Birth is not a crucible

Failure - sign series for business terms.

When it comes to controlling women, there are few better ways to encourage desired behavior than inducing shame. For most of recorded history, women were controlled into maintaining their virginity before marriage and sexual fidelity after marriage by surrounding women’s sexuality with intense shame. Women who had never been married were rendered unmarriageable by sexual intercourse. In most cultures married women who had sex outside the bound of marriage were subject to severe punishment up to and including execution.

Fortunately we’ve moved beyond that in industrialized societies in 2014, and it’s not by making sure that all women are virgins until their wedding night. It’s by removing the shame from women’s sexual satisfaction.

Now we need to do something similar for childbirth.

Just as shame was used by men to control women’s sexuality, shame is used by natural childbirth advocates to control women’s experience of childbirth. Where would the natural childbirth industry be if they couldn’t convince women to be ashamed for “failing”? They’d be poor and unemployed without using shaming as a marketing tool.

Childbirth educator Gabrielle Volkmer, in her piece Birth As a Crucible perfectly illustrates the intense shame that is integral to natural childbirth advocacy.

You prepare painstakingly — religiously fervent, almost — for your birth. You read, you study, you attend classes, you watch videos, you talk, you research, you listen, you question. You form firm core beliefs about pregnancy, labor, birth, femininity and motherhood. You have surrounded yourself with people you think will support you on your big day. You have conquered your fear and are prepared to have the best birth you can. You are ready to get your birth “right,” whatever unpredictable course it takes, because getting your birth right simply means doing all you can to achieve the best birth possible.

Only… you don’t achieve your best possible birth. You are left with the feeling that you and those around you didn’t do all you could to attain your goals. You have failed at getting it right — not because of your outcome, but because of how you got to that outcome. (emphasis in the original)

Why does that happen?

And all the time you wonder why. Why are you so upset? You have a healthy baby. You are safe. Your body has healed from the beating you called birth. It was fairly normal. No crazy complications. No coerced procedures. No emergency C-section or anything quite so dramatic. Just a normal birth gone a little off on an unexpected track…

It happens because Volkmer imbibed the shame-making nonsense of natural childbirth “education” that teaches women to judge themselves by their birth performance and to emotionally flagellate themselves if they don’t perform as mandated.

I have some advice for Ms. Volkmer:

Birth is not a piece of performance art
Birth is not a test of personal fortitude
Birth is not a crucible

Come closer and I’ll share with you the secret of the true meaning of birth:

BIRTH IS THE WAY THAT A BABY GETS FROM INSIDE YOUR BODY TO OUTSIDE IT … PERIOD!

Yes, I realize that natural childbirth privileges process over outcome, and views birth as primarily an opportunity for boasting when done properly or shaming if you don’t follow the pre-approved script. That’s how natural childbirth advocacy perpetuates itself. First they get you to believe, then they punish or reward you based on how faithful you are to dogma.

Volkmer responds just as prescribed:

You may not be able to control your pain, but you can channel it. After a while you use it to help you heal. You let it drive you to prepare for a better birth next time around. It motivates you to try to help other women avoid what you have gone through.

Or you could address the shaming integral to natural childbirth advocacy in the same way we addressed the shame surrounding women’s sexuality. You can reject it!

There is no “best” way to give birth. Don’t let anyone tell you that there is, because believing it means ceding power and agency to a group of people who control other women by making them feel like failures. You can’t be empowered giving others power to shame you, mandating how you must give birth and finding you wanting if you don’t comply.

Women find their power by rejecting efforts to control them, not by giving in.

  • Jen

    I just gave birth to my first baby via elective C-Section. My doctor and I chose this to try and mitigate any further urinary incontinence issues for me after delivery. The whole experience was amazing and pain free for me and as stress free as possible for my husband. Baby is healthy and happy and able to breast feed, although I did stock up on good formula too just in case breast feeding wasn’t right for us. Bonding was instant for us and I can’t help but think that having a pain free and easy delivery was a big contributor for me.

    I used to be so nervous of giving birth because of pain and damage to my body that I wasn’t sure I wanted kids. An elective C-section mitigated that fear and allowed our little family to have as healthy and happy of a start as possible. I know C-Section is not the best choice for every woman, but it’s certainly a healthy and great option for many.

    Thank you doctor Amy for getting good information out there and helping fight the stigma and judgmental attitudes that women face as soon as they become pregnant. It’s refreshing to see forums like this focused on realigning the priority to be on making sure both mom and baby are healthy and happy. There are so many different ways to achieve this outcome. Moms need accurate information and honesty to be able to make these choices. Thanks for being a nonjudgmental voice of reason for so many women.

    • fiftyfifty1

      Congrats to you and to your whole family! Welcome to the world baby!

      I, too, chose an elective c-section in consultation with my OB (and a pelvic floor specialist). It worked out very well for us, and I’m so glad it worked out well for you as well. For this “Labor Day” I wish I could send every mother/baby pair a healthy and smooth birth and start to life, by whatever mode is right for them!

    • Young CC Prof

      Congratulations, glad you and the baby are doing well.

    • Mishimoo

      Congratulations! Glad to hear that you’re all happy and doing well.

    • attitude devant

      Congratulations! So happy about every part of your post.

  • Jared Frederick Hall

    Half those comments rip the ob’s stance. It’s pretty humorous.

    Now, talking about shaming women. I’m pretty sure using scare tactics force women to feel shame in the general public by inducing the fear if harming their baby. I’m pretty sure women and families are shamed every time we hear stories of police and CPS intervention. I’m pretty sure that because somehow hospitals became the beacon for money, that that’s why we hear stories of doctors not only advocating for, but also strongly encouraging cesareans while at the same time denying vbac care.
    These are the same doctors who use this opportunity to preach about how safe the practice of hospital birth is, but would rather perform a risky selective surgery instead. These same doctors ignore all the medical evidence that points to the crazy stats that the USA is severely behind in infant and maternal mortality rates for being such a highly advanced medically professional nation.

    But these are all lies. Because we don’t know any better and are shamed when we don’t fall in line.

    • KarenJJ

      “These are the same doctors who use this opportunity to preach about how safe the practice of hospital birth is, but would rather perform a risky selective surgery instead. ”

      What risky selective surgery are they performing?

      “These same doctors ignore all the medical evidence that points to the crazy stats that the USA is severely behind in infant and maternal mortality rates for being such a highly advanced medically professional nation.”

      Except infant mortality is the wrong measure and the USA does very well at perinatal mortality. Why do YOU think maternal mortality might be higher than others? What exactly is the evidence you think doctors are ignoring?

      “Because we don’t know any better and are shamed when we don’t fall in line.”

      Why do we need to “fall into line”? I was empowered enough to have an adult discussion with my doctors about my care and my daughter’s care for a rare syndrome. I was empowered enough to have an open discussion with my obgyn about my care during pregnancy and childbirth. There was nothing about “falling into line”, but talking and discussing information I’d come across and putting into the context of my medical history and working things out that suited my preferences and were most likely to lead to a good outcome for me and my baby. That included c-sections in my case. In no instance was I threatened with CPS or the police.

      VBAC was of no interest to me, so I can’t really discuss that. I know someone that is going for a VBA2C in the next few weeks, her main concern is that her and her baby are healthy and her doctors and midwives (the Australian system, so these are university trained, hospital based midwives) are doing what they can to ensure that.

      • Jared Frederick Hall

        I’ve already stated that I believe doctors and the medical field in general push for interventions if labor or delivery is not on their time table. It’s fairly obvious when so many women wanting a certain birth get pressured into changing their plans out of ‘fear of harming the baby.’ Doctors lie about stats all the time. Vbac chance of uterine rupture: .6%; first time labor chance if rupture: anywhere from .007 to .3% depending on the studies. This only means that it is highly unlikely in a first time pregnancy, but studies have shown that it goes up with the number of births. So honestly, either way, the chances are slim.

        And any time there is an operation, it’s risky. Just because it’s common does not mean that there aren’t risks involved. Risks include injury to organs at .002%, incisional pain lasting six months at .07%, a greater chance of maternal mortality vs. a vaginal birth (stat from americanpregnancy.org), not to mention a 1-6% chance for the need to have blood transfusions due to hemorrhaging or increased blood loss.

        Part of the problem is that we don’t get to make informed decisions on birth until we have been through an emotionally draining and traumatic birth experience (which you don’t get to define. Which can also occur in non natural/vaginal intended births).

        • KarenJJ

          Risk of rupture is much higher than the risks of c-section that you listed. On top of that the potential outcome of the risk of rupture is death/brain damage to baby and there’s a risk of blood loss for mum too and risk of losing her uterus.

          Risk of organ injury is 0.002% – of which what is the actual outcome to mum? A nick to a bladder, say? What am I actually risking – outcome-wise in that scenario?

          But like you say, all these risks can really only be evaluated in retrospect. You can’t definitely say which side of the stats you are going to fall on so you make the decision you are most comfortable with at the time of the decision. Some of those decisions include a risk of brain damage/injury for the child.

