The philosophy of natural childbirth is sadistic

STOP PAIN

Nearly a month ago, the website Feminist Current featured a powerful, thought provoking piece entitled Eve’s punishment rebooted: The ideology of natural birth by philosophy graduate student C.K. Egbert.

There’s something pornographic about the way we depict childbirth. A woman’s agony becomes either the brunt of a joke, or else it is discussed as an awesome spiritual experience… [W]e talk about the pain of childbirth — with few exceptions, the most excruciating, exhausting, and dangerous ordeal within human experience — as valuable in and of itself. Hurting women is sexy.

The euphemistically termed “natural childbirth” is often justified on the basis that it is a woman’s choice, that pregnancy and birth is a “natural process,” and that it is best for the woman and baby (both for medical reasons, and because a woman won’t feel attached to her child otherwise). Put into context, these arguments ultimately boil down to “women’s suffering is good.” …

When people tout “natural birth” as an “empowering choice” (sound familiar?), they conveniently ignore all the women who have been harmed by these practices and for whom giving birth was (completely understandably and legitimately) one of the worst experiences of their lives. Natural birth advocates, just like many in the pro-sex movement, don’t seem to be concerned about the harm that women suffer through this practice or finding ways of preventing this harm from occurring. Women can choose, as long as they choose to suffer and see themselves as liberated through suffering.

Egbert is brutally honest about the philosophy of natural childbirth. Responding to the claim that natural childbirth is “better,” she notes:

What about the argument for women’s health? We probably wouldn’t give much credit to an argument that we should strap patients to the operating table and refuse them anesthetic during surgery, even though general anesthetic is usually the most dangerous part of surgery. Rather than eliminating palliative care, we seek safer and more effective means of performing surgeries and administering anesthetic. Natural birth advocates are not concerned with women’s welfare, because they are not advocating for safer and more effective forms of pain management; they argue they should be eliminated, because women’s suffering is itself a good. And while feminists applaud efforts to give women support and comfort during the birth process (e.g., emotional support, more home-like birthing environments, etc.), this is compatible with providing women pain medication. Once again, the danger of anesthetic only becomes an issue — rather than a normalized part of medical treatment — only when and because it can be used to hurt women. (my emphasis)

Not surprisingly, there was tremendous push-back from natural childbirth advocates, but Egbert skillfully defended her thesis in the comments section.

But this isn’t about the best way to give birth. It’s about what significance we give to women’s suffering and pain, and how that relates to women’s subordination in general.

Exactly, and in the world of natural childbirth advocacy, women’s pain and suffering is “sexy” and “empowering.”

That’s not surprising when you consider that the philosophy of natural childbirth was created by old, white men who tried to convince women that the pain of childbirth was in their heads, not their bodies. And the philosophy of natural childbirth has been perpetuated by white women (midwives, doulas and childbirth educators) who enjoy wielding power over other women and glory in humiliating them for failing to mirror their own choices back to them. The tragedy is that many women are complicit in their own subjugation and claim to be “empowered” by it, because they are so used to being judged and bullied that they believe it is for their own good.

Simply put, the philosophy of natural childbirth is deeply retrograde and profoundly anti-feminist.

I’ll even go a step further. The philosophy of natural childbirth is sadistic in that its promoters derive pleasure from inflicting pain, suffering, or humiliation on others and actively prevent others from seeking relief for their pain.

The originators of the philosophy of natural childbirth were sadists when it came to women’s pain. They felt that it was irrelevant, unworthy of treatment, and annoying to doctors. The philosophy of natural childbirth could best be encapsulated as, “Shut up and give birth without bothering us.”

The contemporary avatars of the philosophy of natural childbirth are often sadists when it comes to women’s pain. They consider it irrelevant, unworthy of treatment, and resent effective pain relief as “weakness” and “unhealthy,” when it is neither.

The midwives and doulas who chivvy women into refusing pain relief, who “delay” calling the anesthesiologist when a woman requests an epidural, who promote inadequate forms of pain relief (waterbirth) and praise women as warrior mamas (i.e. “good girls”) for enduring labor without pain relief are sadists. They believe that women’s pain and suffering aren’t worthy of their compassion and concern. They believe that women are improved by agonizing pain, and diminished by relief.

The philosophy of natural childbirth is not based on science; it is based on fundamental beliefs about the irrelevance of women’s suffering, beliefs about the ways that women “should” use their bodies, and value that natural childbirth providers place on their (the providers’) autonomy and having their own personal choices mirrored back to them.

The philosophy of natural childbirth is about glorifying and enjoying women’s agony, and that, of course, is nothing more than sadism.

 

For more of my thoughts on the subject, you can listen to the Feminist Current Podcast Is ‘natural’ better when it comes to birth? An interview with Dr. Amy Tuteur.

  • MichelleJo

    When I went into the hospital to be induced, after a particularly awful pregnanct, (HG and deep Clinical Depression),just the thought of a contraction was more than I could cope with. I was just so beaten down emotionally. I wanted them to knock me out and cut the kid out. But they wouldn’t do it. After that whenever a member of staff asked me my name, I just answered ‘epidural’. In fact is was the answer I gave to anything they asked me. They thought it was quite amusing, but it got their attention. They got the epidural up and running before starting the pit. Completely pain free birth – bliss. And she’s the kid who’s attached to me at the hip at age eight. And she wasn’t placed on me at delivery. This particular must doesn’t seem to have reached the Middle East. The cord was cut immediately, the baby taken straight to a warming bed with oxygen being blown in her direction. They might do more, I would’t know (or care). This is standard procedure. They handed me a beautiful pink faced baby all nicely wrapped up, and I couldn’t have asked for more. I was on cloud nine and all these things you have to do were of so little importance, they didn’t even enter my mind. The NCB movement convince the young and gullible about all sorts of nonsense, so that they don’t get that deliriously happy feeling after birth that they deserve.
    They are both sadistic and robbers.

  • Ink

    Liked, but completely confused by the following line: Natural birth advocates, just like many in the pro-sex movement, don’t seem to be concerned about the harm that women suffer through this practice or finding ways of preventing this harm from occurring.” —- What does being sex-positive have to do with harming women? The pro-sex movement says sex is good and healthy and that we should quit on all the slut-shaming that women are subjected to disproportionitely. Not sure why it is being equated with the glorified dangerous and painful practice of homebirth.

    • Stacy48918

      Perhaps because some in the “pro-sex movement” are also in support of prostitution. It is not just as a result of it illegality that prostitution as an institution preys upon and hurts women.

      • Roadstergal

        I kinda… have issues with that as a blanket statement. Probably outside of the scope of this discussion by a long shot, though.

    • anion

      There are a LOT of ways it harms women, actually, but I don’t think this is necessarily the place (and I don’t have the time at the moment) to go into it.

  • Dr Kitty

    So this study possibly classified as “major haemorrhage” losses as small as 501ml?

    BTW- blood donation is 475mls, and pregnant women have expanded blood volumes and physiological mechanisms designed to cope with some blood loss.

    Should we be telling blood donor that their donations are 5 teaspoonfulls away from a major haemorrhage?

    Ridiculous.

  • Emily

    OT: I rarely post here, but I had a question I couldn’t find a definitive answer to. A close friend of mine had an induction after her membrane ruptured. Labor took a long while to kick off and she ended up getting an epidural so she could rest and relax. Baby was born, happy and healthy, no problems. But a nurse mentioned that the epidural can sometimes make the babe sleepy and a little reluctant to nurse. She was in no way unkind and seemed to have genuinely seen a connection between epidurals and sleepy babies. Is there any truth to this at all?

    • Anj Fabian

      Zero proof.
      Zero truth.

    • The Computer Ate My Nym

      I’ve never heard of epidurals making babies sleepy. The point of an epidural is that you can use only a very small amount of medication since you’re applying it right to the area where it’s needed so there should be a very low level of pain medication in the mother’s blood.

      • araikwao

        I came across a paper titled (something like) Neurobehavioral changes associated with fentanyl used in epidural analgesia when I was looking into this to rebut a very nasty NCB MW I saw antenatally. Didn’t read it. Also had a lactivist doc&researcher insist she had the data to prove it, she just hadn’t written it up, and that all the MW’s on the ward had observed it….no bias there, f course!

      • Lynn Ratcliffe

        Beilin Y, Bodian CA, Weiser J, Hossain S, Arnold I, Feierman DE, Martin G, Holzman I. Effect of labor epidural analgesia with and without fentanyl on infant breast-feeding: a prospective, randomized, double-blind study. Anesthesiology 2005; 103: 1211-1217.

    • The Bofa, Being of the Sofa

      But a nurse mentioned that the epidural can sometimes make the babe sleepy

      “How does that work?”

      Narcotic pain relief I can understand. Epidurals? You got some ‘splainin’ to do….

    • D/

      The hypothesis (belief) is that epidurals can affect infant behaviors, and there are concerns about potential decreases in maternal oxytocin/ prolactin levels after delivery.

      From the Academy of Breastfeeding Medicine Protocol: Analgesia/ Anesthesia for the BF Mother

      “Like many other aspects of breastfeeding, epidural analgesia likely has no effect on women who are determined to breastfeed.and have good support but may be one more subtle challenge to women whose intention to breastfeed is more vulnerable.”

      “When epidural analgesia has been used for labor particular care to provide mothers with good breastfeeding support and close follow-up after postpartum hospitalization should be taken.”

      … which I don’t really see as a distinction from how to help every breastfeeding mother myself.

      http://www.bfmed.org/Media/Files/Protocols/Protocol_15_revised_2012.pdf

      • The Bofa, Being of the Sofa

        But how does a decrease in maternal levels of oxytocin make the baby sleepy and reluctant to nurse?

        it might affect the ABILITY to nurse, but that is a different claim.

        • D/

          It doesn’t. Just mentioned both since they are being increasingly lumped together as the “reasons” not to have an epidural if you want to successfully breastfeed.

      • Amy Tuteur, MD

        It’s not a hypothesis. It’s wishful thinking. There is ZERO evidence that epidurals impact breastfeeding.

        • D/

          Yep, I agree. but it’s certainly (handy) wishful thinking that is always used by anyone needing another reason to encourage mothers to forego pain relief … one that unfortunately seems to prove itself true since most babies are initially sleepy. And one that every mother runs into if she does any “research” and often even when she doesn’t.

        • Lynn Ratcliffe

          actually there is a growing body of evidence that fentanyl, the opiate part of epidurals, may cause breastfeeding problems. Even the RCOG and the OAA in the uK acknowledges this.See Beilin Y, Bodian CA, Weiser J, Hossain S, Arnold I, Feierman DE, Martin G, Holzman I. Effect of labor epidural analgesia with and without fentanyl on infant breast-feeding: a prospective, randomized, double-blind study. Anesthesiology 2005; 103: 1211-1217.

          • Amy Tuteur, MD

            Actually, that paper is underpowered to show much of anything and most of the difference weren’t statistically significant in any case.

          • Karen in SC

            How does a study from 2005 show a “growing body of evidence”?

          • Stacy48918

            Tell us Lynn, what is the duration of action of fentanyl as compared to other pure agonist opioids? Surely you know as you’re very educated about birth and physiology and now pharmacology.

            Having some actual training in pharmacology and assuming some cross species similarity in T1/2, fentanyl would actually be my opioid of choice should I need an epidural in labor.

          • Siri

            Could it be that women are more likely to request epidurals if their labours are long and arduous? And that babies born after long and arduous labours are more likely to be exhausted and a bit slow to feed?

            In any case, a possible slight delay in breastfeeding seems a pretty small price to pay for good pain relief in labour.

    • EmbraceYourInnerCrone

      I always wonder why people don’t put initial sleepiness in a newborn down to simple exhaustion, if the mom is tired from a long or stressful labor why would anyone think the baby is going to be perky and raring to go? I had a short but stressful labor , complete with fetal distress and vacumm extraction due to late decels. I was not surprised when my daughter was very tired the first 2 days of her life. I would have been surprised if she WASN’T exhausted!

      • Amy Tuteur, MD

        What I wonder is why people think that shoving the breast in the baby’s mouth in the first few minutes after birth is what the baby wants or needs.

        Let the baby catch her breath, learn to breath, explore the new sights, sounds, sensations. It’s unlikely that the baby is hungry since its nutritional needs have been met by the placenta only moments before. So why would the baby need or want to nurse immediately?

        • Junebug

          I was pressured to feed the baby after my first immediately. She was covered in MEC!!! I tried to.

          The second baby I didn’t even try for 3 hours. She breastfed until almost a year and then only stopped due to a serious illness.

          Third baby went to NICU so I didn’t try for a week. She breastfed for 2 months until she too had a health problem.

          Baby four? No plans to jam my breast in her mouth while there is still blood in her eyes and nose.

        • Are you nuts

          I had never thought of that. Good point! Aren’t the nutritional needs of baby the first day essentially zero anyway?

          • fiftyfifty1

            “Aren’t the nutritional needs of baby the first day essentially zero anyway?”

            I’ve wondered about this. It seems like yet another piece of breastfeeding half-truth propaganda. Lactivists use it when a newborn is crying with hunger and thirst to try to persuade parents not to supplement.

            It’s true that a baby will not die if it is not fed for the first 24 or 48 hours. And it’s true that the majority of babies will not suffer serious consequences if they receive only colostrum until the milk comes in. But that doesn’t make it ideal. Some babies do suffer major consequences if they are not supplemented. But lactivists will say that the reason that only small amounts are produced on the first few days is because such small volumes are “best” for newborns when there is no evidence that is the case. It’s making a virtue out of necessity.

            It’s like baby chicks. Farmers know that it’s possible for a baby chick to live off of its internalized yolk sack remnant for the first 72 hours. That’s how hatcheries can send baby chicks in the mail. But that doesn’t mean it’s ideal. In real life baby chicks spend a couple of hours drying off and perking up. Then they start pecking and sipping away! If you deny them food for the first 3 days, most will still live, but a few won’t and the rest will be looking pretty sorry by that point.

          • D/

            Unfortunately, it isn’t just the lactivists using this. JCAHO has included breastfeeding as a Perinatal Core measure and now requires every hospital delivering > 1,100 babies to report (and show improving) rates of exclusive breastmilk feedings. This is creating pressure to avoid formula supplementation and seems to be contributing to a shift in timing with some pediatricians to postpone formula supplementation. Even with babies 10% (or more) below birth weight, some are just telling moms to start the supplementation as soon as they get home, and others are encouraging waiting until they are seen in the office the next day (or maybe longer) to consider it.

            It’s a kicking the can down the road approach that meets the JCAHO requirement of increased exclusive breastfeeding in the hospital. Unfortunately it is also increasing the likelihood of more babies suffering major consequences from inadequate feedings … especially if they aren’t going to be followed up appropriately.

          • Lynn Ratcliffe

            8-10% UNICEF recommends skin to skin, 8-12 feeds in 24 hours, HCP to observe latch & check output.
            10-12% UNICEF recommends as above + supplementation with EBM fed by teaspoon or cup.
            12-14% UNICEF recommends as above but also possible use of formula if mother’s supply inadequate
            14%+ readmission.

