There are countless women who hate their bodies.
Why? Because those bodies don’t meet the contemporary culturally constructed ideal of female beauty.
Don’t believe that the “ideal” female body is culturally constructed? Consider the Venus figures, prehistoric carved art depicting women and goddess. As the Venus of Willendorf above demonstrates, for most of human history, the ideal female figure looked very different than today’s ideal. The prehistoric figurines have pendulous breasts, very wide hips and large bellies.
The contemporary ideal of female beauty is dramatically different: regular features, low BMI, large breasts, thin waist. This cultural construct is everywhere you look. It’s in movies and on TV, in fashion magazines, in advertisements of products of all kinds.
The message has been received loud and clear; there is a “right” way to look and a wrong way to look. Those who don’t meet the cultural construct should work assiduously, diet obsessively, submit themselves to plastic surgery, squeeze themselves into “shapewear” and otherwise torture their errant bodies into the desirable ideal. And those who can’t or don’t submit to the ideal should hate the way they look and they themselves for lack of willpower.
Childbirth is much the same.
The natural childbirth community has created and enforced an “ideal” birth that bears as much resemblance to childbirth in nature as Paris Hilton bears to the Venus of Willendorf.
The contemporary ideal of birth is an unmedicated vaginal delivery without interventions of any kind. Women don’t experience pain or have contractions; they have “waves” and “surges” instead. Women don’t scream, they “vocalize.” They don’t fear birth; fearing birth is now a sign of weakness and lack of ideological fervor. They don’t have complications; everything is a “variation of normal.” They don’t die and their babies don’t die unless they are “meant to die,” in which case embracing technology could not have saved them.
The message has been received loud and clear; there is a “right” way to give birth and a wrong way. Women should stoically bear excruciating pain or even pretend that the pain is orgasmic. They should risk their lives and their babies lives to meet the ideal. Those who can’t or won’t submit to the idea should hate the way they gave birth and hate themselves for lack of will power and ideological fervor. They should embarked upon another pregnancy in order to have a “healing” birth that they can brag about on blogs and message boards.
When it comes to body image, most of us now understand that the culturally constructed ideal is corrosive to women’s view of themselves. It leads to shame, anger and self-loathing. As the various prehistoric Venus figurines demonstrate, women are not meant to be thin, with large perky breasts, moderate sized hips and tiny waists. That ideal was imposed externally and serves to oppress women while simultaneously enriching the fashion, diet and plastic surgery industries, among others.
Hopefully, we encourage our daughters (and ourselves) to love our bodies regardless of whether or not they meet an externally imposed standard. We encourage or should be encouraging our daughters to subvert externally imposed standards by rejecting them. They, and we, should recognize that beauty comes in many different shapes and sizes.
I’d like to suggest an equally subversive response to the natural childbirth industry, an industry that promotes and profits from a culturally constructed “ideal” of childbirth. Those who respect science recognize that unmedicated vaginal birth is not better, safer, healthier, or superior in any way to birth with every intervention known to obstetrics. Those who understand history know that childbirth in nature was always feared, death was a constant accompaniment, the agony of childbirth was deplored and understood to be a divine punishment, not “good” pain.
When it comes to childbirth, the cultural constructed ideal of unmedicated vaginal birth is corrosive to women’s view of themselves. It leads to shame, anger and self-loathing. It only serves to oppress women while simultaneously enriching midwives, doulas, childbirth educators and purveyors of everything from Hypnobirthing tapes to plastic birthing pools.
We should be encouraging women to love their births regardless of whether or not they meet an externally imposed standard. We should encourage women to subvert that externally imposed standard by choosing pain relief if they have pain, technological interventions to predict complications, and Cesarean sections to rescue babies and mothers who might otherwise die. We should recognize that a beautiful birth comes in a million possible iterations, spanning births in which no interventions are needed to those which involve every bit of technology known to man.
The beauty of birth resides in the arrival of a new life and the inauguration of the extraordinarily powerful mother-infant bond, which may take weeks or months to develop, but lasts a lifetime. It has nothing to do with how the baby was born; it has nothing to do with unmedicated vaginal birth; it has nothing to do with meeting a birthing “ideal” so you can boast to friends and acquaintances that you “rocked” the birth, as if anyone could care less.
It’s time to reject both culturally imposed standards of beauty and culturally imposed standards of birth.
Say no to the natural childbirth industry that wants you to feel bad about epidurals, shamed by C-sections, to loathe yourself for not having the “ideal” birth, and to redouble your efforts to have a “healing” birth next time.
Be subversive: love your body as it is.
Be subversive: love your birth as it is.
“Love your body as it is”
How about loving your baby boy’s body as it is, too?
“love your body as it is” -SOB = “A woman’s body knows how to give birth.” -TFB The rhetoric/advice is the same as in HCB/NCB. Unfortunately, telling women to love themselves will not improve outcomes, it will make them worse than they already are. Lots of self-love won’t change the risks.
This post really helped me. Thank you.
You’re actually playing right into NCBers own beliefs while possibly causing more harm than NCB. The “natural” Venus of Willendorf way is also the out of hospital way.
Why is the preshistoric, 25,000yo culturally influenced “ideal” better than the current one? Do you think people 25k years ago were smarter than doctors today?
Because when you promote obesity, you promote dozens of complications in pregnancy and birth which leads to very poor outcomes. Obesity may be the single biggest issue affecting safe, low risk obstetrical practice and outcomes today. ACOG would seem to agree: “In the United States, more than one third of women are obese, more than one half of pregnant women are overweight or obese, and 8% of reproductive-aged women are extremely obese, putting them at a greater risk of pregnancy complications.” -ACOG
Your Venus of Willendorf looks to have an “ideal” with a BMI > 30.
“In a prospective multicenter study of more than 16,000 patients, a BMI of 30–39.9 was associated with an increased risk of gestational diabetes mellitus (odds ratio [OR], 2.6 and 4.0), gestational hypertension (OR, 2.5 and 3.2), preeclampsia (OR, 1.6 and 3.3), and fetal macrosomia (OR, 1.7 and 1.9), when compared with a BMI of less than 30 (7). In this same study, the cesarean delivery rate was 20.7% for women with a BMI of 29.9 or less, 33.8% for women with a BMI of 30–34.9, and 47.4% for women with a BMI of 35–39.9. Other studies have consistently reported higher rates of preeclampsia, gestational diabetes mellitus, and cesarean delivery (particularly for arrest of labor) in obese women than in nonobese women (4–6).” -ACOG
Readers can go with ACOG and modern medicine(and common sense) on this or they can base their decision making on a hunch and speculation that 25,000 years ago obesity was culturally acceptable…while ignoring even older cave drawings depicting extremely slender people which contradicts that conclusion. Appealing to tradition is unscientific and no way to justify medical advice.
I’m sorry but this rhetoric of birth at any size/shape with low risk is no different than the NCB rhetoric of birth at any -place- with low risk…either way, you’re both selling dangerous, irresponsible ideas. I take that back, its worse.
Over 50% of pregnant women are obese or overweight, what percentage of pregnant women will attempt NCB?
https://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Obstetric_Practice/Obesity_in_Pregnancy
Yes, obesity is a health risk and can lead to poor pregnancy outcomes. However, let me point out two very important things:
1) There are many people who are at a healthy weight by any reasonable measure and still dislike their bodies because they don’t look like sculpted and airbrushed magazine models, the woman with a BMI of 22 who wishes she could get it down to 20.
2) There is shame and stigma attached to obesity that goes beyond any reasonable health concerns. Consider anemia, for example. It’s associated with adverse health outcomes and adverse pregnancy outcomes. It can sometimes be improved through lifestyle changes. And yet there’s no SHAME to being anemic. It’s just a problem to be addressed with your doctor’s help. Obesity is considered not just a health problem but a moral one as well, and that doesn’t help anyone or anything.
You completely missed the point. Dr. Amy isn’t saying that we should replace our modern beauty ideals with ancient beauty ideals. She’s saying we should stop trying to hold ourselves to standards that are unhealthy and unattainable. The Venus of Willendorf ideal was just that, an ideal. It’s doubtful that most women of the era looked anything like that, given how hard people had to work to feed themselves. Artists of that era used clay instead of Photoshop to present an ideal that was largely unattainable in their culture. Now that a lot of women can look like VoW without too much effort, the rounded look has lost its social cachet and it has been replaced with an exaggeratedly angular look that only a fraction of the population has the genes and/or the steely determination to achieve.
LOVE this!!! Brava!!!
I love this. I would add women not only need to love themselves, but trust themselves too. I’m tired of seeing friends drive themselves to the brink listening too much to these stupid, unattainable ideals you read in the flowery ‘ideal birth/childrearing’ books and branding themselves as ‘bad moms’ because they don’t meet it. Just trust your instincts (and sensible medical advice), embrace birth for the messy, and sometimes naturally brutal business that it is, and stop beating yourselves up trying to march to some ‘Stepford wife’ drum. You and your baby deserve it.
On that excellent note, I’m going to go eat ice cream! 😉
I wish more women would read this. The ideation of the perfect woman be it shape, the way they give birth, or the way they parent has truly gotten out of control and in the end all it does it hurt women.
As a woman I’m told in any childbirth class in my state that the only way to go is unmedicated, low intervention, vaginal birth. If I come up short on that I’m not a real woman and not a real mother.
As a mother I’m told that my baby is going to die of SIDS because I formula feed, and that my child won’t bond with me because I don’t co-sleep, I believe in CIO starting at a certain age, and because I wanted my child to have a bath before skin to skin. Which I think is funny considering my four year old is attached to my hip and is going through her Mommy only phase right now.
The feminine ideal changes so much, yet there are idiot men who walk around in shirts with “No Fat Chicks” written on them while the shirt doesn’t cover their beer gut. As women we need to support one another not denigrate one another for our life choices. We need to agree that if your child is happy, healthy and safe most parenting methods should remain the sole domain of the parents not the judgmental sanctimommys out there who have nothing better to do with their time.
I’m sure the AP parents would say your 4 year old was attached to your hip because she missed out on the crucial bonding period when she was a baby and is now trying to compensate for what she is lacking. So I wouldn’t use that anecdote if you were ever in a debate with one of them.
I wonder what they would say about my EDD whom I placed with a wonderful adoptive family because I was 15 and unable to take care of her. Diva (not her real name) regularly says her mother has been her best friend her entire life, no bonding at birth or breastfeeding there either and she turned out to be a beautiful, well adjusted loving teenager who has room in her heart for me, but is fiercely loyal to her Mom and Dad.
Maybe if you do extra bonding and refrain from things like CIO you can make up for some of the early damage.
I think you’re playing devil’s advocate so I’m going to replay to anyone who wants to criticize a mother’s choices:
Are you with my child day in and day out? No? Then who the hell are you to tell me my child is damaged. She’s a bright, beautiful little girl who is getting used to not being the baby of the family anymore. You raise your kids in your way I’ll raise mine in mine.
Just wanted to say that giving a baby up for adoption is about the most courageous thing a mother can do for their child. Your comparison to a c-section without pain relief hits the mark.
Are you being sarcastic here? I can’t tell. There’s nothing wrong or damaging about CIO, in fact, teaching your child how to soothe themselves so they get the optimal amount of sleep (never mind how that skill will translate to other situations as they get older) is one of the most important things you can do for their health. It’s not a radical practice in the least.
I just want to say that is beautiful.
It’s bittersweet to talk about, because I consider doing what was best for her rather than myself as one of my greatest accomplishments but it’s was also the hardest thing I ever had to do and I’d rather have a C-section with no pain relief at all than go through that again.
I’m reminded of an early lesson in the heartache and deep love involved in adoption. High school sweethearts, salutatorian and valedictorian in their senior year going to their respective Ivy League schools on full scholarships, having hidden the pregnancy from everyone. The love and pain in that room was tremendous and the strongest memory was the blur of dark hair as the two sobbed with their heads together and the babe between them. Their strength and resolve taught me so much that night. Broke my heart it would remain a grieving secret between the two of them for a lifetime. I cannot imagine how difficult it is, and even more so young, alone and frightened. I always wondered who they turned out to be, but never doubted the selflessness of their actions or the unparalleled pain it took for them to come to that decision.
Thank you for sharing your experience with us.
The pain must have been staggering.
I believe that being adopted has insulated me from so much of this silly woo nonsense. I place very little value in so many of these details that NCBers are adamant about because its pretty obvious from the millions of happy families formed from adoption that it makes absolutely NO difference whether or not the baby wore a hat, or did the breast crawl, or got a bath….
And in my very unscientific opinion, adoption is such a beautiful institution that I cannot imagine it would put families at such a disadvantage from forming strong, loving bonds.
Thank you for sharing. Adoption provides a very poignant counterpoint to almost any NCB argument, it is too bad that it often gets overlooked.
I don’t think it is merely a counterpoint to the NCB argument, it actually really reveals the cruelty that is implicit in it.
Take their claims and challenge them to admit that they must be opposed to adoption, then, right?
They might try to deny it, but there is no denying it honestly. If you honestly think that immediate skin-to-skin contact is important to establish a mother-child bond, then the implication is that adoptive parents won’t get that bonding. Therefore, all adoptive relationships must be flawed because they can’t be bonded. There is no way around it.
The only way to resolve the cognitive dissonance is to pretend it doesn’t exist. It’s that not that the issue is overlooked in NCB, it is deliberately hushed away, because if you think about it honestly, you realize how big of a monster you must be. Of course adoption is a beautiful institution. NCB people realize that. Therefore, the only way to rationalize themselves, knowing that their position is inherently anti-adoption, is to bury it away. Because the truth hurts.
It’s anti-adoption, anti-fathers, anti-lesbian, anti-gay, and just generally anti-reality.
Kids are pretty resilient, if you are doing what works for your kid and your family and they know you love them, they will probably be fine.
Mine survived formula feeding, disposable diapers, sleeping in her own crib from birth and CIO after the age of 6 months or so.
She’s 20 and studying to be an engineer. She seems to have bonded to me/us just fine. She has friends and a job and is moving out to continue school in a month. She went through a really clingy period as a preschooler too, but then so did all four of my sisters kids and and she’s a SAHM who breastfed all four. Her kids all seem happy and well adjusted too. You do the best you can with what you have and what works for your particular kid.
Has anyone read “A Thousand Splendid Suns,” by Khaled Hosseini? If not, it tells the story of two women living in Taliban controlled Kabul, Afghanistan. It features a rather gruesome scene in which one of them is forced to endure a c section without pain relief of any kind, because all of these drugs have been allocated to the hospitals that service males. There is literally none to give her. The point is that “Loving one’s birth” is a privilege denied to the majority of the world’s women. If we were to go up to any of them and whine about a “Birth experience” and “Birth rape,” I’m sure they’d laugh in our faces once they were done knocking out our teeth. A little perspective is a wonderful thing to have.
I recall that scene in the book; it was physically painful to read…as was the rest of the book, to be honest. Some books are beautifully written, but the subject matter is so awful that I would have a hard time ever reading them again.
It really is the epitome of #FirstWorldProblems
I’ve read that book. It was very beautifully written but very painfull too. I had just given birth to my second child and it was a stark contrast to the woman in the book. I had an easy birth, but I couldn’t imagine having a c section without pain relief…
Well put. I sometimes wonder if they would be so stupefied by that sort of narrative that they couldn’t even comprehend the concept, you know? It really is so divorced from necessity and reason, some of the nonsense in the NCB folklore, that we must sound like aliens to people with bigger fish to fry.
I rather think that people devoting a great deal of worry to absurd or irrelevant matters is a universal part of the human experience.
I can’t get to sleep
I think about the implications
Of diving in too deep
And possibly the complications
Especially at night
I worry over situations that
I know will be all right
It’s just overkill
Sort of OT but not really: http://m.theweek.com/article/index/263443/the-cult-of-natural-childbirth-has-gone-too-far
Here’s what we’ve been saying all along!