          For me a repeat C-section made a lot of sense – medical history, choosing birthdate, had a husband that could take 6 weeks off. For my friend choosing a VBA2C – 2 active young boys, husband that works away in the mines – her considerations are very different. We both made a decision that works for us best in conjunction with our medical history and medical professionals. It really should be that straight forward.

        • Trixie

          Dude, do you seriously think a uterus with a scar in it is basically the same as one without? WTF are you talking about?

        • FormerPhysicist

          Sure, operations have risks, c-sections are operations and c-sections have risks.

          C-sections are done when the risk of not doing one outweighs the risk of doing it. What makes one set of risks higher than the other varies from woman to woman. What makes set of risks more palatable than the other varies from woman to woman.

          It’s not like the pregnancy just goes away if you choose not to do a c-section. The fetus is coming out, one way or the other, and both ways have risks.

          • Jared Frederick Hall

            This is probably the kindest and most informed response given to me yet. Thank you.

    • Lombardi

      You have anything other than strawmen to offer?

      • Jared Frederick Hall

        The op was a straw man. It assumes families don’t know anything about birth. Or that they need to.

    • Belle

      Do you solve your own or your child’s medical issues (like a broken leg) because you know better than all those preaching doctors who use shame and scare tactics letting you know what can happen if you don’t get that broken bone set? Oh but that’s just to” make you fall in line.” It’s all just lies, and besides, you know better. Really, aren’t they just performing a risky, selective surgery, setting that broken bone? After all, since hospitals are just beacons for money, and doctors advocate for that, they would most certainly encourage setting that leg (for all that income) instead of “denying” you the choice to just “let it heal”. And isn’t that what the body is perfectly designed to do, heal those broken bones without intervention?

      • Jared Frederick Hall

        Sure, why not. Let’s compare apples to oranges.

        • Belle

          You missed the point.. to illustrate how so off target your arguments are..

        • Young CC Prof

          Lets! Broken legs are actually less likely to kill you than birth gone wrong.

          • Jared Frederick Hall

            It’s not about birth gone wrong. It’s about being given the opportunity. The op said women are shamed into feeling bad if they didn’t go natural. But women are can be shamed and humiliated even if they are having plan c-secs or pain medicated births. It’s about empowerment in general for the mother. So many times doctors and nurses flat out ignore the mother’s desires.
            Death death death, that’s your only argument. Every single person who has responded, except Karen. Death, is a straw man. The chances of that are very minimal.

          • MaineJen

            Tell that to the (many) women who comment here who have lost children due to complications during birth. I suspect that yes, they think that the threat of death *is* a pretty compelling argument. Birth can and does go wrong. If you don’t believe that, you know less than you think you do.

          • Belle

            He has no clue..

          • Jared Frederick Hall

            I guess I’ll ignore all the stuff my doula wife has learned and all the info I’ve come across in ICAN and other support groups.

          • Young CC Prof

            Please do. ICAN’s information is extremely biased and often flat-out wrong. For example, they encourage women to avoid induction if at all possible, claiming that inductions cause c-sections. In fact, timely inductions PREVENT many c-sections by getting the baby out before trouble crops up. Unlike this forum, ICAN deletes dissenting posts, no matter how polite.

          • Trixie

            A doula. Your argument is that your wife is a doula who goes to ICAN meetings?
            A doulas job is to rub your back, get you beverages, make you comfortable. Not to offer advice about whether a section is necessary or not.

          • Jared Frederick Hall

            Example: my wife is type 1 diabetic. Considered high risk here. Induced at 39 weeks because it’ll be a large baby. It’ll end up in the nicu. Might have problems with placenta… Pitocin caused irregular heart rhythms. Epidural. Labor stalled. Forced c-sec. Son weighed 7lbs. Four day hospital stay.
            Omg a large baby!

            Second baby: natural friendly doctor. Not high risk. Labor started on it’s own. No pain meds. Vaginal birth. 7 lbs baby. Went home the next day.

            The first csec wasn’t needed. That’s what going off of. Personal history.
            I’m sure some of you have had bad experiences. All were asking for is to be treated fairly and with respect and given a fighting chance for what’s desired.

          • Young CC Prof

            Look, I’m sorry your first child’s birth didn’t go smoothly, but you have no way to know what might have happened. If you’d waited, maybe things would have been fine, maybe the baby never would have tolerated contractions, natural or otherwise, maybe he could have been stillborn due to placental failure.

            Type 1 diabetes is a high-risk pregnancy by any definition. If she found a doctor who treated her as low-risk, she found a bad doctor who played fast and loose with not just the baby’s health but her own.

          • Jared Frederick Hall

            Not with an a1c in the fives. A closely monitored pregnancy with type 1 is not a high risk factor as long as blood sugars stay in optimal ranges and blood pressure is normal.

          • KarenJJ

            I don’t know about type 1 diabetes specifically, but a wonky immune system can be dangerous to the baby as the immune system can turn and also attack the placenta by creating anti-bodies against the placenta too (and having one autoimmune issue can lead to other auto-immune issues).

          • attitude devant

            bullshit. You know nothing about diabetes if you are going to make that claim. A Type I, no matter how well controlled has vascular changes in HER own body that makes the pregnancy risky and makes close monitoring appropriate. You couldn’t have picked a worse argument to make.

          • Karen in SC

            Has this guy even seen Steel Magnolias? It used to be that Type 1 diabetes were told not to have children because it was so risky for the mother! What a chump to believe all the ICAN crap and eschew medical advice.

          • The Bofa, Being of the Sofa

            Has this guy even seen Steel Magnolias?

            Of course not. No guy has.

          • MaineJen

            Second labors are often faster and easier than first labors. You can’t know that anything you did affected that.

          • Jared Frederick Hall

            That doesn’t address the interventions based on the idea that the baby would be too big or tear her placenta.

          • Life Tip

            Just because it didn’t happen doesn’t mean there wasn’t a high risk of it happening.

            Apologies for the tired analogy, but if I get home safely after driving completely hammered, it doesn’t mean it was a safe choice or that the risk wasn’t there.

          • Young CC Prof

            Or to make a similar analogy, my son is about to outgrow his car seat. Thankfully, he has never been in a car accident. Was the seat a waste of money, or a reasonable precaution?

          • Stacy48918

            What would have convinced you that the first Csection was “needed”? A 12 pound brain damaged newborn?

            The doctors weren’t trying to screw you out of a vaginal delivery. I guarantee you they don’t care which way the baby exits the body. As long as it exits alive and healthy. Which yours did. And like a petulant child you are completely ungrateful for their genuine concern for your child’s well being. Just because it didn’t come out your wife’s vagina.

          • Guesteleh

            Even though Jared has deleted I wanted to comment on his assertion that because the second OB gave his wife a trial of labor her first OB was negligent in recommending a CS. The second doctor had far more information to work with than the first doctor. The second OB had your wife’s medical history from her first pregnancy. Second OB could make an educated calculation about your wife’s relative risk in her second pregnancy and offer a trial of labor. The first OB had no idea how your wife would tolerate pregnancy or labor. All first OB had to go on was data on women with type 1 diabetes. Given how incredibly high risk pregnancy is for women with type 1 diabetes and the fact your wife was a primigravida, it was perfectly reasonable for the first OB to recommend the CS.

          • Trixie

            Wait, did you just delete everything you wrote?

          • Belle

            Exactly! NO medical education yet they think it’s “OK” to give medical advice..

          • FormerPhysicist

            Yep, basically.

          • Stacy48918

            Great idea! None of them have any real medical education so why should you look to them for medical guidance?

            I don’t ask the NASCAR fan for advice fixing my car. I go to a mechanic. Someone that actually knows what they are talking about.

          • KarenJJ

            Please do. There is so much misinformation about it. Or if not ignore, at least attempt to correct misinformation and empower women to have productive discussions with their medical professionals and not put so much pressure on themselves to try and change their biological reality. Some of us are going to need medical interventions – it shouldn’t be shameful for someone to have medical interventions should they desire/need it.

            There is also a blog on the side here called “what ifs and fears are welcome’ written by a doula who strives to be honest and balanced in her views if you are looking for further information.

          • Belle

            “so many times doctors and nurses flat out ignore the mother’s desires” Really?? And how would you know? I I wouldn’t dream of ignoring a patient’s wishes, neither would any of the fabulous doctors I work with every day. Patients’ wishes are always respected. Death is NOT our argument.. informed consent is! If anyone is shaming, and dis-empowering women it’s the NCB crowd doing it. You have a lot of nerve making those claims, you have no idea what you are talking about… how about following me around for a couple of 12 hour shifts in L&D, then tell me about empowerment. You are right, though, the chances of death are minimal… with appropriate treatment and interventions…

          • MLE

            Death is a reality for many here. They are showing compassion by warning you. Feel free to ignore their advice, but do not trivialize it.

          • Jared Frederick Hall

            This article from AJOG (The American Journal of Obstetrics and Gynecology) collected data from 1.5 million deliveries between 2000 and 2006. They found the following:

            “Ninety-five maternal deaths occurred in 1,461,270 pregnancies (6.5 per 100,000 pregnancies.) Leading causes of death were complications of preeclampsia, pulmonary thromboembolism, amniotic fluid embolism, obstetric hemorrhage, and cardiac disease. Only 1 death was seen from placenta accreta. Twenty-seven deaths (28%) were deemed preventable (17 by actions of health care personnel and 10 by actions of non-health care personnel). The rate of maternal death causally related to mode of delivery was 0.2 per 100,000 for vaginal birth and 2.2 per 100,0000 for cesarean delivery, suggesting that the number of annual deaths resulting causally from cesarean delivery in the United States is about 20.”

          • Young CC Prof

            That’s interesting, but please explain how it is relevant to the discussion. Which part of it are you bringing up, and why?

          • Jared Frederick Hall

            So far I’m simply responding to the critiques of my original comments that women can feel pressured into giving up on a vaginal delivery. They also, regardless of birth method, be made to feel simply like a number and not a person. I think that death is used too much as a scare tactic. So here, my previous comment with ACOG stats was in response being told not to trivialize death, when I didn’t think I was.

          • KarenJJ

            But these results might be good BECAUSE doctors were on the ball, informed women about the higher risk of death to their babies and women chose to be cautious? It says nothing of the risk of ignoring medical advise and just doing your own thing.

          • Stacy48918

            You’re right. Death is perhaps the least likely adverse outcome. Though the worst of course. Death is a more finite marker though. Following babies to quantify brain damage is a lot harder.

            My friend’s baby is in the NICU right now. Has been for the whole 10 days of her life now. You’re right she didn’t die at birth. But she still lost her life. She’s alive but she may never talk, walk, read a book, go down a slide, swim, love, marry, have children of her own. All for a VBAC. Her mothers uterus ruptured and the baby didn’t die but she still lost her life.

            A small risk does not mean no risk and I guarantee my friend would prefer to have had a mandated prelabor C-section at 39 weeks than go through this last 10 days.

            Do you think ICAN would feature her story? Of course not. Because they don’t care about the women that “fail”. It’s a tiny risk and a scare tactic after all.

          • MLE

            Very sorry to hear that.

          • Mishimoo

            So sorry to hear that.

          • MLE

            “Death, death, death, that’s your only argument.” I think that’s what you wrote.

          • Stacy48918

            You cannot force a doctor to practice medicine in a way they feel is unsafe. Just because a mother “desires” something doesn’t mean she can compel the doctor to go along. Doctors have a right to say no.

    • Stacy48918

      Have you ever googled the definition on infant mortality? It doesn’t mean what you think it does. If you (your doula wife, the folks at ICAN, etc) don’t know something so basic as a definition, why should I place any stock in anything you (or they?) say?

    • MLE

      Did you erase your comments? Or is disqus acting up?

  • Cobalt

    I generally agree with the post, but not the title. Birth is a crucible. Regardless of process (including adoption), regardless of outcome, having a baby fundamentally changes you. Aside from death, it is the most transformative (and possibly dangerous) life experience most will ever have. This is true for both the parents and the baby. The person you were becomes the parent you are.

    • fiftyfifty1

      Meh. I know many people don’t feel the way I do about it, but for me becoming a parent didn’t feel transformative. Maybe it’s because I spent a lot of time caring for sibs growing up. From washing diapers to attending school conferences to staying up with a sick kid, I had done most of it already….then later some more kids came out of my own body. Yes, this time I have primary responsibility for them (along with their dad), but it’s a matter of degree. The person I was is still the person I am. Also, I think that if having a child truly had been transformative for me that I would feel that those who were childless were somehow different from me in some perceptible way. But it doesn’t feel that way to me.

    • Amy Tuteur, MD

      But that would make parenting a crucible, not birth.

  • ngozi

    I understand a person feeling emotionally bad about how their birth turned out. I think that is real. A person could feel that way because of the way the staff acted, something that happened to the person during labor/delivery that she feels was embarassing, or an emergency. I have had these things to happen, but my main focus has been my healthy babies–or trying to nurse them back to health. I don’t think that it should be ignored that a woman can end up upset by what happens during labor and delivery. I think Dr. Amy is cautioning women not to be so caught up with the experience of labor and delivery that the health of the baby is compromised, forgotten, etc.

    • Amy M

      Or the mother’s own health too…dwelling on what was bad, instead of getting help. I know it is easier said than done. When I had PPD, it took me almost 18mos to get help. Luckily, my PPD wasn’t severe, but it sure would have been better to get help earlier. I didn’t because I didn’t recognize the problem at first, and then was too unmotivated to get help. Of course, this is not entirely on the mother—if there were better screenings in place, and less of a stigma on mental illness, maybe women who need it could get help much sooner.

      • ngozi

        I couldn’t agree more. I had a hard time after one of my miscarriages. I got no help from anyone (the family I tried to get help from either pretended I didn’t need it or didn’t know how to help). My OB at the time just had me confined to a mental facility for a 3 day evaluation that didn’t last 3 days. I am still very upset and the only reason why I am saying as much here is because I can stay pretty anonymous here.

        • Siri

          I’m so sorry; that’s horrible. Say exactly what you want; this is a safe space to vent. The debate may get fierce at times, but everyone’s really supportive.

          • ngozi

            I wanted to file a complaint against him, but then I would have to deal with the embarassment of being put in a mental facility. I had to spend all that time wondering if my husband was going too be disgusted with me to the point of divorce. If my husband had of been working out of town no one would have been at home to get my children from the bus. What would have happened to them? My OB asked me if I wanted to speak to someone about my issues. I said yes, next thing I know I am basically jailed in a mental ward. I feel I was abused. I think I was let out early because I told everyone that could listen that I was being jailed at that mental facility

          • KarenJJ

            Wow that’s awful.

          • Mishimoo

            That is so incredibly unfair and I’m sorry that happened to you.

    • MaineJen

      Or, not to raise your expectations up so high that you cannot help but be disappointed. Birth is laborious (hence the term “labor”) and painful for most of us, and there aren’t a lot of ways to change that…if you go in expecting a beautiful, transformative experience and instead you get “the typical birth” (pain, effort, screaming etc), you’re bound to be disappointed.

  • Anon

    So I stumbled in this post this morning, and my mind has been blown, both by your caustic attitude and by your readers support of it. Um…did you just tell someone writing about feelings of depression and guilt to “get over it”? What is wrong with you? I mean, really, that is the opposite of how to deal with PPD, and a medical doctor should know that! Also, do your homework before you call someone a crank. I took two seconds to check out her blog, and read this in her About section:
    “This is not a blog advocating one method or another. It is not a part of the “birth wars” that takes sides between doctors and midwives, hospitals and home birth.Birth Beyond Bias goes deeper than that. I choose to look at what really matters: accurate, scientific, useful information.
    That is what this space is all about. I believe in science. I believe in evidence. Here at Birth Beyond Bias, science and evidence becomes interesting, mainstream and accessible. All those techniques you’ve been told to use during pregnancy and birth? You’ll find out why they do or don’t work, right here.”

    Doesn’t sound like someone who’s drinking the looney-tune NCB cool-aid to me. But I think I’ve had about enough of the poison you’re serving after reading this arrogant bs from a supposed “doctor”.

    • The Bofa, Being of the Sofa

      Um…did you just tell someone writing about feelings of depression and guilt to “get over it”?

      Did she? Where is that?

      • Anon

        I admit to reading between the lines. Guilty as charged. But is shouting necessary?

        “BIRTH IS THE WAY THAT A BABY GETS FROM INSIDE YOUR BODY TO OUTSIDE IT … PERIOD!”

        I also don’t see anything in this article or the writer’s blog titles that indicates she wants anyone to feel ashamed:

        “Or you could address the shaming integral to natural childbirth advocacy in the same way we addressed the shame surrounding women’s sexuality. You can reject it!”

        If anything, she seems to follow Dr. Amy’s un-asked-for advice. I admit I haven’t read the whole blog, or even most of it, but this critique makes a lot of assumptions that don’t seem to bear out.

        • The Bofa, Being of the Sofa

          I admit to reading between the lines. Guilty as charged. But is shouting necessary?

          Well, talking quietly hasn’t been all that effective. Sometimes, you need to shout to get people’s attention.

          I also don’t see anything in this article or the writer’s blog titles that indicates she wants anyone to feel ashamed

          But if she doesn’t want anyone to be ashamed, why does she fuel the attitude to causes leads to people being ashamed?

          “Your birth wasn’t good enough, you need to do it better.”

          • Amy M

            I took it as the writer herself being ashamed, because she was so indoctrinated with NCB. Also, she didn’t seem quite separated from the NCB, with the bit near the bottom about setting up the next birth to be better.

          • Anon

            Is there something wrong with wanting to feel better next time she gives birth? I really see you criticizing someone for feeling like crap and wanting to not feel like crap in the future. I don’t see anything else in the article about natural childbirth. I have a problem with the way you addressed her, because depression kills people, and you are doing the opposite of responding to that in a productive way.

            Also, just something for you to think about: at the end you say “There is no “best” way to give birth.” Very early in her article – in fact, quoted by you, she says, “You are ready to get your birth “right,” whatever unpredictable course it takes, because getting your birth right simply means doing all you can to achieve the best birth possible.” Doesn’t sound that far off, to me. I would think that the best birth is the one where everyone is healthy and happy, however it happens. Seems like that’s what she is saying she wanted, and wants to get next time around since she had such negative feelings this time. Food for thought.

          • Amy M

            I’m not criticizing anyone. In the article (the HuffPo one) linked, I don’t recall the term ‘PPD” or “depression”coming up at all. I had PPD myself, I know how awful it is. And I read the author’s blog posts about her PPD and how she got better, and I think she did the right things (seeing a doctor, getting medicine). I think the wrong thing, in terms of mental health, is to dwell on how the birth went, and to believe that if everything just goes perfectly next time, there will be no depression. That’s dangerous thinking…what if things don’t go perfectly next time? Or what if they do, and she gets PPD anyway? I am genuinely sorry that the author got sucked into the NCB mindset, that led to her feeling disappointment when she could have felt joy.

          • Amy Tuteur, MD

            I want her to feel better next time she gives birth and I suspect the best way to feel better is to let go of the totally arbitrary, culturally determined “standards” of natural childdbirth.

            She felt bad because she was disapointed in herself. Whose fault was that? The fault of the people who convinced her that their arbitrary standards for a “best” birth are the ones she should aspire to.

          • theadequatemother

            ^^^^^

            THIS.

            The author writes about her disappointment in not performing properly despite preparation. But she doesn’t question the assumption that preparation and process is meaningful or even are able to affect the overall process of birth and she continues to fail to examine that asusmption. It’s that underlying assumption that is leading to shame and it is that underlying assumption that is being heavily promoted by the NCB community and in more mainstream media/ sources.

          • Anon

            Did it occur to you that this article is probably about her experience? Her feelings? I thought that seemed obvious, from the writing style, but maybe it’s not so clear.

          • The Bofa, Being of the Sofa

            I don’t get the point.

            So what if it is? Does that make it not supporting the meme that if birth goes bad, one needs to do it again so they can do it “better”?

    • KarenJJ

      I felt a lot of guilt and was probably somewhat depressed about my inability to breastfeed my baby. I found it very refreshing to hear that breastfeeding benefits I’d heard were exaggerated and that in the face of a baby that was hungry and not thriving, formula was going to be infinitely better.

      My mother had c-sections for her babies, a condescending and paternalistic doctor (back in the 70s) and with little support after her third child had PPD. She focussed A LOT on her birth experiences.

      It was very difficult from the outside looking in how to talk to her about it, how to help her (I was 6, so really wasn’t able to help much). She read a lot of books of her her births “should have been” (including Dick Grantly’s one) and felt robbed. It was an enormous focus of her depression. Her own sisters couldn’t talk to her about it. They’d had vaginal births (and one especially was quite blunt about how it was not at all that great an experience for her – unmedicated in a rural hospital) but she couldn’t hear them.

      I really think mum needed better support and management of her PPD (difficult in regional Australia in the early 80s), not more idealised “brochure” style birth imagery that only really served to make her feel more miserable about her experiences.

  • http://www.birthbeyondbias.com unbiasedmama

    Thanks for giving my article, Birth as a Crucible, your attention. As you probably noticed, I have just begun featuring my work on the Huffington Post and to have my first article there receive so much attention from a well known, well followed blog like yours is exciting! As I am trying to grow my blog’s audience (www.birthbeyondbias.com – you should check out the whole thing, not just my Huffington Post page), I believe that there is no such thing as bad press. I hope that you continue to follow my work in both places, and I really would love for you to read over more of my blog. I feel certain that it will give you inspiration for more of your own posts. – Gabrielle Volkmer/UnbiasedMama

    • LibrarianSarah

      So…no response to Dr. Amy’s points/criticisms? No effort to engage in some of the discussions here? Just “hey give me more pageview$!” Okay then.

      • KarenJJ

        Guesteleh has written one of the best comments I’ve read ever about body, control and social class in response to these issues (see below) and unbiasedmama is excited about page views… This is such an interesting conversation to be had, it’s a shame NCB aren’t interested in nutting it out and pursuing it further.

        • http://www.birthbeyondbias.com unbiasedmama

          See above. :-)

          • Amy

            What’s that supposed to mean? It just goes back to you wanting more page views, no interest in engaging in a serious dialog about the points raised.

          • KarenJJ

            I don’t know that control is about Americans. I think autonomy is a basic right and something that all humans have a deep need for – not just Americans (I’m not American, but culturally I’d say we’re kinda similar). Problem is biology doesn’t care about rights and will do whatever. Then the case for autonomy is not trying to change biology but having autonomy to make decisions about what you want to happen next. Empowerment isn’t about trying to change biology but in being to access best medical care.

            I’m not sure how NCB got this so mixed up?

      • http://www.birthbeyondbias.com unbiasedmama

        This article was a way for me to express and talk about how I processed my experience of birth, which, based on the many assumptions she makes about who I am, clearly does not correspond to Dr. Amy’s or many of her readers. However, you will also notice that I invited her to actually read my blog. I invite you to do the same, rather than making assumptions about what I stand for based on her opinions. If you did, you might learn that I actually don’t advocate one brand of birth over another. Instead, I am trying to educate expecting parents about the science behind maternity care so that they can make informed decisions. I regularly cite my sources, too, in case you want to be a legitimate skeptic. Or you could just dismiss me without bothering to note that my actual views are publicly available. It’s a free country.

        I do intend on answering these points in a carefully written post, not a hastily typed comment. I do agree that NCB tends to guilt women. That is not what I am about. Notice that I do not define what “your best birth is”. That is up to each woman to decide – epidural, c-section, natural, your choice. What I want is your each family to do their research and decide what birth is “best” for them in their situation. I would suggest you read “A Good Birth”, by Anne Drapkin Lyerly. Don’t worry, I don’t have any personal ties to her, so I won’t profit from you looking at her work in any ways, but her writing on what makes a good birth has deeply inspired my philosophy.

        • LibrarianSarah

          Dr Amy has read and linked to at least one post on your blog. If anyone is interested in reading your original words they can click on the link. I usually do click the links to read the authors original words but I won’t for you. If you can’t see how your original comment comes across as a cynical ploy to drive traffic to your blog then you lack insight into your own words.

          If you feel that Dr. Amy has misrepresented your position or you want to address her criticisms the comment area here is the best place to do so. Dr. Amy doesn’t ban commenters for disagreeing so you will be able to say your piece here. But using the comment section of another blog to drive traffic to your own is tacky and bad netiquette.

          • Anon

            Actually, if you had clicked the link or read her post, you would see that the link is to the Huffington Post, not her blog. So readers of this article would have extra work if they wanted any kind of context, which is good for the Dr., since she clearly wants to portray this blogger in a manner not consistent with the content of her blog. Took me all of 5 minutes to figure this out. Frankly, I find critiquing someone without due diligence to be tacky, but there you go.

          • LibrarianSarah

            Again, my bad. It’s just when the first comment I see says “hey give me more traffic” I don’t want to comply. Perhaps I am contrarian that way.

            And again, I didn’t critique her point of view on childbirth, her post or her blog. I criticized her for trying to score pageviews off Dr. Amy’s traffic. I don’t need to read her blog to make that criticism. I just have to read her comment.

          • Poogles

            So, since it only took you “all of 5 minutes to figure this out”, what’s the problem? Dr. Amy linked to the specific post she was responding to, and apparently, according to you, it takes very little effort to find the author’s personal blog to get a more complete picture of her views on birth. So, again, what exactly is your gripe?

          • http://www.birthbeyondbias.com unbiasedmama

            Actually, she didn’t link to my blog. She linked to a page that featured my work. Knowing Dr. Amy’s track record, I highly doubt that she even bothered to look over my blog to see what I am all about. Don’t worry, I will copy and paste the post into the comments so that you don’t have to give my blog traffic. In my original comment, I found it highly amusing that Dr. Amy apparently feels threatened by my small blog. I was under the impression that she only attacks larger sites and groups, so it was surprising and rather humorous to find my work under attack here.

            As far as the discussion that you referred to, I believe I opened it in my previous comment.

          • Belle

            I highly doubt Dr. Amy feels “threatened” by your blog. It doesn’t take much for anyone with any sense to easily determine what you are all about. The phrase, ” a better birth next time around” sums it up… it doesn’t get much more demeaning than that…

          • Amy Tuteur, MD

            Why would I feel threatened by your blog? Why would I feel threatened by any blog?

          • LibrarianSarah

            Yeah, unless the blog is just various pictures of someone standing outside your house with a crazed look on their face and holding a weapon of some sort I doubt that there is any reason to find a blog threatening.

          • LibrarianSarah

            My mistake then. You do not need to copy and paste sections of your blog into to the comment section (in fact please don’t). Just state how you felt you were mischaracterized or respond to what Dr. Amy wrote.How do you feel that you were misrepresented?

            Also, I did not attack you. I pointed out that your originally post sounded like you were trying to use Dr. Amy’s readership to drive traffic to your blog. I didn’t need to do any further research beyond reading your comment to make that judgement.

    • RNMomma

      Perhaps there is no such thing as bad press, but there is such a thing as a bad message. Thanks for spreading one around.

    • Amy Tuteur, MD

      Lots if words, Gabrielle, but so far none that indicate that I misrepresented your views. You drank the NCB koolaid and were disappointed that you couldn’t create the piece of birth performance art that you wanted.

      You then had two choices: feel ashamed or reject the NCB nonsense that insists that birth is performance art. You chose to feel ashamed.

      • http://www.birthbeyondbias.com unbiasedmama

        Postpartum Depression is not a choice, Dr. Amy. My feelings and experience were real, and your rhetoric is hurtful, both to me, and to other women who shared similar experiences.

        You misrepresent me because you fail to notice that I write about two things on my blog: the emotional experience surrounding birth for many women, myself included, and scientific evidence surrounding making various medical decisions.

        My experience of your blog, and your readers, has been a very hostile one so far. I think this is very unfortunate, because dialogue is important to me. I will most likely respond to this post in a more thorough and thoughtful way on my own blog at a later date. For now, I think I’m going to step back from this conversation, as I feel very attacked about an experience that affected me deeply.

        • Amy Tuteur, MD

          Why were you disappointed in your birth beyond the fact that it didn’t comport with the idealized birth experience mandated by natural childbirth advocates? You yourself admit that there was nothing wrong with the birth, just that it didn’t meet your culturally determined ideals.

          So my question to you is: did it ever occur to you to question the culturally determined ideal that you chose to adopt?

          When a woman doesn’t have the childbirth of her dreams she has two options: 1. to feel ashamed and try to do better next time, or 2. to question whether her dreams were ever realistic in the first place. In other words, you could blame yourself or you could blame the unrealistic idealized experience promoted by natural childbirth advocates.

          You’re really in a difficult position here because your income depends on buying in to the natural childbirth “ideal.” So you could preserve your income by choosing to feel ashamed, or you could threaten your income by choosing to examine whether what you teach has any basis in reality or scientific evidence. I can see why you are struggling.

          However, if you have insight you may realize that your misery was a direct result of the shaming integral to natural childbirth advocacy. You could stop feeling ashamed and you could stop teaching other women a philosophy that leads them to feel ashamed, too.

          • http://www.birthbeyondbias.com unbiasedmama

            I am a birth junkie. I think our bodies are amazing.

            I am not a medical professional.

            I am an educator. My job is to help families know their options and the risks and benefits associated with them so that they can choose what course to take.

            I could go through and refute each of Dr. Amy’s points but why bother?

            I believe in women’s ability to decide what options they want for their births. If they want a natural birth, God bless them. If they want an epidural, hats off! Nowhere in my article do I say that natural birth is best.

            My article Birth as a Crucible was a highly personal narrative of my experiences. Writing and sharing it has been highly therapeutic for me until now. It was not meant to define a particular type of birth or what a best birth is. Hence why “natural birth” or “epidural” was never mentioned.

            I did my research before I decided that I wanted to try for a natural birth (originally I was set on an epidural!). It felt right for me. I knew it would be painful and laborious. I was under no illusion of an “orgasmic birth”. Yes, sometimes our culture does over glorify natural birth. It does boast, brag and shame. I hope to help change that because there is no excuse for such behavior. There are extremists on both sides and I am trying (though I do make mistakes) to find a sweet spot in the middle.

            Next time around my birth will be “better” because I know not to put so much faith into my labor team. I will be more able to advocate for myself and to accept the outcome so long as I feel like I am supported and have a chance to achieve what I want. If I do this, if I surrender myself to things I cannot control and advocate for myself, I know I can accept my birth outcome. If I feel supported, loved and cared for by those around me, I can be proud of my next birth, no matter what happens.

            And trust me, regardless of how my next birth goes, I will either stay on antidepressants or get back on them, because I do not blame my PPD on the trauma. It was a factor, yes, but not the cause.

            I try very hard to stay balanced and accept what is backed by evidence, whether it be medical or natural in nature. I am not charmed by something simply because someone claims it is natural. I look into the science behind it to see if it’s worth my time and often it’s not (I recently researched doTerra and Young Living essential oils and don’t see how science backs them up, so they are something I won’t support).I accept and welcome necessary medical intervention (I willingly received antibiotics for Group B Strep and CFM for meconium staining). What hurt me in my birth was that my team didn’t support me like I thought they would, so it didn’t seem like I’d really gotten the shot I should have. If you really want to know the whole story, look for it on my blog.

            I don’t regret getting an epidural – not for a minute. I regret that I felt unsupported by the people I thought would help me. I felt undermined by them. That is why I experienced birth trauma. As I have pulled through my PPD, I have left the shame and anger of my birth behind, but that doesn’t mean other people don’t feel this way. I hope to let them know they aren’t alone and that others understand the way they are feeling.

            Regardless of what route a woman wants to go with her birth, I firmly believe that she should know the basic process of what is going to happen. She should know know what interventions may be performed and how they will affect her and baby – both positively and negatively. She should know how to support and advocate for herself and what she wants, while always keeping in mind the risks and benefits of any course of action she does or does not take.

            I don’t mandate a particular kind of birth on my blog or in my education classes – hence why I am studying birth education through ICEA, not Bradley or Lamaze. I want to educate families on the risks and benefits of all options. Then they can choose what is best for them.

            Dr. Amy’s picking apart of my very personal story, her assumptions about how “naturally” minded I am or am not, her assumption that I blame my PPD on my birth, and her seeming disdain for those who seek to help inform women of their options in birth have served as my first internet encounter with scathing cruelty and ignorance. I am a person. I have feelings and am looking to find the right balance. Looking back over this unfortunate incident, I see that I shouldn’t have engaged and will not do so again.

            It has however, served as a poignant reminder to step back and look at the underlying messages in my work – to make sure that I don’t sway too far to one side or the other and then to stand all the more firmly with my beliefs and message.

          • Amy Tuteur, MD

            I AM a medical professional. And I’ve given birth to four children.

            You can’t refute my points or you would.

            You didn’t do your “research.” Reading nonsense by other equally uneducated laypeople in books, on websites and message boards is not research, it’s indoctrination. Research means reading many scientific papers from beginning to end.

            You’ve accepted the philosophy of the natural childbirth industry that benefits them and has already profoundly harmed you. It’s a cult, and the sooner you recognize the cult-like hold it has on you, the healthier you will be both physically and mentally.

            The philosophy of natural childbirth is harmful to women. It reduces women to the function of their reproductive organs, As you admit, it leads women to ignore the outcome of childbirth in favor of the process.

            You’ve been had, and it’s time to ask yourself whether the nonsense you believe has helped you or harmed you. Based on your own testimony, it caused you to react to the uncomplicated birth of a healthy baby with shame at your poor performance. The philosophy of natural childbirth hurts women. It’s already hurt you.

          • fiftyfifty1

            “I believe in women’s ability to decide what options they want for their births.”

            I believe in women’s ability to decide what options they WANT for their births too. I just don’t believe that women’s wanting will make it so. Nature gives you what it gives you. But NCB tells women that what what they get is a reward or punishment for having done it “right” or done it “wrong”.

          • MLE

            Dr. Amy’s picking apart of your very personal story? You mean the one YOU posted for the world to see, specifically so strangers would read it? I guess you now know that you can no more control other people’s reactions than you can birth.

          • fiftyfifty1

            “When a woman doesn’t have the childbirth of her dreams she has two options:”

            Naw, she’s got 3 options:

            1. Question and reject NCB ideology
            2. Do not question NCB, and blame yourself
            3. Do not question NCB, and play hot potato and blame your “unsupportive team”

        • Amy M

          I had PPD also. Mine was triggered by sleep deprivation, the birth of my children was fine. Are you suggesting that having another child would cure your PPD? Or that having the perfect birth situation would prevent it?

          I looked at your posts on PPD, and you said you felt better once you got the proper meds. Same for me. Trying to recreate and improve the scenario that triggered your PPD is a very long way to end up disappointed, and maybe with PPD again.

          If you have had PPD once, you are much more likely to have it again, if you have more children. But, knowing you are at risk allows you to put some pre-emptive measures in place, like taking your meds during pregnancy, or beginning immediately upon your baby’s birth.

          Finally, there are many known risk factors for PPD, which include previous episodes of anxiety/depression, infertility, multiples, and SES. It is also known that sleep deprivation can trigger/exacerbate PPD (or any depression really), and so can getting stuck on a disappointment (inability to breastfeed, or the birth didn’t go as planned.)

          I am glad you got help, and feel better, but Dr. Amy’s post had nothing to do with your PPD. She was pointing out that indoctrination with NCB rhetoric led to your disappointment about your child’s birth, and that by not allowing NCB to have that kind of control over them, women could be spared that disappointment.

          It sounds like your disappointment about your child’s birth had a role in triggering your PPD, but even if you hadn’t been disappointed about the birth, you may have gotten PPD anyway. By the end of your article, you seem to have reached the conclusion that if only the birth had gone to plan, you wouldn’t have suffered PPD, so next time, you’ll be better prepared, so your plans don’t go awry. If that is the case, you are still in the grip of NCB rhetoric and it might help you a lot if you could realize that the extreme NCB/AP/everything must this way mindset limits the potential for a successful (PPD-free) outcome.

    • PrimaryCareDoc

      I’ve looked over the blog. Seems like just another birth junkie blog from someone whose main qualification involves having given birth.

      • S

        I agree. Maybe less blatantly anti-epidural than some NCB blogs (so far; the series of monthly epidural posts hasn’t really gotten underway yet), but otherwise, honestly Gabrielle it looks like the same old natural birth glorifying, birth junkie stuff to me. Maybe you’ll be able to take it further. You seem like a thoughtful person. Good luck.

        • S

          …or maybe you like your blog the way it is. Didn’t mean to suggest what you should or shouldn’t do.

    • fiftyfifty1

      Your blog—where women who chose natural unmedicated homebirth are “superwomen”. Where you suggest that women who plan an epidural if the pain gets bad should instead “put on their big girl panties”, “educate themselves” and choose natural birth. Where women who have pit but refuse an epidural are lauded as “brave souls”.

      It’s so screwed up that women are reduced to how they perform in childbirth. Superman was super because he saved the World. Education for a man means an actual education, and being a “big boy” means actual adult responsibilities. Men are regarded as brave souls when they risk themselves to speak out against tyranny or sacrifice their lives for others. But women? Apparently their tests of character are all about their crotches.

      This is so infantilizing and antifeminist, and I reject it.

  • PrimaryCareDoc
    • Ash

      It burns me up that the response to this should have been SO frickin’ easy.

      When the chiropractor received the call, the appropriate response should have been “That is outside my scope of practice. I recommend that you seek medical care if you have questions about your newborn’s health” Done and done!

  • Deborah

    Wow. I thought Dr Amy had stumbled upon a childbirth educator who actually had an important message for women after reading the first quote. I am absolutely flabbergasted that this woman, rather than attempting to unravel the false, fixed beliefs gained from all the painstaking efforts of the women seeking a perfect, idealised birth, she actually goes on to coach them to do better next time! Absolutely unbelievable.

  • Zornorph

    I do find the focus on the birth itself to be curious. Of course, I’m coming at it from the perspective of a guy, but for me, it was something I wanted to be over as fast as possible. I was aware that the risks, while obviously low, are highest during the birth and I wanted him out of there as soon as he could be. I had thought of all the ‘firsts’ (first feeding, first bath, etc) but those were the things I was looking forward to and wanting to get to. Plus, knowing birth is not the most comfortable experience, I didn’t want my lovely surrogate to be having to labor any more than it took. I came across the concept of ‘birth plans’ and ‘birth stories’ when going through the pregnancy – I had never heard of a birth plan before and thought it was something everybody did but just didn’t talk about. I realize now that it’s more often than not just a list of silly instructions. As for ‘birth stories’, I sort of put them down to the female equivalent of war stories. I imagine most people would find them boring.

    • The Bofa, Being of the Sofa

      As for ‘birth stories’, I sort of put them down to the female equivalent of war stories. I imagine most people would find them boring.

      When I was doing Dad’s boot camp, we would try to do some birth stories, but even the people telling them didn’t say all that much, because they knew they weren’t that interesting on the whole.

      Life with the baby stories, however, were extremely interesting, sometimes awesome, sometimes scary.

  • Still tired

    As someone who comes from a different culture, I have been struggling with understanding of the North American obsession about The Perfect Birth. I did L&D rotations back home on top of being around pregnant friends, relatives and whatnot. Sure there were women who were traumatized by difficult deliveries but feeling intense guilt and disempowerment? Endless questioning and analysis? I don’t think so… Sure it sucked but you move on, there is life to take care of and a baby to love. It also isn’t ok culturally to brag about your perfect birth and feel superior because someone else didn’t get one. Women who didn’t have it easy generally receive genuine sympathies and extra support. Could it be because in our culture birth isn’t viewed as this candy-wrapped beautiful ‘rite of passage’? It’s more of a ‘oh crap, I hope all goes well, let’s get it over with’. Why do you think The Perfect Birth is a popular local concept?

    • The Bofa, Being of the Sofa

      Why do you think The Perfect Birth is a popular local concept?

      To be honest, I’ve never heard anyone I know outside of this forum ever talk about the concept.

    • Guesteleh`

      Having control over your body is a strong signifier of social class in the U.S. You see it with weight control, exercise, birth and breastfeeding. In general, health outcomes are strongly correlated with social class–the more money you have, the healthier you are. But it gets framed as you, as an individual, making the “right” choices to gain control over your body: I only eat organic, I train for marathons, I had a perfectly executed “natural” birth, I breastfed my child for two years, etc.

      By framing it this way your good health and control over your body become personal virtues–you are a “good” person–rather than accidents of birth–I happened to be born to relatively affluent parents. And a nifty side effect of this frame is you are free to hate on people who are sicker than you without admitting that what you’re really doing is stigmatizing people who are poorer than you are. Race figures into this too since people of color are more likely to be poor and have bad health outcomes.

      • Amy Tuteur, MD

        This, exactly!

      • DiomedesV

        Well said. That’s exactly what’s going on.

      • fiftyfifty1

        “You see it with weight control, exercise, birth and breastfeeding.”

        I would add to that list visible signs of aging.

      • Pseudonymous BC

        Can I buy you a beer? You nailed it!

      • Allie

        Exactly. I believe this about weight. Back when poor people were thin, it was fashionable to be chubby (Anne of Green Gables, for example, longs for dimpled elbows). Now, thanks to cheap and readily available junk food, laden with saturated fat and sugar, it’s easy for the poor to be fat, so it’s fashionable to be thin, and as competition ramps up, the wealthy just keep getting thinner.

      • Anon

        Okay, everyone is jumping on this bandwagon, but this comment is not the bee’s knees. You make some interesting points, Guesteleh, and I don’t mean to attack you. However, you also manage support the Skeptical OB’s straw man, oversimplify this issue, conflate correlation with causation, fail to cite any sources, and create a false dichotomy when you imply that if a person is concerned with making healthy choices, they are rich and snobbish, and therefore wrong. I care about eating healthy and exercising, I care about making informed medical decisions and getting optimal outcomes, and I am a white male. On the other hand, my parents net worth is negative, I was born out of wedlock, and my own household takes home less than $40k annually. I’ve also never criticized anyone for their health choices, and deeply sympathize with people who struggle with weight, depression, and feeling validated by both their decisions and their outcomes in life. Please see: http://scienceornot.net/2012/04/25/duplicity-and-distraction-false-dichotomy/

        This also disregards the beneficial effects of psychological empowerment, which there is some empirical evidence to support. (http://onlinelibrary.wiley.com/doi/10.1046/j.1369-6513.1999.00048.x/abstract;jsessionid=86EFBA6420E462E8A517055AAB77459D.f01t03?)

        Straw Man: http://scienceornot.net/2012/07/19/straw-man-crushing-concocted-canards/

        Does anyone know that the blogger in question is an NCB? I didn’t see that in the article. And if so, does that automatically mean that her opinion is always wrong? If it is wrong for NCB’s to criticize other women’s medical choices, is it not wrong for the Skeptical OB to publicly demean and invalidate this women’s experience without any context? This is relevant since you argue to support the OB’s commentary regarding NCB advocates dragging other women down. “a nifty side effect of this frame is you are free to hate on people who are sicker than you without admitting that what you’re really doing is stigmatizing people who are poorer than you are”.

        Oversimplification: http://scienceornot.net/2012/02/12/science-acknowledges-that-it-cannot-explain-everything/
        http://scienceornot.net/2012/07/05/confusing-correlation-with-causation-rooster-syndrome/

        You seem to imply that personal choices are not important and that medical outcomes are all about, ironically enough, the lottery of birth. Do you really believe that it is not possible for an individual to improve their health by becoming educated and making better choices? I think this is obviously false, and that your argument needs clarification – correlation is not causation, and causation is much more complicated than the current discussion seems to acknowledge.

        Again, you make a valid point regarding the correlation of health outcomes with affluence (as an example of supporting evidence: http://health.bsd.uchicago.edu/members/cagneykat/cagney_poverty03.pdf). However, your conclusion is highly questionable at best, and in all honesty, I read it as you stigmatizing people of whose situations you have no knowledge – the very thing you criticize in others.

        Not only is that unsupported by the evidence, it’s unproductive. The only way to make any progress on these issues to open up communication between opposing viewpoints and get to the heart of what each group and person really wants. Unfortunately, a quick scan of the article titles on this blog makes it clear that this is not the author’s goals. Hopefully I don’t need to cite my sources for that point.

        • Guesteleh

          http://ije.oxfordjournals.org/content/35/1/55.full

          The exponential increase in mass media attention to obesity in the US and abroad seems to have many of the elements of what social scientists call a ‘moral panic’. Moral panics are typical during times of rapid social change and involve an exaggeration or fabrication of risks, the use of disaster analogies, and the projection of societal anxieties onto a stigmatized group.47,48 Despite the very weak evidence that obesity represents a health crisis, scientific studies and news articles alike continue to treat the population’s weight gain as an impending disaster. A content analysis of 221 press articles discussing scientific studies of obesity found that over half employed alarming metaphors such as ‘time bomb’.41 This same study also found that >60% of the news blamed obesity on individual choices, while only ∼30% discussed any structural factors that might influence weight gain. Articles that reported on blacks or Latinos were over eight times more likely than articles that did not blame obesity on bad food choices, and over 13 times more likely to blame it on sedentary lifestyles, while articles reporting on the poor were four times as likely as other articles to blame obesity on sedentary lifestyles. Such findings lend support to the theory that talk of an ‘obesity epidemic’ is serving to reinforce moral boundaries against minorities and the poor.

          Public opinion studies also show that negative attitudes towards the obese are highly correlated with negative attitudes towards minorities and the poor, such as the belief that all these groups are lazy and lack self-control and will power. This suggests that anxieties about racial integration and immigration may be an underlying cause of some of the concern over obesity.49–51

        • Guesteleh

          P.S. I grew up on welfare and Medicare, living in Section 8 housing and eating government cheese, so your assumptions about me are wrong.

          • fiftyfifty1

            To this day I yearn for that government cheese….big oblong blocks of VERY sharp cheddar gilded with a misty white bloom. Cabot Seriously Sharp is the closest I have come to reliving my memories, but the texture just isn’t quite right.

    • Smoochagator

      I think you actually hit on it when you mentioned bragging about a perfect birth and feeling superior to someone else who didn’t get one. Americans are very competitive and enjoy feeling superior about just about everything. What we eat, what we look like, what we wear, what our children eat and look like and wear, how they perform at school, where we live, how clean or pretty our homes are, how successful we are in our jobs, our possessions, etc. It’s all over the media from the TV shows we watch (competitions of every sort, from weight loss to home renovations) to the blogs we read (makeovers! easy recipes! weight loss secrets!) to the advertisements and products we consume. It seems to me that the American dream has become being better than your fellow (wo)man in every way – even giving birth – rather than an individual living a life that pleases THAT particular individual.

    • Life Tip

      Because wealthy, privileged people who live boring, normal lives want something to feel troubled/persecuted/exceedingly important about?

  • Young CC Prof

    Actually, if your birth IS a crucible, you’re doing it wrong.

    If your birth is filled with terror and uncertainty, if it requires you to prove your strength of character, something has gone horribly wrong. The goal of your preparations for birth should be to have a BORING one.

  • no longer drinking the koolaid

    I tell women from the beginning that there are things about the pregnancy and birth over which they will have no control and that you can’t fail at birth if those things happen. You can only fail at the things you control. The rest you just have to roll with.
    The words of the NCB community are so deeply imbedded in some women that they believe their thoughts and feelings control whether the baby is breech, asynclitic, or deflexed. Many have a really hard time differentiating what they control and don’t.
    With that thinking I can see why some women end up with serious postpartum depression concerning what happened at their birth.

    • Young CC Prof

      This is why I particularly hate the alties who claim to be able to fix malpositioned babies. Because the idea that someone out there can fix it implies it’s the mother’s responsibility to seek out this help, and hence that if her baby is malpositioned, it’s because she didn’t burn enough herbs on her toes, or go to the chiropractor, or the right chiropractor, or go often enough.

      The facts are:

      1) The only things that can change a baby’s position is an external version, performed by a doctor, or rotational forceps. These are not risk-free.

      2) If you need a c-section for a malpositioned baby, that’s OK.

      3) Therefore, don’t go nuts trying to make your baby turn. Just roll with it, whatever happens.

      • The Bofa, Being of the Sofa

        This is what happened with us. First was breech, doctor says, I can try an external version, but it’s not comfy and I only have a 1/6 success rate. We can try it, or you can just do a c-section.

      • Pseudonymous BC

        You’ve got it right that the NCB community is all about trying to place blame for things that simply aren’t ours to control. My friend had 2 breech twins, neither engaged, and she (with her other friends’ encouragement) tried everything to induce labor so she could have a TOLAC with breech twins. Maddening! Oh, I assure you she didn’t forget her moxibustion or her funny drinks or obsessive visits to the chiropractor or funny yoga positions. Sometimes, it is what it is what it is. I think the American mainstream cultural obsession with being “in control” and controlling difficult circumstances probably feeds this fire.

      • Sue

        Luckily for the alties, most early breeches turn themselves (it;s easy to look up the percentages by gestational age) – but the ”therapist” claims the credit and the $$$.

  • itry2brational

    “…shame is used by natural childbirth advocates to control women’s experience of childbirth.”

    …shame is used by [women feminists] to control women’s experience of childbirth.

    Fixed.

    • Trixie

      ………….

      • Mishimoo

        Personally, I find the phrase “women feminists” in place of natural childbirth advocates” amusing. To me, it’s a clear indication that they don’t quite grasp the situation being discussed and are allowing personal prejudices to influence their understanding.

    • OttawaAlison

      Maybe it’s the lack of sleep but what?

      • attitude devant

        He’s whacked. Men’s Rights Activist and fat-shamer extraordinaire. His Discus profile is worth a perusal—he’s even commented on Return of Kings.

        • Trixie

          Also imagines whether internet strangers’ children are circumcised and then shouts at them about it.

        • Guesteleh

          My husband tells me that Return of Kings is some kind of front for a mail order bride business. Of course it is.

    • Spamamander

      Oh yippie, a Moronic Repulsive Asshole. (MRA)

  • Amy M

    One of the worst things they do is pull out the old “No one can make you feel guilty but yourself!” to absolve themselves of their wrongdoings. We all know that’s bullshit. The whole point of shaming someone is to make her feel guilty (and ashamed of course). Guilt about making a choice that was different than the one the accusers made, and shame about herself and her quality as mother. Many women are vulnerable to this, and to make it worse, they begin to tie all of their self-worth into their motherhood, since that’s what NCB tells them to do.

    The jerks who spout the above adage know perfectly well what they are doing, and they set it up so if the woman tries to fight back, she’ll be told she’s defensive and if she’s defensive she must not be comfortable with her choices. Well sure. Maybe she WAS comfortable with her choices until you, jerk, came along and picked away until you found a little hole in the defenses, and wiggled your way in. The only guilty party here is the NCB jerk, who, for whatever reason, chooses to commit serious assholery in order to upset other women. Some of those women go on to develop PPD. Hey NCB jerk, I hope you feel guilty about leading a woman down that dark path, and I hope you are ashamed of yourself because you are terrible person. No one can make you feel guilty but you, so you better get on that.

    • Belle

      Excellent points! NCB jerks just don’t give a crap about what they do to women.. it’s all about their agenda and making women “see” how “superior” their position is.. as Dr. Amy said, it’s all about shaming and control..

  • RNMomma

    A great example of “relative deprivation due to rising expectations.”

  • The Bofa, Being of the Sofa

    You prepare painstakingly — religiously fervent, almost — for your birth. You read, you study, you attend classes, you watch videos, you talk, you research, you listen, you question.

    OK, I must be completely out of touch with what’s going on, because, um, no.

    We prepared painstakingly, absolutely, but not for “birth” but for BEING PARENTS and having a baby!

    Yeah, we went to baby classes, but only a small amount was about actually giving birth. Oh, we talked about the hospital, and pain management options, and whether you can cut the umbilical cord in a c-section. But we also spent a lot of time talking about dealing with pregnancy and parenting, including feeding options. We met about 90 minutes a week for 5 weeks, I think, and the amount of time we spent on the actual birth itself was probably 90 minutes, with half of that watching videos of births.

    And in terms of our own “painstaking preparations” it was about getting carseats and which stroller was the best and what are our sleeping arrangements going to be and how are we going to handle the work situation, and how are we going to handle feeding when my wife starts working. We also worried about parenting issues, like how are we going to cope with a screaming baby in the middle of the night, and when do we have to open a college fund. And not only the future, we also focused on the here and now, like how is mom’s health and how is she feeling in pregnancy, and what are good things to eat and what are bad things to eat?

    There is so much more to having a baby than the event itself. You aren’t just preparing for a birth, you are preparing for a lifetime. You need to go through the event to get to that point, but that is one moment in time. As Amy says, birth is the way the baby gets out. It is the way you go from not having a baby to having a baby.

    But it’s not the birth that is the transformative event. It is having a baby.

    • RNMomma

      I often equate it to the people (women, usually) who become obsessive in planning for their wedding day rather than focusing on their future marriage. Sure, you want it to go well and you may dream about how you’d like it to be, but it’s just ONE DAY and it shouldn’t define you or your marriage.

      • The Bofa, Being of the Sofa

        Sure, you want it to go well and you may dream about how you’d like it to be,

        At least with a marriage, you have some control, nominally. You can pick the date, time, location, food, guests, attendants, write your own vows and schedule the order of events.

        For childbirth, you can decide where, and you can usually get there, and you might be able to get people there you want, assuming it goes sufficiently, but then again birth has it’s way of deciding when and how it’s going to occur, without consulting you.

        So despite the fact that they are both nominally “one day in a lifetime”, they still aren’t all that comparable.

        • RNMomma

          I do agree it’s a poor example, but I think it’s one that many women can easily relate to. It may rain during your outdoor wedding, or the flowers or cake gets messed up, or someone spills a ton of red punch on your dress. Extremely minor issues when compared to the stakes in childbirth, but the concept is the same. You shouldn’t plan on perfection because life promises no guarantees.

        • Mishimoo

          That’s why I’m having a healing wedding next year ;)

          10 year anniversary party, as a celebration rather than a do-over because our marriage is awesome even though we didn’t get to pick anything for the wedding except each other, the flowers, and the minister.

          • Who?

            Sounds beautiful, enjoy every minute.

          • Mishimoo

            Awww thanks! I’m kind of excited already.

      • jhr

        should we coin a new word? MOMZILLA? Like Bridezilla?

      • Who?

        It’s true.

        But there’s something social or cultural about it too-the same people often eat obsessively, diet obsessively, work obsessively, decorate their houses obsessively etc, which goes to the earlier point about weight and appearance management.

        Is it around a kind of latent perfectionism that’s fed by the plethora of ‘choice’ we’re all confronted with-what a disaster to choose the ‘wrong’ rug, or wedding dress: somehow choosing the ‘wrong’ husband almost seems easier to solve. If you did your homework it’s surely his fault? And as for getting the ‘wrong’ child, well, you wouldn’t want to do anything to cause that or make it more likely. Would you?

        Which is handy because these people can show you (and sell you stuff) to help you do it right. But of course if it doesn’t go exactly as planned that just means you didn’t work hard enough.

        Hang on, it’s the perfect business scheme. Oh damn, those ethics again! Back to the laptop…

    • Medwife

      It always takes me aback when I hear it referred to as the woman’s birth. It’s the baby’s birth!

      • Trixie

        I think it makes sense in conversational use to say, “I had two births” or “my births were in 2008 and 2011″ or whatever. I think that’s just common phrasing without any particular connotations. But yes, this takes it too far.

        • Roadstergal

          I have to admit, I’ve never heard that. The moms I know say “I had two babies” or “My son/daugher/love of my life and light of my days was born on *date*.” I consider the end of September to be my birthday, not my mom’s. :)

          • The Bofa, Being of the Sofa

            “My kids were born in 2008 and 2011″

          • Sue

            I don’t know how many of you are familiar with The Goons (1960′s UK radio comedy), but I will always remember this line:

            “I was born at an early age, once in 1936 and again in 1942″.

        • Cobalt

          I actually end up phrasing it as “my births” when talking to OB/GYNs, L&D nurses, etc. As opposed to my pregnancies, or my miscarriages.

    • TsuDhoNimh

      You prepare painstakingly — religiously fervent, almost — for your birth.

      Good points … this intense focus on birth is like obsessively planning how to leave the driveway on your way to the airport for your vacation and beating yourself up because you didn’t leave lined up straight.

    • Anaesthetist

      I dont think I really prepared for my birth
      not consciously anyway, I was a bit of a passenger

      My childrens births on the other hand….

      • Sue

        I certainly prepared for my birth. First I implanted in my mother’s endometrium. Then I started developing organ systems, growing, moving around. And of course I knew when it was time to be born….. ;-)

      • Amy M

        I know, its crazy, right?!? I don’t even REMEMBER my birth, and according to my mom, she did everything right (vaginal, drug-free delivery). You’d think an achievement like that (being born the right way) would have a greater impact on my life, but so far, I’m not a millionaire.

    • Montserrat Blanco

      Exactly! I can not add a single word to it.

  • Pilo
    • Cobalt

      Towards the bottom of the thread she mentions she went from 6 to 10 cm in one contraction after a cervical check. That’s when the pain level went through the roof. I wonder if the midwife ‘helped’ her dilation by forcing the cervix open.

      • Cobalt

        “I think things went wrong with the cervix. My mw checked me and said I was at 6, then with the next contraction I was at 10 and pushing. The cervix just reacted really strongly to the exam, and that’s when the excruciating pain began. I suppose that odd turn of events is unlikely to happen again.”

        • moto_librarian

          Sounds like she was a victim of power birth. Deplorable.

      • Staceyjw

        Someone might want to drop her a link about power birthing, and its invasiveness.

        • Cobalt

          I can’t get their reply to thread option working on my device.

        • RNMomma

          It does sound like that, doesn’t it? I replied to her post with a link… We’ll see if it gets posted. I’ve never spent much time over there so I have no clue what the moderators allow through.

      • http://www.antigonos.blogspot.com/ Antigonos CNM

        Alas, that works in theory; practice is another matter. The cervix opens in its own good time [unless you have an incompetent os], and sometimes it doesn’t open at all, or only partially.

  • moto_librarian

    “Only… you don’t achieve your best possible birth. You are left with the feeling that you and those around you didn’t do all you could to attain your goals. You have failed at getting it right”

    Five years ago on Saturday, I gave birth to my oldest son. I attained my “goal” of an unmedicated labor. And then spent the next few months trying to understand why the experience was so unbelievably awful and disempowering.

    It was NOT because I didn’t give my all, nor was it because of my husband, my midwife, and the L&D nurses. It was because I was fed outright lies by the NCB movement. Things like the nonexistent “cascade of interventions,” the idea that labor pain was “productive” pain, that vaginal birth was superior. In the midst of trying to sort through my feelings, I found Dr. Amy’s blog. More than anything, your evidence-based analysis helped me to realize that I hadn’t done anything wrong. For that, I will always be grateful.

    • RNMomma

      This is exactly my story, only it happened following the birth of my daughter just this past December. I, too, am extremely grateful to have been released from the self imprisonment that is guarded by the NCB community.

    • The Bofa, Being of the Sofa

      It was because I was fed outright lies by the NCB movement. Things like the nonexistent “cascade of interventions,” the idea that labor pain was “productive” pain, that vaginal birth was superior.

      How much of it is also the fact that, once it is over, you realized the lack of significance?

      Beforehand, you had a goal that you thought was important. However, once the baby comes, you realize, hmmm, that didn’t matter. I was all gung-ho for nothing!

      Just wondering how much of the problem is being sold something that once you get it, just isn’t what it is cracked up to be.

      • RNMomma

        A huge part of it, it my opinion.

      • moto_librarian

        I think that you’re right about this, Bofa. When you are expecting your first, everything is an unknown. Like you and your wife, we spend a lot of time preparing for parenting – car seats, how long my maternity leave would be, finding a good daycare, etc. – but I was extremely anxious about the actual birth itself. I vividly remember going to our first childbirth class and hearing EVERYONE state that they wanted a “natural” birth. I had actually been feeling open-minded up to that point, but I almost felt bad saying that we were just going to see how things went. And then we started learning about all of the NCB lore, and it snowballed from there. My husband remained a skeptic about it, but I allowed my emotions to steer me far too much.

        When it came to the day I went into labor, things were quite tolerable up until transition. I really thought that it wasn’t going to get any worse – if I had known how painful pushing would be or that I was going to have complications, I would have had an epidural for sure.

        • The Bofa, Being of the Sofa

          Maybe it’s like caviar. You hear a lot about caviar, and how it’s a delicacy. And you hear people talk about fancy shindigs with caviar, and figure, caviar must be something pretty special.

          And then you try caviar. Imagine the scene from Big with Tom Hanks where he is trying to scrape it off his tongue. Yeah, that’s not hyperbole.

          You could start worrying that you just don’t have the great sophisticated palette that those fancy people have, and feel that you are a failure.

          Or you can wonder, are all these people who are talking about how great caviar is are a bunch of liars? Because that shit is nasty!

          • moto_librarian

            Personally, I like caviar, but have only eaten it a handful of times. And I don’t think that I have ever actually purchased it because there are lots of things that I find far more delicious than caviar for a fraction of the cost.

            That being said, I think the analogy holds true. Once I actually researched the claims being made about the glories of natural birth, I realized that they were all a bunch of lies. The epidural with our second son was the best thing ever.

          • Liz Leyden

            I’ve come to define “delicacy” as “something you wouldn’t normally eat unless you were on the verge of starvation.”

          • Young CC Prof

            How about, “Something you wouldn’t have considered eating until your in-laws served it to you?”

            Actually, quite a few of those turned out to be tasty. Some, not so much.