          • Trixie

            UNICEF recommends skin to skin because it keeps babies warm, which is great, but sort of irrelevant in a modern hospital with alternative ways to warm babies. It’s awfully snuggly and nice, of course.

          • Lynn Ratcliffe

            UNICEF recommends skin to skin because it seeds the human biome; coats the baby in the mother’s protective bacteria, the mother’s temp helps the baby to regulate his temp, her heart beat helps the baby to regulate his, & her breathing helps the baby to regulate his. It also encourages the release of oxytocin which is essential for bonding & for the let-down reflex. SKin to skin is important for all babies, regardless of how they are fed.

          • Elizabeth A

            Has UNICEF recommended anything about newborn care? Last time I looked, that was WHO’s beat. Lynn, have you read the text of any WHO recommendations? They don’t get into grandiose terms like “seeding the human biome”.

            Skin to skin is very sweet and cuddly, and can help with heart and respiratory rates in some circumstances, but modern NICU care in the first world has more tools than skin to skin, many of which are more effective, and some of which preclude skin to skin holding.

          • Lynn Ratcliffe

            Have you heard of kangaroo care in NICU?

            Of course not all babies are well enough for skin to skin, but I’m talking about full-term healthy babies. And WHO-Unicef work together in the babyfriendly initiative.

            Moore ER, Anderson GC, Bergman N, Dowswell T (2012) Early skin-to-skin contact for mother and their
            healthy newborn infants (Review). The Cochrane Library. Issue 5. http://www.thecochranelibrary.com.

          • Elizabeth A

            Have you heard of kangaroo care in NICU?

            Have. I. Heard. Of kangaroo care in NICU.

            Have I.

            My daughter, whose birth has been described in conversation with you, was in the NICU for 32 days. I came into this experience fired with passion for kangaroo care, which I was sure was the intervention that would save my baby. I thought that if only I could hold hold her in my arms and feed her at my breast, everything would come right.

            I cannot tell you how painful my education on this particular subject was. My daughter did not need my arms or my milk at first. If she had managed to latch on to my breast in those first weeks, she’d have choked. I had been told by caring friends that my touch would help stabilize her respiratory rates, but it in fact did no such thing. She needed parenteral nutrition, gavage feeding, CPAP ventilation, lung surfactant, and time.

            The NICU staff could not have been less moved by the assorted information on kangaroo care that I showed them. The original research on the subject was done in 1978, in NICUs that had very little to offer. By supplementing their wildly insufficient tools with kangarooing, researchers in Colombia managed to achieve a survival rate for pre-term infants that would cause first world NICUs to be burned down by angry mobs. The papers I waved around (mostly from March of Dimes and La Leche League) were not evidence. The numbers on my daughter’s bedside monitors were evidence.

            Furthermore, I wasn’t remotely capable of kangarooing my infant! Kangaroo care is not just about holding the baby with your shirt off. It also requires the person caring (usually the mother) to sit up so that the baby remains upright. Guess how much of that I was capable of in the first few days after having a c-section.

            In the end, I can’t recall “properly” kangarooing my baby at all. We held her as much as we could, mostly with shirts on everyone. I napped in recliners by her isolette and pumped breastmilk while the nurses chatted with me about how she was doing. After 32 days, we brought her home.

            I doubt anyone could tell the difference between the kangarooed preemies and the not-kangarooed preemies at this stage. We are talking about a child who starts pre-kindergarten next month. She sings, dances, chases pigeons, torments her older brother, and resists bedtime just like any other child her age. I would consider it a great kindness if people would stop suggesting kangaroo care as though it was the Holy Grail. What modern NICUs actually do with preemies is evaluate them, treat the problems they have, and help them grow. They get amazing results with that process. Having someone hold the baby in exactly the right way all the time isn’t a vital part of that.

          • Hiro

            Why am I not astonished she hasn’t even replied to this? I find your story moving and I am grateful that a modern NICU was there for you!

          • Amazed

            God help the women you counsel, you dangerous ignoramus. I can only hope you contain your bullshit in the area of breastfeeding alone.

            Full-term healthy babies, she says. Guess what, Ms Educator? Full-term healthy babies usually don’t end up in NICU. And the few who do are there for short-term problems. Nothing demands the kangaroo (by the way, terribly lacking compared to the care in any NICU with good resources) care you praise.

            Normally, I would suggest that you ask moto, a regular poster here, how her full-term healthy baby treatment immediately after birth went and whether he needed a kangaroo care or just a competent one. But I won’t since she has better things to do with her time than explaining simple truths to a woman who will accept them just the way she accepted Elizabeth A’s NICU story – either dismissing them or sprouting her propaganda again, insisting that it’s a bunch of facts instead a bunch of nonsense. A dangerous one.

          • The Bofa, Being of the Sofa

            Have you heard of kangaroo care in NICU?

            Have you heard of Pablo’s First Law of Internet Discussion?

            “Regardless of the topic, assume someone knows more about it than you do.”

            Of course not all babies are well enough for skin to skin, but I’m talking about full-term healthy babies.

            Why would full-term healthy babies be in the NICU?

          • MaineJen

            Warning: we have mention of the microbiome. Repeat: mention of the microbiome has occurred. Next on the agenda: mention of lactobacillus and prevention of obesity.

          • Trixie

            That reminds me, I wonder what’s happening with those Microbirth people lately.

          • Durango

            There needs to be a new internet law about making up facts about the microbiome to support one’s position don’t you think?

          • Anj Fabian

            Quantum biomes!

          • D/

            Weight loss >10% is not normal. In fact, weight loss > 7- 8% warrants close attention to both the adequacy of infant intake and protection of milk production potential for those mothers planning to breastfeed.

            Some babies can feed 12 times a day for an hour (or more) at a time and only transfer minuscule amounts. No amount of skin-to-skin and unrestricted breastfeeding will reduce issues of insufficient production and inadequate infant intake if babies become so calorie-deprived that they lack the ability to feed effectively. And yes, diaper counts can absolutely provide reassurance between weight checks, but “proof” in feeding adequacy is normal weight loss (<10%) followed by adequate weight gain.

            It is not simply a matter of keeping a baby skin to skin, latching well to an adequately producing breast and nursing 8- 12 times a day. What matters is whether the baby is transferring enough milk to meet his caloric needs *and* doing that in a manner that is manageable (survivable) for the parents.

          • S

            My second child could’ve used the hydration, maybe not in the first few minutes after birth, but certainly in the first few days when i could not get him to wake up and nurse. I regret believing the lactation consultant who told me he was fine. I should have supplemented him. He was jaundiced upon discharge, and when my milk (which causes breastmilk jaundice) came in, his bilirubin shot up and he was readmitted.

            He ended up getting a full day of formula in the NICU (due to the breastmilk component of the jaundice). I find it ironic that a couple of bottles early on may have prevented that.

          • Lynn Ratcliffe

            what would have helped your baby to nurse would have been help & support from your carer. You should have been told about spending as much time as possible skin to skin with your baby which stimulates babies to nurse, & you should have been shown how to hand express your colostrum which could have been fed to your baby by syringe or teaspoon. A newborn baby’s stomach capacity is only about 5ml so they need frequent small feeds. Formula would not have been the answer. More correct support was. I suggest you complain about your lack of care in the strongest possible terms to ensure that no other baby ends up in the same situation.

          • Amy Tuteur, MD

            Where’s the evidence that skin to skin stimulates nursing?

          • Trixie

            To the extent that the baby’s face and hands are pressed against a bared breast, isn’t nursing pretty much always skin to skin?

          • Lynn Ratcliffe

            skin to skin is the baby’s naked body ( wearing nappy)against the mother’s naked body ( chest or stomach). The closeness, the smell of the mother, the smell of the milk, the heart beat & the breathing all help to stimulate a baby to nurse.

          • Trixie

            I know the definition of skin to skin. I liked skin to skin. It was great!
            But where’s the evidence that it stimulates a baby to nurse, and how do you design a study to test that?

          • Lynn Ratcliffe

            Just go a look at a few babies Amy.

          • The Bofa, Being of the Sofa

            You want a challenge?

            Let’s see, Lynn, how many births/newborn babies have you attended?

            And now, Dr Amy. How many have you attended?

            Lynn – you realize you are telling an OB to “look at a few babies”?

          • Lynn Ratcliffe

            Amy asked me about the evidence that skin to skin stimulates nursing. http://www.medscape.com/viewarticle/806325_3 There’s a little bit here.

          • Lynn Ratcliffe

            You may think that the sun shines out Amy’s a** but I’m not afraid to challenge her. Yes she needs to watch a few UNMEDICATED newborns and observe their instinctive behaviours. And in answer to your question, “how many births/newborn babies have you attended” I’ve lost count, but it’s nearing over 1000. Enough I think to be able to speak with some authority. I wonder if Amy, you have seen the work of Susanne Colson, or Helen Ball? No? You might find some useful info there.

          • Bombshellrisa

            She has observed unmedicated babies, but maybe it doesn’t count since they were hers

          • Stacy48918

            No that’s not it at all. It’s the OTHER babies that don’t count. You know, the MEDICATED ones. Poor little druggie babies. We should just pile them in a closet and shut the door because it’s the unmedicated babies that are perfect and instinctive and worthy of our worship and admiration. Oh and their mothers too. Put the loser wimp epidural moms in with their babies since they’re all hopped up on fentanyl and their bonding is ruined anyway.

            Oh the UNMEDICATED babies!!!!!!

          • Bombshellrisa

            You know what happens to those moms who describe their epidurals as wonderful? They turn into the moms whose kids brag about how they didn’t cry because their vaccinations didn’t hurt. Poor misguided, unbonded souls!

          • Siri

            You mean their vaccinations don’t hurt because the kids are still drugged up years later?!

          • Anj Fabian

            I don’t care about “instinctive behaviors”. Big whoop. I can get a baby to show me an instinctive behavior by lightly stroking their cheek. It doesn’t mean anything.

            Show me the numbers, the studies, the data. Peer reviewed, s’il vous plait.

          • The Bofa, Being of the Sofa

            Y. Yes she needs to watch a few UNMEDICATED newborns and observe their instinctive behaviours..

            You think she hasn’t?

            Clueless, she has had unmedicated births herself!!!!!

            Seriously, the concept of telling an OB to “look at a few babies” is about as silly as I could ever hear.

          • Amy Tuteur, MD

            Don’t flatter yourself. You’re not challenging me. You’re just demonstrating your ignorance by disagreeing without presenting data to support your claims.

            Why do you think you know more about childbirth, obstetrics, science and statistics than me? Why are you arguing with me?

            Hasn’t it ever occurred to you that I know a very great deal more than you do about these subjects and that if we are disagreeing it is because YOUR knowledge is deficient, that YOU have been tricked into believing something that is not true?

          • Elizabeth A

            “how many births/newborn babies have you attended” I’ve lost count, but it’s nearing over 1000.

            Congratulations! You’ve seen almost as many births as a first year OB resident.

          • Amy Tuteur, MD
          • ngozi

            Oh gosh I guess we will all be called “Dr. Amy’s Minions” all over again. Excuse me while I put on my foil hat…

          • Bombshellrisa

            You have attended 1000 births?

          • Karen in SC

            Almost ALL babies are unmedicated at birth! An epidural is placed in the dura of the spine and very little reaches the baby.

            Show any studies that prove your position, current studies.

          • auntbea

            Did you hear that, S? Your interpretation of what you and your baby experienced is just wrong! This random person on the internet can tell you the way it was!

          • Lynn Ratcliffe

            that’s not what I’m saying & i’m sorry if that’s how you have interpreted it. I’m just saying what should have been done to help S

          • auntbea

            And…who are you to decide what help she needed? Do you know what S’ s goals were? Have you been in discussion with her doctor? Do you care that some mothers might have different priorities than avoiding formula at all costs and don’t find your “help” helpful? No? Then hush.

          • anion

            “I’m not saying what happened was wrong, I’m just saying what the right thing to have happened was and how it’s different from what actually happened. But that’s not saying how it was wrong! It’s totally different.”

          • auntbea

            And I’m sorry you didn’t interpret what I said correctly.

          • Elizabeth A

            You’re Monday morning quarterbacking a situation you have extremely scant data on. You have no more idea what should have been done to help S now than you did before you read her experience – you weren’t there, you have no idea what information her care provider was responding to, and you didn’t have the chance to evaluate the situation yourself.

            Second-guessing the guy on the ground feels great for your ego, but otherwise is just kind of mean.

          • MichelleJo

            You made a statement that a newborn’s stomach can only hold 5 ml, and tried to back that up with some articles or what you might call studies. I am not a doctor and I am not a scientist or researcher, so I cannot usually argue with a professiohnally done study. However, your statement needs no studies to refute it, and I can say with 100% certainty that your claim is completely untrue. I am a mother who formula fed five babies exclusivley. By the time we got home from the hospital, they were usually draining 100 grams of milk, 20 x the amount you say that their stomachs can hold. Please, take what I am saying seriously, because it is 100% true, and what you are telling mothers, as an NHS consultant is absolutely incorrect. The information you have from your training is wrong, so please make sure to go to it’s source to correct it, and have all consultants like yourself informed that this statement is untrue. By saying this, you are starving babies, leaving them screaming so that their mothers are exhausted, and most importantly YOU ARE NOT HELPING ANYONE. I believe you do what you do because you want to make life easier and good for new mothers. You are doing the opposite if you are telling them false information as fact.

          • Theoneandonly

            I don’t understand why you think there is only one way (your stated way) to get a baby to nurse.

            I had a c-section after induction, where my baby never engaged and I never made it past 3 centimetres, even after nearly 8 hours of syntocinon and AROM.
            My baby was born at 2:30 am, my (hospital) midwife expressed off 6ml of colostrum, which my husband gave to her through syringe while I was in recovery. He was fully clothed the whole time, I never held her during that time due to shaking from blood loss (1 litre – OMG PPH! Not.)

            She slept all day that first day – I held her a few times, not a concerted effort for skin to skin, she was reluctant to nurse, so we ended up getting a heel prick done to check blood sugar levels. She was fine so we let her sleep.
            My milk came in about 36-40 hours after she was born, along with terrible engorgement, and she went on to (exclusively) breast feed until solids, and weaned herself at 15 months.
            TL;DR – there are many reasons why breast feeding does or does not work, and telling someone that if they just would have followed your method they would have been guaranteed success is just plain wrong

          • fiftyfifty1

            “A newborn baby’s stomach capacity is only about 5ml so they need frequent small feeds. ”

            Total bullshit. This is what I mean when I saw lactivists make a virtue out of necessity when it comes to the fact that unfortunately milk does not come in for the first few days. It takes a few days for the pregnancy hormones to be cleared and for the lactation hormones to get up and running. It’s an imperfect system for sure, but one that *most* babies survive. But lactivists pretend that that delay is what is best for babies and make stuff up like that stomach capacity is only 5cc. I can’t believe people fall for that lie! Go to any newborn nursery and watch a newborn being bottle fed. Do they stop at 5cc? Hell no. A typical newborn happily takes about 2 ounces which is 60 cc.

            So here’s my question Lynn: Do you yourself believe that idiocy about newborn stomach capacity being 5cc (i.e. you’re not very smart and you have no real experience with babies) or do you know it’s false but use it anyway to manipulate women (i.e. you’re a liar)?

