

          • S

            Nothing to do with birth, but it is a hugely pressing parenting issue for a number of people trying to figure out how to keep their boys safe.

          • Therese

            Talking to an EMT counts as medical care, really? If his head had actually been bashed into the sidewalk multiple times that is something the EMTs would have stuck him in the ambulance for and drove directly to the hospital. I doubt they would even listen to you if you tried to decline the ambulance ride because someone who had just sustained that severe of a head injury isn’t really in a place to be declining medical treatment. GZ is obviously full of it and I don’t see why so many are sure that everything he says is 100% truth.

    • Captain Obvious

      They are both wrong. GZ should have called the police and stayed in the car. TM should have left in those 4 minutes and not attack GZ punching him in the nose and driving his head into the sidewalk. “Sweet tea and skittles”? How about the marijuana in his pockets and in his system that was not allowed into evidence? Does one act different when under the influence? Did GZ know TM was using and or passing along marijuana and fireworks among the neighbor kids? GZ is Hispanic. GZ had mentored a couple of black kids in his own home who were troubled and whose father was in jail. GZ said “those people”, did that mean black or teenage thugs in the neighborhood. TM said “stupid cracker”. Racially motivated or motivated by previous events that TM had caused in the neighborhood. GZ called the police saying a suspicious character was walking between the houses in the neighborhood apparently looking into windows in fear of bulgarizing houses. Only when the dispatcher asked him to describe the person of what race he was did he say black. a news reported got fired when he reported that GZ called because of a black kid in the neighborhood. Nevertheless, at the time of the fight it appears GZ was in fear of his life and the gun that he was legally carrying became a gun either one had access to, and if TM was going for it then GZ may be justified to save his own life at that point. The prosecutors had all of their evidence allowed, the defense had much evidence not allowed and GZ was found not guilty. I feel for both families. I have had vandalizing to my house several times, certain kids in the neighborhood are repeat offenders, and some 17 yo males (not a child with skittles) can kick my ass. I could easily be in fear of my life if I confronted a 17 year old male vandalizing or stalking my house and then ended up in a fight.

      • yentavegan

        I did not believe GZ’s rendition of events. 17 year old kids have marijuana in their systems all the time where i come from. I don’t believe Trayvon was up to no-good, or peering in windows or even that Trayvon attacked George Zimmerman first. however I do believe in the order of law and I will not rally or riot. I will just abide with my sadness.

      • Captain Obvious

        About the IT expert of the Florida’s State’s Attorney office who was placed on administrative leave and then later fired.
        “Kruidbos says there were 2958 photos in original report. In Kruidbos report, there were 4275 photos. The photos included Martin blowing smoke, pot, underage naked females, and a clump of jewelry on a bed.” So much for a child walking home with sweet tea and skittles that the media has broadcasted from hill or high mountain. I admit this doesn’t necessitate TM to be killed, just that the prosecution withheld evidence then was allowed to keep it out of the trial. In the long run, it didn’t matter because the jury still felt ( that regardless of what squabble lead up to the fight) it was self defense at the point of the fight.

        • yentavegan

          at the risk of telling too much, 17 year old boys are known to frolic naked with girls still in high school, and yea, they take photos of the crazy crap they do.

          • Captain Obvious

            Really? I am a father to seven, one grandchild, and I have been a gynecologist for 21 years. I have delivered 12 year old girls and treated every known std imaginable. Kids who use marijuana will almost certainly use other drugs like k2 or pills. ADHD drugs, benzodiazepines, and narcotics are high on their list. Usually getting or stealing it from family members. They save money by using their school lunch money or pawning stuff from around the house. You are telling me every teen around you smokes weed? God save you. I wasn’t so interested in the naked pictures on the phone (that you responded about), as much as the heaps of jewelry on his bed (that you didn’t comment on). Drugs, money, and stolen property go hand in hand. And since there were burglaries in that neighborhood in Sanford Fl needing a neighborhood watch, I have to wonder.

          • Bombshellrisa

            K2? I must be out of the loop.
            I have dealt with both teens and adults who smoke pot. Most of the time, I have dealt with ones who have smoked a small amount and haven’t been users, but who exhibit panic and paranoia because that is how it affects them (usually come through the ER).

          • theadequatemother

            A significant amount of pot on the street is laced with meth and cocaine. When someone smokes pot I always find out if they produce their own. If they buy it on the street I assume they have meth and or cocaine in their system also until proven otherwise.

          • auntbea

            Wow. This makes me so glad I never tried the pot my friends in college offered me. And here I just thought I was being lame.

          • yentavegan

            We have neighborhood watches in my neighborhood too. I think they are fairly common.

          • Lindsay Beyerstein

            Unlike Trayvon Martin, George Zimmerman had a serious rap sheet. In 2005 he was charged with resisting arrest with violence and battery of a police officer. His girlfriend also got a domestic violence restraining order against him.

            But the jury wasn’t told any of this because the rules of evidence say you can only admit evidence about someone’s past bad behavior if it proves some fact about the current case. That makes sense. You can’t mention someone’s arrest record or convictions or drug use just to show that, in your opinion, they’re the sort of lousy person who would commit a crime like that.

            Fair’s fair. If Zimmerman’s battery charges aren’t admissible, then neither is Martin’s school suspension, or hearsay about his prior drug use.

            One reason you have to go on evidence of what happened that night vs. stereotypes is that different people bring different stereotypes to the table.

            Almost everyone I grew up with would have ended up with a similar toxicology report if they’d somehow gotten shot dead on their way home from the corner store at age 17–because they’d probably smoked pot sometime in the previous month. These were nice kids, A students, athletes, Model Youth Parliament and debate team stars. Their doctors probably had no idea they smoked pot occasionally. They grew up to be doctors and lawyers and accountants who probably still smoke pot from time to time. But because they’re functional, productive members of society who don’t have drug problems, they’re as discreet as they’ve always been, and their cases don’t count towards the average person’s stereotype of a casual pot smoker.

            My stereotype of a hardcore stoner is that he’s the last person you’d expect to get in a fistfight. He’s the guy wearing the Big Bird t-shirt and inviting you over to play Mario Kart. You politely decline because he’s boring, not because he’s dangerous. I grew up in Vancouver, British Columbia, so I’ve known a lot of stoners. I even shared an apartment with some after college and somehow lived to tell the tale. But I wouldn’t want my stereotypes to count against anyone in court.

        • MikoT

          So much for a child walking home with sweet tea and skittles
          But that’s exactly what GZ saw. A child walking home with sweet tea and skittles, nothing more.

          I admit this doesn’t necessitate TM to be killed
          You’re still massively missing the point.

          These things have nothing to do with Trayvon being killed, and it was correct for the judge to exclude them.

          The question is whether GZ’s actions were appropriate in that situation given what occurred.

        • S

          My male Black and Hispanic classmates were always getting followed and put up against fences and walls. For walking too fast, for walking too slowly, who knows what else. I started hearing about this in sixth or seventh grade (and i wasn’t particularly perceptive at that age). These were good boys in a gifted program at school. It doesn’t matter if you’ve got pot in your pocket, if you’re president of the honors society, or if you’re disabled.

      • Lindsay Beyerstein

        Carl Hart, a psychopharmacologist at Columbia University who studies the effects of marijuana on performance, had a great op/ed on why the judge was absolutely right to keep the marijuana data out of evidence. The amount that Martin had in his bloodstream was so low that it couldn’t have affected his behavior: http://nyti.ms/13J6jNK

        The only reason to introduce that into evidence would be to signal to the jury that Martin was a “bad kid,” which was just more victim-blaming.

        • Captain Obvious

          The behavior of teenagers who smoke marijuana is altered whether they have recently smoked or not. Personally and professionally I have dealt with these behaviors of paranoia, denial, lies, and confrontation. These teenagers do not want you in their bedroom, they belittle the seriousness of smoking marijuana or K2, they defend their beliefs strongly even to the point of confrontation and physicality. I don’t care if there was no marijuana in his system, because he has a user and possibly an abuser, when confronted about his behavior that night I believe he challenged GZ and attacked him. Now that’s my speculation based on my personal and profession treatment of people with user and abuser/addiction personalities. So I believe that should be entered as evidence. As well as all his pictures from his phone.

          • Karen in SC

            Interesting. that may explain a few things that have happened in my own family. I will be looking this up, especially with regards to how to “get back to normal.”

          • Lindsay Beyerstein

            Stereotypes about the “kinds of teenagers who use marijuana” have no place in a court of law. Either he was high when George Zimmerman shot him, or he wasn’t. We have no idea if he was a regular user, let alone an abuser. You can’t just posit that he had an “abuser personality” based on the fact that he smoked pot sometime in the month before he died.

          • MikoT

            when confronted about his behavior that night

            What behaviour are you speaking of? He was merely walking home at the time eating Skittles.

            And whether Trayvon had previously done bad things (and he hadn’t really, at least not by modern standards) is irrelevant – the question is whether his actions at the time warranted being stalked by GZ?

            As for his response – he was a gawky kid walking home by himself late at night being stalked by a stranger.
            He had two real options:

            1. Run, which marks him as prey and may encourage his attacker to escalate. This is like running away from a barking dog.

            2. Confront his attacker, and fight or bluff his way out of the situation.

            Bearing in mind that many muggers/criminals/rapists etc will ‘test’ a potential victim’s resolve via intimidation before striking, #2 is not an unreasonable option.

            The behavior of teenagers who smoke marijuana is altered whether they have recently smoked or not.
            Do you think that the teenagers you see in the course of your practice might not be a representative sample? There are many obvious confounding factors when it comes to precocious sexual behaviour and disciplinary problems, and it’s ill advised to simplistically assign cause and effect like this.

    • Mary

      I wear a hoodie everyday. A black one. When I was in HS I wore a trench coat everyday, which was the same time period as Columbine. I was bullied, beat up, and spat on for how I looked as well as followed in stores for fear I’d steal.

      I am sad for Trayvon’s famiy’s loss, and relieved for Zimmerman and his family. I personally don’t believe the media’s re telling of the story or the prosecutions ‘wannabe cop’ narrative. I see two people that made stupid mistakes, Zimmerman shouldn’t have confronted Martin, Martin shouldn’t have broken Zimmerman’s nose, no matter how personally insulting Zimmerman may have been.

      The jurors were presented with the evidence and heard from both sides and made their decision. We are biased. We are biased in where we get our info from and how in depth we choose to investigate. Their opinion and verdict is no doubt fairer than any ours, especially the activists that decided Zimmerman was guilty before they even knew anything about the case.

  • anh

    I freely admit I got sucked into the woo when I was pregnant. I thought epidurals were dangerous. blah blah. I thought giving birth naturally was such a feminist act. but then I started to realize that all the NCB advocates were insanely prolife, which I consider to be very anti-feminist. These same women crowing about the importance of women having bodily autonomy and making decisions about her health and body believed any pregnant woman should be forced to carry that baby no matter what.
    These same women who would go INSANE if you said the only thing that mattered was a happy baby would then turn around and say that a woman should sacrifice EVERYTHING to breast feed, even if she’s in agony, even if her marriage is falling apart, even if she has to get gov assistance because she can’t work, even if her other kids are neglected, even if she is nearly suicidal, because breast is best for the baby and the only thing that matters is a healthy baby. seriously, WTF?
    hardcore NCB advocates are anti-feminist hypocrites and I’m exhausted by then.

    • Bombshellrisa

      There is a birth center that has different support groups in the area, one is a drop in breastfeeding group. This past Valentine’s Day, they were saying it was the “perfect way to spend Valentine’s Day” by dropping in and nursing your baby in a room full of like minded women. Just what a chick wants to hear, that her baby is her valentine!

      • AmyP

        It’s very natural for a baby to displace the baby’s daddy in the mother’s affections (at least temporarily), but it’s a good idea to be more discreet about it.

        • Antigonos CNM

          Or to recognize that it is happening, and make sure that Daddy doesn’t feel left out.

          My husband is a Grade-A, 100% Yiddishe Momma, in spite of being male. When, with our second child, I developed severe mastitis [and from experience with #1, knew I wasn't producing hardly any milk anyway] and decided to stop any attempt to breastfeed, you should have seen my husband’s face light up: “Now *I* can feed Ahuva!”

          Some women actually feel MORE affectionate towards their husbands after birth — the baby brings them closer, doesn’t come between them. I was like this.

          • Lindsay Beyerstein

            What a cute story. I feel (platonically) affectionate towards your husband just hearing about it.

      • Gene

        I don’t understand. Why would I go to a place specifically to breastfeed? I mean, I am a do-it-anywhere type (hiking, WalMart, restaurants, whatever), so I have no reason to go to a place SPECIFICALLY to breastfeed. A social group with baby? Sure. But to make a special trip just one time seems weird.

        • Bombshellrisa

          It does to me too, I don’t understand the point

          • Vanessa Robertson

            It’s because some of these people are weirdos and need someone to help them justify all the pseudo-sexual feelings they have about breastfeeding.

        • anh

          it’s so everyone can all sit around and affirm the sh*t out of each other! in all seriousness, I understand it in the beginning. I went to a support group at a local breast feeding center and it was kinda useful. Although I once saw a LLL group meeting and several of them had toddlers with them. I was kind of perplexed why they needed support

          • http://housefulofchaos.com/ Christy

            Some of the people with toddlers may well have been leaders-in-training. The process for becoming a leader takes quite a while, and the people in the process aren’t allowed to introduce themselves as leaders-in-training during the meetings. Or they might have just made friends with the leaders and be going htere for the social contact.

      • Vanessa Robertson

        The reason I didn’t breastfeed (well one of them) was that while I was doing all my NCB and attachment parent research I got completely ooged out by the way these women talk about breastfeeding and their babies. It was waaaaaaaaaay perverted. They always say stuff about Americans being prudes and (somehow simultaneously) sexualizing breasts but they were definitely making me uncomfortable with the sensual way they were talking about breastfeeding. Especially Blossom’s book. UGH. It was just so gross.

      • Sue

        What a thoughtful gift to one’s partner, and presumably co-parent, on Valentine’s Day…(NOT)

    • Eyerollin

      Well if you don’t know any better and you hear from them first, the idea of an epidural sounds very frightening. It did to me, I’d heard all the crap about the horrors of epidurals, etc. Childbirth ended up being a total nightmare for me and when time came and they asked if I was ready for one I said yes quite readily. It was, truthfully, rather awful going in, but worked so wonderfully – and with no ill after-effects – that I was left wondering why they were so dead set against them.

      • rh1985

        I want pain relief but the epidural sounds a bit scary to me just because the type of needle/placement (and not because of any woo). But I will probably be in such pain that I will get over the fear of it fast enough…

        • anon

          I have the lowest pain tolerance on earth. Srsly. I had zero pain with any of my three epidurals- the pain from the contractions is so intense and all-consuming, I felt nothing when they did the epidural. I am not exaggerating. I know everyone’s experience is different, but that was mine. My only complaint was that I had to wait too long with my second (8cm) and third (complete, grrrrr) because the anesthesiologists were too busy.

          • rh1985

            I’m pretty sure that’s how I’ll end up feeling. My pain tolerance sucks.

          • Eater of Worlds

            I had an epidural for a surgery, not pregnancy. They had to go in four times before they could placed it properly on the 5th try. It hurt but it was not the end of the world painful. I got sweaty from it and the nurse had to hold me in the right position because I was struggling to do that and not respond to the pain of the placement. HOWEVER, I did not have the pain of labor at the same time. Given how bad my cramps were (they made me pass out from pain), I would suspect that if I were in labor and I had an epidural I wouldn’t think the epidural was very painful at all. Plus, most people do not need 5 tries to get it in, my vertebrae are very tight, unusually so, and that was the reason for it.

          • Squillo

            I had a similar experience with a pre-op spinal–resident had trouble placing it, and the attending finally came in to do it–but I felt almost nothing.

          • theadequatemother

            was your epidural for surgery lumbar (low back) or mid thoracic (middle of the back)? cos the latter is much harder to place.

            The nice thing about epidurals for post operative pain control is that you can have lots of lovely sedation while they are placed. Preggo ladies just get to be distracted by contractions.

            My epidural was quick and painless. I had to wait for the attending though…the resident wasn’t willing to do it, even though she was in her last year, I told her I was fine with her doing it and we both knew I would not be in a position to be her attending ever again prior to her graduation.

          • Eater of Worlds

            It was lumbar, supposedly the easier of the two! I just have weird anatomy, I have a bunch of deformed joints to boot.

          • BeatlesFan

            Same here- I had an epidural with my first and didn’t feel a thing. The only thing that “bothered” me at all was when the epi catheter was removed, and that was because it felt really weird, not because it hurt. My main concern was hoping I wouldn’t have another contraction while the epi was being placed. The anesthesiologist told me I had to be perfectly still while he placed it. I told him my contractions were 90 seconds apart- I sat through another contraction, said “Go!” as soon as it was done, and he had my epi placed within 25 seconds. I wanted to kiss him.

        • Vanessa Robertson

          I had an intense phobia of needles (and of being cut) to the point that I would pass out cold just THINKING about needles (or being cut). That’s part of the reason I wanted to “go natural”. I ended up at the hospital and the epidural did not hurt one iota. I didn’t feel the needle go in, I felt a rush of cold down my lower back and through my legs and then just ….awwwww. There was no pain bringing back out or afterward. Don’t be scared. (I’m over my fear of needles now, to boot! Four months ago I would have been on the floor dead to the world just typing this ;)

        • MichelleJo

          Promise you, by the time you ask for an epidural in labor without initially wanting to, even if the doctor stuck a 12 inch needle in front of your face, you’d tell him to stop wasting his time and stick it into your back already.

  • Mel

    Look, if you want to have a drug-free childbirth, you should be able to say to the nurse or doctor or whoever – “I’m good” or “No thanks” or “No” as many times as they ask you. If you don’t have the mental stamina to deal with that trivial inconvenience, you aren’t gonna do well on natural childbirth.

    • I don’t have a creative name

      Or parenting in general.

  • Charlotte

    I had a friend give birth a few days ago and brag loudly about how she did it with no pain relief. That’s part of how these crazy ideas are spread – if all your friends are preening about how they gave birth the “correct” way, it’s a little hard for you to buck the trend And do your own thing because you know you’re going to get criticized for it.

    • Bomb

      I planned a homebirth for my first, but avoiding pain medication wasnt something I was shooting for. I told my husband if I transferred I wanted an epidural. Long story short lets just say I thought unnecessary c section was rampant and I wanted to avoid that, but I didn’t think med free was important or preferable.

      Yet 3 months after my ‘failed’ homebirth I was inexplicably jealous of my BFF because she had a natural birth in the hospital complete with belly dancing videos and otherwise blasting it out into the universe. It was so weird. Aside from crippling PPD and being in the middle of my breastmilk drying up and my baby failing to thrive (stopped BF at four months, WAY later than I should have), I can’t think of any reason I would be jealous given my stance on pain meds going into HB.

      The ‘med free is better’ is just so pervasive amongst my peers it just infiltrates your thoughts even when you don’t want or care about being med free.

      • Charlotte

        I wanted a med-free birth for my first, but looking back, I’m not really sure why. I remember nodding in agreement when a friend claimed it was better for the baby, but I don’t recall what made me think that was true.

        • BeatlesFan

          Same here- with my first I wanted to try for natural… I guess because I hadn’t been through labor before (stalled labor, at that) and had no idea how badly it would hurt. For some vague reason, I thought med-free birth was something to strive for, something to be proud of. Then I got the epidural (after having to fight for it for over an hour) and as soon as it kicked in, I felt stupid for not having asked for it hours earlier.

      • Vanessa Robertson

        I’m sorry! That must have been horrible for you. I hope everything has settle down now with the baby and the PPD. I hate how this is some sort of competition and how easy it is to get sucked into it.

    • fiftyfifty1

      Yep, received the mass text last week from a friend of mine: “[Gender], [weight], no epidural”.
      Announcements used to state things like the name and “mom and baby doing well” etc. But I guess in some circles the epidural/no epidural info is deemed more important.

      • Anj Fabian

        I’m of a generation that I’m waiting more for the “Mom and baby doing well.” than the name or gender.

        • Haelmoon

          I posted that I had an emergency c-section with my first. But I was an inpatient in the hospital where I worked, everyone knew I was in with complications and then was suddenly delivered on a Sunday night due to a cord prolapse. I was only 32 weeks, and it was just a quick explanation of why baby was in NICU and why we asked for some private time because initially she wasn’t doing so well. However, I didn’t mention the failed spinal or general anaesethic.

      • Clarissa Darling

        When did it become common to include details about the labor and delivery in birth announcements? My friend who is a Dr. even tweeted in her birth announcement that her child was born via natural birth. In her case, I’m pretty sure she just meant she didn’t have a C-section (and maybe not an epidural). I know for a fact she doesn’t have a philosophical issue with either procedure. It just struck me as odd to include this kind personal info in the announcement. I could see discussing it with close friends who ask because are curious about how my labor went but, I don’t think I would tweet it to everybody.

        • Vanessa Robertson

          Yeah, for real, no one wants that much information about you.

    • Something From Nothing

      Someone who brags about giving birth without drugs is a bit of an idiot in same manner as people who put amber teething necklaces on small children. To me, it’s like announcing your gullibility to the world.

  • Lizz

    Slightly OT but has anybody else had an issue with the magical thinking in childbearing and breastfeeding when it comes to fixing postpartum depression, being a sexual abuse survivor in general,etc? That it’s such a magical experience that if you do it right it will cure what ails you psychologically?
    I know I caught a lot of flack for saying that breastfeeding and childbirth pain triggered my PTSD rather then fixing it.

    • amazonmom

      I know the woo pitchers were telling me my antenatal depression would go away if I just had natural childbirth, breastfed exclusively, etc etc etc. When I wised up 6 weeks postpartum and got a real diagnosis with real treatment, I realized the emperor had no clothes. NCB nuts are dangerous. They lead women away from what is safe and effective into practices that are useless at best and life threatening at worst. I do get flack for speaking out against the nutjobs, but if I can save the life of even one person in the process its all been worth it.

      • Antigonos CNM

        Interestingly, there is some brand-new research which deals with PP depression just out, including development of a prenatal blood test which is supposed to be able to indicate if a woman is susceptible to it. This would seem, to me, to indicate that better treatment might soon be on its way, and that the main causative factor may be a chemical or hormonal imbalance, possibly triggered by some gene, of some kind rather than a psychological one. I await further disclosures with interest. It’s not so long ago that a less severe form of PP depression, which has late onset [several months after birth] was identified — and which I think I had, after my second child was born. Like a lot of OB, since birth is “normal” for women, research into conditions associated with birth has been more or less neglected for decades: “Just buck up and cope” or “Don’t eat this” or “It’s all in your head” or “it will pass”, which isn’t very helpful.

      • Bombshellrisa

        I hope that you keep speaking out. You are in an area that is saturated with the woo and the believers!

      • Vanessa Robertson

        Oh my. I had (we called it perinatal) depression and that was the main reason I decided not to breastfeed. I needed to get those hormone levels back to normal to be fully functional. I did hear a lot of BS from people trying to convince me to at least do it for 6 weeks (even months later people still tell me why I should have). I figured that I wanted to 1. not kill myself or my baby and also 2. enjoy my time with the baby.

        • amazonmom

          My therapist (locally famous for her work in perinatal depression) was permanently banned from the WA state LLL conferences. Her crime? Wanting to make a presentation about how to support women who need to stop breastfeeding due to physical or mental health concerns.

  • yentavegan

    Perhaps the time has come for level headed folks to re-claim the language describing birth. All birth is natural. It is not magical or mystical or unnatural.
    So I have answered people who want to know if I gave birth naturally to my dd2, (who was 10 lbs at birth,) I say, why yes. I am her mother so naturally, I gave birth to her via a c/section.

    • Lisa from NY

      Were you overdue?

      • yentavegan

        Interestingly, no. She was c/sec’d on her due date.

    • Antigonos CNM

      A very wise and elderly OB I knew once told me that NO birth is “natural” but that there are only “complicated” and “uncomplicated” births — and that can be known only in retrospect. We are not a species which normally gives birth unassisted in some fashion, even if it is only moral support from attendants.

      • Lizzie Dee

        Doesn’t that mean that a complicated birth is just as natural? I would be curious to know what proportion of births – especially first births – are 100% uncomplicated. Obviously, the majority of births are largely unproblemmatic in that everyone ends up more or less OK.- but that is not the same as uncomplicated. Some of these blissful homebirths I read about seem far from uncomplicated to me – and I am dubious that they always are entirely free from unwanted consequences. The triumph of “natural” might be a bit of Pyrrhic victory sometimes, given the complications that don’t get talked about/show up later.

        • The Bofa on the Sofa

          Doesn’t that mean that a complicated birth is just as natural?

          Complications are just a variation of normal, don’t you know?

          You know what else is normal? Pain in childbirth. And wanting relief from the pain. That’s about as normal as you can get.

        • Antigonos CNM

          I can’t quote exact percentages — anyone with hard data? — especially for primips. But the percentage of NSVDs –normal spontaneous vertex deliveries — hovers at around 80%. This is a deceptive figure, however, just as the C/S rate is deceptive, since not all C/S are primary; elective repeats get lumped in so the total is higher and it could be argued that a certain percentage of elective repeats MIGHT have been VBACs in different situations [For example, a primary C/S for placenta previa, or breech, or twins, or fetal distress -- the subsequent pregnancies being normal but the doctor, the patient, and/or the hospital unwilling to risk uterine rupture. Theoretically, an NSVD is possible] A pre-eclamptic woman can have an NSVD, but she has complications; or a PPH after an NSVD or premature rupture of membranes, etc. So one has to look to the entire period of both labor and what is sometimes called the “4th stage” of labor, the immediate postpartum period to assign a complicated or uncomplicated label. As in so many things, “define your terms!” because the numbers can change dramatically depending on the parameters considered.

        • drmoss

          “Doesn’t that mean that a complicated birth is just as natural?”

          Of course – one that would have resulted at one time in a completely natural neonatal death. It’s becoming obvious that NCB is more about the mother than the child, and that seems to deny the actual point of reproducing. Perhaps there’s an unconscious element of risk-taking behaviour – the thrill of gambling on a chance that you will get away with it and the elation of bragging that you did. A cautious person who simply (!) wants a healthy baby would do everything in her power to improve the chances of that outcome. Back in the days when I did deliveries my experience was that all births are complicated in that I would spend the process constantly anticipating trouble (too much knowledge is a burden) and then sometimes meeting it. And that was a real ‘Oh, shit!’ moment as the nearest OB and anesthetist was an hour away over the top of a snowy mountain. Two years of that was enough to make me quit delivering, despite much outcry among the community. A year later the provincial government closed all obstetrics outside regional hospitals on cost grounds anyway, but I had no regrets whatsoever about stopping deliveries as a family doc in a remote place with no backup.

          • Lizzie Dee

            It is blatantly more about the mother than the child as far as I am concerned – which I don’t find all that surprising or shocking if it wasn’t wrapped up in rhetoric about being a better mother. I find it rather weird that the increased safety that has come from all those nasty interventions has shifted the focus from a healthy child to an “experience.” and I find it a bit hard to admire people who are either very poorly informed about risk, or content that it is the baby who bears most of it.

        • Sue

          ”Doesn’t that mean that a complicated birth is just as natural?”

          I propose a new classification. There are no ”unnatural” births, just three classes of natural:
          1. Natural with no complications;
          2. Natural with complications averted or managed; and
          3. natural with bad outcome(s).

    • Guesty Guest

      I agree. I think wanting a healthy baby is the most natural thing in the world – how mom and her providers get there is secondary. And asking for safe, effective pain relief when you’re in pain is definitely natural.

  • Antigonos CNM

    No one has ever explained to me why feeling pain in labor is obstetrically and/or medically beneficial to the mother. And that is now the way the NCB movement has framed the discussion: pain has become a good thing, even desirable.
    Tolerating unavoidable pain to lessen risks to the newborn is one thing, but to make analgesia undesirable when it does not endanger the infant presupposes that there is some inherent virtue in suffering, and I can’t see it. There’s no virtue in feeling discomfort, manageable or not, in any other condition. I’m not a better person for avoiding the ingestion of ibuprofen for my arthritic knees. I might say [but don't] that long-term use of ibuprofen can do unpleasant things to my liver and to avoid that I will choose to hobble around in constant fairly severe discomfort. But if tomorrow a pill would be developed that would make my knees feel 20 years younger AND not have any effect on my liver, you betcha I’d be at the head of the line to buy it. I don’t want to “manage” my pain, I want to get rid of it! Why shouldn’t the goal of childbirth be the same? Completely safe, completely pain-free? Don’t women DESERVE that? [If men got pregnant and gave birth, how many would choose not to take an offered epidural?]

    Another thing: more than nurses offer epidurals at the onset of labor ["when you do want it?'], it is my experience that women begin demanding an epidural when labor is not sufficiently established to warrant beginning one. I have had to explain this to countless women who would have been very happy if the anesthesiologist, rather than their OB, had met them at the door. And not infrequently they have been very angry at having to wait.

    • fiftyfifty1

      “when labor is not sufficiently established to warrant beginning one”
      Do you mean when they are not in labor at all but rather have Braxton Hicks? Or do you mean your hospital has a rule about having to be a certain number of cm before getting an epidural?

      • Isramommy

        I hope she means because they are not in labor at all yet. I am one of those women who would like to be met at the door by the anesthesiologist, even if I’m only at 1 or 2 cm. With both my kids I got my epidural at 2 cm. That’s when I began to feel pain. I would have been livid if I’d been denied, or told I had to wait until I reached a certain magic number before getting effective pain relief. And while I know individual anecdotes prove nothing, both my labors were very short despite (or maybe even because of?) the early epidural.

        • theadequatemother

          your experience is backed up by RCTs!!!! Early epidural analgesia ( 4 cm.

          • Antigonos CNM

            The conventional wisdom has been that early epidural almost always requires pitocin augmentation as contractions tend to stop if the patient is less than 4 cm dilated. Nurses and midwives on L&D would probably dispute that, as many of us have seen sudden and rapid dilatation AFTER the woman’s epidural has let her relax generally. Whether this is an anecdotal phenomenon, or can be backed up with hard evidence, I don’t know. Further, it raises the question whether augmentation of labor is itself a bad thing [that dreaded "cascade of interventions", doncha know?] A patient receiving pit DOES need to be closely monitored, which means a higher staff/patient ratio, so economics gets into the equation, and hospitals are businesses. OB is NOT a money-maker for hospitals, unlike other departments where bed capacity can be kept at nearly 100% all the time.

            I don’t know the current thinking — I haven’t worked in hospital since 2001 — but doctors used to be reluctant to give epidurals to VBAC patients because they wanted the patient to be able to report any sudden, severe pain which might indicate the uterine scar was in danger.

            My point is that unless one can give me a good medical reason why women NEED to have pain/discomfort in labor [for example, a baby's first cry aerates the lungs and with the changes in pressure, begins the change from fetal to normal blood circulation, therefore, while it might distress parents to hear a newborn scream instants after birth, there is a good reason for it], why shouldn’t labor be without any pain or discomfort? Short answer: because today’s technology does not provide a truly 100% method of avoiding all pain without associated risks of some sort to the infant or to the mother’s own health. So one has to balance risk against effect. For now.

        • fiftyfifty1

          I know this is nothing other than obvious, but sometimes when I read a comment it strikes me all over again how lucky we are to have modern medicine to help us with childbirth. Think of the millions (billions?) of women before us who have rightly dreaded childbirth:Severe unavoidable pain. A very real chance of death.

          But now even those women who want to go NCB don’t have to dread. They know there is always an “out” to be had to their experience.

          • Lizzie Dee

            Or at least, they think there is always an out. (You can always transfer…)

            How terrible to find out that it isn’t always that simple!

            (I might regard homebirth as reasonable if cEFM and blood transfusions were feasible. But being looked after by an optimistic enthusiast for nature equipped with an infrequently used fetascope and herbs has zero appeal.)

      • amazonmom

        Providers were getting scolded by upper management at my hospital because they were admitting women in early labor for pain control. The bed turnover was slower and upper management only wanted women in active labor admitted so the labor bed could be turned over at least twice a day. Staff and providers refused to turn away suffering women and told upper management to stick their memo where the sun doesn’t shine. If there are beds available we admit for pain control and it doesn’t matter how far labor has progressed. When the unit is overflowing into other departments then we do try to triage who is getting a bed first but we do admit as soon as we possibly can.

        If I choose VBAC this time around I will be asking for an epidural as soon as I can get it.

      • RebeccaGJ

        I have given birth in two provinces in Canada. The policies where I gave birth was no less than 4cm, no greater than 8cm. Otherwise it’s not going to happen. The only exception was induction, they would allow you to get the epi. When they started the pit. drip.

        I have had unmedicated births because I walked into hospital at 8cms. I didn’t much appreciate that. Being forced to endure abject misery like that was terrible. I remember feeling traumatized afterwards like I had just been through a car accident. I remember begging my dh not to go home afterwards because I couldn’t process how bad that was. I would have much rather had the epi and been able to relax and enjoyed my baby’s birth.

        • Lizzie Dee

          It has always seemed to me that the psychological effect of unrelieved, unremitting pain is traumatic – isn’t the whole point of torture to break down psychological defences? If you can brainwash yourself into believing that somehow this pain is different, or that a baby is your reward for suffering it, maybe the effects can be mitigated. What worries me is first time mothers who expect it to be manageable because they have been sold the idea, and then find out it isn’t.

          Once my daughter got her epi, she DID relax and enjoy her baby’s birth. I think that is amazing and wonderful myself, given that the risk of complications is so slight.

    • Renee Martin

      We ask for epidurLs ASAP because we know it can take time, and because we want to preempt that pain. why would anyone prefer to wait for pain first, then have to sit still to have it placed? No thanks. I will get mine as soon as possible

      • me

        I wanted to wait and see how it was each time. I was interested (but not totally dead set on) in doing it without meds (especially after my first where there were epidural related complications), but I also knew that I had a threshold where, potential complications be damned, I would take medication. I knew it might be more difficult to hold still if the pan was intense, but the ‘wait and see’ approach worked well for me. Now, if you are planning an epidural anyway, no there is no point in waiting. But if you are interested in unmedicated delivery, having that wait and see approach makes sense.

        • Jocelyn

          This was same for me on my first delivery – I didn’t know what the pain would be like, so I decided to wait and see if it would be okay or if I’d want pain relief. Turns out I wanted pain relief. I’ll probably get the epidural right when I go in next time, because now I know what my labors are like.

          • me

            My labors were all pretty different. My second was far and away the easiest (I was truly shocked to find I was 8 cm at admission and rated my pain as a 3-4 until pushing). The first was the most difficult (partly because it was my first and partly, maybe, because it was induced). The third wasn’t too bad, until I stalled out at 6 cm for about 5 hours. The pain wasn’t too bad, it was just demoralizing to not be making progress despite regular, strong ctx. When the resident anesthesiologists couldn’t place the epidural I started to panic (in my head anyway), but fortunately I had flown from 6 to nearly complete (“just a lip left” as my CNM put it) in the half hour or so it took for them to try and fail, so overall it was positive; in the end I was glad that they had failed to place the epidural. I was glad to be able to be up and about throughout my second two labors, and even more glad to be able to be up and about afterward (esp since my husband had to leave to attend to my older child(ren). I’m not a big fan of catheters :)

            If we were to lose our minds and have another baby, I’d take the same wait and see approach, but I’d definitely ask that the attending do the epidural (should I choose one). I’m all for giving students the opportunity to learn, but holding perfectly still thru what turned out to be transition, only to have them not be able to place it anyway kinda sucked :)

          • Jocelyn

            I hope all my labors are different! :) My first one was similar to how you described your third one – very slow progression despite regular, strong contractions. I got to the hospital at 11 pm the day I went into labor, and they didn’t admit me until seven hours later because I was progressing so slowly. When I first got there, I was only at 1 1/2 cm (even though I’d been having regular contractions for most of the day), and my pain was already about a “6.” An hour and a half later, I’d only progressed to 2 cm, and my pain was about an 8. They said they couldn’t admit me because I wasn’t progressing fast enough, and sent me home with a shot of morphine. We came back two and a half hours later…and I was only at 2 1/2 cm. At this point, my pain was at a 10, and they still wouldn’t admit me. They observed me for a couple more hours, and finally admitted me at six in the morning when I was at 5 cm. At this point, I’d been having regular, extremely painful contractions all night long.