Wow! That was really awesome to read! I particularly like this, because is almost exactly what I told the staff at the hospital, too: “When my doctor asked me what my birthing plan was I told her I was looking at it.” I said, “I’m not the expert, you guys are so just keep me in the loop and I’ll be happy.” 🙂
She links to Dr. Amy, too! I think it was the sixth paragraph or so, about feminists and pain meds in the early 20th century.
When faced with someone’s romantic notion of a less technological birth, I ask if they have read Catherine Schaefer’s journals. She was a 17th century midwife and kept several jouranls detailing the many births she attended. One small journal listed the details of the 300 plus births where the mother, or baby, or both died from complications of childbirth.
do you have a source for those journals? I’d like to read them.
Mother and Child were Saved : the memoirs (1693-1740) of the Frisian midwife Catharina Schrader
http://www.worldcat.org/title/mother-and-child-were-saved-the-memoirs-1693-1740-of-the-frisian-midwife-catharina-schrader/oclc/17641120&referer=brief_results
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1721769/pdf/v089p0F560.pdf
The second link was a fascinating read but the very last sentence struck me as odd.
“That 19 out of each of 20 of Schrader’s deliveries were normal and spontaneous without intervention and that 95% of her babies survived childbirth should give us pause for reflection in this present time of high intervention.”
Am I reading that wrong or is the author implying that a 5% death rate is good and a reason to rethink interventions?!
As a former NICU nurse at a facility with ~2800 deliveries per year, I must say (after pausing) that I’m certainly thankful that I didn’t have to witness 11 or 12 babies dying every month!
I read it as ‘the c section rate has no business being higher than 5%, because look at these results!’ Not taking into account the horrible complications many of those women and babies may have sustained, even if they did survive. *shudder*
Right…survived childbirth, but for how long? And what quality of life?
And (upon reflection) I wouldn’t be so keen on the prospects of a mother dying every month either!
I can just imagine, “Theodoric of York – Medieval Midwife”
“Oh Broom Gilda!”
Then we could get Jane Curtain to let loose. ” You charlatan! You killed my daughter, just like you killed most of my other children! Why don’t you admit it! You don’t know what you’re doing!”
https://screen.yahoo.com/medieval-barber-000000006.html
I shudder to think about this, but before the middle of this century child birth was the number one cause of death in both mother and babies. I dare anyone to go to a historic cemetery, see all of the graves of women and infants who died in this “natural” process and then say the end goal shouldn’t be a healthy mother and baby but the fulfillment of ever requirement on your 12 page birth plan.
I have mentioned this before in a different context, but back in the early 20th century, the average lifespan of a male farmer in rural china was 25. Quite a testament to the effectiveness, or lack thereof, of traditional chinese medicine.
But here’s the relevant part: the average lifespan of a woman there and then was….24. Because women were more likely to die younger in childbirth.
There’s a reason why so many fairy tales involve the evil step-mother. And it’s not because the parents got divorced and then re-married.
Thanks for finding that D. I had the last name wrong and had to go check my library. Here’s the amazon link http://www.amazon.com/Mother-Child-Were-Saved-Natuurwetenschappen/dp/9062036201/ref=sr_1_173?s=books&ie=UTF8&qid=1403617628&sr=1-173&keywords=midwives
You’re most welcome 🙂
God, the details on that placenta previa case (the second link D/ posted).
“The Killing Fields” has a great example of intervention-free childbirth. When the Kmehr Rouge took over Cambodia in the 1970s, they decided to return the country to its Glory Days, which were in the medieval period. They emptied the cities, forcibly moved the population to the countryside, and killed anyone with an education. People were killed for wearing glasses.
Hang Ngor was a doctor who managed to escape execution early on. Later on, while living in a rural work camp, his pregnant wife went into labor. When her labor stalled, her husband knew she needed a C-section. He knew performing one in the field would expose him as an educated man, and both of them would be killed. He and his wife decided to try to deliver vaginally. His wife ended up dying in childbirth.
I think it’s only a very marginal group that expects a fearless, painless birth with “surges”, orgasms and whatnot. Most women who choose natural birth are much more mainstream, at least where I live.
While I was pregnant for the first time, I heard that being mobile and upright facilitates labor and birth, so I wanted to try it. I didn’t fancy a big needle being stuck in my spine, so I wanted to avoid an epidural *if I could*. I also wanted to avoid pitocin because I knew it causes more painful contractions. So it really was about health and comfort, not ideology. I wanted to do what I could for a quick, smooth birth.
Having said that, I did realize later on that some people try to make big bucks on natural childbirth (as there are people who will try to make money on just about anything, from internet scams to dodgy “nutrition supplements”).
In a comment on another post, I mentioned going to a tour for expectant mothers in an Israeli hospital. The tour was pretty much all about how natural birth is so great, so wonderful, so spiritual, so healthy, how they always make every effort to promote it… but when I came to this hospital in early labor, the treatment I encountered was not at all pro-NCB (I switched hospitals before I hit active labor). Later on, I thought – why advertise the hospital as so very pro-NCB if it really isn’t?
Then, in retrospect, it hit me: I realized that the hospital tour was in reality nothing much more than advertising their special (and very costly) NCB services: their luxury “natural birth-designed” suites with birthing tubs, their own doulas, their childbirth classes, etc. It was implied that if you want natural childbirth, you had better pay for all that to improve your chances of success.
I could not afford that. I didn’t pay. I wasn’t “entitled” to NCB.
The second hospital (where I eventually gave birth) was not so boastful. It catered mainly to ultra-Orthodox Jewish population – families that have 10 kids (or plan to have 10 kids) and have no money to spare for luxury suites or doulas. The L&D rooms only had showers, not tubs. The NCB equipment in every room was basic and inexpensive – a birthing ball and a birthing stool. But in its practice, the hospital was really much more pro-NCB than the hospital that offered all the fancy services.
I never had any childbirth classes either. I just couldn’t afford them. So I read up what I could and did what I was most comfortable with, and that was enough.
You don’t need to spend a lot of money to have a natural birth if you want one, but I’m sure there are people out there who will try to convince you otherwise.
I have a question for the older women here, who were having babies in the age before the internet: if you were NOT surrounded by hordes of NCB groupies at the time, did you even hear about NCB and this trope of “the right way to give birth?”
I know yentavegan was involved in NCB, but I get the impression she was in a tight-knit community of other NCBers. Yentavegan, do you think things would have been different if you’d lived somewhere else, and those around you were all about the medical model?
I do remember when my sister was born (1980) and a number of my peers had younger siblings born around that time as well. All of our parents went to the hospital. Some of the mothers breastfed, some didn’t. I remember seeing both, as a child. I babysat, starting in the late 80s/early 90s—none of the people whose children I watched were these extreme AP people. They all had cribs and strollers. I often let the children watch videos (the parents said it was ok). Obviously, the NCB/extreme APers were out there, but wo/the internet, it seems to me that their message simply couldn’t be spread very effectively. Or am I just speaking from my own experience and I am totally wrong here?
My mom who gave birth in the mid-70’s flipped out when I told her I was going to a breastfeeding class. She practically yelled “It’s not by La Leche League is it??!??!” She said when she was in her birthing class an LLL rep came and really ripped into formula feeding and was very nasty cruel.
I suppose I should have directed this at all the Amys and Jennifers, since they are probably about my age and therefore, have mothers who were giving birth before the internet age. 🙂
Ha!
Sigh…yes
lol
My mom hated LLL too, but because she had a friend who belonged to it and thought “those women” nursed too long.
My mom formula fed me, and nursed my sister. In retrospect, she said she preferred formula feeding because I slept longer intervals between feedings, and it was easier for her in general. When I was having difficulty trying to pump enough for my babies, she was the first one to say “It isn’t worth it. The babies will be fine with formula, get some sleep.” I took her at her word and never regretted it.