          • The Bofa, Being of the Sofa

            She’s the one who told Dr Amy to “go watch a baby”, implying that she has, so it appears to be the latter.

          • auntbea

            This makes me very happy. I was perpetually terrified that I was overfeeding my daughter and she was going to spit it all back up (or possibly die, like when you overfeed a goldfish). My hospital had signs everywhere indicating that my child’s stomach was the size of a grape, but she was routinely eating way more than a grape’s-worth. Plus, I couldn’t figure out how there was so little room for a stomach in that big old belly of hers.

          • fiftyfifty1

            Wow, that is incredibly depressing to me that this sort of misinformation is being promoted in hospitals. It’s really sad how special interest groups have been able to make headway and push science out. The lactation consultants at the hospital I trained in promoted a lot of misinformation too. We docs need to recognize it for what it is and be more persistent about weeding it out.

          • auntbea

            An Ivy-League research hospital, too!

          • KarenJJ

            I got the same rubbish from my Australian private hospital midwives.

          • The Bofa, Being of the Sofa

            possibly die, like when you overfeed a goldfish

            “When you feed a fish, never give him a lot. So much and no more, never more than a spot.”

            But he won’t die, he will just grow too big to fit in the bowl, the vase, pots and pans, the bathtub or even the pool.

            “I like this fish, and he likes me. I will call him Otto.”

          • Lynn Ratcliffe
          • Young CC Prof

            Your link appears broken to me.

          • Lynn Ratcliffe

            BREASTFEEDING MEDICINE

            Volume 4, Number 3, 2009

            © Mary Ann Liebert, Inc.

            DOI: 10.1089/bfm.2009.9991

          • D/

            The typical newborn’s stomach capacity is not 5 mLs. If that were the case, it would be necessary to restrict access to even colostrum in many cases. What you are describing is instead the *average* colostrum intake during the first 24 hours. Stomach capacity varies dependent on the infant’s physical size and for the typical newborn is 2- 3 oz.

            Reasonable limitation of formula quantities relates more to ensuring adequate frequency of nursing/breast stimulation to initiate milk production, rather than an infant not accommodating (or even requiring) larger amounts. The ABM protocol you have referenced offers guidelines for suggested intake, but clearly states feeding should be by infant cue to satiation.

            http://www.bfmed.org/Media/Files/Protocols/Protocol%203%20English%20Supplementation.pdf

          • Karen in SC

            See Table 3 of that article for feeding amounts. It’s only the first 24 hrs that’s is as low as 2-10 mL per feed.

          • fiftyfifty1

            You have posted a broken link.

          • Siri

            Can you send babies in the mail if you leave their cords intact?

          • Lynn Ratcliffe

            er NO!

        • JfromNYC

          Where I work, we place the babies skin to skin with their mothers (if the mom wants it and if both mom and baby are doing well.) If the baby starts nuzzling at the breast, we consider that the first breast feeding even if no actual feeding occurs. We find that babies who spend that time skin to skin will breast feed better even if they do not actually eat right away.

      • Lynn Ratcliffe

        if a baby is born full of the naturally occuring hormones of adrenaline, oxytocin & endorphins it will be keen to seek out the breast, just like any other unmedicated baby mammal. See the UNICEF Babyfriendly website http://www.unicef.org.uk/BabyFriendly/Health-Professionals/Care-Pathways/Breastfeeding/Birth/. This is not about lactivism, it’s about newborn & maternal health. If a baby is latched properly & feeds a minimum of 8 times in 24hours & is producing adequate wet & dirty nappies there is no need for supplementation. IF the above is not occurring, then the baby can be supplemented with EBM by syringe or teaspoon. Formula should be a last resort and not used unless the weight loss is over 12% at 72 hours and the mother’s supply is inadequate.

        • Amy Tuteur, MD

          Where did you get the idea that the baby is full of adrenaline, oxytocin and endorphins?

          • Lynn Ratcliffe

            Really?? Adrenaline is released by mother & baby during second stage & then as the head is born there is a surge of oxytocin from the mother, which of course the baby receives ( provided the cord isn’t cut immediately). This is what enables the birth of the placenta & bonding between mother & baby. If the mother has been unmedicated she will have produced endorphins which pass through to the baby.

          • Amy Tuteur, MD

            Your personal opinion on what happens is worse than useless. Show me the data.

          • Lynn Ratcliffe

            This is physiology. It’s not data!

          • Elizabeth A

            In the real world, we have a ton of data on physiology. So maternal-infant “physiology” that is neither backed by data nor familiar to board-certified obstetricians is quite possible totally made up.

          • Lynn Ratcliffe

            Ok ladies. During pregnancy you produce masses of oxytocin. You are already bonded with your baby before s/he is born & know your baby better than any “expert obstetrician”. Oxytocin is the hormone that we produce when we are in love, when we make love & when in labour & when we breastfeed or cuddle our babies. And actually yes, falling in love is about chemistry; the chemistry of our bodies. However you give birth to your baby, you will produce lots. However, it is in lower levels after a planned Caearean birth or when synthetic oxytocin is used (Pitocin in the US I believe. I am in the UK). Pitocin suppresses the naturally occuring oxytocin as it crosses into the brain. This also supresses the endorphins, which is why induced or augmented labours may be more painful. However the levels, of course, rise when you meet your baby, and when you cuddle or feed your baby. Skin to skin increases it dramatically, which is why all babies, when they are ok, are offered unlimited skin to skin contact and rooming in with their mothers here in the UK.There is a ton of work being done on this by Kerstin Uvas-Moberg et al in Norway http://online.liebertpub.com/doi/abs/10.1089/bfm.2009.0001. She has also written a book called The Oxytocin Factor which you can buy on Amazon. It talks about the importance of oxytocin for all lots of aspects of physiology, not just around birth. There is also an over view of the research used by the UNICEF babyfriendly initiative here http://www.unicef.org.uk/BabyFriendly/News-and-Research/Research/.
            Looks like you’re going to be a bit busy catching up on your physiology, Amy.

          • Amy Tuteur, MD

            It is truly appalling that you provide breastfeeding support through the NHS. You lack a basic understanding of science and the scientific literature. Your mind has been filled with nonsense from your lactivists colleagues. You lack the ability to differentiate between science and nonsense, and, most dangerous of all, you actually think you are knowledgeable when you are profoundly ignorant and merely repeating stuff you heard that you liked whether it is true or not.

          • Lynn Ratcliffe

            Amy I think you need to stop getting personal here. I’m always open to new information and research. My work & knowledge is based on the information from my UNICEF training, and from the training I received from the NHS. I don’t have any axe to grind. Id like to know which aspect of my post you think is nonsense as I’m sure the RCOG and RCM would be very interested.

          • Karen in SC

            Begin with the fact that pitocin is chemically equivalent to oxytocin and acts in the body the same way. Then you could link to a paper with data measuring oxytocin levels in baby’s blood before and after birth, before and after skin to skin, for vaginal and c-section births. Then possibly there might by a conclusion to be drawn.

          • Lynn Ratcliffe

            do you know of any studies?

          • Karen in SC

            You stated it for a fact that babies are born with an oxytocin rush, you supply the study.

          • Stacy48918

            “it’s physiology! Not data!”

            Remember when you said that?

            Lady you don’t have a clue and I feel badly for every mother and baby you talk to ever on any topic whatsoever maybe barring which brand wipes to buy.

          • MLE

            Stacy48918, NOOOO! You musn’t wipe off the microbiome!

          • KarenJJ

            I still remember my husband’s cheesy grin and how his voiced catched a little as he told me that we now had a baby girl. No pregnancy hormones needed for him to feel bonded to our baby. The love for our children is so much more complicated then a passive rush of hormones.

          • Roadstergal

            Seriously? You work for the NHS? That does explain a few things. No wonder my UK friend has so much anger over the C-section that saved the life of her and her baby, and is scared of the unmedicated pain and tearing that she thinks she’ll have to just deal with for her second because pain relief is Wrong. No wonder she kills herself to do EBF and AP. People like you have been endlessly feeding her NCB BS with a frikkin’ syringe or teaspoon. It both frustrates me and breaks my heart. You’re a cruel person.

          • Elizabeth A

            Oh how nice! I’m a lady, and knew my babies at the moment of birth better than any expert obstetrician did. They should totally have rolled me off the operating table and had me administer the lung surfactant myself. Then I could have delivered a lecture to the assembled OB and neonatalogy team concerning DD’s heart murmur and its implications for immediate feeding. We’d have saved all kinds of time, and could have not bothered with the parenteral feeding or the EKG.

            Lynn, you’ve stomped in here and been a hundred kinds of condescending. You presume you know what we felt during pregnancy, for example, which is a bit of a shock to me, because I don’t recall meeting you at that time. You assume you know what should properly have been done in lactation consult cases even when you have no idea about what WAS done. You ask us to uncritically swallow your every statement, and accuse the owner of the site of getting too personal in her responses, while you traipse around giving people you’ve never met astoundingly personal advice.

            You seem incredibly uncritical about the information you’ve gotten from the UNICEF Baby Friendly initiative in the UK. You have not considered whether it’s been affected by any particular ideology. You haven’t listened when mothers describe the effects of these policies on themselves and their babies, and you don’t seem to consider that conditions in the UK might not prevail elsewhere.

          • Young CC Prof

            63 mothers, in 4 subgroups, evaluated on multiple factors. Was it randomized? Was there any drop-out or crossover?

            Statistically, that’s worthless.

          • Anj Fabian

            Yes. They’ve done studies on children with autism with oxytocin in nasal sprays.

            [Giggles to self imagining people snorting oxytocin trying to replicate the birth high.]

            At least it’s safer than birth!

          • MLE

            Oh jeez, you know this is going to be the next big thing now Anj. You shouldn’t even think these thoughts because “they” will pick up on the vibrations!

          • Bombshellrisa

            So how do you explain prenatal depression? Depression during pregnancy happens a lot more than is talked about. If oxytocin is so amazing and important, wouldn’t it protect women from depression during pregnancy?

          • Elizabeth A

            For that matter, how does Lynn explain elective abortion? Shouldn’t the oxytocin result in women bonding with their babies, loving them, and NOT aborting them? (When exactly does the oxytocin rush start?)

          • Lynn Ratcliffe

            I think this is really unnecessary. Abortion is not an easy decision & women abort their babies for all sorts of reasons, including medical ones, My own niece was aborted at 21 weeks because she had a condition incompatible with life.

          • Bombshellrisa

            You know, women choose not to breast feed for all sorts of reasons too. It may not be feasible with their situation. But it feels like that will never be a good enough reason and these women are badgered and questioned and treated like they aren’t mature enough to make a decision like feeding their child in a way that works.

          • Stacy48918

            No Lynn. Your unrelenting and willfully ignorant shaming of formula feeding, epidural choosing or C-section needing/wanting mothers is unnecessary.

            Get this Lynn – I’ve had TWO unmedicated births and I CAN’T WAIT to have an epi with the next one. I breastfed my son for a year but I LOVE formula feeding my daughter.

            Your agenda hurts women and babies and is completely unnecessary. Stop it. Go flip burgers or something.

          • KarenJJ

            Elizabeth A wasn’t talking about how easy a choice abortion is/isn’t but that your argument does not appear to be consistent with the reality of what women are going through with their pregnancy and/or bonding with their children. All this fuss over things that may or may not increase a mother’s feeling of responsibility towards their baby (aka bonding). Can’t we just trust mothers to love their kids? Maybe look more into barriers against bonding such as mental health?

          • Elizabeth A

            Posting to endorse Karen’s interpretation. Of course abortion isn’t an easy decision – but the fact that women make that decision is an indication that not all women have the same feelings about all pregnancies. Hormones are never the only factor in how we feel.

          • Lynn Ratcliffe

            perhaps it’s because we lead such hectic, stressful lives nowadays that adrenalin keeps it suppressed? Maybe.

          • Young CC Prof

            Paleofantasy time! Hurray!

            We live more stressful lives than people did 10,000 years ago? Tell me, how many times has an animal or another person actively tried to kill you? How many hours per day do you spend trying to gather enough food and fuel to survive the night? When your child develops a fever, are you afraid that the child will die as you stand by helplessly?

          • DiomedesV

            Women were never prenatally depressed before 1929.

          • Siri

            Is your life expectancy 30 years? Do you suffer constantly from unrelieved pain? Have most of your teeth fallen out? Do you open your bowels in the open air? Do most of your children never reach adolescence? Are you a slave/thrall/serf/peon? Oh, those happy golden days of yore!

          • Bombshellrisa

            Adrenal fatigue? Next thing you know, someone is going to start talking about leaky gut syndrome.

          • Mishimoo

            I ended up changing optometrists because one started going on about adrenal fatigue and trying to sell me some products containing Siberian Ginseng. The woo is everywhere! *sighs*

          • KarenJJ

            Well, ya know, when your gut leaks into your microbiome and fatigues your adrenal you just know you’re going to need some serious homeopathy to quantum all that.

          • Karen in SC

            You will need the QUICHE treatment, of course, or maybe those Liquid Crystals.

          • FormerPhysicist

            Oh lord. I can’t decide if I prefer to hear new woo, or the acquaintance that still goes on and on about candida.

          • Siri

            We do not lead hectic, stressful lives nowadays! We are soft, spoilt, and cosseted beyond previous generations’ wildest imaginings. We have contraception, supermarkets, indoor plumbing, clean water, soft beds, round-the-clock entertainment, schools, kindergartens, modern medicine, appliances, easy transport options, a long life expectancy and an absence of war, famine, dictatorship, theocracy, and most other unpleasant and dangerous things that would have threatened the lives and wellbeing of humans in the past. Most of the stress we experience comes from our own choices – choices that have never been open to people before our highly privileged time and place in history. This level of ignorance/arrogance (poor us modern Western humans, we’re, like, SO stressed!) really riles me.

          • Siri

            Obviously war, famine, et al still very much happen to people in the world today. Do you think Syrian mothers bond less well with their babies because of adrenal fatigue? Do mothers in Gaza need professional help to encourage a strong mother-baby relationship? Aarrrggghh.

          • KarenJJ

            It does feel like midwives are twiddling with the fine tuning dial of bonding by making minor adjustments to “increase hormones” and therefore bonding and breastfeeding and missing the major tuning required that may actually help new parents, like sending parents home well rested and confident in their ability to provide for their child.

          • Siri

            Yes!! And secure in the knowledge that bonding will happen, regardless of epidurals, caesareans, skin to skin, breastfeeding etc etc. Instead of feeling as if becoming a parent is one big minefield of ‘wrong’ choices that, once made, will ruin attachment or at least delay it. Women don’t need a bunch of professionals fiddling with their hormones any more than men do.

          • DiomedesV

            It’s truly amusing to me how someone who is merely a “breastfeeding helper” can manage to be so condescending to all the women here who don’t agree with you, many of whom are scientists, engineers, and doctors.

            But, hey, go ON….

          • The Bofa, Being of the Sofa

            Pablo’s First Law….

          • anion

            Translation: “These are my feels! They’re true because I say so!”