            Anyway, I hope my second is like your second! :)

          • Jocelyn

            Hahaha, and I just saw this Hyperbole and a Half Guesteleh posted below. This is totally the pain scale I’m using. http://hyperboleandahalf.blogspot.com/2010/02/boyfriend-doesnt-have-ebola-probably.html

          • me

            You never know! :)

            What’s interesting (and bear in mind this is n=3 and it’s not really something you have control over) is that my second baby was a full pound bigger than her similarly sized sisters (8 lb 5 oz and 8 lb 4 oz). IDK if being larger meant she had to get in a better position for labor to begin and that made the difference or what. I’ve heard that sentiment expressed by other women, but don’t know if studies exist, or how you would even study something so subjective anyway. The trade off for the easier labor was a longer, more difficult pushing phase (about an hour and a half compared to an hour for my first child and less than 30 minutes for my third), but really if it was her size that made a difference, I’d happily have seven or eight 9 lb babies over one 8 lb baby, lol.

          • Guest

            Hahaha, and I just saw this Hyperbole and a Half pain scale Guesteleh posted below. This is totally the pain scale I’m using. http://hyperboleandahalf.blogspot.com/2010/02/boyfriend-doesnt-have-ebola-probably.html

          • Jocelyn

            Hm, this was me…I don’t know why it’s showing up as “guest.” Disqus being weird again.

        • AmyP

          With my most recent epidural (my third), I knew that I wanted it, but 1) I wanted some mobility as long as possible 2) I’m a naturally squeamish type and I knew that the sensation of getting an epidural placed was strange and unpleasant and a little scary and that I needed enough labor pain underway to make getting the epidural seem tolerable (if that makes any sense). I had nearly missed getting any pain relief with a previous delivery, so I kept informed as to how busy the anesthesiologist was and got the epidural early enough not to feel serious pain but late enough that I was motivated to cope with having a guy poking around my spine. I was really happy with the timing. (And by the way, at some point, it’s positively a blessing to get a catheter and not have to fuss about transporting one’s laboring self to the bathroom every hour or so.)

          The downside was that after delivery when my legs were still frozen, my husband had to leave me to collect our big kids and get dinner. I was stuck alone with the baby with frozen legs and it was kind of rough, especially when figuring out how to eat dinner. I guess I could have asked for nursing help, but it was just barely manageable, so I managed.

    • theadequatemother

      The median cervical dilation of the 20 000 + women in two studies of early vs late (> 4cm) epidural analgesia at first request for pain relief was 2 cm. These ladies had a median pain rating of 8/10.

      We have good randomized prospective clinical trial evidence that there is no need to wait…so why do women wait? It might have something to do with a fear of “stalling” or “stopping” labour – in which case we simply need a bit of education..but I suspect it’s a resource issue. Cheaper to run a birth unit where women only get in at 5+ cm dilation and stay for shorter lengths of time.

    • Ainsley Nicholson

      My reasons for choosing not to use pain meds have nothing to do with thinking that pain is a good thing, or having anything to prove to anyone. My reasons are much more along the lines of your ibuprofen example. And they are specific to me…they don’t apply to anyone else and I would never think less of someone for chosing pain relief or more of someone for going without.

      • Rachel Mallory

        Ainsley, I completely agree with you. I gave birth without pain medication was because it was right for me, but I don’t judge people who make other choices or try to tell everyone that it’s right for them.

    • L&DLaura

      I read on a natural birth forum that I frequent, that by the woman not feeling pain she is not releasing natural pain killing hormones and therefore the baby feels the pain instead.

      • Antigonos CNM

        When I finish laughing, I’d like to know how that was determined –that the baby feels pain in utero if the mother doesn’t.

        No woo is too woo, apparently.

        But again, the point seems to be to try and find a justification for the necessity of suffering. The Victorians thought that the mother wouldn’t bond with her infant if she didn’t suffer, and that is why, although general anesthesia was available from about 1840, it was not used in childbirth until the Queen herself got a few whiffs of chloroform with her last child [it was called "the Queen's anesthesia" for a long time afterward].

  • Ashley Wilson

    I have a new theory about NCB’ers. WIth so many of them being advocates of Attachment Parenting and having to give every last bit of themselves to their child or they are the worst parent ever, they view pregnancy and giving birth as their last chance to be completely selfish, it’s Their Birth, Their Special Day. And they over correct. Nevermind that parenting is a balancing act that you shouldn’t lose yourself to, and thus no need to make this one thing their One and Only Thing that defines them. Nevermind that these parents tend to be the most selfish parents ever. That I have to bend over backwards to accommodate their parenting style (or risk my kid’s health because they won’t vaccinate their kid). How they all talk about their birth story or what have you sounds like they view the birth to be like the Bachelorette party to being a parent. You can get away with anything because you’re not a parent yet.

    • suchende

      It reminds me of gypsy weddings, with one very elaborate special day for the bride who will thereafter be expected to selflessly serve her family.

      • Dr Kitty

        Gypsy is a loaded term.
        Irish Travellers prefer “Traveller” and Roma prefer “Roma” or “Rrom”.

        Other than that, I don’t disagree with the sentiment.

        Nothing breaks my heart as much as a Traveller woman in her early 40s with “eight children doctor, if you only count the living” who can’t read her own name on the board signalling it is time to come into my room.

        • auntbea

          Do you happen to know if New Age Travelers and Irish Travelers are the same thing? I didn’t know that Travelers and Roma were not the same until just a few weeks ago.

          • Dr Kitty

            New Age Travellers are, as far as I know people who have made a lifestyle choice to Travel and who have New Age beliefs.
            Irish Travellers are an ethnic Irish group who have a traditionally nomadic lifestyle and worked as Tinkers, horse traders and seasonal agricultural workers. They have their own language, and do not tend to marry outside the community.
            With industrialisation their lifestyle has become less viable, and many were “settled” into social housing against their wishes.
            Irish Travellers in Ireland have a shorter life expectancy than the non traveller community.
            So no, not the same,

        • Bomb

          There is a show in the US (dont know if it runs in the UK) called My Big Fat Gypsy Wedding that details the ins and outs of the process. In the show they are referred to as travelers mostly. I assume that is what suchende was referencing, and that they weren’t trying to be offensive. Lots of people take issue with being called a redneck just because they have an alternative lifestyle, but probably not the ones on My Big Redneck Wedding.

          • suchende

            Whoops, yup, exactly this. That show is my only exposure to this group of people.

        • Ainsley Nicholson

          Interesting study came out a few months ago showing that the Gypsy families in much of Europe (the ones called Roma, I beleive) have ancestors in common with certain lower-caste populations in northern India.

  • Hava NaturalMama

    Appropriate pharmaceutical pain relief should be available to anyone who is in pain for any reason, but people should also have the option of choosing to just deal with the pain. Childbirth is not that painful for everyone; mine was way easier that I expected. Some women would rather not deal with the side affects of drugs, and that’s okay. Not everyone who chooses natural birth judges people who choose differently.

    • The Bofa on the Sofa

      Appropriate pharmaceutical pain relief should be available to anyone who is in pain for any reason, but people should also have the option of choosing to just deal with the pain.

      Yeah? Who doesn’t?

      Where has anyone, anywhere, suggested that pain medication such as epidurals should be required?

      • Hava NaturalMama

        I’ve had friends get asked “when do you want your epidural?” as if an epidural was the only option.

        If someone chooses to just deal with the pain, they also need to be allowed to do that. It needs to be okay to move around, make noise, etc. If hospitals don’t allow self comfort measures, that’s just as bad as denying epidurals. The nurses also need to be trained in how to react appropriately to women who choose not to take drugs.

        • Amy Tuteur, MD

          It’s the only option that actually works?

          What’s wrong with asking women in pain whether they would like pain relief? There doesn’t seem to be anything wrong except for those who want to follow the misogynist lies of NCB.

          • Hava NaturalMama

            Depends what the goal is. If goal is to eliminate the pain, go for the epidural. If the goal is to make the pain bearable, a walk, a back massage, a shower (etc) do make the pain bearable for some women.

            There is nothing wrong with asking IF a woman would like an epidural (unless she asked not to be asked), but the question shouldn’t be WHEN, assuming the answer is yes.

            ALL birth choices that are safe for mom and baby should be respected.

          • Karen in SC

            I think nurses asking the question, “When do you want your epidural?” is an urban (NCB) myth!!!

            The mother actually doesn’t decide, even when making a very clear request for an epidural, it doesn’t happen just on that say so. So that question is probably never asked.

          • Hava NaturalMama

            Okay you’re welcome to to think that. I choose to believe my friends.

          • Haelmoon

            Nurse don’t ask patients when they want an epidural, unless this is a request on their pre-admission. If anything, nurses will encourage women to delay their epidural, especially in busy labour units, because it is actually more work to have a patient with an epidural than without. Natural labour is not discouraged in any unit I have ever worked on. Its a lie!!

            I was taught that being offended is a two person event. Someone may say something thoughtless, but the other person also has to CHOOSE to be offended and they control there reactions. (I am not trying to say there is never an appropriate time to be offended, but many times reactions are blow way out of proportion).

          • Hava NaturalMama

            Obviously there is geographic variation, and your experience (or my experience) may not be representative.

            Offense is a two way street, but the greater burden falls on the person who isn’t is labor or deathly ill or in any type of sensitive situation. If someone is having a rough day, one should go out of his/her way to be sensitive.

          • anne

            With offense being a two way street then maybe it is difficult for nurses, who are medical professionals, to watch women needlessly suffering all day.

            I sat in on my friend’s two unmedicated labors. According to her they were quick, and easy. Less than 6 hours. Yet she screamed, begged God, and was flailing so hard that when she decided she would accept pain relief they were not able to seat the needle properly in her arm.

            Listening to someone’s agony when there is no real reason for it is very difficult.

          • me

            “Natural labour is not discouraged in any unit I have ever worked on.”

            This! I’ll never forget how excited my L&D nurses were to encounter a woman who wanted a NCB and then followed thru (esp with my 3rd child – I was the newer nurse’s first ‘natural’ delivery). They were ready, willing, and eager to help and encourage me.

          • The Bofa on the Sofa

            Okay you’re welcome to to think that. I choose to believe my friends.

            But by your own admission, your friends were out of their heads in pain and can’t be trusted. If labor makes them lose their heads, why would you actually believe what they say is what really how it happened?

            Now, others have indicated that they don’t buy it, but hey, it’s your story.

          • Hava NaturalMama

            Most of my friends chose epidurals; often do to nurse pressure. Some of them are happy they got them; other wish they had felt they had more choices.

            Pain may make calm logical conversations difficult. I never said anything about losing heads or distorting memory.

          • Bombshellrisa

            I wish my NCB from hell nurse would have pressured me to get an epidural instead of making it sound like a moral issue and that I should avoid it.

          • Hava NaturalMama

            I am sorry she made it sound like a moral issue… that’s awful!

          • Bombshellrisa

            The wording went something like “Oh, come on, you CAN give birth naturally” and what makes it worse was that I was afraid of the effects an epidural would have on me. I am a survivor of sexual abuse, I didn’t want the feeling of not being able to have control of my legs (not that I could go very far anyway) and I was already triggered and terrified. My husband had called my family to come to the hospital because HE was scared watching me cry and groan and hurt so much (nothing like having to deal with the people who make you craziest when you are feeling your worst). I had taken a class about when survivors give birth, I thought I knew a lot about birth because I had trained to be a midwife and had seen plenty of laboring women in their homes and at a birth center. I am also a nurse, so I felt I knew enough that I was well informed. I just had no idea that I would be dealing with a nurse like that and that I would be so utterly scared and unable to speak up for myself.

          • Hava NaturalMama

            awful just awful

          • Lizz

            Where did you take your class on when survivors give birth? Personally I wasn’t even close to prepared and to be honest I blanked out large portions of labor with my son.
            While all of my future children will be c-sections but it would be nice to take a class on this.
            Oh, did it cover breastfeeding at all? I found that seems to be really misunderstood in survivors.
            I just want to find something that isn’t all about how NCB and breastfeeding will empower and fix you.

          • Bombshellrisa

            I took the workshop at Bastyr (I know, I know), it was actually a class focused on those who are caregivers for those survivors. I don’t know of any other class or book (because Penny Simkin wrote a book “When Survivors give birth) that talks about this subject. She did talk about elective C-sections, but the tone was more about how healing a vaginal delivery can be. Breastfeeding was talked about more as a bonding experience than possible trigger, but again, it was touched on lightly. I wish there was more for survivors in the way of resources. Talking with your doctor or CNM can be extremely helpful too.

          • Box of Salt

            Hava, your and your friends’ experiences are far from universal. I choose to believe the friends and family with whom I’ve discussed labor, and none of them reported having the question of getting an epidural posed as “when?”

            And it’s not a regional thing – I have family members who have given birth in several different areas of the US (I’ll admit mostly urban and suburban; no rural).

          • Bombshellrisa

            i could see the use of “when” in a rural situation, one where there isn’t anesthesiologist on site 24 hours. If you are dealing with on call anesthesia, it might be helpful to ask “when” instead of “if”.

          • me

            Well yeah…. how does that go “I’d like it at precisely 3:45″ or “when I’m exactly 3.5 cm dilated” or “in no less than three hours but no more than 4″

            I can see ‘do you want’ or ‘are you planning’ or some variation on that, but “when”? I hope you and your friends answered that nonsensical question with a nonsensical answer….

          • Box of Salt

            me, its possible this was lost upthread. I am responding to Hava’s claim yesterday that “I’ve had friends get asked “when do you want your epidural?” as if an epidural was the only option.”

            *I’ve* never heard anyone tell me a nurse asked that phrased that way (“when?”). It’s Hava’s claim.

          • me

            I know, sorry, I should have posted that to Hava… this thread is getting unwieldy :)

          • GuestB

            Are women really this fragile?? IF is acceptable but WHEN is not? This just seems silly to me.

          • Hava NaturalMama

            Yes women in labor are really that sensitive.

          • EllenL

            Some people look for offense where none is intended, and NCB zealots seem to be especially good at that.

          • Hava NaturalMama

            But who should the burden of sensitivity be placed on. The L&D staff who do this every day or the woman who is in pain and may only do it a few times in a lifetime?

          • Antigonos CNM

            In all my career, from 1967 onwards, I have never seen a woman given analgesia against her will, particularly not an epidural. In fact, despite all the rhetoric about what the hospital staff and doctors are capable of doing to you, I’ve never seen ANY procedure in labor and delivery done to a patient involuntarily except in life and death situations where the patient was not in a state to give consent [such as during an eclamptic seizure] There is something deeply disturbing about this paranoiac aspect of the NCB folks. Birth rape, indeed.

          • Sullivan ThePoop

            A tiny fraction of women in labor might be that sensitive, but I have never known any.

          • Hava NaturalMama

            How many have you seen in late labor with no pain relief? If you want women to be calm and reasonable, an epidural helps.

          • Sullivan ThePoop

            at least a dozen and have many more friends that had babies, some natural, some not.

          • Hava NaturalMama

            I didn’t say losing all mental capacities. I personally could not talk much during contractions, but I was totally fine in between. Timing of nurse questions matters too.

          • theadequatemother

            anesthesiologists have done studies looking at the ability of women in labour to hear and later recall information (you know, the kind that you need to get consent) and yeah…they can do it. Labour pain doesn’t make them incompetent.

          • Sullivan ThePoop

            Oh and also, I had two completely paid med free births and 1 where I just had IV pain meds. I have never had an epidural.

          • Hava NaturalMama

            Okay. That’s great that you were able to be calm and reasonable the whole time; that wasn’t my experience and my guess is that its not the norm. Calm and reasonable and extreme pain/fatigue don’t mix in my mind.

          • Sullivan ThePoop

            If I was in extreme pain I would have gotten pain relief, like I did with my son.

          • me

            You are contradicting yourself here. If you aren’t calm and reasonable, maybe you aren’t coping so well. You said earlier it wasn’t that bad, but here you are saying it was so bad that you were no longer calm or reasonable. Something doesn’t jive. I had two unmed births. I remained calm and reasonable throughout both of them (well, maybe not during pushing, but it’s too late to get pain meds at that point, not to mention it wasn’t necessarily the pain but the hard work that required so much concentration that I didn’t have time/energy for ‘calm and reasonable’ lol). If I had become unglued or incapable of rational thought at some point, that would have been precisely when to throw in the towel (so to speak) and get an epidural (or some other option); heck, that would be a sign that I’d waited *too long* to get meds.

          • Jocelyn

            I completely agree with this – if you aren’t calm and reasonable, you’re not really coping well. In fact, I might even define “coping well” as being calm and reasonable through the pain. If you become distressed and irrational – well, who wants that? Is that really what people desire when they decide to go unmedicated? Is that how you want to feel the moment your baby is born?

          • Hava NaturalMama

            For me, I was totally fine between contractions, and could manage during contractions is allowed to move freely and focus. However, I could not handle being forced to stay still during contractions and being asked questions, and I found side conversations very annoying. So I could manage when I was allowed to, if that makes sense.

            I happened to have nice breaks in between contractions, which is what made labor feel easy to me. So most of time, I was calm and reasonable.

            I hope that makes sense.

          • me

            Makes perfect sense. In active labor I wouldn’t expect a woman to be carrying on a conversation during a ctx. Sorry if I misunderstood, your post suggested that women in late labor were not “calm and reasonable” at all. Yeah, I’d get miffed if someone tried to talk to me during a ctx (more likely I’d just ignore them until it was over). I do remember shushing my husband and CNM during a ctx during my second labor (they were making small talk and I found it distracting). But had my CNM or nurse asked me a direct question during a ctx? I’d wait until it was over, then answer. I’ve heard of women describing ‘going into “laborland”‘ and basically zoning out, even between ctx, but that didn’t happen to me. I remained fully present the whole time. No one tried to force me to stay still. But it seems that’s a whole separate issue (why were they restricting your movement in the first place, if you don’t mind my asking?).

            FWIW, I get that labor can make a woman more vulnerable. I also get that impatient providers (who for whatever reason insist on talking/asking question/doing things during ctx) can make coping harder. Having a support person answer the questions, or at least speak up for you and tell the nurse to please wait until between ctx to ask questions (or asking the nurse to do that yourself) seems a pretty easy fix for this.

          • Hava NaturalMama

            They wanted me to stay still because when I moved around during contractions the monitor started picking up my heart rate instead of the baby’s. My nurse also ask primary survey questions throughout contractions. Thankfully, my CNM came in and rescued me.

            If you can’t afford a doula, and your husband is not pushy it can be hard.

          • Ainsley Nicholson

            I know I would have found it very annoying to be asked repeatedly if I wanted painkillers during labor- which is why during my last delivery I explained to the nurse that I would ask if I needed pain relief and requested that she not ask me- a request that she graciously respected. I tend to go into a “zone” when I am in pain- even at the dentist (I’m ususally in at least some pain while at the dentist because I metabolize painkillers extremely quickly)- and don’t want to be distracted.

          • Box of Salt

            Hava, I’m going to repeat myself. You note: “Calm and reasonable and extreme pain/fatigue don’t mix in my mind.”

            That is exactly why pain relief is offered.

          • Box of Salt

            “Yes women in labor are really that sensitive.”

            Perhaps it’s because they’re in unbearable pain.

            Facetiousness aside, Hava, please consider that woman who is experiencing pain at a level that compromises her ability to reason and/or respond to simple questions without going into emotional overload, she actually should be offered relief from that pain.

          • Box of Salt

            Apologies to all for the poor editing. There should be “a” in front of woman in the last paragraph, and no comma nor “she” at the end.

          • Something From Nothing

            Lets face it, you are making this into a much bigger deal than it is. While your friend might be accurately describing the phrasing of the question in her case, I seriously doubt it is the norm. Patients are generally asked what they have considered for pain relief and then given info on appropriate choices. Keep in mind also, that a woman who is feeling sensitive about her pain relief choices is more likely to “hear” the question in a negative way, or to embellish the wording during the storytelling. And, no, not all women feel they can ask for relief. It they are made to feel as if pain meds are bad, they may never ask, and regret afterwards that pain relief wasn’t offered. I’ve heard this on more than one occasion.

          • Hava NaturalMama

            I don’t have enough data to say if it is the norm or not.

            Nobody should be made to feel pain meds are bad, and nobody should be made to feel avoiding them is bad either. A woman in a hospital where epidurals are the norm is likely to feel some amount of sensitivity about her choices.

          • Box of Salt

            Hava, “Nobody should be made to feel pain meds are bad”

            You’re the one making a big drama out of refusing them. Can you see how this contributes to the idea that pain meds are bad?

            Your drama is propagating that very idea.

          • Sullivan ThePoop

            That is exactly the way it happened for me. First my OB asked if I had thought about pain relief and gave me information on what was available. Then when I was in at the hospital they again asked me if me and my OB had talked about pain relief and gave me information on what was available. I never got an epidural and was only asked one more time and only with my first.

          • I don’t have a creative name

            “ALL birth choices that are safe for mom and baby should be respected.”

            I agree with this. But I also think that sometimes those wanting respect don’t give it, ie, coming unglued at the idea that the nurse saw an epidural as the default. Just a “No thanks. I’d also appreciate it not being brought up again unless I mention it.” would suffice. If the nurse is pushy and won’t stop badgering about it, the patient is right to be upset. If the only thing she did is use then word ‘when’ instead of ‘if’ and then backed off when the patient requested it, the patient is ridiculous to still be fuming about that later.

          • Bombshellrisa

            I will respect my patient’s need to vocalize through labor, but I assure you, the 7 other women who are trying to nap while they enjoy their epidurals will not respect her choice. They will also expect me to go and shut up said vocalizing woman.

          • Hava NaturalMama

            It’s a problem, but we should all try to be respectful. Ideally hospital rooms would be more sound proof.

          • Bombshellrisa

            I am guessing you have never had the support people for 7 different laboring women assault you at a nursing station insisting you “SHUT THAT WOMAN UP!” on the grounds that she is upsetting their friend/family member. It’s not a problem unique to L&D, there are patients in other units who choose to vocalize through pain as opposed to treating it, but the situation is always the same. They have the absolute right to do as they wish, but it affects the other patients as well as the staff. Not every hospital has private rooms for all their patients either-it’s rare to be able to room two patients of the same acuity who both prefer to vocalize and have no issues with a roommate who wants to do the same.

          • Hava NaturalMama

            You’re right. I’m not a nurse. Clearly its a difficult situation. Earplugs? How do you handle it?

            I’ve never heard of shared rooms for L&D.

          • Bombshellrisa

            We usually just have to settle for being yelled at by family members and go and ask the vocalizing woman if she would like something for pain.
            I have worked in many other units of a hospital, vocalization as a method of dealing with pain is still respected (because some people would rather moan or cry) but the other patients will not tolerate it. One patient’s family member didn’t want her father to get pain medication because it made him sleepy (not sure why that was a problem at midnight), so she had him saying “Lord Jesus help me” all night, sometimes crying it out. Of course, that caused all the other patients to get worried that 1) there was someone who needed help that we were ignoring, 2) that they were going to be ignored and 3) that they were not going to get any sleep (they didn’t). We did hand out earplugs in that instance.

          • Vanessa Robertson

            ideally those women will be at a bc or at home!

          • Hava NaturalMama

            There are no birth centers in many areas. I wish it were a more common option, but it’s not.

            If you read Dr. Amy’s blog regularly, you know home birth is not safe. I would rather have patients be pissed off by a screaming woman that have her baby die because she doesn’t have the medical support she needs.

          • Vanessa Robertson

            This is the first time I’ve read her blog. I may have been taken in by the propaganda because we were considering a homebirth. I’d have to look more into it but I won’t since I don’t plan on having anymore children. I don’t think screaming is appropriate at the hospital, however, regardless. It’s not just you there. Anyone involved in the Bradley Method would know that for the other laboring women to hear screaming would be awful for them and their deliveries.

          • fiftyfifty1

            Do you think it is also wrong that nurses don’t spend time with post-op patients applying counter-pressure, encouraging them to walk to distract them from the pain. Telling them that they should feel free to scream because that will help them cope? Why should they immediately pigeon hole them by offering medical management of their pain?

          • Hava NaturalMama

            I have had surgery (twice) and I have given birth.

            I was very upset that after my first surgery I was given drugs with no explanation of their side affects, which for me happened to be very negative, and no suggested alternatives. But that’s just me.

            I think we can also assume that after immediately after most surgeries, comfort measures don’t cut it, and people want drugs. But if someone didn’t, I would hope the nursing staff would work with them.

          • fiftyfifty1

            “I think we can also assume that after immediately after most surgeries, comfort measures don’t cut it, and people want drugs”
            I find it telling that you state we can assume that people will want drugs post-op but that we should NOT assume (indeed that it is wrong and oppressive to assume) that they will want pharmacologic pain relief during labor.
            I have had surgery (major abdominal surgery) and while I was sore after surgery it was nothing compared to the pain of labor, even the pain of early labor. Post op pain can usually be controlled completely or nearly completely with narcotics. The same is almost never the case in labor. And yet you argue that we should not explicitly offer pharmacologic pain relief in labor but rather ask a veiled questions like “do you need anything” or “can I help you”. Why must we infantilize and do a disservice to all women in order to avoid stepping on the toes of NCB zealots?

          • Hava NaturalMama

            I freely admit that my perspective is baised by the fact that I found my surgeries FAR more painful than my labor and birth.

            I think pain medications should be offered freely and explicitly in labor. It would be unethical not to do so. But if someone has said they don’t want to be asked, that should be respected, and they have alternatives available.

          • Box of Salt

            Hava, in another comment you mentioned you teach high school. If you have a student who is struggling in class, do you offer them extra study resources? If the student declines, and continues to do poorly, do you leave them to flounder or offer again?

          • Hava NaturalMama

            Of course, I do whatever I can to help them succeed, but I don’t buy the analogy.

            In L&D the goal is not pain relief, the goal is a healthy baby and healthy mother. Pain relief is completely a secondary issue.

          • Box of Salt

            Hava NaturalMama “but I don’t buy the analogy.”
            The analogy lies in the fact that if you see a clear need for assistance, you have an ethical obligation to offer it.

            The nurses have the same ethical obligation.

            You yourself noted this on the comment to which I replied: “It would be unethical not to do so.”

            I’m not going to bite on your diversionary tactic (secondary issue?) because honestly this whole discussion with you is rather one note. And how I’m hearing that one note is “everyone should be doing things only exactly the way Hava NaturalMama thinks is polite and respectful” regardless of how they view their own professional obligations.

            I see lots platitudes coming from you, but I don’t see any attempt to look at things from anyone else’s point of view but your own.

          • Hava NaturalMama

            I am definitely trying to take on other people’s prospectives and acknowledge that what I want out of birth is not the norm. Ideally a health care practitioner will take that particular patient’s preferences into consideration when using their professional judgement as to how to proceed.

          • Amy Tuteur, MD

            The goal in medicine and nursing is ALWAYS to relieve pain and suffering whenever possible.

          • Box of Salt

            Thank you, Dr Amy!

          • Hava NaturalMama

            Yes, but it is secondary. The pain is temporary. A healthy baby and mom is the goal. Epidural, C-section, vacuum, pitocin whatever it takes to get there.

          • Amy Tuteur, MD

            No more or less than post surgical pain or cancer pain or the pain of a broken bone.

            Labor pain is no different than any other form of severe pain and therefore, there is no reason to treat it any differently. NCB is a philosophy that has tried to con women into believing they are improved or superior for refusing pain medication. I understand that you fell for it, but that doesn’t make it true.

          • DaisyGrrl

            “I think we can also assume that after immediately after most surgeries, comfort measures don’t cut it, and people want drugs. But if someone didn’t, I would hope the nursing staff would work with them.”

            I see a double standard here. Why is this attitude okay for surgical patients and not for obstetric patients? From your other posts, it seems like assuming a woman in labour wants drugs is offensive, but it’s not offensive for people who’ve had surgery?

            Pain is pain, and health care professionals have an obligation to do what they can to minimize it for patients. If a patient does not want effective pain relief, that’s fine, but the onus should be on the patient to say “hey, I’d rather suffer in agony than use proven methods to reduce it.”

          • Box of Salt

            Hava, I can sympathisize with you on “side affects, which for me happened to be very negative” – I have family members who suffer the same with certain common drugs.

            “people want drugs. But if someone didn’t, I would hope the nursing staff would work with them.”

            I have to do this with my dentist. Any time I’ve had anything beyond minor work done (not often), they offer painkillers afterwards, including one I don’t take. Every time, they forget that I’m not going to take that particular one, and every time I turn it down, but they’ve already put it in the cup with the one I will take (we do go over meds I am taking beforehand, but not the ones I’m not). I feel bad that they probably have to waste the pill, it’s not a big deal. Maybe next time I’ll remember to remind them not to put that one in the cup before they do it.

            Why did I relate that story? Maybe I’ve just figured out the difference between our points of view.

            You also have to work with the nursing staff.

            Unless you have a private nurse, don’t expect that person to remember every single detail about your medical history every time you interact.

            You seem to assume that the burden of “work with” is on the nursing staff. You need to remember what “with” means – part of that burden is on you.

          • Hava NaturalMama

            If they forget every time… it’s a problem. I would not be okay with that. If they forget that much, what would prevent them from making a more serious mistake?

            The burden should be shared, but not equally. You can’t compare the burden of a woman who is having a baby for the 1st/2nd/3rd time, to a nurse who works in L&D every day.

          • Box of Salt

            Hava I just found this reply of yours 9 hours later. “If they forget every time… it’s a problem.” Not really – I’m not allergic to the medication (or it would be in my chart as such), I’m just the one person who doesn’t like its side effects (which most folks don’t even notice). And while I note that it is every time, these events are months if not years apart and I can recognize that they’ve had hundreds of patients who appreciate being offered that drug in between.

            “The burden should be shared, but not equally. You can’t compare the burden of a woman who is having a baby for the 1st/2nd/3rd time, to a nurse who works in L&D every day.”

            You’re right. Most of the burden should be on the person with the extra special needs to make sure those needs are met, not the person who every day has to meet the needs of everybody.

          • Tim

            The problem Dr Amy, is that they want to say that laboring women are simultaneously all powerful spiritual goddesses who can accomplish anything, but so emotionally fragile that they can be easily duped into giving up on the chants their bradley teacher taught them to use as pain relief by someone asking them nicely if they want an anesthesiologist.

          • Amy Tuteur, MD

            An even bigger problem is that NCB advocates are so emotionally vulnerable that they’ve been tricked into basing their self-esteem on a giant con. Childbirth is painful and pain relief is extremely beneficial. Grantly Dick-Read said the opposite for his own racist and misogynistic reasons.

            As a general rule, the more “empowered” a woman claims to be by NCB, the more powerless and emotionally fragile she is in real life. Hence anyone disagreeing must be deleted and banned from her blog, Facebook page, or website.

          • Meerkat

            Oh, Dr. Amy, no, no, no! How could you forget the technique Ina May described in one of her books? ” Shaking of apples” is where a midwife shakes woman’s leg and butt muscles. Maybe this technique also works with migraines! I will try it and report my findings.

          • Bombshellrisa

            Or Ina May’s other, more disgusting suggestions about getting a woman more relaxed in labor. Or Penny Simkin’s suggestion of wrist massages? Massage my wrist while I am having a contraction AND YOU WILL DIE.

          • Meerkat

            Oh yeah, the “button” massage! I forgot!
            I honestly suspect that a lot of women who are subjected to these manipulations are too exhausted from the pain to fight them off.
            I too would have freaked out if anyone shook my “apples” to touched my “button.”

          • Bombshellrisa

            I never thought about it that way, but I think you are right. Maybe these women are in so much pain and are so tired that they can’t defend themselves. Perhaps too, they are unable to speak up and ask for what they need and tell her to GET YOUR HANDS OFF ME. Who would be able to fight someone like Ina May, who is supposed to be an expert in normal birth. If she is doing something, no matter how strange or uncomfortable it makes someone feel, it must be right because she is the midwife!

          • Vanessa Robertson

            not really able to fight someone off or defend yourself during a contraction!

        • S

          “I don’t need one, thanks.”

          “I’ll let you know if i need it. You don’t need to ask me. Thanks.”

          What’s the problem, exactly?

          • Karen in SC

            Some NCBers excel in finding problems where they never existed – see the hatting controversy.

          • GuestB

            Exactly!

          • Bombshellrisa

            That would be hatting, bathing and swaddling-the sensitivity is mushrooming.

          • Sullivan ThePoop

            It seems similar to problems my son used to have with his teachers. I think he grew out of it at about 16.

          • Meerkat

            The problem, as NCB crowd sees it, is in the fact that the nurse asked. She put the thought of an epidural in a woman’s head. Because a woman might be full of resolve before experiencing labor pains, and lose it after realizing what labor really feels like. She will get an epidural and will fail to get that special experience.
            There are even books on how to avoid interventions and “talk to nurses.” NCB crowd also says such questions are distracting to a woman as she is “going inside herself.”

            I was full of resolve, too. Then, right before my emergency C- Section, writhing in pain, I had an epiphany- I didn’t have to feel this pain! It was not sexy, it was not transformative, it was awful. When I saw my anesthesiologist, I was stupid with pain. I thought he was the most beautiful human being in existence. And I told him so.

          • The Bofa on the Sofa

            The problem, as NCB crowd sees it, is in the fact that the nurse asked.

            True, this is the group that can’t bear to have formula coupons given to them at the hospital because it is going to destroy their breastfeeding.

          • Antigonos CNM

            How difficult is it to throw the coupons in the trash? Or give them to someone not breastfeeding?

            What gets their dander up is that someone has actually thought that they might just USE those blankety-blank coupons! How insulting!

            Ditto the whole epidural thing: Do I look to you such a wimp that you think I’m going to need an epidural??!! I AM WARRIOR WOMAN! What an insult!

          • Meerkat

            Yes, exactly. Dr. Amy mentioned in one of her previous posts that a doula’s purpose is to prevent her clients from getting pain relief. Several of my friends who had doulas say the same thing- that at the most critical time when they were asking for epidural, doulas “fought” for them and they ended up going without.

          • Vanessa Robertson

            thankfully my doula was there to advocate for my needs and she wholly supported my transfer to the hospital for pain relief.

          • Vanessa Robertson

            These are the same people who think the availability of formula within a ten mile radius of a new mother is a direct insult on her body not being able to produce milk.

          • Bombshellrisa

            They also seem to have trouble with suggestions of nipple shields, apparently you are only a good mother if you let your nipples get shredded!

          • KarenJJ

            “The problem, as NCB crowd sees it, is in the fact that the nurse asked. She put the thought of an epidural in a woman’s head. Because a woman might be full of resolve before experiencing labor pains, and lose it after realizing what labor really feels like. She will get an epidural and will fail to get that special experience.”

            That’s what I was told in my hypnobirthing course. That NCB requires a great amount of concentration and commitment and that having anyone remind you of pain relief or anyone show the slightest doubt that you can do it will make the pain even worse and you could lose confidence in yourself.

            When I got to hospital I was found to need a c-section (not a super emergency, just needed to have one soon). The nurse asked if I wanted some pain relief. I said ‘no thanks, I’m fine’ and she left. I got the spinal block once I got to the operating theatre.

            The problem with my hypnobirthing class was that it set up NCB to be something to aspire to and to ‘work’ towards even in the face of excruciating pain – it wasn’t just learning something to help cope with the pain. Once the mind tricks aren’t working (my labour wasn’t very painful but it was also dysfunctional), then I would think asking about an epidural or pain relief makes sense.

          • Squillo

            In other words, “natural” birth is the goal in itself, rather than a means to achieve the goal.

          • KarenJJ

            Yep. And by my estimate half the class I was in was there due to fears and anxieties around doctors, hospitals and medical procedures rather than any loyalty to give birth naturally.

            We were lucky though and although the info was largely rubbish (cervix as a sphincter stuff), the midwife actually worked to reduce our anxieties and increase our trust of the doctors so for me it was a somewhat worthwhile exercise after all. There was nobody on the course that was having a homebirth (in fact we were all private hospital patients under obgyns).

          • http://gamesgirlsgods.blogspot.com/ Feminerd

            I have been known to thank God (which I am quite, quite sure does not exist) when the Vicoprofen kicks in, that’s how much cessation of pain is a wonderful, nigh-magical thing.

            And I’ve never even been pregnant or given birth! That was for other painful things. I’m not looking forward to L&D at all if future-me has kids, and I’m probably going to be one of the women who asks for an epidural right away. Pain hurts, and I don’t like it.

    • Allie P

      No one thinks pain relief should be mandatory. But do not also assume that there are “side effects” of the drugs that are mandatory — I had zero side effects. I had my epidural and felt no pain during the birth of my child. When the epidural was over, I was just the same as I’d been before.

      • Hava NaturalMama

        Some hospitals treat epidurals like they are a standard procedure; i.e. “when would you like your epidural placed?”

        I’m glad to hear you had a positive birth experience with your epidural. Not everyone experiences side effects, but it is a risk.

        • GuestB

          I am a dentist. I most definitely treat local anesthesia as a standard procedure. Why? Because 99.9 % of people want it. Those who don’t tell me “I’d rather go without.” Fine. But I am not going to assume that everyon wants to go without, or waste my time bothering to ask every patient if they want the anesthesia or not.
          Why is such a big deal made out of this? The nurse says “when would you like your epidural placed?” Patient says “Never. Thank you.” Simple, as far as I can see.

          • Hava NaturalMama

            That’s fine if the question is asked before labor, which is ideal.

            In the heat of natural labor, women can be more sensitive, and a when question can feel like a statement that their choices are wrong.

          • The Bofa on the Sofa

            But then again, it is during the “heat of labour” that women decide they want it.

            The reason nurses keep asking is because they know that women change their minds, and women who were dead set on doing it “naturally” decide that an epidural is worth it.

            If they didn’t ask, then these women would be complaining that they were not given the option to change their mind. In the end, the nurses are going to do what is best in the end, and that is to allow the patient the option.

          • Hava NaturalMama

            How about waiting for the patient to ask or asking more general questions like “Is there anything I can do to make you more comfortable?”

            If a woman really wants it, she’ll ask. I don’t know anyone complaining that they weren’t asked often enough.

          • The Bofa on the Sofa

            How about waiting for the patient to ask or asking more general questions like “Is there anything I can do to make you more comfortable?”

            Oh for pete’s sake, she can’t ask if she wants an epidural, but a euphemism is ok? Because when the nurse asks that, everyone knows what she is talking about. Jeez, why not just add, “Wink, wink, nudge, nudge” on to it?

            The comments by the others about infantilism are not all that far off the mark, I am concluding.

          • Hava NaturalMama

            There are lots of things nurses can do to help their patients besides ordering an epidural. Nurses should be empowered to support their patients in whatever way best helps the patient.

          • The Bofa on the Sofa

            There are lots of things nurses can do to help their patients besides ordering an epidural.

            But who says they aren’t already doing that?

            Jeez, they can do other things AND offer the epidural at the same time.

          • auntbea

            No! No they can’t! IT IS EPIDURAL OR NOTHING!

          • Hava NaturalMama

            I agree, but based on my experience and my friends experience, they often don’t offer options beside the epidural. Those experiences may or may not be representative. Obviously there is a wide range.

          • Ainsley Nicholson

            The nurses are there to offer medical care. If a woman wants back-rubs and other things that make the pain more bearable, that is what her support people (partners, friends, siblings, doulas, etc) are for.

          • The Bofa on the Sofa

            But nurses will absolutely offer other options. It’s just like Dr Amy notes, most of them pale compared to an epidural (and not everyone is available all the time – is a woman in hard labour really going to be getting up to walk around? Change positions? Sure, but it’s not the time to go stand in the shower)

          • Ainsley Nicholson

            Absolutely, if they have the time and knowledge, it is great to have the nurses offer other options. But if their primary focus and responsibility has to be for the medical care of the patient. A woman who plans to decline pain meds should also plan to have people there who will provide the emotional support and non-medical comfort care that she might need. Taking care to select people who will support her no matter whether or not she choses pain relief at some point during labor, of course!

          • The Bofa on the Sofa

            Is there any indication that this doesn’t happen?

            Besides, of course, the evil nurses who insult women by asking them if they want an epidural?

          • Ainsley Nicholson

            No indication at all…in fact I have no doubt that many times the nurses provide a lot of comfort care. My point is simply that they should not be expected to, or condemned for not providing it. When they do, it is an added bonus.

          • me

            Exactly! Most nurses are absolutely wonderful and knowledgeable about ‘alternative’ methods of dealing with labor pain. I’ve had three kids in three different states and the nurses were great each time (maybe I was just really lucky, but I tend to think most nurses are good at their jobs). Without my having to ask they brought the birthing ball, they encouraged me to roam the halls, to shower, to try different positions, to keep my fluid intake up, etc. With my first, shortly after the pit was started I asked for an epidural (that stuff is hardcore). But with my second and third child? I was able to employ different tactics throughout. And they actually helped (maybe that’s why my nurses didn’t offer meds). As I said earlier, with my third things were getting prolonged, so I requested the epidural that apparently wasn’t meant to be ;) But if the nurses see that these different techniques are helping, no they aren’t going to brow beat you into accepting an epidural you have told them earlier you don’t want. It’s when these techniques *don’t* work that the nurses will ask again.

          • Antigonos CNM

            That might just be because the epidural is the most effective modality of pain relief for most women, while alternatives just don’t do the job.

          • Hava NaturalMama

            Depends what the goal is; is it to eliminate pain or make it bearable?

          • Bombshellrisa

            But why put up with something you can get rid of completely?

          • Hava NaturalMama

            Because I didn’t think it was that bad, and I have had very bad experiences with anesthesia side effects with a prior surgery.

          • Guestll

            Great, you didn’t think it was that bad, and you didn’t get an epidural. Fantastic. What is the problem, then?
            I thought it was horrible. I was asked, I agreed, and my only regret is that I didn’t speak up before I was asked.
            Is there some evil Illuminati-esque group of nurses forcing women to cede to epidurals?? Asking them over and over and over again, do you want it? How about now? Changed your mind yet? Epidural? How ’bout it?

          • Hava NaturalMama

            Not evil nurses, I hope. Just nurses who see their patients in pain and want to help, but don’t know how to help besides for suggesting an epidural.

          • Kristie

            Really? They didn’t get shown around the room and told they were free to shower, use the tub (if there was one), walk around, etc after they were done being checked in and examined? Aside from the time I was in preterm labor, every hospital I’ve delivered at explained what they had to offer, showed my husband where to get ice and drinks, offered to get a rocking chair or a ball if they weren’t in the room, and ALSO asked if I wanted pain meds. Also, non medication methods of pain relief are things a woman or her support people can do themselves. What does the nurse really have to do with it?

          • Hava NaturalMama

            Sounds like you had a great nurse. My L&D nurse didn’t show us any of that; although we had some idea from our hospital tour.

            A nurse can remind patients who may in the moment not be able to think of all their options. My CNM thought to offer me a hot pack for my back which helped a lot, but I didn’t think to ask.

          • me

            Well, if you are really committed to having a NCB I would hope that you have bothered to educate yourself (and your support person) about things that might be useful so you aren’t totally reliant on the nurse. Myself? I found out ahead of time that the hospital would provide a ball, had showers in every room (and tubs in some rooms), and that water, juice and popsicles would be available. I brought my own hot pack, gatorade, snacks (applesauce, pudding, crackers),and music (on an iPad). Okay, you can do all of the above and still have a labor where you end up changing your mind and getting pain meds. However, part of preparing for NCB is well, *preparing*. Yes, it’s nice when the nurse or CNM is able to make suggestions, but the main responsibility lies on you. If it’s all that important to you, you will ideally be prepared and ready with different coping techniques (and have practiced them prior to labor).

            Its not the nurses’ fault if/when a woman comes in wanting a “natural birth” but has failed to prepare adequately. The nurse often has more than one patient and has a lot of other responsibilities beyond helping with labor coping measures. Either make sure your support person is thoroughly involved and knows some techniques, or hire someone that does (doula – just make sure she’s not out to simply push her own agenda).

          • Hava NaturalMama

            Agreed, but in the moment, a nurse who is in L&D every day can and should be helpful.

          • me

            And generally they *are* helpful. The notion that nurses are useless wrt natural birth is propaganda straight out of a Jennifer Block novel. You may run into some nurses that are better at it than others, and you can request a different nurse if the one you are assigned to is really terrible (tho, beware what you wish, the one you get in her place could be worse), better still let the admitting staff know that you are hoping for a natural delivery and politely request that they pair you with a nurse who really likes helping with ‘natural’ deliveries (they may/may not be able to accommodate that, but at least you have done all you can).

            If the hospital your friends delivered at has a reputation for being NCB-un-friendly, then you were probably right to go elsewhere. It sounds like you did your due diligence and had a good experience because of it. I, too, switched to a hospital that was further from home for similar reasons. I don’t fault the hospital (or their nurses) that I switched from… I figure they are catering to what the majority of their clientele wants. If you want the L&D to be handled a specific way, go look for a place that is willing/able to accommodate that. I really think it’s not such a big deal as you are making it out to be.

          • Hava NaturalMama

            I was lucky enough to have a better option. Depending on the area, not everyone has several options to choose from.

          • Antigonos CNM

            If we did that, everyone WOULD get an epidural. No, nurses need to support patients’ choices as long as they are medically appropriate, and explain when necessary why a particular course of action is desirable. It isn’t for the nurse to coerce a patient into doing what she [the nurse] thinks best, but rather to try and make the patient understand why she is suggesting a certain course of action and the two of them working together to achieve the best outcome.

          • Hava NaturalMama

            I agree with except about the idea that everyone would get an epidural. I wouldn’t, maybe I am the only one, but I doubt it.

          • S

            I have read comments on this site from women who experienced such extreme pain that they could not communicate.

          • S

            I meant to add — Those are the women i am concerned about. Not the particular sensitivities of someone who by her own account had a surprisingly manageable level of pain. Yes, everyone deserves the best care possible, but let’s have some perspective here.

          • Hava NaturalMama

            Then what is they ethical thing to do… you can’t give an epidural without consent? If the nurse think that particular patient needs to be asked directly, then they of course can use their professional judgement.

          • S

            I am saying that nurses will (i hope and assume!) want to err on the side of making sure their patients’ pain is adequately treated, even if that means possibly annoying a few patients who are otherwise coping well. And i think that is reasonable.

          • me

            But that’s exactly what they do – they use their professional judgement. I suppose you might run into some here and there that just go on autopilot and ask every patient the same thing. But more often than not the nurse will (while she’s doing other things in the room) observe the mother through a few ctx and size up the situation. If you are coping well and are rating your pain as being tolerable, what makes you think the nurse will offer pain meds? IME, they don’t. It is when you are rating your pain as being very high and/or you don’t appear to be coping well (and I trust the L&D nurse’s judgement on that front) that they may offer/ask. Okay, if she walks in and the first thing she says each time, without observing how you are handling ctx or even asking you to rate your pain, “When do you want that epidural?” you might have a point. But outside NCB propaganda scare-stories does that even happen? Not IME.

          • Antigonos CNM

            Patients are more intimidated than one thinks by the thought that they will be thought “stupid” or “weak” or “crazy” by hospital staff. And not just lower-class, poorly educated patients. I’ve seen this over and over. A surprising number have the idea that a nurse or doctor will be contemptuous if they ask what is for the patient a real request for knowledge but what the patient thinks the doctor or nurse “thinks everyone except stupid ol’ me knows”. I used to tell my Lamaze couples, in class, to ask me absolutely anything “because I bet someone else is dying to ask the same question but is too shy to do so”.

            In labor, I would usually ask something like “Are you coping OK? You are? Good! But be sure to let me know if you need some help”. I didn’t ask it every hour on the hour, but I did ask often enough to let the patient know I cared how she felt and that she shouldn’t hesitate should the situation change. You are damned if you do, and damned if you don’t. The patient thinks you’re pushing unwanted analgesia if you offer it, or you are indifferent to their suffering if you don’t. [Body language tells you a lot, btw]

          • Hava NaturalMama

            You sound like very sensitive and thoughtful health care provider.

          • fiftyfifty1

            “How about waiting for the patient to ask or asking more general questions like “Is there anything I can do to make you more comfortable?””
            But this is the mirror image of what you say you don’t like. You say you don’t want the nurse to say “would you like an epidural?” because the patient may feel that the nurse is pushing it. But if the nurse only says something vague like “how can I help make you more comfortable?” the patient may believe the nurse is thinking “she doesn’t want/need/deserve/qualify for anesthesia services.
            See the problem? Nurses aren’t mind readers. That’s why I think a direct approach is best.

          • Clarissa Darling

            Well, I personally would be offended if the nurse didn’t ask me WHEN I want the epidural. Like, maybe
            by asking me IF I want an epidural she is insinuating that I would be better off without the epidural or suggesting that a lot of women don’t take epidurals
            and maybe I shouldn’t have one either. I
            think the nurse should magically know in advance that I’m the kind of person who wants an epidural and ask the question in the way that would be the most sensitive to MY needs! You know what else? I’m also offended when I get asked; do you want fries with that? Uh, no I don’t want fries, I want the side salad thankyouverymuch! I’m trying to eat healthy here! Why do they assume that everyone who orders
            food at a restaurant wants to maximize their calorie intake with a side of fries? Why are they pushing me to eat something that’s not good for me? Last but not least, when I go to the grocery store they ask do I want paper or plastic. Paper or Plastic? Since when did going without a bag or brining your own environmentally friendly reusable, sustainable fair trade cloth bag not become an option? Ugh, it’s like it would be too much to expect the WHOLE WORLD to stop communicating with me as if I were a total stranger and start considering MY own unique thoughts, needs, feelings and over sensitivities
            when addressing ME!

          • Hava NaturalMama

            I see your point, but giving birth is a bit more sensitive a time that grocery shopping. Ideally, patients would have a list of birth preferences and all nurses would have time to read them. If someone has indicated that they want an epidural, WHEN would be the right question to ask.

            I was very impressed by the attention my medical team paid to my preferences.

          • Clarissa Darling

            No, I t don’t think you do get my point. There is no reason that the question of whether you want an epidural should be any more sensitive than whether you want fries or a bag at the grocery store. The
            majority of people DO want epidurals; DO want fries as their side and DO want bags. It is absolutely impractical and ridiculous to expect that people should tailor how they word these questions to fit A) The minority of people who don’t want them B) The extreme minority of the minority who will read more meaning into an innocent question than is actually there and be offended by it. If you want to sit around and split hairs about what is the most acceptable, politically correct way to phrase a question when addressing YOU or YOUR friends that’s up to you but, but please keep in mind that there are approximately 6.9 billion other people in the world who, frankly my dear, won’t give a damn.

            Also,even if the nurse had said “WHEN you do want the epidural” you are being extremely unfair in your assumption that she is being judgmental. How do you know that she didn’t just accidentally misspeak or have you momentarily confused with another patient who mentioned they did want the epidural? I think the assumption that nurse had some hidden meaning in her question (and also the assumption that all pregnant women are delicate flowers who can be so easily offended by an offer of medication that the hospital staff ought to use polite euphamisms or veiled references) is about as ridiculous as assuming your waiter has some hidden agenda when they ask if you want fries.

            Personally, this is all the thought I want to put into the question of the correct way for nurses to offer patients pain relief without offending anyone. But, please feel free to continue to debate it as if it were a serious problem.

          • Hava NaturalMama

            You’re right. It is a first world problem.

          • Clarissa Darling

            Given the amount of time you continue to devote to this issue, I don’t think you understand that First World Problem=/= Problem experienced by someone who happens to live in the first world. First world problem= Whiney over reaction to a minor annoyance experienced by someone who lives a relatively privileged and problem free life.

          • Ainsley Nicholson

            Yep, and if the woman doesn’t want the nurse to keep asking, it is very simple to explain to the nurse “I may chose to have an epidural at some point, and I’ll let you know if I decide to have one, but in the meantime you don’t have to ask.”

          • The Bofa on the Sofa

            But she could even change her mind about that. She may insist at the beginning that she will never change her mind, but nurses know full well that you can’t rely on that, and even those women who insist beforehand that they will never get an epidural change their mind.

          • Ainsley Nicholson

            I completely agree that a woman who insists ahead of time that she will never get an epidural might change her mind when she finds out just how much labor hurts, or how much more it hurts than she remembers. But if a woman asks specifically not to be asked about pain relief, and chooses to take the responsibility for asking for it if she wants it, that should be respected. In my experience, it was respected. But in a way, I can’t completely disagree with you, because being in labor is definitely an altered state of mind, and the nurses know that.

          • The Bofa on the Sofa

            But in a way, I can’t completely disagree with you, because being in labor is definitely an altered state of mind, and the nurses know that.

            And this is my take on it. The nurses aren’t doing it to bug you, or to convince you to do it, they are doing it because they know, having been through thousands of deliveries, that a significant number change their mind. They’ve seen more than their share of those who insist they are going to do it without change their mind about it. Shoot, they’ve likely had many more deliveries where the patient has intended to do it “naturally” than the typical HB midwife.

          • Amy

            Plus, it’s way easier on everybody to do it earlier. With my middle child, I had a fast-developing labor (four hours total) and only managed to start getting an epidural in transition when I was thrashing around uncontrollably. It was not an ideal situation (it took easily half a dozen tries) and I only got pain relief just before it was time to push.

            Note to self: Your mileage may vary with that standard advice about sticking around the house as long as possible. My last-minute shower at home almost cost me my epidural.

            Presumably, labor and delivery nurses have had that situation unfold in front of them a number of times, and they’d like to do everything possible to avoid unnecessary pain.

          • Lizzie Dee

            Then what was going on with my daughter’s midwives then? Young, enthusiastic – and showing zero interest in doing anything that useful about my daughter’s pain. Fortunately, it wasn’t that extreme, but she was asking for an epi and being put off from about 11 am to 8 pm. I was dreading having to watch her in worsening pain for a couple more hours, but fortunately the last bit went fast. Yes, she coped with the pain, but it was not her choice and it should not have been imposed on her that way. The feeling of being cheated and not listened to is just as strong that way round.

          • Karen in SC

            Another NCB irony — infantalizing and calling it empowering.

            I had two un-medicated births and had no problems understanding questions and making decisions. Never was I asked about getting an epidural. Maybe if I would have been asked, my first birth would be a better memory. However, I am content with the short term experience as it happened.

            Now tell me how to make teenage boys clean up their rooms and communicate. And these are NCB and BF babies!!

          • Tim

            THANK YOU. Either you’re a sucker who can’t possibly resist a friendly question from a nurse, or an all powerful goddess. You can’t be both at the same time.

          • Hava NaturalMama

            I have no interest in being either. I was just a woman in labor who wanted to give birth to my baby with all the medical help available if needed, but to be left alone to do my thing as long as things were going normally.

          • Tim

            Then why is asking you a question such a horrible thing? Believe it or not, there are probably a ton of women who DONT realize they can get the epidural at that point, or at all, and it would be doing them a huge disservice to not bring it up. People who have been dead set on doing it naturally are not getting duped into getting an epidural by the nurse asking them if/when they want one, so what is the big deal.
            Making people have to seek out modern medicine at a hospital is such a horrible thing to do to underprivileged people.

          • Hava NaturalMama

            It’s not such a horrible thing. I just think it should be done with respect and sensitivity.

            You’re right is some ways. A friend of mine who did his OB internship in the Bronx had such horror stories about trying to explain epidurals to women in labor, with little education, and poor English comprehension.

          • Tim

            That’s what I mean – as hard as it is to believe, there are a lot of people who are woefully underinformed and undereducated in this country, and it’s more moral (IMO) to make the middle class white women have to say “no” to an epidural than to have women who might not even know what an epidural is go in agony because they don’t know there is another option.

          • Hava NaturalMama

            But we shouldn’t assume the uneducated would want an epidural if they knew what it was. The interactions should be tailored to the individual patient needs. It’s a really tough call.

          • Amy Tuteur, MD

            Hava, are you equally disturbed if a nurse offers a cancer patient pain relief? How about if a nurse offers a woman with a broken leg pain relief? Why should the nurse treat a laboring woman any differently?

          • Hava NaturalMama

            Different people react differently. I can only speak based on my experience.

          • Sullivan ThePoop

            Thank you! I have no idea what these people are talking about. I never lost my self to child birth. I was starting to wonder if that was really a thing or just made up nonsense.

          • Rabbit

            I lose the ability to communicate clearly. I can understand what people are telling me, and formulate the response I want in my head, but something breaks down between my brain and my mouth. For me, labor isn’t actually very painful, but it is a ton of effort – it is almost as if my brain decides that speaking requires too much effort in addition to the effort of labor, and speaking gets the short end of the resources stick.

          • Amy Tuteur, MD

            I think what you mean, Hava, is that in the midst of labor, women can be in greater pain and therefore amenable to pain relief.

            You seem to have missed the central point of this post. Natural childbirth is a giant con that certain women have embraced because they are gullible. There is nothing wrong with having pain medication and there is nothing wrong with asking women about it. It’s the con that keep them enduring pain, not any concern about risks.

          • Hava NaturalMama

            That’s not what I mean. I mean that reptative offers of pain relief can imply that the nurse/doctor disapproves of the patient’s choice.

            You’re right there is nothing wrong with pain relief, but there is also nothing wrong with deciding not to go with it. We should respect ALL decisions as long as they don’t endanger mom or baby.

            The pain wasn’t a con for me. It really wasn’t that bad. If it was that bad, I would have gotten an epidural and felt fine about that.

          • auntbea

            Or it could imply that the nurse is asking whether you want pain relief, because she doesn’t know if you want it or not. Are you suggesting that nurses should not ask/offer pain relief, lest someone feel judged?

          • Hava NaturalMama

            I think they should be trained to offer choices in as sensitive and non judgmental a way as possible. Hopefully the choices are wider that epidural or no epidural.

          • Guestll

            Yes, yes, by all means. Other choices. Like the TENS machine (fun distraction but only until 6 cms) counterpressure (worked okay but really, when pain is a 12 on a scale of 1-10, fuck counterpressure), water (loved puking and shitting in the bath), sterile water injections (like getting stung by 4 bees at the height of a contraction, I can’t tell you how pain-relieving that was) walking/movement (fun to try esp. in transition when you can barely stand!), yoga ball (what was I thinking?) heating pad (ditto)…yes, by all means, hospitals should offer all of these choices, just as mine did. I’m not sure why, since there’s little evidence that any of them do jack, but they help former woos like me to feel good about avoiding that nasty, terrible, doctor-given epidural!

          • Hava NaturalMama

            I personally found counter-pressure, movement, and the yoga ball made the pain bearable and an epidural unnecessary and if I didn’t, i would have gotten the epidural. I am happy that I had those options.

          • Guestll

            I find that Ben & Jerry’s Cherry Garcia makes my back pain bearable. But since there’s no evidence to suggest that Cherry Garcia is an effective analgesic, and when there are proven alternatives to relieving back pain, I’ll stop short of suggesting to my physiotherapist that she offer Cherry Garcia to all of her patients.

          • Hava NaturalMama

            I love the analogy. It’s a good one.

            I’m just saying that nurses should be open to a range of pharmaceutical and non pharmaceutical measures. It shouldn’t be “Well if you don’t want drugs, there is nothing I can do to help you”

            I don’t know how much research has been done to see what comfort measures help as many women as possible. It’s hard to find sources that aren’t from natural childbirth advocates.

          • Bombshellrisa

            ” It’s hard to find sources that aren’t from natural childbirth advocates” That is true. The only person I know who teaches “comfort measures” is Penny Simkin. I think it’s the very nature of calling them comfort measures that makes nurses want to offer the most proven and effective pain relief possible. When we are told to offer comfort measures on a care plan (this is talking units in the hospital OTHER than L&D), “comfort measures” refer to palliative or hospice care.

          • Hava NaturalMama

            You’re right about the language issue.

          • Squillo

            And that’s a god-damned shame.

          • Vanessa Robertson

            all those things helped me too, until they didnt and i had to beg to be taken to the hospital for pain relief after almost 40 hours.

          • me

            I needed none of those things with baby number two (I sat up in bed and breathed, joking with my husband between ctx). With baby numbers one and three, I tried them all (and then some) to no avail. I won’t say my second child is my favorite ;) (TIC obviously), but all labors are different, all mothers are different, and yes, having choices is important. But women shouldn’t be refusing an epidural/afraid to accept one because of “risks” (they are really incredibly small). And no one should be forced to put off an epidural in favor of these other methods if they don’t want to.

          • Hava NaturalMama

            amen

          • AmyP

            “sterile water injections”

            Huh?

            Is that in place of an IV or what?

          • Guestll

            No.

            They are sub-q injections of sterile water, injected into certain points in the back. It’s typically done at the height of a contraction in order to “hide” the pain (it’s painful). Sterile water injections purportedly help with the pain of back labour. Since my daughter was OP and back labour is correlated with OP, my RM discussed their use with me prior to the onset of labour.

            I agreed to try sterile water injections, I had 4 done simultaneously in my lower back during transition, when back labour was at its apex. They hurt a great deal and did nothing to relieve my pain.

          • Captain Obvious

            I am having an empowering natural birth but don’t ask me questions that may be interpreted different ways because I am too sensitive to tell the difference and that would ruin my birth experience? Really?

          • Hava NaturalMama

            How about “I’m having a baby. Just shut up and let me do my thing!” That’s certainly how I felt.

          • Captain Obvious

            The NCB calls it vocalizing, where I’m from we call it trucker mouth, but it is just really screaming because of the pain and if conservative measures are not helping the patient, the nurse is going to ask again, “if you are still in pain and your coping measures are not helping, would you like to consider a narcotic shot or epidural?” There is nothing wrong with asking.

          • Hava NaturalMama

            as long as it is done sensitively and respectfully and the patient has indicated ahead of time that they don’t want to be asked.

          • Guestll

            Why is it so terrible to be asked? Why can’t the patient change her mind? I did. So what? So what if I said, I don’t want an epidural, then I changed my mind? So what if my RM asked me, “do you want an epidural?”, even after I’d made my preference clear?
            So? What?
            What are you afraid of? There are two answers in life, yes and no.

          • Hava NaturalMama

            A patient can change her mind, and that fine. But, if a patient has taken the time to indicate preferences ahead of time, why not respect them?

            I am concerned about disrespect and nagging. Obviously not horrible outcomes, but certainly not good things.

          • me

            Because you run into scenarios where a woman is dead set against having any pain meds upon admission, and has built it up in her mind, but then labor get far more intense than she anticipated. If the L&D nurse comes in to check on her and sees that she is obviously not coping well, but she isn’t asking for help… well, that puts the nurse in a really tough situation. If the nurse suspects that the patient would benefit greatly from medication (and that if she were being honest with herself would request it), but is needlessly suffering in an attempt to achieve some ideal, well, can’t you see where an offer of pain medication is warranted? Not pressure (she can always say no). Not judgement. But rather, ‘I know you expressed interest in unmedicated delivery, but you are rating you pain very high and appear to be suffering. It’s okay to change your mind. Are you sure you don’t want to revisit the idea of taking something to help with the pain?’ (or some variation of that).

            It’s not about not respecting preferences. I expressed a preference to forgo pain meds with all of my kids. I also expressed *openness* in the even things didn’t go smoothly. Perhaps that’s why no one “bothered” me; my nurses knew from the get-go that I wouldn’t be afraid/ashamed to ask for help if I needed it. Maybe women wanting NCB would be well served to express that same openness (of course, it works best if you actually mean it). What you see as “nagging” and “disrespect” I tend to see as compassion and trying to insure that the patient gets adequate care, including adequate pain management.

          • Hava NaturalMama

            I have no doubt that the “nagging” is almost always well intentioned, and I 100% agree with you about the importance of being open to things not going as planned.

          • theadequatemother

            the only reason that you think there is all this “judgement” around asking for pain relief is because of the PROPAGANDA SPEWED BY THE NCB movement. Read post above.

            Lots of women don’t feel any sensitivity around the choice to get or forgo pain relief in labour…probably because they don’t spend as much time on the internet as I do and didn’t accidentally wind up in a NCB oriented childbrith class or unwittingly take out an Ina May book from the library like I did when I was preggo with my first and CLUELESS.

          • The Bofa on the Sofa

            the only reason that you think there is all this “judgement” around
            asking for pain relief is because of the PROPAGANDA SPEWED BY THE NCB
            movement.

            This is such an important point. Once again, the NCB sets up the meme that you are a failure if you don’t do it their way.

            This is something I think we really need to get talking about. THEY are the ones who are creating this culture of “broken women” and “failures.”

          • S

            This is such a pet peeve of mine, assuming that a person means something other than what they’ve said. It makes for such inefficient communication. If you’re not sure what they mean, then ask them! “Are you trying to tell me that i _should_ get pain relief?”

            Also, i hope i’m not opening a can of worms with this, but where i’m from, your nurse is very likely not going to be a native English speaker. So for instance, she might not use the preposition that most accurately conveys what she means (“when” vs. “if”), or she might speak in a more brusque tone than you’re used to, because these kinds of subtleties are hard to learn. There would be absolutely no point in reading any implications into wording or tone of voice in this situation.

          • S

            I feel i should clarify that i understand it’s not always easy for people to communicate directly. I’m not a particularly assertive person in most situations, and i hate asking for things, especially in a health care setting. But that is _my_ issue and my responsibility. (I’ve never had issues with nurses as an inpatient, though. Only with doctors; they tend to think i’m nuts. =)

          • Bombshellrisa

            I don’t think that asking someone who is progressing along and whose pain is getting more intense if they want adequate pain relief is in any way judging a patient’s choice. It doesn’t apply to any other patient care situation where pain medication is involved. Imagine trying to suggest any of the alternatives that NCB types seem to think are acceptable to any other patient in the hospital. Warm bath or shower for someone passing a kidney stone? Backrubs for post mastectomy pain? Wrist massages for pain after a knee replacement? How about vocalizing and deep breathing for pain after a hysterectomy? I ask my patients if they are in pain, if they are ok with the level of pain they have (some are) and if they want something for that. Not every person will want something, but I keep asking to make sure that they know its available and an option for them.

          • Captain Obvious

            Can you imagine the Press Ganey patient evaluations if the nurses did NOT offer pain medicines to them throughout labor? Stuff like, “I was getting more and more intense pain with my labor, but the nurse never came into my room to offer me any pain meds. I just labored there in pain.”

          • Bombshellrisa

            Any other unit of the hospital, having a nurse ask only once if you needed something for the pain and the nurse would have been written up. Even if the patient never desired anything for the pain, asking ONLY ONCE is not acceptable.

          • realityycheque

            Labour pain increases in intensity, too. A woman at 3cm may not require pain relief, but by the time she’s at 7cm she might find herself needing it. Given this, it doesn’t seem unreasonable for the nurse to continue checking in to see how she’s coping.

          • Hava NaturalMama

            I doubt anyone would say that if the nurse kept checking in on them asking what they needed or wanted.

          • realityycheque

            To me, it seems like a natural, compassionate response to see a person in pain and try to alleviate their suffering.

            Whenever my partner’s been sick, one of the first things I ask is if I can do anything to help him feel better, “Can I get you some pain killers? Would you like a cup of tea/hot water bottle? etc.”

          • DaisyGrrl

            My sister gave birth in a hospital with a midwife. She had decided ahead of time to try and go without an epidural if at all possible – our mother had a terrible reaction to both of her epidurals and that made my sister more cautious. The midwife encouraged this by telling her about all the (incredibly rare and/or based on outdated practice) risks she was running by having one.

            When the pain became unmanageable, my sister asked for an epidural. The midwife put her off for OVER 3 HOURS before she got her epidural (made her try various “natural” remedies first).

            Repetitive delays in providing pain relief can mean that the midwife disapproves of the patient’s choice.

            I’d rather have the health care provider who is interested in making sure I’m comfortable than the one who disregards my request for pain relief.

          • realityycheque

            On more than a few occasions I’ve heard of midwives deliberately stalling getting their patients pain relief until it was too late to receive an epidural. This, to me is absolutely beyond revolting. Some of the ones I saw online who admitted to doing it acted as though they were doing the labouring women a favour. Horrible people.

          • Hava NaturalMama

            That’s awful. Definitely as an example of one negative extreme.

          • theadequatemother

            if the repetitive offers of pain relief are occuring one after the other within 10 minutes…sure I’d agree with you that maybe they might make the patient feel like they are being pressured…but if the offers of pain relief accompany the periodic pain scores taken by the nurses (like every 2 hours for example) then no, that is not pressure. That is standard for pain scores reported to be over 4.

          • me

            “I mean that repetitive offers of pain relief can imply that the nurse/doctor disapproves of the patient’s choice.”

            But does that really happen? I suppose it’s possible, but at the same time, it seems extremely unlikely. I’ve had three babies. All three times the nurses asked what my plans were for pain management upon admission. And after that, it was up to me.

            With my first I was induced, and being a FTM I told them I’d see how it goes before making up my mind one way or the other. No one “bothered” me again. When I requested an epidural, I got it quickly and without pressure or judgement. Unfortunately it didn’t help with second stage labor, but that’s another story ;)

            With my second and third babies I went into labor spontaneously and found it much easier to handle. With baby #2 I was asked upon admission and told my nurse I wasn’t planning for an epidural, rated my pain at a 4, and found out I was 8 cm. The word “epidural” never came up again (not from my nurse or my CNM, or even in my own head, lol).

            With baby #3 I presented at 5 cm planning on going without an epidural (but not close-minded about pain relief either). I got “stuck” at 6 cm for several hours and started to worry about having enough energy left to push. So, while I had been asked upon admission, no one offered or asked again until I requested it. My CNM explained that I may find I dilate very quickly once the epidural is in place, basically warning me not to get upset if I find it’s time to push shortly after getting the epidural. That was the sum total of our conversation before calling anesthesia. Now, the two residents couldn’t seem to find the epidural space and on the third attempt I felt them strike bone so I canceled my request, lol. There was a moment of panic in my mind between the time I said “NO, I’ve changed my mind” and before my CNM checked me again. That was the scariest moment of that labor – knowing that I wouldn’t be able to get an epidural, but wondering if I was still at a 6, and what that would mean and how could I cope.

            Thank everything holy (and few unholy things) that I had gotten to 9 cm in that 30 minutes that I had been sitting up, hunched over, perfectly still (so much for needing to be moving around for labor to progress, lol). I had a “lip” of cervix left, my CNM encouraged me to give a little push to see if I could push past it, I did, the overwhelming urge took over and she was out in three ctx.

            Had things gone the other way (still been stuck at 6, with no end in site)…. I don’t even know how it would have gone. The thought of having to suffer through hours and hours more was scary enough for the 15 minutes that the thought was in my head. If it had turned into reality I probably would have experienced some level of PTSD. I guess that experience gives me sympathy for women who are denied or pressured to go natural. I was incredibly lucky. And no one was denying me pain relief (just having a hard time delivering it, I have no idea why). Prolonged, unmanaged pain is traumatic. They assess, reassess, and offer pain relief to avoid that trauma. There is nothing wrong with that.

          • suchende

            I showed up to the hospital in labor, of course? Neither midwives nor OBs begin attending your birth before you’re in labor.

          • Hava NaturalMama

            Hopefully a woman meets here OB before she’s in labor and has a chance to talk about her options when she is better able to understand the choices.

          • S

            While i agree with your comment, i don’t see its relevance in response to suchende’s comment. Assuming we’re talking about the US, the L&D nurses do most of the monitoring, as i’m sure you know, and you’re not likely to meet them ahead of time.

            Yes, it is best to understand your options for pain relief ahead of time, while you’re still clear headed, but you won’t be equipped to make an actual informed decision until you actually know what the pain is like, i.e. until you’re actually in labor.

          • Hava NaturalMama

            Suchende mentioned both nurses and OBs.

            Since you brought it up, I think its a problem that most care for women in labor in the US is done by people they have never met before, and may know nothing about. That not the norm in other countries (like Israel).

            I was very fortunate to have a CNM who read my birth plan, respected my decisions, and stayed with me throughout my labor and delivery, but that is not the norm.

          • Antigonos CNM

            Not the norm in Israel either, where the staff midwives work 8 hour shifts, and do not have contact with their patients antenatally.

            I think it is worth reminding ourselves that “natural childbirth” began as a movement to prevent neonatal respiratory depression in the days when IV analgesia was the norm –indeed, just about the only form of pain relief available. IV pain meds go straight to the baby. About the time of the Vietnam war some of the residents who’d been in the army came home with skill in giving caudal anesthesia — epidural anesthesia is a refinement of that. The great advantage is that no medication reaches the baby unless the epidural is very prolonged and consequently the risk of respiratory depression is much reduced. The mother is lucid and responsive, as well.

            No one, back in the first days of the NCB movement, would have objected in the least to a method of analgesia that removed all pain and was without side effects. Only later did it become a virtue to experience as much pain as possible so one could brag about it.

          • Renee Martin

            Ah, continuity of care…
            I had a wonderful team for my DD- an amazing OB, and a group of MFMs, that I knew would be there for the birth (planned RCS). I saw them every week from 19 weeks on, and even spent some time in the hospital with them. I knew them pretty well and they knew me, even te US tech at the office knew me.
            I’m on some medication that complicates things, and having a team that knew all about it was wonderful.

            Then I had pPROM while traveling, and ended up in an emergent situation, in a city far from home and family, and far from any docs that knew me, and far from anyone that knew my history and medication needs. I was afraid of what would happen next.

            You know what? My team sent records, and it went well anyway! I spent days in there prior to the birth, and baby spent 4 weeks in the NICU.

            I *was* pressured into a birth I hadn’t planned (VBAC, which I had no desire for), but the end result was good. I decided to listen to the experts, and thankfully, it all went well.

          • Isramommy

            Um, no. Women in Israel just show up at the hospital and are delivered by whatever nurse-midwife or ob (if necessary) is on call. I had never seen the people who delivered my babies before they walked int the delivery room, and that was fine with me. The delivery room staff are all professionals and all act according to the same standard of care. I expected professional care and I received it. I didn’t need to have a personal relationship with my midwives anymore than I needed one with the anesthesiologist. I just needed them to get my babies and I safely through the births, which they did.

          • Hava NaturalMama

            Then who does the prenatal care?

            That is not what my Israeli friends have told me, but I suppose I may have misunderstood.

          • Isramommy

            Prenatal care is done by the woman’s regular ob in his/her office, as well as monthly/bi-weekly/weekly nurses’ checks for blood pressure, weight and urine. Basic ultrasounds (early dating, routine checks) are done by either the regular ob or a tech in a health clinic. Our health clinics usually have a lab, nurses center, u/s and any number of doctors and specialties all located in a single building, so it’s very convenient. Advanced scans (usually nuchal translucency, two anatomy scans around 14 and 20 weeks, and a 36 week growth estimate) are done by obs who specialize in ultrasound.

            The primary care ob usually has nothing to do with delivery unless, by chance, that ob also works a few shifts on-call at a given hospital and the woman happens to go into labor and show up when her doctor is there. With my first baby my ob mentioned that she worked two shifts at my chosen hospital on Mondays and Wednesdays, so I might see her there. My baby was born on a Sunday though, so I was seen by a midwife and an on-call ob resident. As far as I know, non-emergent c-sections and inductions are also scheduled around the hospital’s availability, not according to a women’s primary ob’s schedule.

            ETA: Our medical records are all electronic, so any doctor, nurse or hospital can get instant access to a woman’s prenatal history no matter where in the country she shows up for an exam or delivery. Women are also asked to bring a print out of their most recent “ma-akav hariyon” (a summary of their prenatal care) with them to the hospital for delivery.

          • theadequatemother

            Nurses also ask about pain so they can see how pain is changing throughout labor. Increases in pain usually accompany greater dilatation…but more importantly increases in pain can signal pathology like chorio, abruption, uterine rupture (which can be partial), malpositioned babies…etc. They keep tabs on pain because they are looking after women…so yeah, they have to ask about it from time to time.

          • WhatPaleBlueDot

            Why should a woman decide whether she wants pain relief before she is experiencing the thing that might cause pain? That’s stupid.

          • Hava NaturalMama

            She should make an objective decision knowing the pros and cons, and she should feel comfortable changing it if the pain is more than she anticipated. For me, the pain was much easier than I expected, but that is not the norm.

          • S

            I am sitting here chuckling to myself at all the very similar responses being posted simultaneously. I guess what is obvious to some people is not obvious to others. =)

            Hava, i’ll grant you this — you’re doing pretty well at keeping up with all these comments.

          • theadequatemother

            I just don’t see the utility of what you are saying. Most women who give birth in hospitals in NA want an epidural. The epidural rates are very high. Satisfaction is very high. Why should we base STANDARD hospital policy on the needs of the minority of women who would rather eschew pain medication during labour so much so that they don’t even want to be ASKED about their pain or OFFERED pain pharmacologic management solutions?/??? That just doesn’t make sense. Hospital policies are NOT created to full the wishes of the minority.

          • Guestll

            C’mon, you KNOW the epidural rates are very high because nurses push epidurals on empowered yet bullied women! Look at places, like…Africa! Look at their epidural rates. See how comparatively low they are in that country? That’s because no one is asking the wombyn over and over and over again and with great insensitivity, “Would you like an epidural?”

            Further proof that we need to emulate the Africans.

          • Hava NaturalMama

            I think hospitals should care for all their patients with kindness and respect, even if they have a minority view. I think policies should be flexible to accommodate that as much as safety allows.

            I am not saying don’t offer epidurals because a small portion of women don’t want them. I am saying respect those who accept and those who decline.

          • Lizzie Dee

            I place a very high value on kindness in all things, and would agree that it is highly desirable when people are vulnerable. But tell me, do you practice what you preach? Are you invariably kind at the end of a long working day, when people tell you how to do your job, make it more difficult? Are you kind, in daily life, to people who may seem to you to be being unreasonable or expecting rather a lot?

            The professional distance required to do what is necessary in hospitals may not always make kindness apparent. But unless people are actively and deliberately unkind, is it always a big deal? Unless people are actively distressed? Tolerance and understanding are useful virtues as well.

          • Hava NaturalMama

            Yes. I teach high school. I am often faced with parents who have unreasonable expectations and forget I have dozens of other students. It’s an ongoing challenge to choose language carefully, respect where those parents are coming from and balance the needs of many students. A single poorly chosen phrase can dramatically worsen a situation. All I can do is try my best, and with experience, my best continues to get better. I expect no more or less from nurses.

          • Box of Salt

            Hava, “I am often faced with parents who have unreasonable expectations and forget I have dozens of other students. . . I expect no more or less from nurses.”

            I’m not sure your situation is analogous. You are talking about dealing with the students’ parents, not the students themselves. Your “ongoing challenge to choose language carefully” isn’t taking place on the fly in the classroom as you are trying to do your job of teaching (although I do hope you apply that same idea there, too).

            The nurses are dealing with these situations which you think require more careful turns of phrase while actively caring for their patients. They cannot defer a difficult or inappropriate discussion to the end of class, or to an appointment later in the day. They must deal with each patient need as it arises.

            In addition, the nurses have to balance the safety of the patients (and don’t forget L&D nurses do have at least 2 of them!) while they’re doing all that.

            I’m not trying to excuse disrespectful behavior from hospital staff – just pointing out that what might seem reasonable to you who practices one form of balancing customer service with accomplishing her chosen tasks (teaching high school students) might not apply to a field with charged with a different tasks (patient care).

          • Box of Salt

            typo correction: charged with different tasks (leave out the “a”).

          • Hava NaturalMama

            I obviously haven’t worked both jobs, but never underestimate the dynamics of balancing the needs of 24 students in a classroom.

          • Amazed

            What, exactly, is your definition of respect? Up to the moment, I see only complaining of nurses daring to ask. Not one of your friends was tied to the bed and given the terrible epidural against her will, right? Where, exactly, is the disrespect? I really don’t see it.

            When I was having the plaster taken off my newly healed foot, I told the nurse I wanted to get the job done as quickly as possible and that if I want him to stop because I am in too much pain, I’d tell him. Get it over with, is my way of life. Get it over with as soon as possible and take care of the pain later. Guess what? When I started hissing really hard in pain, he asked me whether I wanted him to stop. I didn’t and I told him so. I didn’t feel that he was disrespectful, merely compassionate towards someone in pain.

          • Hava NaturalMama

            I think its all about attitude of caring and non-judgement. If a nurse really cares; hopefully that will come across.

            For most of my friends who gave birth at the hospital 5 min from me there was some disconnect where they did not feel that respect. They felt the nurses viewed them as clueless first time moms and thought they should just get the epidural already and stop causing trouble. It could be entirely in their heads, but the stories were enough to convince me it was worth driving 45 min away to a different hospital.

          • The Bofa on the Sofa

            But jeez, you can’t please everyone. If someone is going to be offended by the mere fact that they are asked if they want pain relief, then what can you do?

        • Captain Obvious

          Feeling pain or discomfort with labor is 100%. So asking a patient if they are planning on have a pain shot or an epidural is a common sense question to ask every patient. And your precaution of those rare risks with epidurals can be counter questioned about the risks of not getting an epidural. Risks of pushing too soon against a noncompletely dilated cervix, risks for tearing that cervix, risks for pushing too fast and lacerating the vagina and perineum because you couldn’t control your pushing because of the pain. Risk of getting exhausted throughout labor so that you’re too tired to push when it comes time too and need vacuum or forceps because of maternal exhaustion. Risk of stigmata or PTSD from the horrific pain you went through for some. Sometimes the epidural allows women to relax which in turn paradoxically allows them to dilate better and faster which may not happen if you keep refusing the epidural. Risks of the husband’s feeling of helplessness as he watches his wife not get relief and can’t do anything about it, or the things he can do like massage and affirmations aren’t helping.
          There are risks to not getting the epidural as much as there are risks to getting one. And let’s not kid anyone, there is pain in every labor.

          • Guestll

            There are also people like me, who planned to homebirth and didn’t even register ahead of time at the hospital where my RMs have privileges. Because of that, when I did decide to deliver in the hospital, it made getting an epidural a much more lengthy process than it had to be. Add to that, I tried a whole bunch of useless woo that failed miserably when it came to analgesia, and I didn’t end up getting the epidural until I was 8 cms.

            And it failed. It didn’t work. They tried to fix it and couldn’t and had they had more time, maybe they could have. The pain of delivering a posterior eight and a half pound first baby suffering more pain that I could ever possibly imagine is STILL green in my mind two years later, and the helplessness (good word for it) in my husband’s eyes is something I won’t soon forget, either.

          • Vanessa Robertson

            That’s horrible. I saw my husband cry a couple times during my protracted labor as well. I am definitely thankful that the epidural did work for me. I can’t imagine how you felt after you were ready for some relief and it didn’t come.

          • theanastasiabeaverhausen

            Agreed. My first birth was prolonged, over 40 hours of labor before emergency C. I still have nightmares about it. I had an epidural placed at hour 10 ( which is when things started to get painful)…it didn’t work. I lost motor, but not sensory in my abdomen. I felt everything, and was having terrible back labor. My Dad had to leave the hospital because of it, my poor husband was in tears for 2 hours worried about me. It was a horrible experience, and I will never forget it. I would do anything to have had pain relief.
            My second birth was a lovely, pain free, planned c-section. I had a panic attack on the way to the hospital, because I was having flashbacks of my first birth.
            I have never felt pain like I felt during labor.

          • Hava NaturalMama

            You’re right which is why BOTH options deserve respect. Epidurals are definitely the right choice for some.

          • Amy Tuteur, MD

            No, Hava, the opinion that childbirth pain is all in women’s head, that the risks of epidurals outweigh the benefits and that refusing an epidural means that you are an “empowered” person is not worthy of respect because it is based on utter falsehoods.

            That’s the point of this post. You keep quoting the same propaganda and I keep pointing out that it is nothing but propaganda.

          • Hava NaturalMama

            Childbirth pain is not in a woman’s head, it’s real. I never said it wasn’t

            Childbirth can be a wonderful empowering experience no matter how it goes down. C-section, epidural, whatever. You made a baby… that’s amazing and wonderful.

            It’s an individual choice if epidurals costs/benefits win out. The only benefit of an epidural is pain relief, so it would depend how bad the pain is. The pain of childbirth varies from birth to birth and person to person. Also an epidural requires an IV and usually some loss of mobility and a urinary catheter. Some women see those as big cons, some don’t care. It’s a trade off to be made individually by each women and respected.

            I am not quoting any propaganda, I am talking about my views and experiences and respect for all opinions.

          • DaisyGrrl

            I guess you didn’t read Captain Obvious’s list of risks of not getting an epidural. I think I’d take the benefit of not risking PTSD due to hours of uncontrolled pain when the means of avoiding it are so easily available.

            I find it disquieting that there is such a debate about the utility of pain management in childbirth in this day and age. When I had appendicitis, it was made very clear to me that proper post-operative pain management was considered an important part of healing. Does that mean that I needed to take all the painkillers prescribed to me? No, but it does mean that I was careful to take what I felt I needed rather than suffer unnecessarily.

            No doctor would suggest someone pass a kidney stone or heal from abdominal surgery without pain relief. No woman should feel weak because she didn’t want to suffer pain that could be relieved. The current discourse surrounding natural childbirth does not empower mothers to proactively manage their pain and that’s a shame.

          • Hava NaturalMama

            I did read Captain Obvious’s list and it is a very valid lists. There are many good reasons to get an epidural and they should definitely be an option.

            I agree that no woman should feel weak for choosing pain relief.

            But people who don’t want epidurals deserve respect and support too.

          • KarenJJ

            I’m going to be honest here, but I’m a bit over this need for everyone to have support and respect etc etc. My obgyn was a bit of an arse and when I told him I’d taken a hypnobirthing course he wiggled his fingers and said ‘ooobbly-goobly’. At the time I have to say I was a bit annoyed, but looking back it is kinda funny. It didn’t stop me from trying hypnobirthing techniques while in labour, but neither did it stop me from going to hospital when in labour. I don’t think women are really such sensitive flowers as people make out we are.

          • Lizzie Dee

            If a woman’s reason for refusing is that she has made a very clear and fully informed decision against having an epi, then of course that should be respected. But if that decision is made in advance on the grounds that the pain will be manageable, and it isn’t, or that it will harm the baby, when it doesn’t, what then? Why is it disrespectful to be asked if you have changed your mind? Is it about tolerating pain, or resisting temptation? Feminism requires that No means No, regardless of the reasoning, but it also requires that women should not feel obliged to base their decisions on fear of disapproval from others, doesn’t it? If NCB would stop pushing daft definitions of success and failure, this issue would be a lot less sensitive.

          • Hava NaturalMama

            I agree with you; there are time when it is respectful to ask. I think people who promote choosing an epidural as weakness or failure, make the situation much worse for everyone. But I don’t think classifying everyone who wants an unmedicated birth as a brainwashed by propaganda is not helpful either.

          • Vanessa Robertson

            I cannot agree with this post more.

          • theadequatemother

            All of that..and plus babies born to women with epidurals have better blood gases! Adrenaline is NOT good for placental perfusion.

        • Renee Martin

          IIRC, epidurals are used in most labors here (upwards of 75%, IIRC) so it is not a big deal to be asked when you want one, You can easily say “no thanks”.

    • Ainsley Nicholson

      I agree completely; in fact that is what exactly what I thought “natural birth” meant until I started to learn about all the craziness that has become associated with the term (refusing pre-natal care, refusing rho-gram, shaming women who choose to have an epidural, etc). I wish there was a term to simply describe a birth that wasn’t accompanied by pain meds; “unmedicated” is the best I can come up with, but that really doesn’t work for several reasons. Those of us who chose not to use pain meds can still benefit from good prenatal care, electronic fetal monitoring, inductions when medically necessary, etc.

      • Hava NaturalMama

        AMEN!

      • Renee Martin

        Most people I knew IRL when I was pregnant with DS used “natural” to denote “vaginal” birth. That’s it.

        • Ainsley Nicholson

          I’ve heard that use of the term also. It is a little confusing to someone new to this site when they read Dr Amy’s harsh words about the ‘natural childbirth movement’ and don’t realize that what she is arguing against is very differant from what they think of as “natural childbirth”.

      • amazonmom

        Refusing Rhogam! Don’t even get me started! A person should be forced to spend time watching a baby die from hemolytic disease of the newborn to refuse it. Woman up and get your shot in the butt already! Maybe I should start a website talking about how women refuse Rhogam hoping they get sensitized and then can make quite a bit of money selling blood and plasma.

        • Box of Salt

          A question about RhoGam in case anyone knows:

          My understanding is that it’s processed from the donated blood of mothers who were sensitized (USA Today link from 2009, which makes me cry every time I read it since my own children may number among their beneficiaries: http://usatoday30.usatoday.com/news/health/2009-02-08-blood-rhogam_n.htm). Now that most of us Rh- folks are getting RhoGam, donors are becoming scarce. I, for one, got my shots and to my knowledge I am not sensitized.

          What’s going to happen with the next generation if we don’t have enough donors?

          Is there any research going into alternative sources? (Google is unsurprisingly not helpful; perhaps I ought try PubMed.) Does anyone know?

          • Ainsley Nicholson

            Looks like there is a whole new generation of mothers volunteering to become sensitized, so we’ll have a few more decades before shortage of RhoGam becomes a real problem.
            Assuming that these younger women will be as altruistic as the ones in the 2009 article, that is…

          • Ainsley Nicholson

            Setting aside my snarkiness and actually adressing your question: I can speculate that it would not be difficult to generate new donors among women past childbearing age, and men. Sensitizing people is easy- it’s avoiding sensitization that is difficult. Those people would then have a lifelong risk of needing a blood transfusion when no Rh- blood was available, so some monetary compensation would probably have to be offered. RhoGam might become more expensive in the future.

          • Sullivan ThePoop

            Yeah, that is an issue. Most people who have anti-D antibodies have been donating for more than 40 years. Some Rh- males born to Rh+ females make anti-D antibodies, but it is rare and might only be found if they have an immune disorder.

        • Sullivan ThePoop

          I know! I am Rh- and I cannot even imagine refusing something so simple as antibodies that could save my child or future children in the case of the first.

    • GuestK

      Isn’t, then, a problem with homebirth that pain relief is not an option? Many women make the choice to homebirth before they’ve experienced the pain of childbirth, but once they are at home in labor there is no quick access to pain relief should they change their mind. Thus, this seems to be a great argument for hospital birth.

      • Hava NaturalMama

        I think the big argument for hospital birth is that sometimes being 5 min from a hospital is the difference between life and death. Pain relief is a much less significant issue in that debate. There is a reason I read Dr. Amy; there are some things I 100% agree with her about.

        • Sullivan ThePoop

          In England most of the women that transfer from a home birth transfer for pain relief.

          • Hava NaturalMama

            Okay. I hope that their friends and family treat that decision with love and respect.

          • EllenL

            Agreed!

            And I hope they don’t feel like failures because someone sold them the idea that NCB is superior.

          • annamaureen

            I transferred from a freestanding birth center to a hospital for an epidural after hours of agony and not much progress. I never once regretted my decision, but I had a few moments of confusion and shame afer some oh-so-helpful NCB types I knew couldn’t understand why I didn’t have a beautiful, empowering experience and were convinced I must have done something wrong. In hindsight, the only thing I did wrong was not starting at the hospital in the first place…

          • Vanessa Robertson

            Hey! That same thing happened to me! I had to fight and argue for like an hour and convince three people that I was COMPLETELY SERIOUS and THEN I had to agree to sit in the tub for a little while before they would bring me to the hospital. This was after 39 hours of full-on contractions. I wish I had just started at the hospital and not wasted my time with the midwives or the birthing center. I was at 3 cm when I left the BC and because I was so uncomfortable there (my midwife introduced me to three new people AND THEN LEFT. None of those people had read my birth plan and had no regard for my privacy, which was why I was avoiding the hospital in the first place. That and a fear of needles-I’m over that!). I had my baby after 45 or 46 hours. I dialated more in the car en route to the hospital (20 mins) than I did during the 8 or so hours I was at the BC. So awful. I wish I could just start that whole process over and skip all the propaganda BS and the wasted time (it’s further from my house and work to go to the BC) and money (I paid them up front) oh and the pain, I can definitely imagine a full and happy life without that experience. NOVA Birth Center in Chantilly, VA, just don’t!

          • Bombshellrisa

            I am SO sorry, reading this just upset me so much. They didn’t read your birth plan? I thought midwives were all about the birth plans! I hope you wrote a yelp report about that place. I hope everything was better once you transferred to the hospital. Is the baby in the pic yours? Adorable!

          • Vanessa Robertson

            Yeah, it was pretty unbelievable. Basically, everything I was afraid of happening to me at the hospital happened at the birth center (namely, unknown people touching me intimately without my consent, strangers in and out of the room-I’m not a rape victim or anything, but I’m in law enforcement and that’s my subject area, so I’m a little sensitive and I think that’s my right to be!). It was probably the worst experience of my life (not counting the pain, which was manageable until I decided I had to get away from those women if I was going to have the baby at all). I don’t remember the names of two of the three ladies who attended the birth but I remember vividly having my clothing pulled up and being exposed in the midst of contractions when I couldn’t resist or make them stop and having hands come into the shower when I thought I was with my husband and doula and having the midwife I’d never met sit in the bathroom staring at me while I was on the toilet. Just horrific for me, and I discussed all this with the midwives who were supposed to be there and put it in my birth plan that I needed privacy. Luckily when I got to the hospital my nurse Sarah Oh was amazing! The whole thing at the hospital was much closer to what I was expecting at the birth center. She spoke to me like a person instead of just staring at and disrobing me at will, the lights were low, everyone was calm. The doctors were about to change shifts so the departing doctor didn’t come in so that I wouldn’t be disturbed. At that point I didn’t care if I did end up with a Csection, but this doctor saw how much I had been through and monitored my baby really closely (she was in mild distress from the prolonged contractions without accompanying descent down the canal and also because her cord was wrapped around her neck twice) but the doctor still let me push even though I went a little bit beyond the “pushing window” (unless that doesn’t exist and is just more propaganda). They delayed clamping (for just a couple minutes) and put her on my chest immediately. It was handled 100% perfectly when I got to the hospital and I felt stupid for being so afraid of what would happen if I had to transfer. And yep! That’s the baby! The ONLY baby after that horrific mess. ;) Thanks for listening. I haven’t really been able to talk about it.

          • Captain Obvious

            A clear risk of not getting an epidural.

          • Bombshellrisa

            I googled that place, it’s pretty and very modern looking. And apparently a pretty place to agonize in is all that they offer patients. And shame on them!

          • Meerkat

            Is there any way to get your money back? I would definitely try. Tell them you will go to the newspapers and tell anyone who will listen. Go the Better Busuness Bureau. After all, they are a business. They will want to avoid bad press.

          • Vanessa Robertson

            HA! You know I tried. They stonewalled me. I left reviews everywhere I could and I am going to file a complaint with the Better Business Bureau. These people are basically promising a natural birth according to the Bradley method and then just delivering an unmedicated birth. Rule number ONE (in the Bradley Method) is that the laboring woman should be with people she knows and trusts. My midwife left after introducing me to three people, one of which was a midwife from another state who was in just to help out. Thanks for the suggestion and for listening. I really feel duped. The worst part is that afterward I was OH SO GLAD that I had the epidural because I felt everything going on down there except the sensation of pain and I don’t want to know what that pain was like-but I still felt guilty for not being able to “do what my body is meant to do” they say that over and over. Now that I know I would counter with a discussion about how human children are born with such high levels of dependency because of how our brains evolved to be so big and how much more difficult it is for a human baby to pass through the pelvis because of this. So let’s use that big old brain to think of a way to make this less painful! It really is needless (the pain not the brain). At the end of the pregnancy you get to keep the baby either way. THanks for listening.

          • Vanessa Robertson

            Oh and when I shared my feelings with the midwife her reply was “Well natural birth’s not for everyone.” When I told her about feeling everything but pain with the epidural she was really excited, “Good!” She exclaimed. At that point I thought she must be a sadist.

          • Meerkat

            I think bad behavior should be punished… Have you tried contacting the office of your states’s attorney general? I

          • Box of Salt

            Hava “I hope that their friends and family treat that decision with love and respect.”

            Do you?

            Or are you secretly looking down at those of us who found the pain unbearable and decided we had experienced enough of it?

          • EllenL

            Actually, I’m wondering why my decision to have an epidural would be of any interest or consequence to anyone but me!

          • theadequatemother

            In Canada the majority of HB transfers are also for pain relief.

    • S

      Most women experience a great deal of pain in childbirth and, when given the option, choose pain relief. It is reasonable for caregivers to assume that a woman might be in a great deal of pain and might need to be directly questioned about her needs. If you are coping well with your pain, then _you_ should assert yourself and say, “No thank you, i do not need an epidural.” Why do you want to shift that responsibility onto women who are in terrible pain?

      • Hava NaturalMama

        If they are in terrible pain and there is no stigma to asking and the nurse checked in, why wouldn’t they say what they need?

        • auntbea

          Because there IS stigma to asking, because of all the people around insisting that birthing without medication is better/more real/a mama’s duty/RRRAAWWWR.

          • Hava NaturalMama

            Yes its a problem, and a fine line to walk.

          • Dr Kitty

            In any other situation your caregiver will assume you require pain relief, administer it, and THEN take a history.

            The assumption in every other medical situation is that the patient requires analgesia, and that the fact they are in terrible pain prevents them from thinking straight.

            I’ve given morphine to patients with kidney stones or heart attacks when all I knew for sure was their first name and that they didn’t think they were allergic to it.

            Trying to talk through the pros and cons of analgesia with someone who is in pain is often not appropriate. You manage the pain and deal with the fall out if it happens.

          • Hava NaturalMama

            So you think we should give all women epidurals and talk about pros and cons afterward?

            I thought in all medical situations, if possible, you are supposed to get informed consent before doing anything.

          • Renee Martin

            “if possible”
            Some types of pain make it impossible to get any type of consent. I was conscious after my near fatal motorcycle crash, but couldn’t say or do anything until after they gave me some morphine (?? Could have been something else). Only after that was I able to speak.

            Sometimes, pain relief is the only way you can even find out what’s wrong, or get the person to be able to make any such decisions. If you are out of your mind with pain, it can make your perceptions distorted.

            You can’t do this with epidurals, as you have to lie still for them, but it would work with IM or even some IV drugs, like narcotics.

          • Hava NaturalMama

            Of course those situations exist. Usually early labor and time in between contractions would provide time for informed consent as much as possible.

          • moto_librarian

            But what if you come into the hospital in the throes of transition, dilated to 9 cm.? This was what happened to me during my first birth. I was going for an unmedicated delivery, and I remember being incredibly annoyed at the triage nurse for making me sign a bunch of forms when I was incapable of thinking clearly due to the pain. I never had any break between contractions when we got to the pushing stage either.

          • Ainsley Nicholson

            I want the pros and cons of an epidural discussed with me at one of my OB visits, long before I’m in any pain, while I can pay attention to what is being explained and even have time to think it over and come back with questions later. Do you think anesthesiologists would be willing to make OB visits?

          • theadequatemother

            we have printed materials about pain relief options in labour that we give to the OBs, GPs etc to hand out and that are given during the hospital tour. Patients with specific concerns (prior bad reactions, back surgery, scoliosis, anxiety, hx of abuse, etc) should be referred for anesthetic consults at the beginning of the third trimester.

            Often we used to go and give a spiel at the hospital birth classes…sadly, now in my community there are only private birth classes available and they are all 100% woo.

          • PollyPocket

            I brought my little sister to the ER the first time she had a kidney stone and the pain was unmanageable at home. I put the IV in at home (with a doctors order, of course). When we got past triage, the nurse said, “you look like your pain is a 10.” She brought the dilaudid in when the doctor came in to do his initial assessment, he nodded, and she pushed it as he was introducing himself. The only discussion was “this is some pain medicine to make you feel better.”

            Door to dilaudid time was about 8 minutes. Makes me wish the ER routinely delivered babies!

          • auntbea

            Okay, but if you acknowledge that it is tricky, why are you so irritated with nurses who don’t walk that line perfectly? Do nurses somehow become flaw-free when they put on the cushy shoes? Does a nursing degree now convey mind-reading abilities? You have given ONE example of ONE tone-deaf nurse — whose comment could very well have seemed warm and supportive to someone else — and spun it into an entire meme about how nurses are not respectful of patients who want to go without medication.

          • Hava NaturalMama

            Nurses can off course only do their best, which can never be perfect.

            I did not intend to make a sweeping generalization about all nurses. I apologize if it came off that way.

          • amazonmom

            I have sneaky labor RN friends who send the support people out to get mom ice chips or a small snack if they suspect mom is being pressured into refusing pharmacologic pain control. Then the nurse asks the mother what her pain score is and what is her choice of pain control when she is alone. If the mom states she would like medication or epidural that’s what she gets. If she says she really doesn’t want the meds then we support her the best we can.

        • Bombshellrisa

          Sometimes when you have talked to your partner or the other support people about your wish to give birth naturally and the risks are the reason why, when you realize that your are in more pain than you can handle and those same people are in the room with you, they might repeatedly remind you of the risks of accepting an epidural (or what they believe those risks are) and you simply can’t ask for what you need.

        • S

          Because excruciating pain can make it harder to communicate and think. Because for whatever reason they might not realize that they still have the option. Off the top of my head. I’m sure others will chime in.

        • Isramommy

          With my first baby I thought I wanted to go natural because I was afraid of the epidural. After three hours writhing in pain with broken water but stuck at 2cm, the midwife very supportively suggested an epidural. She then talked me through my fears and explained the procedure in detail, and why she thought it would benefit me. I was so lost in fear and pain I couldn’t even begin to think of a way out, and I NEEDED that amazing, amazing woman to lay out my options and explain my choices. I’m sure NCB advocates would say she “pressured” or “bullied” me into getting the epidural.

          She didn’t. Just the opposite- she gave me a choice that I couldn’t see before because I was overcome by the pain and intensity. I think she would have been negligent not to have offered me that choice.

          • Isramommy

            My point above being, that’s an example of why a woman might not ask for pain relief on her own, and why it ought to be incumbent upon care providers to make sure patients are aware of all their medical options. You know, it’s about choice and a woman’s autonomy and having a good experience and all that. Isn’t that what NCB is supposed to be all about?

          • Hava NaturalMama

            Sounds like you had a wonderful and caring midwife who understood that epidurals are the right choice for some women even if it is not what they originally intended.

        • PJ

          If a woman isn’t in significant pain, why would she find it a challenge to decline an offer of pain relief?

          • Hava NaturalMama

            Depends on how the offer is made.

          • PJ

            What, like, “You must have an epidural right now or you will be arrested?”

            All you have to say is “No.” I’m not sure why, unless someone is actually suffering real pain, this should be such a big deal.

    • Bombshellrisa

      Dr Amy is a nice example of someone who chose natural childbirth and has no intention of judging someone who doesn’t choose the same route.

    • Renee Martin

      Of course! Choice is very important, and I respect a womans wishes.

      I know labor can be not too painful, but I think it is the exception not the rule. You are pushing a human out of your vagina, FFS.

      My DD was a VBAC and nearly painless, nothing more than cramps. I am guessing it was because DD was a #4 preemie, and baby #2. I tried to get an epidural just in case, but they didn’t get it placed correctly, and when they came in to get it working, DD was a few pushes from crowning. I thought it was going to hurt, and cussed the staff out for not getting the epi working in time- I thought they tricked me into a unmedicated VBAC! (not wholly untrue) Thankfully, it ended up being no big deal.

      With DS, I was having strong contractions for hours, but never felt them either. Then I got the epidural, so am not sure if it would have hurt or not.

    • theadequatemother

      The way it works in my hospital…RNs take pain scores with the vital signs. Women rate their pain on a scale of 0 (no pain) to 10 (worst pain imaginable). If the pain score is > 4, the RN offers pain control. The woman gets to decide a) if she wants it and b) what she wants from the options available to her (non pharm, gas, narcotics, epidural).

      Its part of nursing protocol to ask people if they want some pain medicine if they rate their pain as greater than 4. They are being compassionate – not “pushing” pain medicine on women. Studies show pain is undertreated in hospitals and this is the system used in LDR, the medical wards and the surgical wards. In this way, laboring women are treated the same as every other competent adult patient in the hospital.

      • Gene

        I remember having surgery on my throat. I was in horrid pain, but was rating it as a 3-4 (one childbirth was 7, one was 9 – because I can ALWAYS imagine worse pain). I asked for drugs. The nurse said she couldn’t offer me drugs unless my pain was at least a 5. WTF? I’ve seen people with a paper cut scream that their pain is a 20 and kids in the midst of a sickle cell crisis rating their pain as a 4 (because they KNOW it can/will get worse). I think pain ratings are stupid. I don’t use them. My questions are: do you have pain and would you like some pain medicine? And then, do you still have pain and would you like more medicine? None of this “rate your pain” BS.

        • Jocelyn

          Have you heard of Brian Regan? He’s a comedian who does this great bit about pain ratings. The full “emergency room” clip is here: http://www.youtube.com/watch?v=cP4zgb9H3Cg

          • The Bofa on the Sofa

            But Brian Regan is a moron. He can’t even use the “you, too” phrase right.

            Getting out of a cab at the airport – “Have a good flight!” “Yeah, you, too!”

            The waitress says, “Enjoy your meal.” “Yeah, you, too!”

            When I was in grad school, “You, too!” was our big phrase. And “It’s a cup of dirt.”

          • KarenJJ

            I do that. It’s bloody embarrassing when I realise what I’ve said about 1.5 seconds after I’ve said it..

        • AmyP

          “I was in horrid pain, but was rating it as a 3-4 (one childbirth was 7, one was 9 – because I can ALWAYS imagine worse pain)”

          True, true. My almost-unmedicated delivery I would have to rate as a 9. It felt like being ripped apart, but I have to save the 10 rating for ACTUALLY being ripped apart.

          • Jennifer2

            Yeah, I rated my labor as a 9 when i asked for the epidural because “I imagine there are things that would hurt worse, like being shot or stabbed repeatedly, but I have never experienced anything worse.” I went from being afraid of the epidural to being a big fan of them in a matter of minutes. Next time (if there is a next time) I will be that woman asking for the anesthesiologist the minute I enter the hospital.

        • Lizz

          Yeah I hate how its always 10 being the worst pain of your life. But I’ve seen people who stand there and tell you they are having a 10 in back pain. My classification of a 10 in back pain is something I’d have to tell you from the floor between sobs. Then if you say it’s a 3-4 and ask for medication they think your looking for drugs.

        • Guesteleh

          Have you seen the Hyperbole and a Half pain scale? I can’t link but here’s a modified url: hyperboleandahalfDOTblogspotDOTcom/2010/02/boyfriend-doesnt-have-ebola-probablyDOThtml

        • theadequatemother

          WTF indeed. The way it works in my center is if you rate your pain as 4 or greater, the nurses HAVE to offer you something. You don’t have to take it, but they are required to offer it and chart that it was offered.

  • Renee Martin

    I am going to have a showing of is in my NCB worshipping town when it comes out. They always play Ina May, why not?

  • Lizz

    I have seen some that are Christian but a lot of the stuff we run into seems to be more for lack of a better term pagan. I mean the placenta worship, the goddess worship, the blessingways which pull from several polytheistic cultures. I remember reading a Sheila Kitzsinger book in which she’s kind of semi morning the loss of birth goddess connection in western protestant culture.
    Although I have seen many quiverfull pieces that are very NCB positive to put it mildly.

  • theadequatemother

    This is awesome. When will it be released and how soon can I watch it?? This is just the thing I need to keep in mind when on my way to prenatal yoga!

  • EllenL

    Bullying and shaming women into enduring dreadful pain now passes for feminism. It’s very disturbing, the perversion of an important movement.

    I, too, would love to see this film.

  • slandy09

    I’m interested in seeing this documentary…

  • Jenna

    I’m a Christian woman who has never identified herself as a feminist… and I agree that pain relief in labor is a human right’s issue. In fact, I’m being induced today and I am looking forward to an epidural.

    • Allie P

      Good luck with your delivery! Good luck with your baby!

    • guest

      Amen!!!
      In Genesis it says God Himself invented anesthesia when he caused “Adam to fall into a deep sleep” so that he could take one of his ribs. So I don’t see how the notion of pain in childbirth is “more spiritual”. That’s just pride! Best wishes to you and your baby!!

      • Lizz

        Maybe we should ask people more often if they aren’t experiencing pride? I mean I seem to remember Jesus himself talking about people claiming to be more spiritual because they prayed in the middle of the streets. It just doesn’t seem like a good idea to go around claiming to be more spiritual because you expressed it more publicly in childbirth.
        Good luck Jenna.

      • slandy09

        I never thought of that before! I’m putting that in my “irk the NCBers” arsenal for the right time. I hope you don’t mind ;)

      • Antigonos CNM

        Yes, but it also says that women will suffer in childbirth. Men get the anesthesia, women get contractions.

  • suchende

    Can’t wait to watch this.

  • PrimroseRoad

    This is why we need history and philosophy! It remains unbelievable to me that people can so naively but so fiercely argue in favor of taking resources (pain relief, hospital care, antibiotics, infant formula) away from people who need them.

  • Karen in SC

    So glad you blogged about this. I read the article yesterday and was also struck by the ironies. Especially how pain relief in childbirth was demanded as a human rights issue, and now it’s almost the opposite!