Sheila Kitzinger was right about childbirth and feminism

Woman Screaming In Horror

Sheila Kitzinger was a brilliant and incisive cultural anthropologist and remained so until the very end.

Her last piece, an excerpt from her final book, printed in today’s Daily Mail under the title Why feminists HATE natural childbirth …, is an unwitting acknowledgement of what I have been writing for years: Natural childbirth is deeply anti-feminist.

To my surprise, it wasn’t just obstetricians who dismissed what I had to say. I also found myself in conflict with feminists, who saw birth in very simplistic terms.

Why? Because they claimed it was every woman’s right to give birth painlessly.

…Polly Toynbee, writing in The Guardian, was particularly virulent, dismissing me as a lentil-eating earth goddess.

‘How extraordinary,’ she said, ‘that those who call themselves feminists fight for women’s right to suffer and, in the process, inflict so much unnecessary suffering on women. The right to safe local anaesthetics, properly administered by experienced obstetric anaesthetists, should come first.’

For most of human existence, women’s worth was judged by the function of vagina, uterus and breasts. In other words, women’s worth was determined entirely by their biology. Kitzinger (like her colleague Ina May Gaskin) came of age when women were not valued for their intellect, talents of character. So they made a virtue of necessity. If they were going to be judged by their biology, they would glorify their biology. Kitzinger was probably the premier biological essentialist in the natural childbirth movement. Biological essentialism is the belief that all women have a biological essence and can only find true fulfillment through having children “as nature intended.”

Kitzinger took the intellectual legacy of the profoundly sexist men who created the philosophy of natural childbirth (Grantly Dick-Read) and Lamaze, and went them one better. It wasn’t merely women’s purpose to utilize their vaginas, uteri and breasts to bear and raise children, it was their glory.

Life had handed them lemons, so they made lemonade.

Kitzinger, as astute as she was, failed to recognize that natural childbirth was and remains a philosophy rooted in profound sexism. Women are no longer restricted to lemons. It is hardly surprising, then, that contemporary women no longer feel any need to pretend that lemonade tastes best or tastes good at all.

There is no more of a need for women to glory in unmedicated childbirth than there is to glory in unmedicated painful periods. Women have replace faux achievements with real achievements in every area of human endeavor from the universities, to the concert halls to outer space.

Kitzinger never made the leap. Indeed the excerpt of her book has her still squeezing those lemons and adding as much sugar as she can:

YOU CAN DANCE THROUGH A DELIVERY

A woman who’s enjoying her labour will swing into the rhythm of contractions as if birth-giving were a powerful dance. As the mother of five children, I’ve not only experienced this myself but seen it happen time and time again…

If you really want to help a woman in labour, try not to manage, conduct or coach. What she needs far more is someone to help boost her strength and confidence

Once we were alone, I lifted the woman off the bed. Holding her lightly, I started to rock and circle my pelvis. As each contraction ebbed away, I gave a long breath out and was still; when I sensed another was coming, I danced and breathed my way through it with her.

After about half an hour, a midwife came in to do a pelvic exam. The woman was fully dilated. We laughed and hugged each other.

Kitzinger is still so embedded within the sexist paradigm of judging women through the function of their reproductive organs that she never acknowledges that most women don’t want to dance through excruciating pain, they want to abolish the pain.

The full title of the Daily Mail piece is “Why feminists HATE natural childbirth… and why their prejudice can harm mothers AND their babies, by the woman who taught a generation how to give birth” but the real title ought to be “Why feminists HATE natural childbirth… and why their views can harm ME and MY PHILOSOPHY”.

Sheila Kitzinger and other early advocates of natural childbirth profoundly changed contemporary childbirth for the better by insisting that women want to remain awake, want to make their own medical decisions and want to be accompanied by their partners. But they lost their way when they embraced the belief that women’s worth is restricted to the function of their reproductive organs.

Kitzinger improved the lives of many women by taking the lemons she was given and making lemonade. She glorified childbirth in an era when women were restricted to childbirth. She never took the next step, the one that contemporary feminists took, demanding to leave the domestic sphere and take their places every field of intellectual and creative endeavor.

It is unfortunate that she failed to recognize that in 2015 women are entitled to drink whatever they want, and are no longer restricted to lemonade.