          • Stacy48918

            Ok, chapter and page number in the Neonatal Physiology textbook of your choice. Where did you learn this? What is your source?

            And how exactly do you think scientists and doctors figured out physiology without studies and data?

            You are completely ignorant of both the scientific method, physiology and birth.

          • anion

            Oh, I see. I didn’t love my babies at birth, it was just hormones. I guess if you shot me up with oxytocin and handed me a kitten, I’d bond with it just like with my children and try to nurse it and raise it like my own child?

            Except…darn, I just remembered. Both my babies were born by c-sections, so I guess all those emotions I felt and all that bonding I did with them at birth was just a big fakey fakeout lie. I couldn’t possibly have truly bonded with them because their heads never passed through my vagina and I never had a “second stage,” so all of the necessary elements weren’t in place. Wow.

          • Trixie

            My cat could smell my milk when I was nursing and he’d come running and try to join in the pile. I have no idea whether his mother practiced delayed cord clamping, because he was already a year old when I got him.

          • anion

            Ha!

          • Beth S

            Hey didn’t you know you could breast feed a kitten? Maybe you should’ve given him a squirt.

          • Trixie

            We’re securely attached.

          • Bombshellrisa

            Yeah, don’t you know that an epidural is considered a “gateway drug” and unless you cuddle them and smell in the birthy smells sans hat, they are doomed to never be bonded to you?!
            That being said, my younger brother was born via csection and is by far the closest to my mother. She has had a stroke and had her knees and hips replaced and he patiently helped care for her and supported me when it was my turn. The first few moments after birth are special but they don’t determine your relationship with your children.

          • anion

            Funnily enough, I went through labor with my first (fully dilated, pushed, she never dropped enough for pushing to do anything) and breastfed her when she was less than three hours old; we bonded just fine, but my second, who was a scheduled c-section and spent seven hours in the nursery while I recovered and was given formula as her first feeding before we started breastfeeding, is my total Mommy’s girl. She cried whenever I wasn’t holding her–I literally couldn’t put her down even if she was fast asleep; she’d wake up within minutes and start crying–breastfed and co-slept for seventeen months, and is still my snugglebug baby at almost ten years old.

            I guess we’re some weird unnatural anomalies, like your brother. :-)

          • Elizabeth A

            I am quite certain that it was not hormones that led to my ability to bond with my children. DD was born by emergency pre-labor c/s, and I was absolutely wired with excitement to finally get to meet her, when they finally wheeled me into the NICU. I don’t think the epidural I had with DS shut down any hormone production, but I was completely knackered (and bleeding out) just after he was born. He didn’t become interesting until a few days later. Both children showed clear evidence of being bonded to me before I felt bonded to them. No harm has come to anyone from the horrible specter of delayed bonding.

          • MLE

            You’re reminding me of awful recurring nightmares I had while pregnant with my first, in which I did give birth to a cat, accepted my fate, and had to breast feed around tiny sharp needle teeth, because even in my dreams I was feeling societal pressure to BF!

          • Beth S

            I was thinking the same thing, I didn’t love my youngest daughter because she came out through a hole in my stomach and all those bonding feelings I got were fake out!

          • ngozi

            My son, born c-section, was not placed on my chest soon after birth because he was born bluish. He didn’t cry; he gave out two squeaks. I had 10 minutes with him before he was transferred to a hospital 40 miles away. I didn’t get to see him until 4 days later.

            When my husband and I went to the hospital he was in the plastic box like crib (sorry, don’t remember the name). As soon as my husband started talking my son turned his head towards us and stared intently. We all bonded even though we hadn’t seen each other in 4 days.
            No, several months later we are all a happily bonded family–sisters, brothers, daddy, momma, and baby boy. The only problem now is that everyone is so taken with him that he gets carried around all the time!

          • Trixie

            Derp

        • fiftyfifty1

          “Formula should be a last resort and not used unless the weight loss is over 12% at 72 hours and the mother’s supply is inadequate.”

          Actually there is no proof at all that formula supplementation should be a last resort. Quite the opposite. Supplementing babies with formula immediately upon reaching a 10% weight loss actually has been shown to substantially increase long-term breastfeeding rates. No need to put in time restrictions (e.g. 72 hours) or make error-prone subjective assessments of whether mother’s supply is “inadequate” or not. These just muddy the waters.

          • The Bofa, Being of the Sofa

            Supplementing babies with formula immediately upon reaching a 10% weight loss actually has been shown to substantially increase long-term breastfeeding rates.

            But, see, those babies aren’t “exclusively” breastfed, so that, apparently, means that they don’t count any more.

            Oh sure, if you are happy with babies being breastfed to some extent more successfully and longer, then supplementing early is good. But if you want to wear the badge of EBF, then no formula can ever pass their lips.

          • Young CC Prof

            Kind of like labor induction, actually. Timely and appropriate induction can actually prevent some c-sections, but it’s still not a “normal birth,” so the NCB types are still opposed to the idea.

        • Beth S

          Formula will never ever be my last resort because I’m on medications that preclude me from breast feeding and I am not willing to give up my health and my brain in order to breast feeding.
          I also do not make breast milk. With my last child I didn’t even have colostrum come in, so what was I supposed to do? Are you telling me I was supposed to starve my child? Nope I would rather feed my baby formula than watch them slowly die and people like you shaming those of us who do formula feed is not what we need.

    • Emily

      thanks, I appreciate the definite “no, there is no proof”. It didn’t make a lot of sense to me, and the hospital we were in is a very folky rural kind of place. Im not surprised to see their lack of updated information

  • Junebug

    OT: apparently pretending to be a healthcare professional costs lots of money. Wannabe midwives want to open Kent Wa’s first birth center and by golly they need you to pay for it! “We can’t fool people into believing we are HCPs unless we have lots of expensive looking equipment. Please pay for it!”
    http://www.youcaring.com/other/the-birth-of-a-midwifery-clinic-/187949

    • Junebug

      Another Washington wannabe midwife lost her gear because she brightly left it in her car. Buy her knew stuff cuz, she’s a professional!

      http://www.youcaring.com/other/birth-bag-supplies/210401

      Can you imagine doctors, lawyers, or accountants begging for money to start their practices?

      • Bombshellrisa

        Who leaves their bag (with MEDS in it!) in their car. If it took her a year and a half to buy all the stuff in there, wouldn’t you think she would want to make sure it was in a secure location?
        I can’t imagine this happening with another profession, as a client I would not look favorably at a contractor, plumber or vehicle paint repair specialist approaching me and asking for funds to replace their broken/lost/stolen equipment.

        • MLE

          It’s something I would want to keep quiet at a minimum and cry silently as I shelled out money to replace everything, hoping that no one found out how stupid I was.

          • guest

            What bothers me the most about this is that despite the fact that these bimbo-wannabe-MW’s do stupid stuff like this all the time, so many women just “fluff it off” and then turn around and trust their lives and their babies lives to these twits! I honestly believe people who fall for the NCB/Home birth/CPM crap are brainwashed..

          • Lynn Ratcliffe

            and you’re not? Listen to yourselves!

          • Bombshellrisa

            What makes you think anyone here is brainwashed? Plenty of the posters have had “natural” births, done extended breast feeding, had home births and some have even attended birth center and home births as doulas or midwives.

          • KarenJJ

            I would never take medical advice from the internet without running it past my actual doctors first. Nobody that I can see here is brainwashed and thinking that Dr Amy is the bees knees and able to access “secret” information that somehow escapes the majority of the scientific and medical community. Things I’ve encountered here have been similarly vetted by my own real-life doctors (including advice to not breastfeed while on a medication).

            Honestly Lynn, if you start discussing most of your information being posted here with the current “at the coal-face” anaesthetists, neonatologists, obgyns, paediatricians etc – how do you think you would fare? Are you only being validated by other midwives and anonymous posters on the internet? What do you make of that? Who’s more likely to be spouting information that is divorced from reality?

          • Stacy48918

            You’re right in that we all share similar opinions it’s just that those opinions happen to not conflict with the data. NCB folks don’t usually even have data (“it’s physiology!”), and what they do is poor data (your breastfeeding and epidural paper) because they have no understanding of how to read and critique a study, they just read the abstract hook line and sinker.

          • Lynn Ratcliffe

            My breastfeeding & epidural paper came from a mother info leaflet produced by the Obestetric Anaesthetists’ Association at http://www.labourpains.com. They felt it was high enough quality to include.

          • Stacy48918

            And the Lancet published Wackjob Wakefield’s MMR paper. Publishing something doesn’t make it true. Referencing it in an info brochure doesn’t either.

            The sample size was <200 women – ~60 per treatment group. Any conclusions whatsoever from a "study" like that are statistically worthless. But you haven't actually studied statistics or critically evaluated studies and study design ever so you haven't a clue how to actually evaluate a paper. You just read the abstract (or a brochure!) and "that's good enough for me!"

        • The Computer Ate My Nym

          She left a bag containing, among other things, controlled substances and needles visible in a car? That’s a serious health hazard. Those needles could end up lying on the street somewhere after being used and infecting who knows whom. Medical professionals need to keep control of their dangerous equipment at all times!

    • Bombshellrisa

      Well, between Puget Sound Birth Center building another woo clinic near Valley Medical Center and Terah Leah aka Foothills midwife trying to get the entire city of Enumclaw to fund her “birth center” (remodel a house by St Elizabeth hospital), it sounds like there are going to be a lot more preventable deaths and injuries to moms and babies in King and Pierce counties. Why would anyone go with a CPM when there are midwives at Valley Medical. If you are wanting a water birth in the south sound, St Joseph does water birth (and if it’s not the magical experience you are hoping for, an epidural is available!). Anyway, seems like all these experts in normal birth have a go fund me or are willing to barter their services to have you furnish their birth centers. Take a look at Terah Leah’s wish list for her birth center at foothills midwife’s web page.

      • Junebug

        A friend had a natural birth at the new hospital in Issaquah (swedish?). The place was like the fanciest spa I’ve ever been to.

        The midwife who lost her bag, then doula, attended the birth and had nothing but negative things to say about the hospital. It was mind blowing. NOTHING is good enough for these wannabes unless it is there own substandard care.

        • Bombshellrisa

          Omg-I loved that hospital! I had my baby there in January. Why in the heck would I settle for a plastic pool in my living room when I could have the amazing tub at Swedish? I didn’t actually get to sit in the tub, but I found the setting beautiful and the team who cared for baby and I to be professional and compassionate. I have to say the room service and movies on demand were a nice touch. What was their complaint about the hospital? The nurses who work there mostly came from the First Hill campus, where there are 9,000 babies born a year. That is a lot of births, and the hospitalists cover shifts at First Hill AND Issaquah. Lots of experience. More than any expert in normal birth. Plus a NICU.

          • jenny

            That sounds awesome

          • Bombshellrisa

            It was awesome. The lactation consultants are truly amazing too, breast feeding support as it should be.

          • Junebug

            She was just nagging on every stupid little thing. They just want to drug you so they can cut you, it is better to stay home as long as possible and come in pushing. (Great, so no monitoring at all during labor? To someone gbs+ and whose last baby aspirated mec?) blah blah blah I’m totally up my own asshole.

            My friend knows better, but I still wanted to scream at the doula. IT IS NOT YOUR JOB TO GIVE MEDICAL ADVICE. IT IS NOT YOUR JOB TO COMPLAIN. STFU!

          • Bombshellrisa

            That doesn’t sound like the hospital AT ALL! She sounds like she is reading from the typical NCB guidebook and has no idea what she is talking about. Anyway, if you come in ready to push (I did, but I didn’t know I was in labor) you won’t get to sit in that awesome huge tub with the great views.And I did get the feeling from looking at her doula page that she wants to give medical advice and sound smart.

        • Bombshellrisa

          I just read her DONA essay-not to be “meen” but isn’t she a little old to be doing such scatter brained things like losing a bag or putting it in a place that is less than secure? I think I get why she thought the hospital was bad, they were not letting her run the show. She wants to be a Sherpa and they wouldn’t let her (read the essay cause she likened doulas to Sherpas)

  • anion

    Gah! I seriously just this minute came across the original post, and my immediate thought was, “I have to send this to Dr. Amy!” :-)

    But I’ve been offline for a few days so thought I’d check here first to make sure you hadn’t seen it yet, and…you have. Sigh.

    (I’m very glad you did, it just would have been fun to be the person who showed it to you.)

  • momofone

    I don’t understand the attraction to pain either. When I was pregnant and spewing some ridiculousness about declining an epidural, my mother wisely said, “Honey, when it’s hot, you turn on the air conditioner.”

    • MichelleJo

      love that

  • Sue

    I can understand the misogynistic model, but I wonder whether their behaviour isn’t more simply related to what they can and can’t provide.

    It’s a bit like the ”vitalistic” chiros celebrating the fact that their practice is ”drug and surgery free”, when the reality is that they can’t provide drugs or surgery, so they are de-emphasised.

    The clue is that lay MWs DO try to provide (ineffective) pain relief – through a range of things from breathing to warm water. Isn’t this acknowledgement that they DO recognise the significance of the pain, but just downplay the things that they aren’t able to provide?

    • Young CC Prof

      You know, I was kind of thinking the same thing. That may be why, when a doctor does a study that mentions epidurals in childbirth, it’s a treatment, but when a midwife does a study that mentions epidurals, it’s an outcome. (A bad one.)

    • fiftyfifty1

      Yes, them not being able to provide it is a big part of it. But it’s not the whole story. This idea that going without pain meds somehow makes for a “better” woman, is present in our society at large. C.K. Egbert’s piece wasn’t about homebirth or the midwifery model of care per se, but rather about how these attitudes can be found to some extent everywhere. Nobody even thinks to ask someone whether they had anesthesia for a colonoscopy, it’s a given that it will be offered and almost everyone accepts, and those very rare few that refuse for their own idiosyncratic reasons don’t expect praise. But for a woman in childbirth, there is still a value system. A “real” woman still goes without.

      • auntbea

        Right. NCB still emphasizes going without pain relief even in a hospital setting. Except for c-sections. At which point I guess you already failed.

    • yugaya

      Rum. She was given rum and lied to about her progress after three days of labour and having asked for other options regarding pain management: http://community.babycenter.com/post/a51460417/trouble_coping

      • Stacy48918

        Wow. That is horrific. That poor woman.

        Her original birth story post is quite a bit easier to read…this baby was the result of fertility treatments too. Gah! When you’ve put so much into getting pregnant in the first place, to risk it all on homebirth.

        “Listen to your gut, and if there is any hint of a could be problem, have
        it checked. I so wish i had asked more questions about my bone
        structure when hubby and I went to the fertility Dr.

        Because the tests would have told us I was incapable of natural birth
        thanks to the shape and size of my pelvis. And we would have had a
        different opinion of trying to conceive from the beginning. This birth
        plan could have killed me. And my precious little rainbow baby.

        Who’s gorgeous and perfectly healthy despite our lack in judgment and education.”

        Poor woman. And the midwife will face absolutely no consequences whatsoever.

        • The Bofa, Being of the Sofa

          Listen to your gut, and if there is any hint of a could be problem, have it checked

          I know this sounds nice, but I don’t think it is good advice at all.