My mother wrote her senior thesis in Nursing School on HomeBirth. About a year later she had me in a military hospital, my cord prolapsed & had a crash classical C under general. The first time I heard about HomeBirth it was because I found a copy of Spiritual Midwifery in our family attic. So yes, my mother had heard of it.
I can only speak from my own experience. I gave birth to my daughter in 1994, (we had Internet but it was text/menu base, oh the horror!) and even then what I term “the woo” had started to creep into pregnancy and baby care. Example: the woman who gave the hospitals child birth/Lamaze class was a retired nurse and was RABIDLY anti pain relief, pro-breastfeeding, anti-cloth diaper. I actually lied in the classs and said of course I was going to breast feed and cloth diaper because honestly, I did not need to be shamed about it by someone I was never going to see again.
Also this is just personal but for me all the Lamaze breathing and “focal point” concentrating did absolutly NOTHING to help with the contractions (possibly because I am a cynic and found it a bit ridiculous). And I would have appreciated the edidural earlier the 41/2 or 5 centimeters, it took 2 tries and by the time they were done(20 minutes) I was at 9 1/2….
AP wasn’t really a thing yet in my circle(active duty military, married to military) but I gave birth in Southern California and some of the “its natural so it must be better” and “women have other ways of knowing” stuff had already started creeping in. There were definitely parents I knew who did co-sleeping and I think a few used slings also.
If I had opted for a VBAC, an epidural ASAP would have been in my birth plan. If I’m going to have it anyway, why wait? Since I’d be a VBAC with no previous successful VB, an epidural would be prudent.
I’ve never understood why a patient should wait to have an epidural if she wants one.
I had my EDD in 1997 when at least in my parts the internet was still something new and shiny and you had to dial into the network through a phone line and sometimes wait an hour for any page with pictures to load. I remember someone at the adoption agency I was working with telling me to labor at home as long as possible so I could avoid all of those nasty drugs and doping the baby.
I was fifteen, this woman had been through hundreds of births so I planned on taking her at her word. I was lucky my Mom stepped in and overrode that decision otherwise I might have 2 accidental homebirths instead of one.
I remember being pregnant in 1984 and reading about some woman who was giving birth in the ocean with her family all around her. The article was titled “Family Birth; Ocean Birth” I thought it was ridiculous then and I still do. I kept thinking “that poor baby, the undertow might take it out to sea!”
I think I saw that too! Was it in Mothering? Stuntbirth was even around back then just a smaller audience to impress.
I remember it was in a magazine. Which one, I do not know? I read Sheila Kitzingers book back then too when I was 7 months pregnant and suddenly realized this birth thing was really going to suck!
My mother had a home birth with me with a CNM in 1978. In her defense, the CNM is very competent and not woo-ish, and hospitals were a lot worse back then, and I think the safety difference between home and hospital was probably smaller then, too. She had a hospital birth with my sister in 1987.
She later became an LLL leader around 1988, and I spent a lot of time at LLL meetings in that era. I don’t recall anyone ever being anti-vax at that time in those circles. My mom tried to help people with breastfeeding-related stuff in an era when hospitals and doctors still often gave pretty bad breastfeeding advice, and there were no or very few professional lactation consultants. She sees the professionalization of lactation consulting as a good thing, and is happy that hospital birth experiences have improved, and encouraged us to give birth in hospitals because it is safer.
In other words, the things that NCBers were justifiably upset about 30-40 years ago, such as patriarchal doctors, not allowing the partner in the delivery room, routinely giving bottles of sugar water in the nursery, no skin to skin, etc. etc. have mostly disappeared, and most reasonable people, like my mom, no longer see a need for an “alternative.”
Meanwhile, NCB has to get more and more extreme to try to stay relevant.
That’s a good point, the last one you made there. I made a similar observation to my husband the other night, that the NCB of 40 years ago or whatever was more about making actual changes than they were trying to guilt and shame every women into adopting their way. Now that conditions are more favorable, what’s left to do but make it the superior way to give birth, rather than another option available to us, which of course should be the only point that matters – that options are available, but apparently some options aren’t valid. So the motivation of NCB advocates back then were different than they are now. I wonder if women from the earlier era ever feel as if their accomplishments are taken for granted now by their current counterparts. Indeed, there’s got to be areas that can benefit from their advocacy still, but it feels like they care more about winning wars with other moms than doing anything worthwhile. Or care more about enforcing their worldview as opposed to ensuring more women have access to a full range of quality options. Sorry, I’m kind of rambling now, but I really like the points you made! 🙂
I am only 30 and had my kiddos in the Internet age but when talking about childbirth with a cousin, an aunt of ours mentioned that she didn’t have pain meds with her kids and took a Lamaze class but that was that. It was not a serious topic of conversation back when she had kids like it is now. It was just one of those things you decide hey I’m gonna try the Lamaze class to go without the drugs. And if you did then hey you did. It wasn’t made out to be a big topic of conversation like it is now. Also, I get the impression that the modern epidural has improved so much the era of mother of 20 and 30 something’s might just opt for the epidural. My mom recalls having a very unpleasant “saddle block” with me or my sister.
I had my children in ’73, ’76, and ’80. There was a NCB organization in my community, mainly the Childbirth Education Association which gave classes on NCB. Husbands were being let in the delivery room for the first time in the very early ’70s provided that they had gone through the class and hospitals that were competing for OB cases were realizing that the future was with the consumer. There was a sea change in attitudes over the 7 years of my OB experience, from having my hands tied down in ’73 (albeit with my ‘trained’ husband in the room) until my last delivery, when I was able to nurse on the delivery table. There were some zealots, for example, one woman with whom I was close who believed that any intervention or medication would negatively affect her child. She pushed for close to 10 hours while her OB and staff tried to turn her baby from a transverse position to a normal head down for a vaginal birth. She refused a c-section and her doctor, the darling among the NCB community, did not “push” her. Eventually the baby was born. This child has had some significant learning problems throughout his life, continuing through adulthood.
I was born in 77, and I mentioned my sister in 1980…my father was in the hospital for our births, but not the delivery room. Still not real common at that point, I guess. My mom wasn’t bothered by this, she didn’t expect him in there.
My dad saw me delivered in ’77. I think it was just starting to be common.
My dad was supposed to be with my mom at my oldest brother’s birth in 1975. The story goes that when he saw how much pain my mom was in, he just couldn’t take it and fled the room.
My dad got kicked out of my scheduled C-section for being a pain in the ass and asking too many questions (of the “Is that a kidney” variety, not the relevant variety). My mother had miscarried quite a bit and was bleeding severely, so as soon as they got me out they told him to follow the person taking me to the nursery.
My mother and aunts all gave birth at the hospital and while the “twilight sleep” might have been a detriment, they at least got 3-5 days stays. Mothers didn’t compare childbirth that I recall growing up, I guess any competition was around developmental milestones, if any.
Go back another generation or two and the danger of childbirth was very real, as was losing children to diseases, or even birth defects that can be corrected or ameliorated today. My mother had a sister with spina bifida that died at age six. Just keeping a home was a hard job – before dishwashers and vacuums. When you had to beat your rugs clean, can your produce, bake your bread, there was little time worry who had a better birth.
My mother had me in 1982. (I had my fingers on the wrong keys and typed 1872! No, I’m not that old.) She reports that an LDR room was a new concept then, and that she wanted to avoid pitocin and an epidural, but did end up getting pitocin. She also did breastfeed me for 6 months, but gave me the occasional bottle of formula. I get the impression that people weren’t as hard-core about these things then.
I was born in ’77; I only recently realized that pitocin and epidurals were a “thing” prior to the 1990s. I literally had never heard of my mother or any of her friends getting pain relief other than demerol. I guess NCB was prized back in the 1970s too. My mom never needed pitocin I don’t think, and I believe she only had pain relief with me because I took the longest. I guess I turned out okay anyway 🙂 She did say that once she got into ‘real’ labor, she realized all that breathing crap was garbage and just dealt with it in her own way. I must remember to call her next weekend…
Heck, apparently even VBACs were a thing back then. My brother-in-law, who’s a couple years older than me, was born by c/s because he was breech. Then when his brother, who is my age, came along, their mom was given the option to try for a VBAC as long as she labored in an OR. She didn’t think that it was worth it, and opted for RCS instead.