  • Matthew

    Yes, baby is a truly miracle. My wife has a certain problems with my health so she couldn’t become pregnant naturally for a long time. Thus we decided to use IVF with donor’s eggs. We were in Kiev clinic BioTexCom. By the way they use only fresh material that is why they have higher success rate. Thus I can 100000% sure recommend you Amelia to contact with this clinic to gain proper service. They have very good references from the clients. I also liked that they can provide all facilities for the clients. There were proposed surrogacy program. We agreed. As a result of the program we had twins and had to pay additional money. We were not against twins. But I met in clinic couples that didn’t want twins categorically. Not so many people know that for example Indian doctors transfer large number of embryos at once. They say that just want increase chances of a successful pregnancy. Our program in Ukraine was about 30 000 euro. And we had “all inclusive” package with meals, accommodation and transfer. The most important is that we had guarantee result. Plus it is not necessary to have a visa for entering Ukraine. Also Kiev is very beautiful city. Full of nice sightseeing places and museums.

    • Empress of the Iguana People

      A) Who is Amelia?
      B) My American fertility clinic is also quite good, and they only needed to transfer 2 at a time for me, one set fresh and the other frozen.
      C) Are you trying to drum up business? If so, go away.

      • The Bofa on the Sofa

        C) Are you trying to drum up business? If so, go away.

        Um, ya think?

        It a random response to a 2 year old post.

        • Empress of the Iguana People

          i know, although we do get nutters replying for real on 2 year old posts now and then.

  • Bry

    While I with everything in the article, statements like “For most of human existence, women’s worth was judged by the function of vagina, uterus and breasts.” are incredibly inaccurate.

    • Bry

      **While I agree with

  • Dr Kitty

    A FB friend has just posted about how wonderful hypnobirthing and delayed cord clamping are, and how beneficial they were to her birth experience, and how sad her first child’s cord was cut early.

    What she neglects to point out is that her first child was born literally 5 minutes after she arrived on the labour ward after a 2hr labour, and her second was born in their bathroom before the paramedics arrived after a labour of less than an hour.

    Hypnobirthing is probably less useful when you’re 18hrs in with no progress, and I’m not sure if “delayed cord clamping” because you had to wait for the paramedics to arrive to cut the cord is necessarily a bonus.

    Her babies, BTW, both had to be admitted for IV Abx, because she’s GBS +ve and intrapartum antibiotics obviously didn’t happen.

  • Sue

    Recollection: I once sat on a discussion panel with Sheila Kissenger at a midwifery conference in Sydney. (Hint: our views differed).

    She was very elegant, though – silver hair.

  • Guesteleh

    It’s buried in the comments below but wanted to point out that guest confessed that she thinks epidurals are harmful. She has no evidence to back that up, it’s just something she feels. So all of this wanking about women having pain relief “forced” on them is based on misinformation and ideology. Of course it is.

    • The Bofa on the Sofa

      Coercion is, of course, bad, but misinformation about the risks of epidurals to dissuade women from using them just feels right…

      • Guesteleh

        The other thing that bugs me is she never gives a good explanation for why repeatedly offering pain relief to a woman laboring in pain is a bad thing, except that it isn’t supportive. If the woman is truly coping well she can just refuse. If she “caves” and gets the drugs, then she probably wasn’t really coping well.

        • Sue

          The providers offering pain relief can be “between the devil and the deep blue sea”. Offer only once, and get the complaint “they never came back to check if I wanted it later”. Offer again, and get “they were coercing me to cave in”. Sigh.

    • The Computer Ate My Nym

      Epidurals can be harmful. Epidural headaches are relatively common (and sometimes quite nasty) and there are rare instances of catatrophic blood pressure decreases after epidural administration. I wouldn’t recommend getting an epidural just because you’re in labor, if you don’t feel like your pain is that bad. OTOH, pain can cause problems as well, up to and including a risk of death from stroke from BP elevations associated with the pain. Like all else in life, it’s a risk/benefit analysis and each person has the right to have the risks and benefits presented to her in a fair, complete, and nonjudgemental way.

      • Guesteleh

        Sure, but what you just wrote is clearly not the POV she’s coming from. She’s not doing any kind of dispassionate risk-benefit analysis.