          Isn’t this just as easily an excuse to IGNORE problems? “My doctor tells me I have GD, but I eat right and I feel fine. My body is not a lemon. My gut tells me everything is just fine.”

          • The Computer Ate My Nym

            I agree that your (generic “your”, not yours in particular) gut is an unreliable indicator. Mine’s both a hypochondriac AND in denial. Nonetheless, people sometimes feel that something is wrong but talk themselves out of getting it checked out because they have no solid reason for being concerned. In those cases, I’d say, yeah, listen to your gut if it’s saying go in for a check–but maintain a healthy skepticism about its reliability.

          • The Bofa, Being of the Sofa

            I agree, but I think “better safe than sorry” is probably more in line with what you are suggesting.

  • theadequatemother

    I can only beg to disagree on one point…the anesthetic is now much safer than the surgery. Oh and the part about the patriarchy wanting women to get epidurals like good little sheep so they are “easier to deal with” made me snort. Epis are suggests because it is very difficult for compassionate people to see women in pain and not want to do something to help them when you know that you can offer safe and effective help.

    • KarenJJ

      Surely ear plugs would be cheaper and easier alternative for the medical staff then supplying anaesthesia should the staff be feeling annoyed by loud “vocalisations” of women giving birth. It’s almost like it’s about supporting patients and not just about the comfort of the staff.

      • jenny

        Pain is always a priority because pain interferes with oxygenation and stresses the body. A person with a broken bone is going to be offered pain medication not because their groans offend the staff but because it is compassionate to offer pain relief. Is childbirth really different?

        • Stacy48918

          “A person with a broken bone is going to be offered pain medication not
          because their groans offend the staff but because it is compassionate to
          offer pain relief. Is childbirth really different?”
          This is a very good point though. A lot of NCB folks get pissed just for being *offered* pain meds in labor. But pain meds SHOULD be offered simply because it’s a painful condition. You’re free to decline but compassionate care should dictate that pain meds be offered. After all, this is how I treat the dogs and cats I see – I’ve seen a dog flop around and try to walk with a dangling broken leg and not so much as whimper. The dog’s entitled to a shot of hydromorphone not because she’s displaying outward signs of pain but because a broken leg is generally a painful condition.

      • jenny

        OMG. Tone. Sorry, you were being tongue in cheek.

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

          Only partly. When one works in L&D, or a newborn nursery, one does become adjusted to quite high levels of noise.

          in fact, when the screaming stops in mid-geshrei, the staff jumps into action. You can’t push and scream at the same time.

          • D/

            Reminds me of a humbling lesson that I learned a couple of years ago.

            After 25 years of being exposed to the hospital nursery … proudly walked in for the first time with my brand new hearing aids that I had finally broken down and gotten (but only after I was essentially non-functional in communicating with patients) … immediate response was “Holy crap, somebody give these babies WHATEVER they want RIGHT NOW … complete with accompanying finger splaying, hiccuping and gagging response.

            Lesson? I’ve actually been confusing patience and deafness for a good portion of my adult life.

      • Dr Jay

        Save your money…I would bet that 99% of us don’t even hear those vocalisations anymore. The other day I was on DS and we had 4 women pushing up around the same time. I was listening to the screams when it kind of dawned on me just how weird my job truly is. I’m pretty sure that level of screaming and crying anywhere else in the hospital would generate a MET call, and if not promptly attended to and corrected, a law suit. But here we sit in what sounds like a House of Horrors, merrily scribbling notes, chasing results, running about, etc….

        • anne

          As a non-medical person I found my first experience on the labor floor very disturbing. Lots and lots of screaming. Some begging for help from God, that type of thing.

          My husband said that even with the epidural I was yelling while pushing.

          • Amy M

            Even with the epidural, I found pushing quite painful, though I wasn’t feeling pain with the contractions. I was making noise, mostly grunting though, but I screamed once, when they hauled Baby A with the vacuum and I tore. No joke about that ring of fire.

          • Guesteleh

            When the baby crowned I said OW, that really hurts, and my OB responded, yeah, that’s the part where women who don’t have epidurals are screaming. Made me so grateful for the meds.

          • toni

            hm, didn’t make me scream but definitely the worst part. that’s interesting that it can still hurt with an epidural.. did they turn it down towards the end?

          • anne

            I swore to my husband that they turned it down but he said I was pressing the button on the bolus (?) over and over again while in labor like it was my lifeline.

            Even with the epidural I felt a lot, the pressure to push was overwhelming, and it felt like my whole body was involved.

          • MLE

            My epidural was nice in that I could feed the progress being made but the pain was dulled A LOT. So I definitely felt strong urges to push, almost like the baby was going to move and I could help or be in severe pain. Crowning and especially the shoulder twist were painful, but what really scared me were my guesses as to the actual damage down there based on what I could feel, even while drugged to the max (per my request).

          • Amy M

            Yes…one of the doctors here explained it once, though I don’t remember exactly how it went. Something about the nerves higher up were affected by the epidural but for some reason (here’s where it gets murky for me), the ones down in the crotch sometimes aren’t, so its not totally uncommon to have painless/low-pain contractions, but painful pushing.

    • fiftyfifty1

      “Epis are suggests because it is very difficult for compassionate people to see women in pain and not want to do something to help”

      I’m not sure it’s even that, at least not for me. If a woman wants to go without, that’s fine with me. She can scream and cry, but I don’t find that emotionally difficult as long as that is what she wants. I know that husbands and partners find it hard to watch, because they love her, but hey she’s my patient, not my wife and I’ve heard it plenty of times before so whatever. I offer pain relief because it’s the right thing to do, not because it hurts me to watch them.

    • Amy M

      Just for the record, I read that in the comments section of the article, I happily accepted when they offered to place the epidural catheter, so I could get pain relief whenever I wanted after that point. (and I wasn’t being difficult anyway.)

  • Allie

    I’ll probably be vilified for saying this, but thinking back on it, the time I had to suffer through the night with a horrible tooth ache was pretty much every bit as painful as childbirth (which I did without pain relief, not by choice but because it was too late for anything by the time I got to the hospital). No one asks me about the pain relief options at my emergency root canal, although everyone wants to know about my pain relief options in childbirth. People have very curious attitudes about pain and pain relief, perhaps because it is such a subjective experience and people like things that are concrete and objective. I presented a paper about pain relief for dying patients at an elder law conference, which was based on my experience of watching my grandma die in excruciating pain over the span of eight days after taking a bad fall and breaking several bones. She was clearly dying and clearly in pain, and we had to beg and plead for every dose of opiates she got. One of the nurses actually told me “we don’t want her to get addicted”. Are you kidding me? I actually contemplated buying street drugs (we were that desperate), but I didn’t know what to buy or how to administer it and I was afraid of doing more harm than good, although I don’t know how things could have gotten any worse.

    • jenny

      That is horrifying. I am so sorry your grandma went through that.

    • Beth S

      Honestly and this is weird, but the best thing I’ve found for a toothache is a BC headache powder which is just crushed up asprin put right on the tooth and then I let it dissolve there, which is disgusting, but it works. However you’re right, no one questions you if you get pain relief for a tooth ache, broken bone, or kidney stone but child birth is another story.
      My DH’s late wife suffered from RSD (crips) and was on high doses of pain medication until the day she passed away, given to her by an anesthesiologist who went into pain management. Yet every time my DH would go to the hospital with her they’d question her medication dosage, or accuse him of taking her meds. Which if you knew my DH and how anti drug and alcohol he was would be friggen funny. I have a hard enough time getting him to take Tylenol and he didn’t know Benadryl made you sleepy.

    • Stacy48918

      I believe that Dr. Amy has written of her battle with hospital staff over pain medication when her father was near death. I’m so sorry about your grandma.

      ETA: here – http://www.skepticalob.com/2009/03/night-before-my-father-died.html

      • Junebug

        What an absolutely vile story. I suddenly feel exceedingly blessed that most of the people I’ve known that died of cancer were very comfortable thanks to hospice care.

        I am so sorry this happened to your father Dr Amy, and so glad he had someone prepared to advocate for him, and that his final 24 hours were spent feeling great.

    • Deborah

      You’ve probably noticed that it’s TOTALLY ARBITRARY and mostly from tradition what is considered worthy of full-on anesthesia vs just some local or pain meds and lots of gritting of the teeth. For example, bone marrow biopsies and vasectomies — no getting put under for those. But a D&C for a miscarriage? Worthy of anesthesia in many places (but not in others . . . )

      • Stacy48918

        “But a D&C for a miscarriage? Worthy of anesthesia in many places”
        I got propofol, fentanyl and midazolam for mine. Wonderful little nap considering the sad circumstances and that I’d been up all night in pain. The anesthesiologist gave me the option of local and epidural/spinal as well…I said, no thanks, I’d like to be out.

      • fiftyfifty1

        A true D&C (where you really need to dilate and scrape, as opposed to say a quick first tri vacuum which some will mistakenly call a D&C) is for sure a more painful procedure than a vasectomy where a little local shot of lidocaine can make it pain free. Totally not arbitrary.

        • KT

          Not only that, but according to someone I know who was chronically injured during a D&C, being awake means you might move…and catastrophic things can happen if you move.

      • Jen

        My husband has a rule – if it’s between his hips and his knees, he’s going under. He’s an anaesthetic nurse. So when he eventually has his vasectomy, he’ll be taking a general thanks very much. And I don’t blame him!

        • Timothy Renzi

          They gave me so much Valium I may as well have been under. I was chatting with the doctor about global warming and I honestly can’t remember a single thing I said – only the topic. (And it was three days ago)

    • Spamamander

      I am SO thankful that my dad has a doctor who put that stupid concern out of mind. My bio grandfather (who died before I was born) had full systemic cancer as a result of radiation at Hanford, and the docs and nurses would refuse more morphine because he would “get addicted” even when he was in agony. He was terminal! Who CARES?? My dad’s cardiologist allowed him a low dose morphine because it is the only thing that helped his constant pain, only one of his arteries flows at all from his heart, and that one just barely. (They already did a quintuple bypass and a couple of angioplasties). “Addiction” was not the biggest concern, and dad uses it sparingly. My dad also began using small amounts of marijuana which has allowed him to cut the pain meds a lot.

      • Sue

        This ”might get addicted” thing is a very old-fashioned attitude – thankfully gone from palliative care practice. The more common problem with under-dosing of opiates at the end of life is family members who are scared of killing the person with an overdose.

      • Daleth

        Yes, the addiction concern when someone is *dying* is just insane. I’m very glad that when my grandma was dying and we called the doctor because she was clearly in pain, he instantly ordered morphine and said, “At this point, if it makes her a little loopy, that’s not a problem. In her condition maybe it’s even a good thing.”

    • Junebug

      I had the opposite problem. When my grandma fell and broke her hip she was in excruciating pain, but my aunt, her power of attorney, didn’t like how morphine made her “loopy” so she only allowed Vicodin when she deemed it necessary. My grandma was crying all the time. When she left the room the nurses actually asked me if she could have pain medication and I said hell yes. So they doped her up really well for about 12 hours until my aunt found out.

      I don’t understand how it is even legal to do such a thing. I wish I could have gotten a restraining order against her, she was so psycho.

      Eta well not opposite problem, just backwards?

      • Young CC Prof

        I have two things to say to that.

        1) Yes, it is incredibly hard to see your parent so disoriented. But if you can’t handle it, don’t look. Better that than torturing them.

        2) Separately, sometimes elders are actually given too much. During one of my grandmother’s hospitalization, they were giving her a standard adult dose. She weighed 80 pounds! Of course she didn’t have the faintest idea what was going on! Then an elder care expert got involved and found a regimen that made her comfortable AND oriented.

      • Kerlyssa

        God. I’ve seen adult children do this during hospice care. ‘You’re killing mom’. It’s refusal to accept the inevitable, that she’s dying and will be dead by next week either in agony or medicated comfortably. You see it a lot more in parachute relatives that don’t actually live with the person in question.

        • Dr Kitty

          Often enough when people are actively dying, and clearly (to me) have hours or days left at the outside, we’ll put up syringe drivers with morphine and midazolam and levomepromazine in them. Dying person will proceed to die, peacefully, in the next day or two.
          Sometimes they die within hours of the syringe driver going up.
          Then I have the “those meds killed grandma” conversation, and I have to explain dual effect and that ethically, if speeding up death is an unintended side effect of ensuring a painless, dignified death, it is OK, and really, did they want grandma to suffer for the last few hours of her life?

          • Dr Kitty

            Oh, I did have someone tell me that she was worried we would increase the doses and bump her off, and I asked her if she was happy with the current doses ( she was) and I showed her the prescriptions and explained that I wouldn’t increase the dose unless she wanted me to, and that she could keep the prescription sheet herself and check the doses with the nurses.
            She was happy with that and passed away a few days later without any dose increases.

          • Kerlyssa

            The last one, sadly, wasn’t even this sort of situation. She was on a half dose as needed (ie, for when she was getting changed/re positioned in bed, and the movement caused her pain). It actually improved her blood ox while it was in effect. Guilt from neglecting mom converts to attempting to take control of treatment during the end, imo.

      • toni

        that’s terrible. I didn’t know power of attorney superseded the grantor when it came to those sort of things. unless she was non compos mentis(?) but presumably she was at least conscious if you could see she was in pain

    • Anna T

      I can totally sympathize. I cried, moaned, drooled, beat my head against the walls, swore “never another baby again!”, wanted to throw myself out of the window, nearly passed out… I felt completely incapacitated and nullified as a person… during labor? Nope; during an especially horrible attack of pregnancy-induced headache. I kid you not, it was THAT horrible. If someone walked in then and offered me adequate, safe pain relief through a pill, gas, I.V. or whatever, I’d accept with tears of gratitude in my eyes, whatever it was. Just stop the pain. Unfortunately anything safe to use during pregnancy was inadequate. We all experience different kinds of pain in different ways, and for someone a headache, a toothache, or a broken limb will be much worse than labor pain.

      Informed choices and adequate pain relief for those who need it, when it is needed.

  • Guest

    Wow! This is a little extreme! Shouldn’t feminists embrace that women are strong and capable of deciding to have a natural childbirth, should they choose to do so, just as they are capable of deciding to have an epidural? I truly don’t think that most women who choose natural childbirth are doing so in subordination to anyone?!?! I have had one labor with an epidural, and 2 natural. I was very fortunate to have uncomplicated labors and quick deliveries. The natural labors were my choice for many reasons, none of which involved any type of sadism, bullying, or judging. 100% my decision. I would have had an epidural or c/s if it would have been needed. I enjoy this site, and I understand the passion behind educating people about dangers of home births, of different capabilities of midwives, and supporting the standard of care that doctors and hospitals provide. But does there really have to be the natural labor bashing? Isn’t that like stay-at-home moms and working moms duking it out unnecessarily? So, some women get epidurals. Some women don’t. BTW, I am a physician as well.

    • Amy Tuteur, MD

      Sadism is celebrating pain. Natural childbirth advocates celebrate pain. There’s nothing feminist about glorifying women’s agony.

      If you don’t want to have an epidural, don’t have one, but don’t expect anyone to be impressed that you refused pain relief. It’s as impressive as refusing novocaine for a root canal.

      It is not “bashing” unmedicated labor to be thoroughly unimpressed with it.

    • jenny

      I’m not a doctor, just a mom who has had three unmedicated births. I don’t think this is bashing unmedicated birth, just pointing out that when women’s pain is idealized, that doesn’t leave much room for compassion. It’s the Angel in the House mythology all over again.

    • LibrarianSarah

      This article (and blog for that matter) is less about an individual woman deciding that she doesn’t need or want an epidural for herself and more about a culture that views labor pain as a test of maternal worthiness and getting an epidural a failure of that test.

      If an individual woman decides that she does not need or want an epidural she has the right to do so. However, giving bith withoU an epidural does not make a woman “stronger,” “better” or “more educated” than any other mother or woman. No one is going to vaginally birth you a medal for going “all natural”and by the time your kid reaches adulthood he/she isnot going to give a damn.

    • Deborah

      The root of my poor skills at supporting natural childbirth is that I am a bad liar. I had a patient recently doing a natural labor (with her first!) and it was going hard and fast, and she was doing AMAZINGLY. So, I tried to be supportive — “I promise you this is really as bad as it gets.” But then I remembered — “Well, except for the part where the head comes out.” She did the whole thing with amazing fortitude, but I just couldn’t encourage her with anything that was stretching the truth, or plain lying, which I think a lot of midwives and doulas might do when counseling patients about their labors.

      • Cobalt

        I wish I had that kind of simple honesty at my unmedicated births. I found the cheerleading super irritating. I wanted information, data, progress.

      • Kerlyssa

        Bless you for your honesty. Professionals who pussyfoot around because they don’t want to upset me really aren’t helping.

    • Stacy48918

      I had an unmedicated birth because (at the time) I thought it was “best”. That I was drugging my child if I got an epidural. That I was harming my child. I DID think I was STRONG for having an unmedicated birth.

      I know better now.

      Good for you that you made your decision “independently”. Most women pursuing a natural birth do so because they think epidurals are “bad”, “harmful” or evidence of “weakness”, even if the OB/nurse didn’t push them into it.

    • auntbea

      If you want us to believe you like this site, Guest, you would drop the “natural labor bashing” canard. No one is bashing natural birth. No one cares if you had a natural birth. (Seriously. No one cares.) We care that there are people who either tell women that pain control is bad/dangerous or that they will be better mothers/warrior women without an epidural. Do you do that? If so, you are a sadist (plus anti-feminist. ) If not, allow me to reiterate: no one cares.

      • Guest

        “Be kind; everyone you meet is fighting a hard battle.” –Ian MacLaren
        “When words are both true and kind, they can change the world.” – Buddha

        • Who?

          No one here bashes natural labour. They bash elevating the experience of natural labour above safe delivery of a healthy child; they bash lying liars who lie who pretend that ‘trusting birth’ gives outcomes that are superior to those resulting from qualified medical care; they bash home birth providers who shun loss parents when they dare to return with questions or stories.

          The people who get bashed here don’t speak the truth, they share anecdotes and mistaken (that’s me being kind) beliefs-anyone who speaks or supports the speaking of lies that seem kind is living so far from anything that Buddha intended that it is simply perverse to suggest otherwise.

        • KarenJJ

          So, do you disagree with Auntbea or agree?

          Or should Auntbea only say supportive, nice things like good women do?

        • auntbea

          You’re right. I was mean. Both tone trolling and strawmen are tiresome, so I won’t apologize for calling you out on that, but my vitriol was more the result of my bad mood than your comment. However, in the future, there is no need to make the Buddha (or otherwise-obscure Scottish pastors) responsible for making your point for you. A simple “Hey, that was mean” would be more than sufficient.

    • Box of Salt

      Guest “Shouldn’t feminists embrace that women are strong and
      capable of deciding to have a natural childbirth, should they choose to do so”

      Women are strong and capable of making decisions. The realities of childbirth have nothing to do with that.

      “But does there really have to be the natural labor bashing?”
      Sure: that will stop as soon as you quit cheerleading for your “very fortunate to have uncomplicated labors and quick deliveries.”

      “BTW, I am a physician as well.”

      I sure hope you made that up for posting, because the rest of your comment suggests your bedside manner would rival that of any 1950’s era patriarch.

  • KarenJJ

    I’m always interested to read feminist ideas on childbirth but I haven’t really been following it much over the years and when I have read it I always got the feeling that it’s been missing the mark. I’ve felt that feminism seemed to treat childbirth as a lifestyle choice at best or an inconvenience at worst. I’ve start to feel that the right to reproduce is as great a right and as great a human need as the right to earn a living and that the freedom to provide care to a young infant is as great a right the freedom to work. Currently the answer I’ve seen from feminism is to try to “talk up” the importance of motherhood and caring for babies and completely overstating the case from the infant’s perspective instead of their own needs (e.g. NCB and AP practises).

    It’s one of the reasons I support the Australian Prime minister’s Parental Leave proposal of paying women a proportion of their salary. It recognises the right for women to be high earners and primary family providers as well as give birth and care for an infant for the first six months. Of course the stupid man termed it as allowing “women of calibre” to have babies – which immediately put lower earners and stay at home mothers off as not being “of calibre” and also annoyed high income women by basically reducing their rights to their ability to breed babies of “calibre” and thus the discourse surrounding the policy has not touched on any of that in the mainstream media…

    • Sue

      Well-said, Karen. Personally, I think the Oz PM is shaping the policy to suit his (priveleged) daughters – which shows insight of a kind, but shaped by his underlying ideals and life experiences.

      I do agree with you, though, that, although having children is clearly a choice, at least SOME women from all social backgrounds will have children as part of a human desire or even instinct. That means we have to shape our society to incorporate it – not ignore or reject it.

      • KarenJJ

        Yes – that motivation of the PM has crossed my mind too.

    • Who?

      Thing is that most of the women in the ‘women of calibre’ category are already getting generous paid parental leave from their employers, who provide it as an employment incentive. So the very companies that are already providing generous ppl will have the privilege of paying a levy to lose their competitive edge. Way to be business friendly!

      And since there are no proposals to do anything about the childcare system, I don’t see it improving participation greatly either.

      So long as this whole parenthood/participation thing is treated as a women’s issue, we are nowhere.

      • Stacy48918

        Sounds like he’s just repackaging and regurgitating Grantly Dick-Read’s philosophy – that upper class women are committing cultural suicide by not having enough babies and so they must be incentivised to have more of them than do women of lower class.

        • Who?

          He’s a trick, no question, though is modest enough to freely admit to not being the suppository of all knowledge (yes, that’s what he said).

          I doubt he’s heard of GDR but he certainly behaves as though he thinks ‘the ladies’ have their place and should be happy to stay in it.

          • Stacy48918

            “not being the suppository of all knowledge”
            WOW. Is he related to GWB? Sounds like something he would say. Haha.

          • Who?

            You wouldn’t be the first to wonder, the parallels are not perfect but are disturbing in many ways.

        • toni

          does sound a bit creepy but it is in a nation’s interest to if not encourage at least not deter their more educated/productive citizens from having children.

    • auntbea

      There is a very fine line for respecting the contribution that women make to society by mothering their children well and setting up motherhood as the ideal role of women. Any time I hear someone talking up the importance of motherhood I wonder what type of anti-woman policy they are about to try and justify.

    • Anka

      I like what you said about the right to reproduce. I’m a feminist, and
      I’ve been feeling that very strongly. I just, well, reproduced after
      moving out of the U.S. to a family-friendlier country; I was very aware
      at work that at my level I’d lose my job if I had a baby (it happened to
      others). I’m looking for work, and I miss that work–it was
      high-powered, intellectual, exciting, and fairly well-compensated–but
      it did not really allow for the formation and maintenance of any human
      relationships outside of work, or any kind of self-care. This “but
      what about your CAREER” stuff, while relevant, also seems to downplay
      the physical and emotional costs of returning so soon after having a
      baby in the US, and minimizes the right of everyone, male or female, to have a life outside of work. Not to mention that many
      jobs in this current economic climate are not so thrilling and fulfilling that you don’t need to go home sometimes, or to a doctor’s appointment, or to a family gathering, or turn your phone off at night sometimes–all things that were frowned upon in my old workplace. Telling people who are only working in thankless, dead-end jobs to survive that they should think about their CAREER seems sort of out of touch to me.

  • jenny

    I noticed in the comments of the other post, that “epidurals are incapacitating.” Well shit. Mindblowing pain is also incapacitating.

    • MLE

      One is mentally and physically incapacitating (at least for me), and the other is only physically incapacitating. I prefer the epidural so I can get out of the now and think about something other than how to get through the next “wave.”

  • sadlady

    Something I have heard from a Christian NCBer is that the word “PAIN” in the Bible is the same word as “TOIL” in the Genesis verses “I will increase your pain in labor” to Eve and then for Adam “I will increase your toil at harvest”. Basically what she was saying is that childbirth doesn’t have to be painful because that isn’t what God really meant. Only in the English translation do we put Pain for women and toil for men with the same word. And then she added that the word for childbirth meant all the rearing as well. Then she pointed out that childbirth and rearing is indeed a lot of “toil” and hard work. SHe was more a believer in the fear-pain cycle and was adamant that pain in the body exists exclusively to alert you of a problem, and reproduction/delivery could not possibly be a problem, because it is necessary. She asked me at what other time is there pain when there is no actual bodily problem and malfunction? I couldn’t think of an answer at the time, but now that I think about it, menstrual cramps are pain, but something good and natural for your body is happening, the uterus needs to contract to flush out the old, and sometimes, for some women that can hurt. But some women are lucky and do not suffer from cramps, or just have painless ones. So no I don’t think all NCBers believe pain in childbirth is good for women, some version of them believe pain does not exist, or it exists only in the mind when your fear-pain cycle is amped up. SO no, I don’t believe that all NCB philosophies are sadistic, but rather unfortunately hopeful that it shouldn’t hurt in the first place…

    • LovleAnjel

      Building muscle causes pain, that’s why you hurt after a good workout. Your body literally tears down and rebuilds itself.

    • araikwao

      But the definition of pain is “…in response to actual or potential tissue damage”, and your uterus et al hurts like crazy during a contraction because of hypoxia. If it continued, there would be tissue damage.

    • Cobalt

      The fear/pain cycle is certainly something I deal with. Whenever I am injured and waiting at the ER to find out how bad, I find the pain to be much worse before imaging and diagnosis. Even when nothing else changes, just knowing that nothing critical got busted up reduces my fear and pain.

    • Stacy48918

      I’ve heard the Eve-pain argument from Christian folks before too – which is ridiculous because they will set up a birth pool in their living room, specifically to help with the pain of labor…but an epidural is a no-no. So you’ve got a verse in Genesis 3 on the pain of childbirth. Give me chapter and verse that says the pool is ok but the epidural isn’t. It’s nonsense.

    • Amy Tuteur, MD

      No, that’s not true.

      The Hebrew words in the two statements are different. Women bring forth children “in sorrow (or pain)” and men bring forth bread “by the sweat of their brow.”

      • Stacy48918

        Do you know the Hebrew/Greek word for what’s translated as “travail”? Birth is often referred to as “travail” in the Bible as well.

        Personally, I don’t have a problem with “bring forth children in sorrow”…having children has completely changed my brain with regards to things I can read/watch/think about. News stories about kids…even just reading Exodus 1 for crying out loud (my first is a boy). I never had a problem with these things before but sometimes I read or see stuff and I’m right THERE as a mother, and it’s my child and the pain and sadness…I never thought those things before having kids.

        Anyway…I think the “sorrow” of bringing forth children can extend so much farther than just the birth itself.

      • Alcharisi

        Actually it depends on which statement you mean. The word used for the woman is “itzav”, (Gen. 3:16) which also comes up in the man’s curse–the phrase translated as “by toil you shall eat of it” (JPS) is “b’itzavon tochalenah” (Gen. 3:17). But the phrase you mention, “by the sweat of your brow shall you get bread to eat,” (3:19) is indeed a different Hebrew word.

    • Sara

      It’s correct that the word origin is the same for Adam’s curse and Eve’s curse “atsab” but the actual words used are slightly different, and I can’t comment on the significance of that because I have no clue.

      But, I do think it’s interesting that woman is expected to suffer through her curse, but man has all manner of technologies that are acceptable for dealing with his. Ultimately, the fact that there is a curse applied has no bearing on how it is to be dealt with. Because Adam must face agriculture with the problem of weeds, does that mean he shouldn’t use weed killer, tractors, etc? And if he does, has he thus eliminated the curse? To either of those questions, I’d say the answer is no. Making improvements hasn’t eliminated the original problem.

      So why should women making improvements in pain management be seen as somehow defying the original curse of Eve? That we’ve made improvements doesn’t mean the problem has been eliminated (ask any woman whose epidural has failed, or who simply could not get one for whatever reason.) The curse is still there, but managed as well as we can.

      And finally, so what if we totally wipe out the suffering of the curse? Is that an offense to God? I don’t see anything in scripture that says if a woman feels no birth pains, she has offended God.

      I had to go study this for a bit because it’s so disturbing. One of the Christian Childbirth websites I found refers directly to Grantley Dick-Read and basically implies that a Christian woman’s salvation hinges on the amount of peace with which she experiences birth. Because unrepentant sin leads to birth pain…

      • Stacy48918

        “Because Adam must face agriculture with the problem of weeds, does that mean he shouldn’t use weed killer, tractors, etc?”
        THIS, exactly! With the possible exception of the Amish (though they exist on a huge spectrum and I don’t think that they eschew technology because of the “curse”) few people espousing the Eve-pain argument would be ready to ditch their chainsaw and riding mower because they thought they needed to sweat some more. But women MUST experience the pain of labor – it’s their curse.

      • Staceyjw

        Eves curse is an excuse and a justification for continued hateful misogyny, an excuse to keep women as chattel with zero rights, or at best, second class citizens.
        It really is that simple.

        • Sara

          Meh, I’ve felt the pain of childbirth. I’d say the curse of pain in childbirth is as easily observed as the thistles in the field.

          That pain isn’t exactly invented by men/women-of-the-patriarchy “to keep women as chattel with zero rights, or at best, second class citizens.”

          • LibrarianSarah

            When Stacey referenced “Eves curse” she was referring to the idea that labor pain is something that is deserved not labor pain itself.

            Personally I find it ludicrous that in the year 2014 we are still talking about this Adam and Eve thing as if it actually happened.

          • Beth S

            I always thought Eve’s curse was PMS and periods, or at least that’s the way my church always interpreted it, however I do remember telling my stepdaughter that Eve could go shove that apple up her twat for all I care I want the epidural and I want it now!
            She was just trying to get my mind off the pain, and I felt so badly afterwards I apologized, but still in that moment I was pissed, hurting, and about ready to twist DH’s balls off and feed them to him raw.

          • Amazed

            Your church isn’t alone in that. I can swear that peridos are Eve’s curse. Fortunately, Saint Alberto (Perez) found the counter curse (works for me) and sent an angel (my zumba instructor) to take care of me.

            I do get the feeling that “woman issues” like periods and labours are brushed away as no big deal, it’s just how it is. At the same time, men are not being terribly quiet if they get hit in the balls! But hey, there is no problem if a hit comes between MY legs because I have no equipment down there… at the same time, it’s no biggie if a strike lands in my chest area despite the ample equipment I do have there (not so ample now, alas. If someone knows the recipe of losing weight without breasts being the first thing to go, please share.). For the record: both times it HURT like hell!

            Same thing with epidural in birth. Why don’t we offer the patients needing renal calculus removed this chance to be heroic?

          • Cobalt

            This reminds me of a riff Dan Savage has about using terms for male and female genitalia as slang. The point of it is that we have it backwards in common usage. Testicles are weak, vulnerable and delicate, whereas female bodies regularly cope with penetration, menstruation, pregnancy, birth, and breastfeeding.

          • Amazed

            Precisely! The case with the heavy dictionary left on my (bent up) knees as I was asleep was very enlightening. I am supposed to take care not to hurt anyone’s equipment, as long as they are male. But when it comes to me? My equipment doesn’t stick off me in like theirs does, so I am a free game. No one even thinks that hey, women might feel pain down there too!

            With such cultural attitude, it’s no wonder why labour pain is just something women have to plough through.

          • Sara

            That’s how you and probably many others feel. It’s not “that simple” for people of faith. I doubt anyone is going to stop perpetuating natural childbirth according to their faith simply because some consider it misogyny. My point above is that it’s really not supported by Scripture, either.

            As far as Eve deserving the pain, Genesis 3 is not about how bad Eve was (it’s not like she committed murder, she just ate fruit.) It’s about God’s sovereignty. The worst curse in the Bible– death to all generations– came from an act of disobedience by two ignorant people. It’s a pretty severe punishment for the deed. Anyone who argues that Eve alone was uniquely bad and deserving of punishment has a flawed theology.

          • LibrarianSarah

            People “of faith” have been rationalizing and reinterpreting their religious texts for 2000+ years. The bible is basically a big book of multiple choice that can say whatever the reader wants it too. You say that the bible does not support NCB a Christian NCBer will say the opposite and both of you could support your opinions and if you can’t you would find a way to spin it so it does. God never seems to disagree with the believer.

          • Sara

            The Bible says what it says. It doesn’t comment on NCB. It just references birth pain. I’ve never heard a Christian NCB woman say that the Bible directly tells women to eschew pain relief in childbirth. Yet they go on to promote that idea, with references to passages like Gen. 3:16, without direct scriptural support for their preference. I haven’t interpreted anything differently from what they have, I’ve just pointed out where they are using scripture and where they aren’t. Humans have various preferences and opinions. That has nothing to do with the Bible and everything to do with how our minds work.

          • LibrarianSarah

            The bible says what it says and a lot of what it says is vague, contradictory, or ignorable. People take the verses they like that talk about loving your nieghbor and ignore the ones about stoning unbelievers, gays and unruly children. People have preferences and opinions but they use a book that they say is either inspired by or created directly by an infallible deity to selectively prop up their own own opinions and everyone else just has to pretend to take that book seriously as anything but a piece of literature or mythology.

            It is about time that people in this country stop accepting bible quotes as arguements on anything other than the bible itself. Origin of the Species was published more than 150 years ago. It is pretty much settled fact that humans and all other creatures slowly evolved over millennia. There were no talking snakes, or apples or people named Eve or Adam involved. If believers want to talk about real life things like childbirth they should do so using real life things like evidence to boost their arguments not fairytales.

          • Sara

            So unbelievers can talk about Adam and Eve without any real theological understanding (e.g- C.K Egberts argument), but when believers do it’s it’s wrong and bad and ludicrous. Fair enough, but just so you know I’m not the one who brought the subject up. Cheers.

          • The Bofa, Being of the Sofa

            I could say that goes both ways

            You could, but you’d be wrong.

            If unbelievers want to talk about real
            life, maybe they should stop trying to engage or condemn believers by
            bashing Scripture and just get back to the facts.

            If believers didn’t bring up the bible, the unbelievers wouldn’t have anything to “bash.”

            You sound just like those who say Dr Amy is anti-breastfeeding or is anti-NCB.

          • Sara

            “You sound just like those who say Dr Amy is anti-breastfeeding or is anti-NCB.”

            Which statement, exactly?

            “If believers didn’t bring up the bible, the unbelievers wouldn’t have anything to ‘bash.’”

            So here’s how I see it: a Bible story was referenced in C.K Egberts piece and I posed a few questions wondering how Bible-believing NCBers support their position with Scripture, because I don’t see it. It was brought up by an (apparent) unbeliever. Not that I regard the Adam and Eve story as purely biblical, because it is also a cultural story as well seeing how most people in the west are familiar with it enough to reference it without even telling the story.

            Then “bashing” commenced. By saying that I’m not referring to the original piece or Dr. Amy’s comments. I’m referring to LibrarianSarah derailing the topic from childbirth to how wrong Scripture is and how bad Christians are at reading comprehension. Or whatever her point was.

            I don’t care if unbelievers want to talk about the Bible and complain about its apparent misogyny. But whenever I’m told that there’s no space for me to talk about it, even though I actually study it on a regular basis, then that’s when I say it goes both ways. We can either discuss it together, or we shouldn’t discuss it.

            I’m not going to have much respect for someone who demands that I can only talk about “real life evidence”, yet gives herself freedom to talk about the subject from every angle. How patronizing. If it’s about evidence then let’s talk about that. If you want to talk childbirth theology, then let’s do that.

            But if the issue is just that I’m foolish for believing, then I get the point. Whatever, let’s move on.

          • The Bofa, Being of the Sofa

            “You sound just like those who say Dr Amy is anti-breastfeeding or is anti-NCB.”

            Which statement, exactly?

            “I could say that goes both ways”

            It “goes both ways” in the same way that Dr Amy opposes lactavists and NCB-pushers. IOW, it doesn’t go “both ways” at all.

          • Sara

            So unbelievers should not have to present evidence when discussing “real life” (ie.- not Biblical) topics?

          • Box of Salt

            Thank you, Librarian Sarah.

            This brings to mind the scene from Firefly when River Tam cuts out passages from the Preacher’s Bible to eliminated the contradictions.

            For the less geeky: Firefly is the series which inspired the movie Serenity (Joss Whedon, also creator of Buffy the Vampire slayer). (And, yes, I’m also the geek who knows which Star Trek series did actually use the transporter to beam out a live baby.)

      • Sue

        Whatever the precise intent of the original words, the overhwhelming fact is that, for almost all women around the world and throughout history, labour and childbirth hurts. A lot.

        Whether it was designed/intended or just evolved that way is immaterial to the fact that it HAPPENS.

  • Amy M

    What I find interesting, in the comments, is that several women there are associating epidurals and the lack of pain with subservience to the patriarchy. They seemed to believe that even if they asked for the epidural (in at least one case), they were then viewed as “good little sheep” by the various medical staff around. So, in the mind of a woman like this, avoiding pain relief is rebelling against the man, because a laboring woman in pain would be more difficult to deal with. Of all the reasons to be opposed to epidurals, that seems up there for one of the weirdest.

    Meanwhile, the actual writer of the article was arguing the opposite: that the patriarchy has been convincing women that pain is good….which would mean the patriarchy is working at cross purposes with itself, because the goals of having women suffer in labor and having women shut up and be docile in labor, are mutually exclusive where an epidural is concerned. Unless the patriarchy is being really insidious and just convincing the women not only to suffer, but that it was their OWN IDEA and they are actually being rebel warrior mammas.

    Regardless, I think a lot of the commentors missed the point.

    • TsuDhoNimh

      “several women there are associating epidurals and the lack of pain with subservience to the patriarchy”

      Here’s the question to ask … would having an epidural for pain control during knee or ankle surgery be considered “subservience to the patriarchy”?

      I had a nerve block (similar effect to epidural) for minor wrist surgery … was I a “good little sheep”?

      • Amy M

        Excellent question! My mom had an epidural for knee surgery, though not for childbirth because they weren’t widely available back then. I think she just wanted pain control, as far as the knee surgery went. And since her knee was in bad shape, she wasn’t in any shape to lord it over anyone else, so by default she was a “good little sheep” because she couldn’t even walk for a few days.

    • The Bofa, Being of the Sofa

      I find the concept of “embracing pain” to be extremely _masculine_ on the whole.

      When I think of embracing pain, I think of tough guys like Arnold and Sly Stallone, who take a beating but persevere at the end. Pain is for the weak. Strong guys don’t let the pain bother them.

      As a guy, this is what I’ve heard my whole life. Personally, I hate it, but then again, I am a “weakling.”

      I just find it odd/interesting that women are taking an attitude that is more like men. And somehow, that is considered feminist, but that is a different issue.

      Of course, the reality is that, when it comes to brass tacks, men are perfectly peachy not feeling the pain. But hey, dealing with pain proves how “tough” you are.

      • Sara

        “Pain is weakness leaving the body.”

      • jenny

        Nah, women enduring pain/discomfort is a pretty longstanding expectation of femninity in Western culture through the denial that women feel pain, or that it is a maternal or wifely duty to subordinate ones own needs to one’s offspring or one’s husband. It’s different from the expectation of maculine toughness.

        • Karen in SC

          “Beauty knows no pain” – high heels, bras, corsets, brow plucking, bound feet, etc etc.

          • jenny

            Indeed. See also women submitting to abuse because God made man the head of the household, women staying in abusive relationships “for the kids” and everyone’s favorite racist, misogynist myth of women picking cotton and squatting to give birth in the fields then getting back to work.

    • fiftyfifty1

      “So, in the mind of a woman like this, avoiding pain relief is rebelling against the man, because a laboring woman in pain would be more difficult to deal with. ”

      So basically they are saying that they are only able to cause trouble and rebel against The Man when they are in such excruciating pain that they are unable to hold back any more? That as soon as they are out of pain, they go back to their typical subservient state and lose their courage to speak out?

      That’s really weird. I myself can choose to be troublesome whenever I want. I don’t have to be in pain in order to give myself permission to speak out. Those poor women must really be repressed.

      • Amy M

        I guess. I’m sure if you put it like that to them, they would huff and get all in a stew about it, and claim to be difficult rebels against the man all the time, and this was just one more way. ‘Cause being a spiteful pain in the ass as much as possible is a great way to overthrow oppressors.

        • fiftyfifty1

          Spiteful is about right. As in cut off your nose to spite your face.

          • Daleth

            Or cut up your vag to spite your OB, as the case may be.

  • TsuDhoNimh

    “They believe that women are improved by agonizing pain, and diminished by relief.”

    Pain doesn’t improve a darned thing!

    And yes, they are not only sadists, but demeaning demoralizing bullies who denigrate women who decide that if pain is optional they are going to opt out.

    Pity they can’t be hooked up to a device that shares the sensations the woman in labor is feeling – in the way she’s feeling them. then we’d see how empowered they are.

    • Amy M

      They can actually—there is a device designed to make men feel pain to give them an idea what women go through. I saw a news article about it….http://abcnews.go.com/blogs/lifestyle/2013/01/men-suffer-pregnancy-pains-in-labor-simulation/
      Here.

      • Medwife

        Bah! Talk to me when they put the mens’ pelvises in a vise and squeeze with each “contraction”. Abdominal pain isn’t half of what childbirth is made of, at least it wasn’t for me.

        Also some rectal stretching would make it more realistic, too!

        • sour_sadie

          You know that would be an option, but then again, I also think if men were able to carry a baby for 9 months, most of them would opt for the C-section. The only difference is that insurance companies would bend over backwards to cover that procedure for men than they would if it were done on a woman.

          • Staceyjw,

            If tomorrow, men suddenly had to have the babies, there would immediately be an effort, in excess of what it took to develop the nuke, or win the space race, to find a way to make this totally easy and painless for them.

            By weeks end, we would see tens of trillions being spent on: developing artificial wombs so their lives wouldn’t need to be interrupted or risked, medical technologies to mitigate any inconvenience and pain, bringing high tech medical care to Dads in developing nations so there is no paternal mortality, providing extended fully paid paternity leave, providing monetary/food/housing stipends for all dads, creation of worldwide labor laws protecting the jobs of any man pregnant/on leave/with kids, mandating unlimited paid time off to care for sick kids, and an abundance of media celebrating how wonderful these men are, and redefining fatherhood as the most important job worthy of payment all on its own.

            You know, all the things women should have today, and could have even under the current system of patriarchy and capitalism- If only we were seen as fully human, equally important, or just worth investing in. The above are all worthy goals, and would improve the lives of women worldwide.

            But as a rad fem, its not enough. I want more than a legally mandated approximation of equality, in a system that was made for men, and still serves, male interests, and the expense of women. Instead, I want to be liberated from patriarchy all together, where we could build a new way of doing things that takes the needs of women into consideration, instead of shoehorning womens needs into the current system.

          • Amy M

            Would women still be having babies too, or would the roles be totally reversed?

        • fiftyfifty1

          Oh whoops, my Empathy Device ripped your levator ani off your ischial tuberosity. Sorry dude, It’s a bummer when that happens.

  • Staceyjw

    This.
    All of this.
    Finally, a feminist response to NCB. Cant wait to read the whole thing.

  • Rita Rippetoe

    Question for Dr. Amy. Have epidurals improved materially since the late 70s? I remember reading material that implied that splitting headaches were a common side effect. I figured that enduring pain during labor was better than a headache with a baby to care for. The other pain relief available at the time was believed to have adverse effects on the baby–i.e. general anesthetic leaving the baby dopey. There was another type I don’t recall the name of that prolonged labor because the mother was unable to feel the urge to push?

    • attitude devant

      It’s actually less than one in 200. Interestingly the risk of rupture at VBAC is higher, and the consequences more dire, but natural childbirth activists are pro-VBAC and anti-epidural. Go figure.

    • Cobalt

      I’m not a doctor but I know epidurals are way better than they used to be. Less medication, better targeting (only numb where it matters, not everywhere), generally some mobility is retained, and fewer side effects. At least for labor/vaginal delivery. Cesarean epidurals are stronger and block a lot more.

    • Guesteleh

      When I had an epidural seven years ago they lowered the amount of medicine I was getting when I reached the pushing stage and I felt everything just fine. And from what I understand epidurals have gotten even better so you can move around during labor.

    • Karen in SC

      Since that was over 40 years ago, I am sure the answer is yes.

    • TsuDhoNimh

      ” I remember reading material that implied that splitting headaches were a common side effect.”

      Uncommon, even then, as long as the person who got the epidural took the “stay flat” advice to heart. Sitting up after one was the trigger for the headache, and not everyone believed the anesthesiologist.

      I drew lots of post-partum blood samples and although there were quite a few women who apologized for not being able to sit up (they thought it would make it easier for me) there were few complaining of headaches.

      It’s improved now, with the better formulas and the delivery pumps.

      • Sue

        The latest evidence on post-lumbar-puncture headaches is that lying flat afterwards doesn’t make any difference. The main determinants are the size and shape of the needle. Are there any key differences that would apply to spinal/epidural?

  • Cobalt

    The only person qualified to judge someone’s pain is the person feeling the pain. The care provider’s only job in regards to pain is to truly inform the patient of available options for relief and risks/benefits, and then provide whatever relief the patient wants out of the available options. Quickly.

    Epidurals, despite the possible side effects, are safe for mother and baby and generally work really well to manage pain without limiting body functionality. I can understand choosing not to have one (been there, done that, didn’t get a Klondike bar), but to try to deny pain relief to anyone is just WRONG. To deny the reasonable expectation of pain relief on a cultural level is oppression.

    • attitude devant

      Preach it, sister!

    • fiftyfifty1

      “The only person qualified to judge someone’s pain is the person feeling the pain”
      I would say this is 100% true for acute pain. Chronic pain gets much more complicated.

      • Staceyjw

        Why would chronic pain be so different that a person having it wouldn’t be the best judge? The big difference is acute vs chronic is only the length of time, not the strength of pain.

        • LibrarianSarah

          With chronic pain you also have to balance pain level with clearheadedness and risk of developing an addiction. In the end you are right that it should be the person in pain that makes the final decision but it is one thing to be one percs for a week after oral surgery and another to be on them for the rest of your life. Most people would try gabapentin and suffer through some pain to keep their wits about them in the latter. It’s more complicated but not all that different.

          • Guesteleh

            Thankfully there are now a lot more options than narcotics for chronic pain: tricyclic antidepressants, anticonvulsives, beta blockers. But a lot of GPs don’t understand how to treat it and neurologists are in short supply.

          • fiftyfifty1

            And convincing patients that what they need to try is nortriptyline or neurontin or propranolol when what they want is oxycodone (or another imitrex refill) is not easy. ‘Cause listen to me when I tell you what works, I’ve tried all those bullshit antidepressants and heart pills and I’m not trying any goddamn epilepsy pill, I’m in fucking 10/10 pain and the only thing that works for me is oxycodone, do you hear me?!

          • Amazed

            Sounds like me when I was having my period before I discovered zumba. The only thing that worked – for real – was something that gave my pharmacist friend hysterics. My doctor was fine with it since I took it just once a month (my problems usually last until the flow comes). But my friend was a woman on a mission to get me off vile pills. Never worked. I mean, I did believe her they were evil and stuff. But then, period came and all I wanted was relief.

            Quite pathetic, heh? But that was my life for about 10 years. Gross.

          • SomeSense

            I am curious – how did Zumba work for your period pain?

          • Amazed

            After a month or two of zumba classes, I realized that if I had one and then, later in the day, my period came, the pain was quite dull and didn’t require any medicine. If I had a class later in the day and was in the beginning of a pain, I left the class without pain. And since I go there like, 5 or 6 times a week, I cannot remember the last time I needed a pill, except for when I was away.

            A pilates class followed by a zumba class practically ensures that if my period came that day, I wouldn’t feel it.

        • fiftyfifty1

          Chronic pain is incredibly complicated. It’s still not well understood, but research is pointing to the idea that the neuronal circuits “learn” to be in pain and that this perception of pain frequently persists even after the thing that originally caused the pain is completely healed. Some people seem more prone to this effect than others, and some medications which are extremely effective for acute pain actually exacerbate this problem. For instance, narcotics, if you use them for more than short term can cause this. And this effect is separate from narcotics abuse/addiction, which is its own problem and is also a risk of using narcotics for more than short term.

          A person with a chronic pain syndrome may come into my office and say their pain is 10/10. But they look and act very different from a woman in labor or a post-op patient who rates her pain 10/10. A woman in labor may be groaning or screaming. A post op patient will have difficulty talking to you and blood pressure may be elevated. But a chronic pain patient will answer a cell-phone call and chat away with the caller while showing no signs of pain. So no, when a chronic pain patient tells me his or her pain is 10/10 and that I should prescribe Oxycontin, no they don’t get to be the judge of whether it is needed.

    • sadlady

      I agree with this, this is why I like the 1-10 scale with the faces in the picture. My face is like an 8 and I agree it feels like its an 8, so its an 8. I know its a cartoonish scale but it helps! And yes I can handle labor if its an 8 but not at a 10! So it depends!

      • Box of Salt

        Even with the cartoon faces, the scale just doesn’t work for me. I have a good imagination, and I could never rate my pain as 10, because I can always imagine it could get worse. I don’t think I’ve ever rated anything (and this includes labor and broken bones) above a 7.

        • Durango

          I’m sure most of you have seen this, but this is the pain scale I’ve ever seen (scroll down): http://hyperboleandahalf.blogspot.com/2010/02/boyfriend-doesnt-have-ebola-probably.html

          • Daleth

            Hahahaha. Omigod that’s brilliant. “10: I am actively being mauled by a bear.”

            I love Hyperbole and a Half.

        • Who?

          I’m the same. The few times I’ve had pain that has made my head spin I was actually more distressed by the spinning than the pain, though when the head cleared I wasn’t terribly happy. Those were when I jammed my thumb between two chunks of wood, and a suspected ectopic, which turned out to be an ovarian cyst. Both times I ended up on the floor semi-conscious, and though the pain was very brief for that time it felt much worse than labour. Perhaps because I hadn’t built up to it, perhaps because in labour the whole situation was so weird.

          So no joy in the pain scale for me.

    • b-p

      No, some people have no true concept of pain. “I have 10/10 pain!” “Did you go through labour? Is this worse than that?” “Oh, goodness no!”… Well it isn’t really 10/10 pain then, is it? Or when people say their pain is “minor and bearable”, but then describe it as 8/10.

      • The Bofa, Being of the Sofa

        “This one goes to 11″

  • The Computer Ate My Nym

    Just to make sure CNMs get their fair share of the credit…When my labor started I had immediate, severe pain which was unremitting. In short, dysfunctional labor. The CNM who was following me took one look at me and suggested an epidural. I was wooish enough to object and say that I just needed a little demerol and everything would be good. She said that when labor is this painful this early on it is unlikely to get better and there is no good reason not to go with an epidural early. So I agreed. It was an excellent decision and allowed me to be awake and alert during the c-section that was ultimately needed. (No, NOT because I had an epidural: the fetus was just not positioned right for birth. It was c-section or death for me…it’s creepy how a relatively small problem with placement (head was not flexed properly) can lead to obstructed labor and no way to give birth successfully.)

  • fiftyfifty1

    This idea of NCB philosophy being a form of sexual sadism is something that I originally would have dismissed as being too over the top to be true. But then you read Ina May and how she promotes the midwife stimulating a woman’s clitoris during birthing pains….and well the connection can’t be ignored. And how the top prize a woman can earn in NCB is if she claimes that the birth made her orgasm.

    • Stephanie B.

      How is THAT not birth rape?

      • The Bofa, Being of the Sofa

        Birth rape only occurs with interventions.

        If midwives do it, it’s not an intervention.

        QED

        Personally, Ina May sounds as creepy as the old turn of the century doctors who treated hysteria with a vibrator. Because, you know, where does hysteria originate? It’s in the name…

        • The Computer Ate My Nym

          Arguably creepier: As far as I know, women went to doctors asking them to give them an orgasm, er, relieve their hysteria with clitoral stimulation. That is, they knew what they were getting into and what was going to be done. Has Gaskin ever asked a woman in labor whether she wants her clitoris stimulated?

    • TsuDhoNimh

      “then you read Ina May and how she promotes the midwife stimulating a woman’s clitoris during birthing pains.”

      WTF!!!!

      • Stacy48918

        Amy’s written a whole post about it before. Ina is a sick woman with a cult following.

        http://www.skepticalob.com/2013/06/would-you-hire-this-midwife.html

      • Cobalt

        Ricky Lake managed to leave that detail out. I wonder if that was deliberate or if she just doesn’t know.

        • MLE

          I bet it was deliberate because I think RL gave IM some sex toys in BOBB2 or whatever the sequel was called.

          • Cobalt

            Wow. I could only make it through 10 minutes of the sequel where she meets Ina May. I saw BoBB years ago, all I remember is thinking that my hospital births weren’t like that and someone is going to die in their bathtub.

            I run a farm. With animals. I don’t trust nature to not balance itself on me and mine.

    • Liz Leyden

      Ina Mae also advocates kissing during contractions and orgasm (via intercourse) to stimulate labor.

  • DoulaGuest

    I also would like to mention, that not all doulas believe that epidurals equate with “bad mothering” or “weakness”. When clients have asked me about epidurals, and my thoughts I relay stories where I have seen them speed up labors and prevent trauma for mothers. This can be especially true for women who have experienced some kind of sexual trauma, as one in three unfortunately have.

    • Stephanie B.

      In my case, getting an epidural appeared to speed up my labor. I had to be induced due to preeclampsia. After of 3 hours of laboring without any pain meds I only dilated 2 cm but after receiving the epidural I was 10 cm after another 3 hours.

      • Dinolindor

        Me too. I don’t remember the specific timing, but after no progress after my water spontaneously broke, I endured about 5 hours of pitocin without pain relief (because I bought into the natural is better, blah blah blah) and stayed at something like 4-5 cm for most of that time. I got the epidural and it was like magic – I got to 10 cm in a matter of a couple hours. Deciding to get that epidural was hands down the BEST decision I have ever made in my life.

      • attitude devant

        There have been several studies that support the idea that epidurals can speed delivery. Possible mechanisms include relaxation of the pelvic floor to allow the head to descend.

  • DoulaGuest

    I am working towards becoming a CNM, and have been reading a book on childbirth in America. It was really striking to read the chapters dedicated to the Suffragette’s struggle to obtain pain relief against men (and women) who felt that it went against God to do so. Of course, the pendulum swung quite drastically in the days of “knock ‘em out, drag ‘em out” (my OB instructor’s phrase in nursing school). I think that often times the NCB movement likes to pretend that we are still in that time in history, or even the times in the 70′s when couples were handcuffing themselves together. They rarely acknowledge the strides that hospitals and OB staff have made in accommodating families during their childbirth experience.

    • fiftyfifty1

      “Knock ‘em out, drag ‘em out” was what women were fighting to OBTAIN back when it was the only method of pain control. If that had been my only pain relief option for my birth, I would have chosen it too. Luckily, doctors worked hard to invent safe and effective pain relief that allowed women to be fully conscious and so by the time I gave birth I could choose an epidural.

      • DoulaGuest

        This is a good point. I have talked to one grandmother about her birth, and I have heard the story of my other. Both were unmedicated (one had a nurse tie her knees together so she couldn’t push before the doc!). I think since the advent of pain meds, we can all agree that *most* women want them. I remember reading “A Tree Grows in Brooklyn”, and the story of the aunt who had multiple babies die in childbirth until she finally birthed in the hospital. A lot like feminism, it seems women of my generation have forgotten these battles that women have fought: both for pain relief and safety.

        • The Bofa, Being of the Sofa

          I think since the advent of pain meds, we can all agree that *most* women want them

          I’ve told the story before of our childbirth classes, and how they weren’t what I expected at all. When I asked the instructor why we didn’t do things like breathing practice, etc, she told me, 90% of the mothers are getting epidurals anyway, so why bother?

          Note, pushing for epidurals wasn’t part of the class or anything, it’s just that we focused on things people need, as opposed to pushing anything.

        • PreggieLady

          My grandmother underwent “knock ‘em out, drag ‘em out” childbirth and had 4 children. My husband’s grandmother, who is exactly the same age, but had her children in Eastern Europe where there was no pain relief in childbirth, decided after the birth of her first child to never do that ever again. And she had an “easy” labor, only 7 hours. Just goes to show that Ina May doesn’t speak for all women, or even most women.

    • Sullivan ThePoop

      I wish you luck. You seem to be the right type of person for the job.

      • DoulaGuest

        Aw shucks! I sure hope so:) Thank you!

    • Stacy48918

      “They rarely acknowledge the strides that hospitals and OB staff have made in accommodating families during their childbirth experience.”
      Very true. Tons of hospitals have tubs, squat bars, in house LCs, etc…but the NCB folks still tell horror stories of pubic shavings and enemas.

      Truth is that what the NCB movement is after isn’t tubs and squat bars. No matter how many concessions hospitals make they will still find a way to be unhappy.

      • Cobalt

        They do make hospital tours difficult for people who aren’t terribly concerned with NCB concessions, though. I got some serious stink eye from the guide and the other expectant moms when I said “What do you mean there’s no nursery! What if I need to sleep!”

        Apparently questions about aromatherapy diffusers, tub size and playlists are more appropriate.

        • Liz Leyden

          My childbirth class was taught by a doula. She was a bit too crunchy for me, but it was the least crunchy class I could find, and it was specifically for couples having hospital births. When we had our hospital tour, she visibly winced when the L&D nurse leading our group said “You are here to have a baby, not a birth experience.”

          The hospital where I had my babies emphasized rooming-in until it had a rash of exhausted new moms dropping their babies.

      • Sue

        ”horror stories of pubic shavings”

        Ironic these days that, as public shaving has disappeared due to evidence, social Brazilian’s (waxing) are the thing for the teens and twenty-somethings. Now THAT’s misogyny!

        • The Bofa, Being of the Sofa

          Yeah, I have to wonder, how effective will the “they will shave you!” threat be to the younger generation?

          “Um, I already am…”

          • LibrarianSarah

            More like “Oh good that usually cost me about $70″

      • Fuzzy

        I’m in a different area of the hospital, but 80% or more of my female patients under 50 are already bare as an egg….

    • Box of Salt

      DoulaGuest ” I think that often times the NCB movement likes to pretend that we are still in that time in history”
      Like the hardcore lactivists, if they admit we’ve actually admit we’ve made progress in these areas they’ll lose part of their identity.

  • Young CC Prof

    Exactly. I’ve read a number of documents written by prominent midwives or thinkers, including research papers, in which they mention an epidural as an adverse outcome. They literally just throw epidural anesthesia into a list of adverse outcomes, say, between blood transfusion for the mother and low Apgar for the baby.

    Did it occur to them to ask the women whether this was an adverse outcome or not? I could see asking women for a subjective assessment of pain, but that would mean actually listening to women, rather than listening only to women saying what you want to hear.

    • araikwao

      One hundred upvotes for you! (if I could)

    • yugaya

      ” I’ve read a number of documents written by prominent midwives or thinkers, including research papers,”

      Sometimes just skimming over the title and the abstract makes my brain freeze in disbelief. You are a brave woman to actually read them.

      http://www.midwiferyjournal.com/article/S0266-6138%2807%2900079-4/abstract

      • FormerPhysicist

        Argh, I knew better than to click that link.

        • araikwao

          Oh no, I have to know what’s at the other end of that link now…oh no..

      • Young CC Prof

        *Boggles*

        That can’t possibly be real, can it?

      • Daleth

        I don’t believe I ever saw a larger, more steaming pile of BS in any publication anywhere, even in my humanities PhD program. Wow. That takes the cake.

  • BostonDoula

    It’s actually very much the opposite of feminist, which many women who are NCB enthusiasts claim to be.

    • LibrarianSarah

      It is obvious from the way many of the NCBers who parachute in to tell Amy what a “cunt” she is for disagreeing with them that they are anything but feminists. They just like to co-opt the label to appeal to women on the left. The second they are challenged they reveal their true colors. My personal favorites are the ones who call Amy an “old bag” or “dinosaur” because nothing says feminist like the idea that a woman loses all her value the moment she hits 40.