There was a time in the late eighties/early nineties when we were afraid insurance companies were going to actually force moms to have VBACs. Not only were they a thing but they were much more common than now. We didn’t do much different then for a VBAC vs anyone else, That was prior to ACOG coming out with the guideline that the OB and anesthesia must be immediately available.
Huh! Interesting. Glad they didn’t gain traction with that.
Two other friends of mine come from families where every kid was a c/s because the first baby was breech, so I just assumed that “once a c/s, always a c/s” was still pretty common at that point, but maybe they were aberrations?
I was born in 1977. Mom had a C-Section because I was 42 weeks and not budging. Apparently, Mom was so eager to get me out that she lied to the OB about being numb. She also said she saw the entire procedure reflected on his glasses.
One sister was born in 1978. She was early, but the thinking was “once a section, always a section”, so Mom had another C-section.
My other sister was born in 1980. Mom said that while was in the OR, prepped for C-Section number 3, she went from 2 cm to 10 cm in 2 minutes as the OB and anesthesiologist argued about something. My youngest sister was an unintended VBA2C.
I too was born in 1982, my mom reminds me all the time that she didn’t even get to a LDR room for either of her first two pregnancies as my middle brother and I were both precipitous labors. She especially loves to tell the story about how the nurse barely caught me before my head hit the floor.
I only knew that labor inductions were a thing prior to the early nineties because my mom’s youngest was an induced labor at 41 weeks, and my grandmother on Dad’s side still reminds us she thinks the induction was more due to the doc wanting to go on vacation rather than needed. So that trope has been around longer than the internet too.
Mom said she’d heard of NCB through a Lamaze class she while pregnant with me, but that the breathing didn’t help much when push came to shove. She didn’t plan on having the “ideal NCB” birth, her body betrayed her. She also reports that the breathing didn’t help her at all, but threatening to rip off the male doctors nuts made her feel better for a few moments.
My sister is an L&D nurse. Last week one of her patients told them she was *allergic* to pitocin. The doctor tried to explain that that was completely impossible, like being allergic to water. The recounting of this conversation was completely hilarious.
But pitocin is synthetic, dontcha know. Therefore it’s not the same as the natural hormone, even when it has the exact same chemical structure. smh.
I got in this exact argument about formaldehyde with some anti-vaccine people. Naturally occurring formaldehyde is not “better” than that made in a lab.
People were way more relaxed about everything back them.
C-section, 1984, military hospital. Lamaze was the latest thing and people were just starting to wear the ‘baby backpacks’ and slings. Not interested in the slightest. I have no idea what they tried to shoot into my back for an anesthetic, because I started yelling at them to just “put me *out* FFS!” So they did. I have a degenerating disc in my lower back, apparently right where the needle was supposed to go. I was rather fond of my c-section. And the surgical team was all women, from the surgeon down to the lowliest instrument handler. I always thought it was cool that my kid was delivered by a Navy Captain. Birth anxiety? Parenting one-ups-man-ship? Bleh.
I wasn’t having babies pre-internet, but I remember as a child in the 80s watching movies–regular Hollywood romcoms and the like–where Lamaze was presented as the best way/the only right way to give birth. So while the idea of unmedicated childbirth never appealed to me (even as a kid I thought those women were nuts for not wanting something to make it stop hurting), I certainly knew about it and knew it was considered “better.”
(When we took the childbirth class at the hospital where my first was born, I was really surprised that we weren’t being taught the weird breathing I saw in those movies. You know, “hee-hee-hee,” and that sort of thing.)
The movies love unmedicated birth, for obvious reasons (drama!!!).
I remember watching Look Who’s Talking back in the eighties, it was the first movie I’d ever seen where a woman was giving birth and got pain medication. Sure they made it seem as if the baby was high but it also made it seem as if it was better for the baby.
Then again given Kirstie Alley and John Travolta are devoted Scientologists it does surprise me that they showed her yelling, screaming and taking drugs. Those are all big no nos.
I was, too, and I actually asked the instructor about it. Her answer was, 90% of women just get an epidural anyway, so it doesn’t make sense spending time teaching breathing exercises when they won’t need them.
Those breathing techniques are stupid and useless anyway, even if you don’t get the epidural.
I was told they moved away from patterned breathing, and encouraged slower, controlled breathing (when possible) because women were “hoo hoo hee hee”-ing themselves into hyperventilation. The only “breathing technique” taught in the childbirth class I went to (at the hospital) for my oldest was basically just encouraging you to focus on your breathing and keep it as slow and controlled as possible (oh, and the panting technique that may be needed to refrain from pushing to soon).
I asked about the breathing at the ante natal classes I went to, the mid wife replied “you do know how to breathe, doing it a special way doesn’t help”. Common sense there, but then her classes were the ones recommended by nearly all doctors in the area I was in.
My mom says the special breathing really helped her not to scream. She was induced when she reached 42 weeks with me, she says it was 8 hours of the type of contractions she had in transition with my siblings (who all arrived 38-40 weeks without induction). She had also been told to repeat a nursery rhyme to take her mind off the pain, and she found hat very useful. She and I both nearly died. When epidurals existed when she had my youngest sibling, she opted not to have one as she was afraid of the pain and said nothing could ever be as painful as my birth so she was sure she would cope.
I had also seen all the breathing in the movies and thought that was how it was done, our classes started with the words “forget everything you have ever seen in a movie about birth” we were all asked how long birth lasted, the answers were two extremes 48 hours and 10 minutes or something along those lines. Those classes were fantastic, but not a whisper about breathing and lots on vaccination and newborn care.
Afraid of the pain of the needle in her back. I left that out. Fingers go slower than my brain.
My mother taught me what to do in order to deal with severe pain. I think it was useful information. Some of it was breathing, some of it was focusing on something else. Years ago we just did not have the pain interventions we have today.
Some folks will find breathing techniques useful. They are very similar to breathing that you would do in a yoga class and trying to focus on relaxing your muscles. Some women are not candidates for epidurals, albeit that is a really small number. So these folks might find the breathing helpful. And some folks may have to wait for a anesthesia provider to be available. Non-medical interventions are all you may have at this point. So you use what you have.
Yes, that was exactly the point I was making about my mom’s experience. I ended up being refused an epidural as the hospital midwife refused to phone the anaesthetist as it was the early hours of the morning and she said he would shout at her (so instead I shouted at her), so I did end up having to make use of whatever I could to distract from the pain. I tried the gas but it just made me woozy, I found walking around helped, changing positions often helped, getting into a deep bath helped. I had a doula with me as I hated just being on my own so much with my husband who played video games throughout my labour, and she was really helpful with coping, she also tried to phone the anaesthetist herself and did tell the doctor, when she arrived what the midwife had done. I had however asked my doctor to recommend a doula she liked working with rather than one who would play whale music and bring crystals, so I did already know that she did what a husband is meant to do during labour rather than try to convince you not to use pain medication. I did not want pethidine, which the midwife did offer, as I know from being given it for migraines that it doesn’t help with severe pain at all and makes me vomit.
My mother can recall every moment of my birth. How she labored very hard, as my father and grandmother were waiting in the waiting room. When she was fully, she was given something to knock her out. She awoke to a bouncing baby girl who had med stained amniotic fluid. She loved her labor and deliveries. She talks about them in vivid detail. She went on to bottle feed and we lived happily ever after. Or until that snotted nosed little brother of mine came around.
Ok, so my point, which I hope came across, but it probably didn’t, was NOT that NCB didn’t exist prior to the internet age, but that it was isolated in whatever little pockets of society, and only the internet has allowed it become so widespread that pretty much every woman who has been pregnant since 1995 has been exposed to it. Not just whether or not to use pain relief, but the whole shebang: that there is a small culture built around natural childbirth being morally superior, and they have wormed their way into the mainstream on many levels. Without the internet, I think Dr. Amy’s post today would be irrelevant because most people wouldn’t even know who those weirdos were, let alone allow them to dictate the way [white, UMC, western] women should give birth/view their bodies with regard to birth. Stupid internet, hard to separate the chaff from the wheat.