      • Amazed

        She didn’t say she thought they were harmful, actually. She said she thought they led to more forceps deliveries, studies be damned. Actual problems, the ones known and acknowledged, were nowhere in her considerations, except for her mentioning that she’s heard of women who had long-term problems with their back after the epidural. But for her, it was the forceps deliveries.

        And she has the galls of accusing us of misrepresenting poor NCBers and SK, in particular. SK lied about epidurals being associated with increase in instrumental deliveries but that was totally fine with Guest.

        • Fallow

          Yeah, my NCB friends never talk about blood pressure crashes, epidural headaches, or the rare spinal epidural abscess or hematoma. They talk about forceps, destroying the bond between mother and baby, the CASCAAAAAADE, being a warrior mother (and thus better than other women), and so forth. They aren’t talking about the real potential issues with epidurals. Just the imaginary ones that feed their ego and reaffirm their devotion to their cult.

          If I remembered my anesthesiologist’s name, I’d write him a thank you card for my epidural.

        • Medwife

          It’s kind of strange, when you think about it, that there is such CONTROVERSY about epidurals in labor, that people have such strong feelings about it. If a woman is in too much pain for her liking, she should get one. It’s usually very effective and the complication rate is very very low. If you are ok without one, don’t get one. It’s simple. Especially in regards to when you are not the laboring woman. What the hell does it matter to you?!

          • Amazed

            I happen to regard my fellow women as human beings who are able to make their own decisions. Give them the information and let them do whatever they want with it and change their bloody mind the moment they feel like it.

            The problem is when women are made to think that it matters so much that they effectively cut themselves off the chance of changing their mind because everyone and their mother knows that they REALLY don’t want this epidural, even if they’re begging for it tearfully.

            What the hell does it matter to the rest of us, indeed?

          • guest

            I agree.

      • Allie P

        I wouldn’t describe PDPH as “common.” The actual rate is close to 1/500.

        • theadequatemother

          1/100-200. Is what is generally quoted.

      • Sue

        Perspective:

        Intravenous morphine can cause low blood pressure, vomiting, sedation, depress breathing….should we stop giving it for people having heart attacks or major trauma? (No, we can anticipate and manage the side-effects).

        General anaesthetics can cause low blood pressure, hyperthermia and a whole range of other complications…should we stop anaesthetising people for surgery? (No, we can anticipate and manage the side-effects).

        Epidurals can cause low blood pressure and (rarely) more serious complications. SHould every labouring woman just endure agonising pain for hours to days? (No, we can anticipate and manage….)

        • guest

          This is getting tiring. I never said people shouldn’t have epidurals. I say in almost every post people should do what they want. Just consider those risks (just as you’d consider them when you administer general anaesthetic).

          • anh

            but saying you’re not convinced by the body of high quality evidence that demonstrates that epidurals do not lead to interventions demonstrates you have a preconceived prejudice against them. If you were looking at the evidence rationally without agenda you’re conclusion would be logical vs emotional

          • guest

            i just said i haven’t looked at the evidence so I don’t have an opinion about it – read my reply above to guesteleh.

          • anh

            “Guest said she was not fully convinced of the evidence that said they don’t lead to increased interventions.” If you haven’t looked at the evidence why are you even discussing it. You do have the opinion that they evidence is not convincing despite having no familiarity with the evidence?

          • guest

            how can i be convinced of evidence without looking at it?

            there are three positions re: believing something.
            1. belief.
            2. disbelief.
            3. haven’t made up my mind – refrain from belief.

            I am at three – I hear different things from different corners but have not properly looked at or weighed all or best evidence.

            Is that such difficult concept?

          • anh

            usually when I haven’t looked at all the evidence I refrain from talking about it all. Saying you aren’t convinced implies an opinion

          • guest

            I was asked.

          • Amazed

            But you’re totally OK with SK lying that epidurals lead to more interventions. Or you’re totally OK with SK not having studied the information that defies her beliefs so she spouted ignorant garbage.

            Which one of those not so nice options are you OK with? Because it looks like the only thing you aren’t OK with is SK being “misrepresented”.

            You’re doing incredible acrobatic tricks to deny her explicitly written position about wanted and unwanted children and turn it into what it isn’t, simply because you admire her. (I would use a much stronger word for your pandering but I’m trying to keep my speech as decent as possible.) Do you really think the majority of women who will read SK precious memoirs will give up to the long philosophical considerations you use to prove her “innocence”? Because most people take what they read at face value.

            SK is not helpful and neither are you.

          • guest

            Hang on. Sk wrote in the 70’s. it was very unclear at the time what the evidence would have been. this was basically before the advent of evidence based medicine!!! I would NEVER go to SK for an opinion on epidurals! that is obviously out of date – if only because epidurals have become much better (anaesthesiology moves on). and because she is an anthropologist. and for so many other reason.

            SK made her impact at a very different time, when episiotomies were largely standard practice – without any evidence. she and her ilk (including that awful dick-read) were part of the movement that improved some of that considerably. That does not mean everything they said was perfect and a lot is clearly outdated and some of it was partially badly motivated (cf dick-read the classist eugenicist).

            I do not kiss the floor on which she walks – but I do take her and other people, including ‘clit-twiddling’ [hilarious] gaskin to be important and influential figures and of their time that have forged some meaningful changes. SK played a major role in e.g. women being allowed of their back, in claiming back some autonomy in birth. She is here being depicted at someone whose only interest was to shame women and reduce their aims in life to their vagina, whereas she was mainly railing against a system that constrained women. I am sorry -I do find that a serious misinterpretation.

            I should also add: face value is a difficult thing. When I say ‘My birth was like this and that worked for me’ a lot of people here ‘my birth was like this and if you don’t do the same you are a failure’. I am sorry – but how does that follow??? Similarly if I (or SK) say ‘it can help to approach pain in these ways, and some women like that and a lot aren’t told about it and i want them to know’ how does that mean ‘these ways are the ONLY correct ways to approach pain and if you do anything else you are a complete failure’.

          • Amazed

            But that’s part of her memoirs. She didn’t die in the 70s. She died not a year ago. Her memoirs were not published in the 70s. They were published now. If she didn’t care to make amendments according to the contemporary evidence, that’s hardly a ringing endorsement to her rigour and actually, her lofty aims.

            You have no problem with her still living in the 70s? Wow.

            And Dr Amy was being very mild to SK. Her stories about the “help” that looked terribly like sexual assault and how pain would be perceived differently if the child is wanted were disgusting. So if you don’t perceive the pain like something good, your child isn’t really wanted? That’s what you defend – and you expect of any rational person to accept it as something different than worship of someone popular? Because that sounds awfully like Ina “She didn’t really want this child, that’s why her labour stalled” May Gaskin.

          • KarenJJ

            My mum was a midwife in the 70s and had a bad time with her births and her obgyn (who she put in a complaint against). When I gave birth around 6 years ago I was very nervous considering her experiences but things went well even though I had a c-section and my mum was amazed, relieved and enthusiastic about the information I was getting about my pregnancy and the records being kept.

            So much has changed and keeps changing, but so many women are still getting the message the epidurals drug babies, that c-sections mean you’ve failed, that inductions cause significant problems, that the pain felt in childbirth is really only ‘surges’ and can be controlled with positive thinking.

          • yugaya

            “I would NEVER go to SK for an opinion on epidurals!”

            But you are comfortable with going to her for an opinion on alternatives to epidurals? As if the natural childbirth support has not evolved an inch since then at all, as if the missteps in the way they viewed physiological and hormonal processes have not changed in light of modern research and as if the medical system that they juxtaposed themselves against as an alternative and its medicalised birth have not changed one bit since the 70’s.

            I see that as probably the biggest problem of natural childbirth advocacy – this refusal to step away and distance itself from caricatures like Jan Tritten and their teachings which, when applied today, are prime examples of substandard care and lack of ethics.

            Sheila Kitzinger’s pelvic assault might have been excused on the grounds of context of time and place back when they happened, but that does not excuse spreading them as a valid alternative to anything in year 2015 and context of patient rights and ethical care and support during childbirth as it is now in the developed world.

          • The Bofa on the Sofa

            I would NEVER go to SK for an opinion on epidurals!

            But by listening to her opine on the virtues of a non-medicated birth and the advocacy thereof, you ARE listening to her opinion on epidurals.

          • fiftyfifty1

            “She is here being depicted at someone whose only interest was to shame women and reduce their aims in life to their vagina, whereas she was mainly railing against a system that constrained women. I am sorry -I do find that a serious misinterpretation.”

            Quite the opposite. Dr. Tuteur explicitly states that SK was trying to improve things for women, and that some of the things she did were helpful, but that biologic essentialism (even the worshipful type) has negative consequences.

            I wonder why Dr. Tuteur’s nuanced and multifaceted opinion on SK is so hard for you to hear. People can be a mix of good and bad. Enlightened in some ways, benighted products of their times in others. Intellectual rigor requires that we address the bad along with the good rather than hero worship.

          • KarenJJ

            I wonder whether the older generations of midwives are tilting at windmills. Afraid of becoming irrelevant with the new ideas and science that is coming through. Sticking to the arguments that have served them well over the past 30-50 years but unable to take in the technical and gender role changes that have been occurring over the past 20 years or so.

          • fiftyfifty1

            Except that the new crop of midwives seems as into the woo as the old guard, if not more so.

          • KarenJJ

            My uneducated opinion on that is that many of the new crop of midwives are not as intelligent as the older crop. The women that would have become midwives in the past might now be training as obgyns…

          • Sue

            I suspect you are right, Karen. The type of intelligent and energetic women who used to be limited to senior roles in nursing, teaching or in convents now can be CEOs of corporations or judges. That’s not to say there aren’t still highly intelligent and motivated women still in nursing or midwifery, but they aren’t limited to those roles.

          • The Bofa on the Sofa

            As I pointed out below, THE FIRST LINE of Dr Amy’s post says…

            “Sheila Kitzinger was a brilliant and incisive cultural anthropologist and remained so until the very end.”

            That doesn’t sound like “being depicted at someone whose only interest was to shame women”

          • Roadstergal

            There are three positions to hold on evidence.

            1: I’ve analyzed it and I’m convinced it supports position A.
            2: I’ve analyzed it and I’m not convinced it supports position A.
            3: I haven’t been exposed to the evidence, or have been exposed to very little, so I can’t comment on what the evidence supports.

            You put yourself clearly in 2 through multiple posts earlier, and are now backpedaling to 3. Doesn’t work that way.

          • guest

            no. there is
            1: I’ve analyzed it well and I’m convinced it supports position A.
            2: I’ve analyzed it well and I’m neither convinced nor unconvinced it supports position A.
            3: I’ve analysed it well and I’m convinced that it does NOT support position A.

            you can repeat 1-3 for anything from ‘i have analysed it but not to my satisfaction’ to ‘i looked at it a bit/barely looked into it/only have hearsay.

            then there is
            4: I haven’t been exposed to the evidence, or have been exposed to very little, so I can’t comment on what the evidence supports.

            I meant to deny 1 – you all immediately inferred 3. in fact i am a version of 2, but not of the ‘I’ve analysed it well’ but only of the ‘i looked at it a bit, a long time ago and hear very conflicting accounts’.

            you may think i am nitpicking or back-pedalling. that is what i mean by being treated like a politician. I am in fact trying to be quite careful in my judgment. but i am also trying to respond to lots of different people saying lots of different things. A lot of this interaction doesnt’ feel like trying to communicate or understand, but like trying to just dismiss or pick holes, regardless of whether that is based on misrepresentation or on what a person actually tried to say.

            [not everyone is like this. some of you are great. surely you know who’s who]

            i have also asked if the links to the best evidence on epidurals please can be re-posted. i would like to look into it sometime, and it will save me a lot searching. please can someone direct me?

          • KarenJJ

            “The reason for this is that guest hasn’t looked in detail at the evidence re: epidurals in isolation. So I can’t pronounce on it.”

            Well, I took that as a 4 personally… We can only go on what you say.

          • NoLongerCrunching

            Is this it?: https://theadequatemother.wordpress.com/epidurals/

            Although it is really unpleasant to have people try to constantly pick holes in what you say, having been through it, I think it’s a very useful process. Like a dissertation defense or mock trial.

          • Sue

            Is guest an anaesthetist/anaesthesiologist? If not, how will his or her assessment of the evidence be more valid than theirs?

          • The Bofa on the Sofa

            i just said i haven’t looked at the evidence so I don’t have an opinion about it –

            How can you claim you don’t find the evidence is not convincing if you haven’t looked at the evidence?

            You are backpeddling like crazy, because you got your bluff called and no damn well you can’t support it.

            If you hadn’t looked at the evidence, your conclusion is NOT “I’m not convinced,” it’s “I don’t know anything about it.”

            We aren’t falling for it.

          • fiftyfifty1

            Naw, you said you weren’t convinced by the evidence. If you are “unconvinced” only because you haven’t read it, that’s intellectually dishonest. And you know it.

          • Wren

            Why do you believe those risks aren’t considered?

        • Wren

          You know, I was given a list of risks of my spinal and my c-section before signing the consent form.

          I was even given a verbal list of possible risks from gas and air with both labours.

          No one ever presented the risks of going without any pain relief. I was given the risks of a vaginal delivery with my first, when they found he was footling breech and a c-section became the only reasonable option. I was given the risks of a VBAC well before my second delivery, but nothing on the day. Funnily enough, the risks I was given did not include the one which actually presented: the cord wrapped around her neck repeatedly. Luckily, that didn’t become a problem.

        • The Computer Ate My Nym

          Epidurals are clearly safer than general anesthesia and probably safer (or at least more convenient and less side effect provoking) than IV morphine.

          As I noted, pain itself as its risks. Labor isn’t safe. Epidurals are extremely effective and generally safe, but they do have their risks and for the lucky women whose labors really are fairly mild those risks might outweigh the benefits. Hence the whole informed consent thing.

          Though I do wonder, given that we know that people overestimate rare risks, is explaining every last 1 in 10,000 risk a good idea? I don’t think it’s fair to not inform people but is the information itself frightening people into bad decisions? Not sure what to do about this problem.

          • The Bofa on the Sofa

            I always like the vaccine information, “The following have been reported, but occur too infrequently to be known if they are associated with vaccination”

            Something like that is a reasonable approach I think

          • Roadstergal

            I wish there were ways of putting risks into perspective, by comparing them to things people have a visceral feel for. “The risk of the following complications is lower than that of dying on a given commute drive. *list* The risk of the following complications is lower than winning the Oregon powerball. *list* Etc.

      • Iasme

        Oh come on. I had a lumbar puncture/spinal tap some months ago to diagnose meningitis (which it was), and headache is a complication of any similar medical procedure. I was one of the cases that didn’t get the headache, but honestly trying to spook women out of epidurals by the fact of a relatively minor headache (compared to the agony of meningitis or childbirth) is plain fearmongering.

        • Iasme

          (Oops, that was meant for the subsequent poster.)

    • guest

      Guest said no such thing. Guest said she was not fully convinced of the evidence that said they don’t lead to increased interventions. That does not mean that guest is convinced they are leading to increased interventions. As it happens, guest also isn’t convinced of the evidence that they do that. Guest simply isn’t convinced either way. The reason for this is that guest hasn’t looked in detail at the evidence re: epidurals in isolation. So I can’t pronounce on it.

      And so you will find that I don’t pronounce on epidurals.

      What guest has looked at in detail is the evidence re: attending hospital birth vs home-birth or birth centres (in the UK!!! e.g. licenced, etc). You can only get epidurals as part of the hospital package, and the hospital package does increase various intervention risks. So all I’d say is, if you plan for an epidural, be aware that you plan for labour-ward, with associated risks (and benefits!!!!!).

      If you have already planned to go to labour ward, then I just don’t know what the choice between epidural and non-epidural looks like. But my inclination (without trawling through the evidence) is: if you fancy it, go for it (caveat the known risks – e.g. headaches, blood pressure, etc. but they are rare).

      Please stop jumping to conclusions – it is very difficult to have a reasoned discussion that way. It is also, again, an instance of what bothers me on this blog. Things one says often gets immediately interpreted as a very extreme position. It makes it rather arduous to write – like being a politician – any soundbite that could possibly be misrepresented, will. very tiring. not conducive to your discussion.

      For your information: unlike many I NEVER include epidurals in my analysis of birth outcomes. when i talk about interventions i mean epi(siotomies), forceps, ventouse, c-sec.

      finally: I would welcome your links to the best evidence on epidurals. it will be fun to look into. please can you re-post?

      • Susan

        In a sense, epidurals lead to more “interventions” every time. If you are going to have an epidural you need, an IV ( not just a saline lock ), you need continuous fetal monitoring, you will need to stay in bed ( my understanding is walking epidurals really should have a different name ), you will almost always need a Foley catheter, you’ll need a pulse oximeter and BP reading’s very frequently with the placement and then at least every half hour thereafter. But for most people, it’s entirely worth the pain relief. Howling to playing cards is a big deal. But it’s a very different experience in terms of feeling more “medical” and to me, when people say hey I just don’t want all the monitoring that comes with the epidural or the very small risks involved. That’s the best reason to not have one.
        I fully support moms to make whatever choice seems best to them and I enjoy supporting a mom through an unmedicated birth, support her if she changes her mind, support her if she comes in with a plan epidural ASAP. What I choose has zero to do with what’s right for her.

  • Linden

    Lewis’ Law:

    Comments on any article about feminism, justify feminism.

    I have yet to see an exception.

    • yugaya

      Laws formulated on Twitter being taken seriously, justify not having a Twitter account.

  • LK

    This crap just makes me more angry every time I read it. I had a medication free labour that took less than 3 hours. I was in terrible pain from the onset of contractions until the baby was born. There was no time for the epidural, I asked for it at 5 cms but was complete before the anesthesiologist arrived. My labour was not a dance or a party or a walk in the park. My body took me for a wild ride and after I was in shock wondering what the hell happened because that labour was nothing like I expected (it was baby #2). That labour is why there will be no #3. I don’t wish that on anyone and those who think my natural labour with no tearing makes me some kind of superstar are clearly delusional because I was a screaming, vomiting mess and I almost hemorrhaged after.

    • CharlotteB

      This is basically exactly what happened to me. I’m so sorry!!! It honest to god felt like torture (ok, what I’d imagine torture would be like) but yeah, all this “move during labor! Focus on the breaks between contractions! Eat!” Blah blah blah doesn’t do anything for pain that intense.

      Like, HOW is it possible to dance? Or move? I felt like an animal, and I felt SO bad about my “behavior” during labor. It was horrendously painful. I feel better now, knowing that other people with short labors also had the same reactions to the pain–screaming, cursing, etc.

      I’ve only had the one baby, but honestly, I can NOT understand how it’s possible to breathe through contractions, or work with the pain, or whatever. Intellectually, sure, but based on my experience? No.

      If I ever have another baby, I plan to insist on induction, with epidural. If they can’t promise me that, (ok, give me 99% odds) then I’m getting a c-section.

      I read here while I was pregnant, and therefore considered myself better educated than many, I have a lot of anger at the whole philosophy of natural childbirth. This idea that walking or whatever can make labor bareable? For some of us, that’s a big, fat lie. For some (many? Most?) women, it just effing hurts. I think we’d all be better served if that were acknowledged.

      • araikwao

        Yes!!I couldn’t think of anything worse than moving! I just sat still, made my husband apply counterpressure (he had sore sore thumbs and i was bruised for days!), close my eyes, breathe slowly and try not to die. I don’t think I could have moved if I wanted to. And I couldn’t be bothered wasting my energy on asking for pain relief because I doubt they’d have given it to me anyway. And, you know, I was “doing so well”.

        • Wren

          My labour honestly wasn’t too awful, but I did not want to move! I also had almost no breaks between contractions.

          It took me nearly 45 minutes to get downstairs and into the car and at least 10 minutes to get onto the bed at the hospital. Dancing was not on the agenda!

      • N

        A C-section? Without any indication for it but pain??? That I can not understand. I had a planned c-section for my third baby. And I almost bled to death afterwards. They didn’t even know where the blood came from, what organ was bleeding, as my uterus seemed fine. My baby and I were separated for 3 days, as I had to recover. I don’t wish anyone this.

        Birth are risky and painful, whatever way we choose!

        • Wren

          That is highly unusual you know, and serious bleeding after a vaginal delivery can certainly happen too.

        • Cobalt

          People have surgery for other body systems specifically to address pain quite frequently. If someone would rather take the very low risk of surgical complications over the very high risk of intense pain, what’s the problem?

          • anotheramy

            That is a great point and I’ve never heard it phrased that way before

          • theadequatemother

            yes like major joint arthroplasties.

          • KeeperOfTheBooks

            I am so stealing this in the future.

        • Amazed

          My mom says hi. The pain you scoff at left her with a broken tooth after her first au naturel delivery. