Reframing the language around childbirth; how about this?

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From Motherwise:

As a birth doula, mother and a woman who has been on a long journey to find a stronger connection to my womb space* and in general, self-love — I feel deeply compelled to discuss the value of positive reframing. The beliefs we hold about ourselves and especially our bodies are very powerful. The words we choose, whether we are conscious of them or not, can shape our ideas and in turn foster strength or fear within us. This applies directly to childbirth outcomes.

Ok. How about this?

Let’s replace the words “birth interventions” with “preventive medicine.”

It’s easy to fear and refuse “birth interventions” but who refuses preventive medicine?

 

* What is a womb space and why would you want to have a connection to it?

  • JT

    Amy why are you so aggressively derisive of kind, caring and gentle? I can’t think of any reason for the way you undermine women other than that you intrinsically despise them, and feel so threatened by women who choose different to you, that you can’t bear it. You have a lot of energy for it, and are clearly an accomplished scholar, it’s a shame that energy and learning couldn’t be put to use supporting and empowering women rather than simply scaring the bejesus out of them.

    • KarenJJ

      What’s kind, caring and gentle about being told that my words matter so much to my womb that unless I talk nicely to it it won’t be able to grow and expel a baby properly? I find it condescending, personally.

    • Jocelyn

      Please show me one instance where Dr. Amy says being kind, caring, or gentle is bad.

  • I found the topics shared in your article are very practical and necessary. What do you make logical, understandable and useful. It’s good for that.

  • I would have shared this with my friends, maybe she needs to know this information.

  • ratiomom

    OT, but have you seen this?! The BFHI velvet glove is coming off, and what`s underneath is not pretty

    http://www.mercurynews.com/ci_23611112

    Quote from the article: ” I`m a big believer in autonomy,” Calhoun said. “But I think that the need for success in breast-feeding supersedes that.”

    This is simply disgusting. They bully women into breastfeeding and they are proud of it too.

    • Dr Kitty

      I agree ratiomom.

      Of ALL the public health issues to decide that the putative benefits warrant removal of autonomy…breastfeeding isn’t it. Smoking, alcohol, obesity, inactivity and illiteracy all cause more harm than bottle feeding, and yet removing autonomy is not advocated as a strategy to manage those problems.

      Breastfeeding requires giving of yourself to nourish a human being, that ANYONE could think it would be justifiable to make that coercive…

      I’m all about making breastfeeding culturally normal and usual and acceptable. Having a culture where it is OK to feed in public, or for longer than 6 months- I’m fine with that. Supporting changes to lifestyles and maternity benefits or parental leave entitlements to make breastfeeding easier- I’m down with that too.

      Removing autonomy or demonising alternative choices to COERCE women to breast feed- not supportive of that at all.

      • KarenJJ

        What the hell? Is not discussing the benefits and provide support enough? Why does breastfeeding matter so much it trumps a woman’s autonomy?

        • Amy Tuteur, MD

          Because it’s not about what is good for babies, it’s about policing women’s bodies.

    • T.

      People don’t CARE if a woman breastfeed by herself. Most people averts their eyes and went with their business. What bothers people is when the woman put herself in the limelight, ostensibly get half naked and fed her baby (who presumely doesn’t care about any of it) looking around as if daring anybody to question her.

      I have personally seen it once or twice. It is rare, though. Most women are businesslike and respectful while breastfeeding in public, and no body minds that.

    • Guesteleh

      I really want to know whether they controlled for SES and race. It’s obvious that a county hospital is going to have lower BF initiation rates than private hospitals in affluent areas. Considering the science literacy of most reporters, the phrase “A review by this newspaper of data from the California Department of Public Health’s newborn-screening program” doesn’t give me a warm fuzzy in terms of trusting any of their numbers. And yes, the comments about autonomy are disgusting. The whole article enrages me.

    • rh1985

      Sick!

    • Lisa Miller

      Oh lord 😛

    • Lisa Miller

      Could the difference in Breastfeed rates have more to do with they types of people that each hospital serves? Economics, ethnicity, education levels??

    • Eddie

      When someone starts off a sentence with, “I’m a big believer in…” you can almost guarantee that they are lying or at best about to contradict themselves. Wow.

  • doc

    Who is paying you?

    • You are, by coming to this blog. We all are. Blogs earn money through page view statistics.

      Aren’t you glad that by posting an inane comment, you’ve helped Dr. Amy spread her message?

    • Amy Tuteur, MD

      No one is paying me. This blog loses money.

    • Squillo

      Interesting that some people believe the only reason anyone would ever write about these issues is because someone pays them to do it. What’s funny is that Amy no longer practices, so there isn’t even a miniscule impact on her income if someone eschews interventions or decides to homebirth.

      Yet no one ever seems to accuse folks like, oh, say, the birth doula quoted above of pecuniary motives when they write about them.

  • For some reason, I just do not think there is any amount of “positive reframing” that is sufficient for some of the out-and-out tragedies that result from the poor decisions made in the name of NCB. Yep, I just don’t think you can positively reframe dead baby or mother or severely injured baby or mother – “it was a really lovely normal birth” just doesn’t seem to make up for that….

    • BeatlesFan

      Unless you’re a midwife.

  • Antigonos CNM

    Thinking about “womb space” made me remember an idea which occurred to me years ago — how men and women perceive themselves and their bodies. Men often have all kinds of nicknames and euphemisms for their reproductive equipment and talk about it in the third person as if it was independent of themselves. Women never say their uteri hurt when they have dysmenorrhea: they say “I have cramps” or “I am in pain” — they usually perceive themselves as whole beings, and when I hear someone deliberately fragment themselves into bits [just as we read how certain women identify themselves by externals like the way they gave birth or fed their infants], I begin to feel a little uneasy. I am the sum of a great many parts, and probably considerably more than each little bit but there are obviously a lot of women out there these days who don’t have any intrinsic sense of self but have to “create” a persona out of externals such as manner of dress or diet, or mothering or profession. Take any one of these externals away and they feel lost. Or so it seems to me.

  • Guestxx
  • Anothergreatpostbydramy

    Terms that I am having trouble ‘reframing’…
    -Shoulder dystocia
    -trapping of the aftercoming head in breech delivery
    -interlocking twins during vaginal delivery
    -fetal bradycardia
    -placental abruption
    -cord prolapse
    -massive obstetric haemorrhage
    I think that we should all throw our textbooks away.

    • Zornorph

      Not to mention ‘stillbirth’. Not ‘born sleeping’.

      • Anothergreatpostbydramy

        Particularly in cases where this is entirely preventable (i.e. when a trained professional knows about active management of labour and is aware that ‘interventions’ are done for the benefit of patients based on current evidence base).

        I get bothered by people who think that doctors spend their day figuring out how to harm people. Apart from undermining a serious pillar of our Hippocratic Oath, most of us are busy trying to do our jobs to the best of our ability and choose this occupation because we actually want to help people.

      • Antigonos CNM

        Or “born still”, which drives me up a wall almost as the use of “birth” as a transitive verb.

      • Stephanie

        “Born sleeping” drives me nuts. Having said that, I’ve never had to suffer the horror of my baby dying before it is born. I understand the psychological, human need for euphemisms. But not when they are used to coerce women into making bad medical decisions.

  • Meerkat

    The videos accompanying this post are disturbing, especially the unassisted birth. I am not a doctor, is the baby supposed to be purple??? He (or she?) looks really bad. The process looks really awful too. What are those chunks dropping out of the woman? Sitting naked on a paper soaked in bodily fluids…Ewwwww. I can’t believe they allowed their little kid to witness it! It has to be traumatizing, especially seeing her mother in pain. I am a woman who had a baby, and I was traumatized after watching this video.
    And why do they post these videos for the whole world to see? Don’t they have jobs, aren’t they worried that their employers, customers, grown children, etc, will see it???

    • stacey

      They are PROUD!
      Doubt they have jobs to worry about.All the ones I have met have working men to support them.

      • Meerkat

        I figured that was the case. So why aren’t they worried about their husbands’ jobs? Especially if it is their only source of income? I guess they don’t live in a real world… I could never understand how grown women could expose themselves so completely-naked, sweating, screaming, bleeding, pooping…Some things should be private, how else would one preserve human dignity? But I forget. They say we are all animals.

        • BeatlesFan

          Not to mention that these are the same women who blow a gasket if interns show up to watch a hospital birth… because birth is supposed to be sacred and private, dontcha know!

          • Meerkat

            I know, right!?!!
            How about “labor can stop if evil intrusive nurses or doctors keep checking on and scaring poor sensitive flowers like us.”
            I guess am vain, but it would never occur to me to display myself in such an unflattering light for the world to see. It’s just not an attractive sight. Those chunks… I can’t forget them. So glad I had a C Section!!!

  • stacey

    OT-

    OH, Oregon. You require licensing of ANYONE offering basic handyman services on Craigslist- with penalty for unlicensed work. But lay MWs can KILL with impunity. They don’t need a license! They protect people from having a bad carpenter doing a minor repair, but NOT Moms and Babies! NICE

    http://eugene.craigslist.org/hss/3909162812.html

    • The Bofa on the Sofa

      Wow. That’s seriously ugly.

      (I didn’t vote you down, stacey, but the topic of your comment)

      • stacey

        Believe me, I know!

        I do think those types of workers ought to be licensed, as they go in your home, can really mess stuff up, and rip you off. But to see this post, by an Oregon state agency, posted like 2x a DAY, while MWs run free, is crazy. They have also been flagging and having unlicensed peoples ads REMOVED! This is already 100x more than they do to HB MWS that KILL. Oh, theres also a HOTLINE to report unlicensed workers!

        I will have to send a copy to the state reps, so they can see what the bare minimum looks like.

        Maybe the Safe MW group here can put ads up too? Warning of the issues here?

  • Dr Kitty

    I am somewhat suspicious of reframing things into more “positive” statements.

    This is probably because I grew up in Northern Ireland during “the Troubles”.

    Nothing like reframing what was almost a civil war to make it sound like a slightly embarrassing minor family scandal to leave one somewhat cynical about the whole idea.

    What we’re really saying is that we should pick a more palatable euphemism.

  • auntbea

    I am pretty sure that between the last sentence and the penultimate sentence there about seven sentences’ worth of handwaving missing.

  • Bomb

    Weird, I was literally just wondering if I could have a hysterectomy after my last child. I apparently have an abusive relationship with my womb space.

  • guest
    • amazonmom

      That story made me cry. Losing your child and your marriage due to quackery, so tragic.

      • wookie130

        So terrible, and senseless, all of it. My heart does go out to this mother for both of her losses…the baby, and the marriage. Sad, all the way around.

    • Anj Fabian

      Comments are predictable. The usual hospital-blaming, midwife-defending and a serious lack of recognition that a person died.

      • Charlotte

        Every time the NCB crowd rushes to defend a midwife who murders a mom or baby through breathtaking negligence, it astounds me how so many people can choose to collectively ignore that someone died.

    • Jocelyn

      Ahhh, that’s terrible. Seriously terrible.

      • KarenJJ

        Oh that’s awful.

        What do they mean by an exemption for traditional birth attendents for cultures that honour homebirths? I’ve not looked into it but I don’t know offhand of any culture that idolises homebirth as such..

        • Amazed

          Ship traditional birth mommies to traditional birth countries in Africa, and all will be happy. All but said mommies who suddenly won’t have their decidedly untraditional facebook, MDC and so on to brag on later.

          Such is life.

          • KarenJJ

            And yet women in Africa deserve so much more than this particular brand of uneducated birth attendent. It’s hardly ‘traditional’ when there are no other choices.

        • anonymous

          Maybe for Amish or Mennonite communities?

    • Squillo

      Marcene Rebeck was given a deferred sentence and ordered by the court to be properly licensed. She says she’s working toward that, but doesn’t believe licensing will make anyone a better midwife.

      And she totally misses the point of licensing.

      • Starling

        But she is 100% right–NARM certification will require her only to take a 6 month correspondence course. She will not be a better midwife by anyone’s standards. And that’s the problem with the CPM.

        • Squillo

          Exactly–licensing and certification is not intended to make anyone a better practitioner (that’s what education is for); it’s to protect the public by creating some accountability and to protect the practitioner by providing some immunity from criminal prosecution.

          • wookie130

            Well, in light of what has happened when she “practices” as a midwife, getting a license and certification couldn’t possibly make her any WORSE…

          • KumquatWriter

            Disagree – its likely to make her MORE overconfident.

          • wookie130

            You’re probably right, Kumquat. Scary.

    • Staceyjw

      Ridiculous. she needs to be JAILED. Like all other killers.

      • Squillo

        This, exactly. By eschewing licensing, midwives like her are making a tradeoff: no oversight, but no protection from criminal prosecution. They don’t seem to understand that you can’t have it both ways. Every other healthcare provider accepts regulation, including mandatory licensing and certification, in exchange for some immunity from prosecution. Licensing creates an alternative way to get bad practitioners out of practice. Without it, the only tool available is prosecution. So everyone should STFU about witch hunts because this is exactly the way Oregon’s midwives wanted things.

        • The Bofa on the Sofa

          It’s funny how they sit and bitch about how these MWs are not representative of the profession and all that, but when they come to light, they refuse to do anything about it.

          Why not create a system that provides a mechanism for eschewing the “bad eggs”? You’d think MWs would clamoring all over themselves to get rid of the riff-raff?

          Personally, I think it’s because they aren’t really so unrepresentative of the profession, and they know, upon closer inspection, if they actually set REAL standards of quality, that most MWs would be running afoul of them in some respect. Especially the CPMs (although that almost goes without saying – CPMs are, pretty much by definition, below any reasonable standards)

        • wookie130

          I absolutely agree with both of you.

          The scarecrow/Wizard of Oz analogy this midwife made about how the license was basically “a piece of paper”, and how the real wisdom in the profession comes from intuition and all of that…well, her “intuition” has led to the unnecessary death of two different babies. So, clearly her “intuition” needs some polishing up. Better yet…STOP delivering babies, and accept that you don’t have the first clue about what you’re doing.

    • Bombshellrisa

      60 hours of labor-unacceptable.
      Marcene Rebeck is the midwife with the Facebook page and the supporters who are selling a cookbook to help her with her legal fund.

  • Victoria

    Did you watch the birth videos accompanying the post? These are videos that are supposed to make us reframe birth in a positive way. I was horrified, and I really am not using that word lightly, with the unassisted birth where baby is struggling to breathe while curled up in mother’s arms and she is suctioning baby with her mouth and spitting it out. I skipped through it but at that point I had to stop watching. It was torturous.

  • yentavegan

    If only my womb had a better self image then perhaps the herpes infection would not have found it to be such easy prey. I must practice saying more self affirmations like begone herpes I have no use for thee…

    • yentavegan

      its from Rosemary”s baby

    • Petanque

      But Herpesvirus is entirely natural, you know. Maybe you need to reframe the Herpes?

  • I don’t have a creative name

    I LOL’d at the very last sentence… at first. Now I would kind of like an actual answer from one of these folks who hold things like this to be of utmost importance. Truly, I do not get it.

    How on earth do they even find time to ponder such matters? Aren’t they busy with the kids who are the results of their never ending quest for the perfect empowering birth?

    • wookie130

      Good grief, I’ve wondered this too. It’s like the birth is the end-all-be-all of the whole thing, and being actually raising the children is secondary for a lot of these women. I have a 4 month-old daughter, and I can’t do ANYTHING outside of the realm of childcare until she’s in her crib sleeping at night…all major household chores, shopping lists, bill-paying, what have you, is done when she sleeps. Like right now, I’m fartin’ around on the web, because she’s in bed, and I’m done doing what needed to be done around here. While I’m wiping her tush, feeding her, playing with her, rocking her, etc., I hardly have time to even consider what the hell a “womb space” is, and how that has any relevance to anything I need to accomplish within a 24 hour period on my daughter’s behalf, or on my own, for that matter. I guess my definition of “empowerment” is that I can manage to raise my daughter day in and day out the way I see fit, and can still get any number of miscellaneous tasks completed at the end of the day. Womb spaces and self-love aren’t luxuries my brain can afford to ponder these days.

      • Elizabeth A

        Wookie, it gets easier. There will come a time when you manage to do non-childcare things while the baby is awake. You’ll still be providing childcare, but there will be a second track available. It snaps in faster for subsequent babies – when we finally brought our daughter home, I was shocked how much I managed to get done one-handed, especially as compared to what I managed in our son’s infancy. Basically, if it doesn’t involve fire or knives, I’ve probably done it while nursing the baby, and if it did involve fire or knives, those playmats with the dangly toys were the bomb.

        • Lizzie Dee

          It certainly does get easier – but mainly because you get used to its endless nature.

          I coped quite well with one, but I found the first weeks/months with two unbelievable at first. After that, there were sporadic periods of mayhem in each day (bathing? Getting out of the house? Arbitrating in disputes? Inconsistent demands coming simultaneously?) Experience, lowering of standards and letting oneself of the hook of perfection works well.

  • Antigonos CNM

    Perhaps “womb space” is a parking space for a fetus?

    • The Bofa on the Sofa

      For some reason, a parking meter pops in my head.

      • rh1985

        My uterus parking meter has a 9 month limit, after that it’s getting evicted! (I did IVF so no doubt on dates, I’m going to use that to argue for an induction if need be, but I think my OBGYN will be open to that since she’d be willing to do an elective c-section)

      • Antigonos CNM

        I thought of that too, but was too lazy to edit my post…

  • Amy M

    Womb space…huh…she could mean the physical space within her womb, the physical space her womb takes up or maybe the theoretical brain space that is taken up with thinking about her womb, which seems like it might be all of it.

    What I don’t get is what that has to do with self-love. I assume she means self-esteem/value and most people don’t base their self-worth on their organs, though maybe how much they think about a given subject. I don’t disagree with the general idea of reframing situations in a positive way, like “preventative medicine”, or as Felicitasz says “the arrival of my baby.” But whatever size her womb space is, she really has no control over that. I guess instead of saying “My womb is too small” she could say “My womb space is humongous” if womb space refers to the space the womb is in.

    Personally, I would have to say I did that, sort of unintentionally. When asked about the pregnancy/birth/infancy of my children, I’ve always told it as a generally good experience with a few scary/bad bits. Once, someone pointed out that a whole lot of things went wrong along the way and I could be really negative and bitter about the whole thing, but I am not…mostly because those things that were bad were beyond anyone’s control and I guess I (subconsciously) chose to reframe the story in a rosier light.

    I hope this lady keeps that in mind when she reframes—things that we can and can’t control, things that might be changed next time (for us or for others). Changing perspective can indeed be powerful and helpful, but not if it aids burying heads in the sand (if she is reframing a homebirth death for example as a learning experience for someone).

  • Felicitasz

    Yes.

    I once wrote a blog post about “the miraculous caesarean”, the article is dealing with childbirth plans, medical necessities and re-framing. One can prepare for (or look back onto) “the arrival of my baby” instead of “the operation”. It is the same event but the mind is really a weird thing, changing words indeed can change the impact and the surrounding story we tell to ourselves.

    • fiftyfifty1

      Although when you are happy with an outcome the words matter less. I was thrilled with my c-section so call it what you like: the arrival of my baby, the birth of my baby, my c-section, my surgical birth, my baby’s extraction etc. I’m even willing to accept “too posh to push”, because really it’s not far off the mark; I decided that what remained of my crotch after my first birth was too precious to risk with more pushing. “Too posh to push” sounds like a sensible choice to me!
      But my favorite terminology is the terminology the beautiful result of the aformentioned c-section uses, i.e. “When the doctor cut you open with her special knife and pulled me out of the hole by my head”.

      • The Bofa on the Sofa

        I’m even willing to accept “too posh to push”, because really it’s not far off the mark;

        This has been my attitude a lot lately: so what if it is? A have seen a lot of crap lately about how, oooooo, so and so is X or Y. And my answer has been, so what if it is? What difference does that make?

        So what if some celebrity is “too posh to push”? What’s wrong with that?

        • Antigonos CNM

          I remember, at the time, that Barbra Streisand was advised that she might damage her vocal cords if she screamed too much in labor, so she opted for C/S but I don’t know if that was true or not.
          My first C/S was after 48 hours of strong contractions, at 40+5, without progress [and I a Lamaze instructor! Fie, for shame!] by which time I would have happily held the scalpel for the surgeon; my subsequent CSs were elective. I was amazed at how nice it was to have the house organized, the kids taken care of, even had a set of meals in the freezer for when I came home…this is the way to go, I thought [I had very easy recuperations from all the operations]
          If I had had any “ideological biases” prior to my own births, my view changed dramatically after. Whatever the woman wants AND is appropriate for her, that’s my ideology now, and it is the very rigidity of the NCB movement that makes me shake my head.

      • CanDoc

        I would like this comment 27 times if it could. 🙂