I do feel grateful that the internet wasn’t around when my mum was reading and in her PND. I think it would have made it worse.
Every book store was loaded with NCB books. And b/c I live on the East coast, among the liberal elite, we were inundated with the back to earth movement..hence drug free interventionless births were a rite of passage. That and family bed, breastfeeding toddlers etc…
That’s me the older woman here. Yes, way back in the day…
My experience tells me you are right, that’s it become more mainstream and the reasons are a little different to. My exposure to the natural birth stuff had everything to do with my exposure to another 1970s problem, a cult. The members of this cult were generally ex hippies, or current ones, and they were typically natural and alternative minded people. One of the edicts of the cult was to be vegetarian, the cult leader’s wife had her babies at home, took Bradley classes and breastfed and pretty much if the cult leader did it that’s how the following did it. I was involved with this group as a young teen and left as an older teen, but the people there had a strong influence on me. I subscribed to Mothering magazine back when in was black and white back in 1980 and to Birth and the Family Journal before it became Birth. My first gifts from friends were Spiritual Midwifery and Immaculate Deception. When I was looking for an OB, even with my first, I interviewed a lay midwife who was very political and I believe a major force behind the licensure laws and CPMs in Florida, and at least in Florida the requirements for education are better than many other places.
So yeah it’s been around a long time but I agree its different now. There wasn’t the competitiveness at all. The midwives were all about risk screening ( most of them ) and I didn’t hear about the stuntbirths.
Hope that helps!
I became a Bradley instructor myself after my son was born. It wasn’t that different who signed up… religious right and granola left. I think there is mostly just a general enchantment with things natural and Eastern these days… not sure why.
I had mine in the UK in 1992 and 1994. First time mums were introduced to the National Childbirth Trust by the doctor’s surgery. Looking back everyone at the class was white and middle class, in a quite interracial and economically mixed area, I have no idea whether that was self selecting or not. NCT ran classes and groups, and so did the doctor and hospital.
Looking back NCT was far more directive than the medical people, and I think they asked who had a normal delivery when we had our post-birth catch up. My son’s birth was probably the least intervened in-mainly because it was quick-but I don’t think I was too popular with the coach as I was pretty relaxed about doing what worked for me, not what was right. And I found breastfeeding really hard and painful, and said so. I was very stubborn in those days.
Certainly the gp surgery and hospital midwives were supportive of whatever I wanted to do.
Went to no classes with the second one, rocked up in labour, again a quick normal delivery.
I had no idea I should have been proud of myself, I just think we were all so lucky. Both mine were 10 days late, I go cold now when I read about what is now understood about the dangers of going so long.
I had my first in 1987 and my last in 2011. I’d heard that avoiding epidurals was better for baby. Thought I would try to skip the epi with some of my births, but I preferred as little pain a possible. Thought about a homebirth in 2004 and read a lot of books about it, couldn’t get comfortable with the idea. I liked my pain relief and not having to clean up after a birth. I find it interesting how much some things have changed. With my first, I was completely covered in blue surgical drapes and the OB hissed at my dh for touching my knee when he leaned forward to see our son being born. With my youngest, the mfm sat on the edge of the bed at my side repairing a small tear, surgical gown removed and his tie dangling a bit. I much preferred his more relaxed, encouraging demeanor. I had preeclampsia with both my first and last baby.
I can say that my mum found both Dick Grantley Read’s book and another called “Silent Knife” back in the 80s sometime. She had c-sections, PND and also an obgyn that was disrespectful, paternalistic and also lied on her medical chart (she was a trained midwife – not practising at the time – and she put in a complaint). I’m not sure how she found it, she certainly didn’t get a lot of sympathy for it from her family or many others. I wonder if it was from some other midwife friends/nurses? Although we’re very close we don’t talk about this stuff much.
I was born at home, as were two of my younger brothers, at a birth attended by a chiropractor. My aunt had all four of her babies at home, too. However, my grandfather was a chiropractor and my mom and aunt were really hippies. My mom had my youngest brother in the hospital because she wanted a tubal. My mom recently told me that she never would have done it if she knew how dangerous childbirth was.
I came across this and thought it also might speak to some of the difficulties in leaving the NCB subculture.
[Series of texts by @fatnutritionist, which read: “People are mad at
me because they ‘work so hard’ to be fit or lose weight. They have told
me this explicitly. It implies that they think my rejecting the values
they subscribe to can somehow take away the fitness they’ve worked for.
That is totally delusional. If you’ve worked hard for fitness, no amount
of fat people rejecting stigma can take that away. So this is obviously
not actually about fitness, at all. It’s about the other thing they
‘worked hard’ for: social status. They DO think, and they know, that the
social status they have worked hard to earn, through ‘fitness,’ can be
devalued. It can be devalued if the hierarchy that rewards them is
crushed. Crushed by people rejecting stigma. We can’t take away your
fitness or whatever weight you’ve lost. But we can devalue those things
by destroying fat stigma. So they are afraid of us, and for good reason.
If fat people aren’t stigmatized, then there is no more thin privilege.
Remember always, fat people: People are afraid of you because you have
an awesome power – to destroy the hierarchy. If they were not afraid of
losing their place in the hierarchy, they would not come after you so
viciously.” All tweets were accompanied by the hashtag,
#notyourgoodfatty]
Read the full thread of Michelle’s tweets on Storify.
Wow, I like that. Especially this: “It’s about the other thing they ‘worked hard’ for: social status.” This is so on the mark. Both for what she’s discussing and for the NCB movement. If we simply aren’t impressed with how long you labored without drugs, does that make their feat less impressive? Well, it all depends on that person’s motivation at that point: if no one else gives a shit, I hope they were only doing it for themselves!
OT: Look at what change.org just emailed me:
Give Families in NJ the right to choose their birth setting, provider and type of birth.
https://www.change.org/petitions/gov-chris-christie-give-families-in-nj-the-right-to-choose-their-birth-setting-provider-and-type-of-birth?utm_source=action_alert&utm_medium=email&utm_campaign=83210&alert_id=iFMqkbHgmt_ODo6uvQbyLlq4qVpnAygRYkvl34sLlqN%2Fy4JBGKS2Bc%3D
“One of the most common obstetrical interventions is continuous fetal
monitoring, an intervention which directly interferes with a woman’s
ability to give birth without medication, particularly epidural
anesthesia, and has been shown for over 40 years to not improve outcomes
but to increase risk for cesarean section. Healthy women in
spontaneous labor are unable to make the Choice to forgo this dangerous
labor intervention in almost all hospitals in New Jersey.”
Fetal monitoring is dangerous, y’all!
“The barriers to access to Midwifery care include restriction of trade
when many hospitals exclude midwives from their medical staff,
obstetricians refuse to consult with midwives, especially midwives
providing homebirth services, Certified Midwives (CM) and Certified
Professional Midwives (CPM) are excluded from obtaining privileges in
hospitals that grant privileges to nurse-midwives.”
Egads!
I wish they would be honest about the “Establishment won’t let us sit at their table!” rhetoric.
The actual professionals who are accountable don’t want some unaccountable hobbyists and amateurs to be associated with them for a variety of reasons. I can think of a half dozen without trying. Lending credibility to wannabes. Setting themselves up for lawsuits for all the births that the midwives screw up.
And if they were sitting at the table, they would have to explain any poor outcomes or low apgars. I have had blowout arguments with providers over giving their babies low apgar scores due to the fact that provider was going to have to explain the apgar to the other folks at the table.
“explain the apgar”?
Nope. I got nothing.
I am thinking they would use the “normal variation of birth” for an explanation. Come to think of it, isn’t death a normal variation of birth?
Continuous Fetal Heart monitors are unhealthy. Right? Because of the electric waves entering the mother’s body and effecting the baby, right? and everyone gets so involved with the baby’s heart rate they cause too much attention to it and that slows down the mother’s labor, right? And why is everyone so focused on just that one aspect of labor? For generations women gave birth without anyone knowing how much normal variation there can be in the baby’s heart rate during labor. Why is everyone so damn concerned about the baby? It’s my labor!
I wouldn’t define continuous fetal monitoring as an “intervention”, but it does limit mobility, which restricts a woman’s abilities to cope with contractions in an effective way if she chooses unmedicated birth.
In the hospital where I gave birth, fetal monitoring was done intermittently, and while it was not done I was able to be in the shower or do whatever made me most comfortable. But of course I was low-risk, and whenever the fetal monitoring was done, it was good.
My hospital had wireless cEFM. We could wear them and walk around the halls, sit in a chair, bounce on a ball, whatever. No immersion though, so no showering (water didn’t do anything for me, so no big deal). Best of all worlds!
Just shows how every woman is different. For me, water was THE one thing that made everything so much better. Nothing could compare with a jet of warm water on my belly during contractions. So if something prevented my access to a shower, it was a big deal.
i had the wireless monitor during my first labor and it WAS waterproof. I had it on in the shower for a long time. I think the monitoring technology is improving. I also loved being able to hear my baby’s heartbeat continuously while my labor was progressing. For me, it was kind of like hearing the ocean in the background – soothing and sweet.
I had to ask them to turn it down for me. If it was loud enough to really notice, I would try to read the strip and start freaking out over every little dip. I had to turn the CNM part of my brain off.
Mobility during labor is OVER_RATED! I had 3 unmedicated labors/deliveries and really I had no urge to move/walk about. I laid in the bed moaning my head off..
It depends on the woman. Everyone is different. Someone here said water did nothing whatsoever to her during birth; I felt wonderful relief during contractions if I could be in the shower. I also experienced contractions as far more painful if I had to lie on my back. Being mobile and able to rock my pelvis was really, really important to make labor bearable. So, when mobility matters, it matters and can’t be dismissed.
I also think it depends on the mom. I found walking and also floating in deep water quite soothing. I was denied an epidural that I wanted so I just had to get on with it. I found lying on my back for monitoring excruciating so, as the nurse had been so nasty and refused to phone an anaesthetist. I yelled at her that I would sit up straight thank you very much. Yelling at her helped a bit too, must have been the release of tension and jaw clamping? By the time I had reached ten cm, nothing helped, I remember telling the doctor that I really need that epidural now and her replying that as baby was crowning it would all be over soon.
Yeah, no kidding – if I had been told to stay in a position I felt uncomfortable in (short of it being necessary for safety) by the person who just denied me an epidural, I think I would’ve told her she’d better shut her trap before I put her in an uncomfortable position! Ha!
That is pretty much how it went 🙂
I agree everyone copes with pain in very different ways and it even changes baby to baby. I spent most of every labor myself on my hands and knees and didn’t hold still. With my youngest, after I had shaken off the woo but still didn’t want an epidural, that meant I asked for internal fetal monitor… !
“One of the most common obstetrical interventions is continuous fetal monitoring, an intervention which directly interferes with a woman’s ability to give birth without medication, particularly epidural anesthesia, and has been shown for over 40 years to not improve outcomes but to increase risk for cesarean section. Healthy women in spontaneous labor are unable to make the Choice to forgo this dangerous labor intervention in almost all hospitals in New Jersey.
Oh, beloved flawed arguments; let me count the ways…
1. Remind me how eCFM directly interferes with a medication-free birth?
2. Why exactly does eCFM cause epidurals?
3. I’d like several citations from peer-reviewed medical journals to support that CFM doesn’t improve outcomes but does increase the risk of c-sections (without improving the outcomes, mind you.)
4. Explain exactly why healthy women are unable to make this choice…. (most, I assume, chose a CS over a dead or sick baby but that’s not the same as unable to choose….)
5. “Almost all hospitals in NJ” – let me know which one ISN’T in that category – I’d like to avoid it on general principles.
6. I’d also like to see several peer-reviewed papers on how a CS has worse outcomes in cases of problematic CFM data than vaginal delivery. (FYI: I don’t want to be in the group that says “Eh. Let’s see if waiting a few more hours works.” Even if it is for science.)
Plus:
1. The first sentence is both a great example of a run-on sentence AND is chock-full of dangling modifiers.
2. Why is “choice” capitalized?
I will agree that being on continuous Electronic Fetal Monitoring will decrease a woman’s freedom of movement. Perhaps we need better monitors? However, I do not keep a woman on an EFM if 1) she is low risk and 2) she has a reactive strip. Do you know why? Because I have to interpret and document for all that time a woman is on the monitor. I don’t receive any bonus for documentation.
If an intrapartum woman is being told to lie on her left side and that she needs to be on CEFM, it is due to the providers concern that her risk has just increased. If you have PIH, and your bps are high, we keep you on your left side. Sorry, that is how it goes.
But you still do intermittent EFM, and I am guessing continuous if mom has an epidural, right? I think that the NCB community thinks that every single woman I the hospital has CEFM, when in reality, if everything is going well and your are unmedicated, you only have it periodically.
So it sounds like the system works in that EFM isn’t necessarily given across the board, or at least there is freedom in making that decision, as you show in your practice (and I imagine you are very good at what you do, so if it’s ok for you to do it, then it’s not hard to come by in ither hospitals).
Also, isn’t wireless monitoring – allowing the woman more freedom of movement – more and more common now? Or is the cost still prohibitive? I’m not clear on that. But anyhow, as you pointed out, there are some situations where being “confined” to a bed is simply indicated and it’s not about being “mean”, it’s about being safe and responsible for the lives entrusted you. At least, that’s how I see it.
When a woman comes into the labor room, we put her on EFM right away to assess how her baby is doing. If the EFM strip looks reassuring, I remove the EFM. Then we intermittently apply the EFM.
Some NCB folks rave about intermittent auscultation. However, that can be more annoying in some ways because we need to find a the baby’s heart rate at the start of a contraction and continue until a while after the contraction. This can be more annoying sometimes.
Certified Midwives have the same midwifery education and take the same national exam as CNMs. I think there is only 84 CMs in the USA. However, I don’t think they should be grouped with CPMs.
I think it depends on the CM. I know of one in Las Vagas who seems more like a CPM than a CNM.
Yes, I imagine it does always come down to the specific practitioner. From reading this board, it sounds like a fair amount of CNMs have drank the cool aid and are behaving irresponsibly too.
Ok, two things: first, are they saying that women in NJ are forced to receive CFM, even if they do not consent? Can that be true? Second: “and has been shown for over 40 years to not improve outcomes
but to increase risk for cesarean section.” Which of course, to the benefit of decreased risks to baby. But if CS are so horrible, it’s better to not monitor and thus not know if you might need a CS. I love the way that trope is worded: it’s shown not to improve outcomes. What does that even mean except that sometimes you might end up with a higher CS rate? Would they prefer a higher death rate? At least then we’d really know which c-sections were necessary, but unfortunately it would be those not undertaken. Never mind that “has not shown to improve outcomes” does not equal “worsens outcomes”. Unless, again, the outcome of most concern is avoid the evil CS.
Maybe it’s just me, maybe I’m odd, but I’m all for as much monitoring as possible in the end. It makes me feel better about feeling so g**damn miserable ALL THE TIME. (Can you tell that I’m 3 weeks out? And carrying a very large baby. Ugh.) Besides caring about the life we’ve created, there is no way I’m going to endure nine months of all kinds of unpleasantness just to play fast and lose with things at the end. But again, maybe I’m odd. (Well, I know for sure that I am…)
My son made sure I’ll never wear a bikini again. But he’s cute, so I forgave him!
My sons made sure I won’t be able to wear a bikini either, and I had a vaginal birth :-S
Me, too. Daughter was normal sized and I looked great in a bikini the next summer. My sis with the section wears a bikini without issues (her scar is low). Son was just HUGE (11lbs) and gave me stretch marks and love handles, darn him.
No stretch marks here, but those varicose veins never completely went away. And I had them in places you don’t want to know about…
Meh…I got the “twin skin” but when my husband and I had the opportunity to go on a child-free vacation a couple of years ago, to a tropical locale where no one knew me anyway, I wore a bikini. I figured most of the other couples there were newly-weds so they weren’t looking AT me, and the other older couples, well, those women probably looked LIKE me, so oh well. 🙂
I remember going to Hawaii and seeing exceptionally large Euorpean men wearing speedos, and thinking, gee, you know, compared to that, I’ve got nothing to be embarrassed about.
And then I thought, are they really going to judge me for how I look? I don’t think so.
That’s kind of when I got to the point where I really didn’t care what people I don’t know and will never see again think about me.
The body change I’m most grumpy about is that my feet spread and my arches fell, meaning I had to get rid of all my shoes TWICE, plus now I’m prone to bouts of plantar fasciitis. Getting rid of all those shoes was really hard!
Yep. My stretch marks looked like a relief map of the Andes, and even at my very thinnest I still have loose wrinkly skin from pelvis to ribcage. I have not put on any kind of swimsuit in almost thirteen years, and do not plan to. (Thankfully I’m not a big fan of water anyway.)
I don’t get the “I can’t wear a bikini” thing with scars and stretch marks.
Wear a bikini if you want to.
Scars show you’ve led an interesting life and survived it, stretch marks show you’re a mother.
Neither of those things should be a source of shame.
Wear a bikini if it makes you happy, and don’t feel that only “perfect”, unmarked bodies are allowed to.
I say this as someone who would probably have to wear a wetsuit to the beach if I had to cover all my scars. I wear bikinis, and haven’t yet had a comment or negative look that bothered me enough to remember it.
For me it’s not the scars or stretch marks that I’m self conscious about, but the “droopy dog” look from the extra skin. How I wish there were more high-waisted bikini bottoms (and that they were more stylish).
Go to vintage shops and bring it back? 40s is the new look? Retro-kinis? If you couple it with those awesome hair styles they had back then and some of the shoes, I think it’ll catch on. 😉
Actually, after I posted that, I went searching, and it turns out I was wrong! (alert the media, someone was wrong on the internet!). While they may not be carried at the local stores I frequent, there are tons of beautiful, retro-inspired, higher-waisted bikinis to be had. So, I went ahead and bought one (and for only 27 bucks… yay sales!).
And while I admit the idea of sporting a bikini makes me a little nervous, I like to remind my self: I was self-conscious of my body in my teens; in my twenties I wondered why. I was self-conscious of my body in my twenties; now that I’m in my thirties, I wonder why. I’m self-conscious of my body now, but I know in my forties, I’ll wonder why. I don’t want to get to be in my sixties and look back and say, ‘good grief, why didn’t I wear a bikini whenever I wanted to?!! I looked damn good, I should have walked around in a bikini 24/7!’.
So I’m going for it. I always thought I looked better in a two piece, I just saw all the low rise options in the stores (seems like that’s all that’s carried, ugh) and gave up. No more. Like Bofa said below (paraphrasing, here) why should I care about the (remote) possibility that I’ll be judged by people I don’t know and whom I will never see again?
Same here. I’m at pre-baby weight, but look much better in a one piece than a bikini. My shoulders changed as well (no idea how THAT happened) and lots of my shirts now fit weird.
I appreciate the positive tone here. I am definitely annoyed when I am telling my birth story & I can tell someone is fitting it into their ‘how she caused her own Cesarean’ rubrick. However I do feel some if this from the OB establishment. I feel like my age (38 probably the next time I birth) & BMI (29) will signal to my providers that I am less likely to birth vaginally. I know that statistics support that, but it is not possible to gather statistics from women whose providers were totally free of preconceived, societally influenced notions about their weight & age. I am making the general point that ageism & sizeism in our culture does not end at the hospital doors. I have a lot of gray hair, for example & it really occurred to me in my last birth to ask ‘am I being treated as older than I am because of my hair?’ I didn’t come in thinking that, but it occurred to me to ask.
I had my 5th at age 41. I can tell you from my experience, pregnancy and post c/sec recovery was a lot easier at age 28 than 41.
Yet my 36 year old pregnancy was smoother in every way than my 28 year old pregnancy. And the delivery might have been better two, except for a pesky double cord knot.
I am just noting that cultural ideas do exist inside the hospital walls & does not always strictly follow the numbers & even the numbers themselves may not be totally independent of provider’s cultural biases.
But there is considerable evidence that real risks exist independent of provider bias. For example, maternal age correlates directly and strongly with the probability of chromosomal disorders.
Should any doctor automatically assume that things will go wrong just because a woman is a first-time mother expecting IVF twins at age 41? No. But extra monitoring is just common sense.
Right, but are older & heavier women more likely to deliver by Cesarean exclusively because of risk factors or does provider bias play in to an extent? Which then creates the stats which inform the care. It is like which came first? The only way to tell would be to compare two similarly advanced cultures. I would hope my care would be based on my chart only, vs. whether it not I choose to color my hair with a chemical derived from coal, kwim? And that is what I felt like would happen but when I was actually in the hospital, it seemed like some of the staff were acting like I was considerably older than 36. Not what I expected ahead of time, but nonetheless, the impression I got.
Well, I always look at the patients age on their arm band when meeting them. If they are greyer than their age, I think hey, “that’s cool they are prematurely grey just like me and my mum” not “it says she’s 36 but she has the hair of a 50 year old so I’d better reduce my anesthetic doses…” 🙂
Depends, are they Di, Di or Mono, Mono?
But in this case (age and weight concerns in medicine), it’s more an issue of statistics than cultural ideas. Some women will give birth without a hitch at 35+, sure, and it’s great for them. But could the OB have told beforehand which ones would not, in hindsight, have needed the precautions? No. It’s about risk management: your OB has to inform you of your risk profile (without being a jerk, of course!) because refraining from talking about weight and age is not being sensitive, it’s refusing to look at what issues might occur and how best to avoid or mitigate them. I do have weight issues myself, plus body image issues, but when my GP told me he was concerned about my high blood pressure and recommended that I go see a dietitian, I listened. He didn’t try to shame me, just give me the tools to better take care of my health.
Have you spoken to your doctor about this? Or you’re just assuming it?
This is a great piece. I agree 100%. I’ve lost track of the number of women that I’ve heard say something to the effect that they thought they had a great birth, until they became more “educated” and now they are disappointed with their experience because it doesn’t fit into the NCB ideal. Loving your birth regardless of whether it was sufficiently “natural” is absolutely subversive in many parenting circles.
It doesn’t just end at birth, though, those same people try to impose their one-size-fits-all methods of raising the child as well. I’m enjoying doing some of the things the ‘wrong’ way. Of course, some I do the ‘right’ way, but that’s because I think they make sense and fit my LO’s personality and needs, not because some NCB nut told me so.
I was born in the wrong era… I could have been one hot prehistoric mama!!!
Loving your birth as it was is just as difficult as loving your body as it is, for precisely the same reason: the social pressure and punishment that come from defying the imposed norms. The sneering comments, the isolating and shunning, the saccharine “concern” for your health. It sounds petty until the circle of mean girls targets you.
I guess I am just lucky, either in where I live, or who I work with/my friends, because nobody I know cares very much about how other people give birth. I’ve seen a lot of stories here, and other places online, so I know people like that are real and I’m sorry that you’ve experienced that. But if it weren’t for the internet, I’d never have heard of NCB.
It’s become it’s own cult, with one trying to outdo the other for the love and approval of the community.
I’m reminded of the testimony I’ve heard from Jonestown survivors where some of the people who escaped the settlement before or during the mass murder who said that if they’d been there they weren’t sure they would have resisted taking the poison because the cult had become all they knew. With some of the hardcore NCB crowd it’s the same way.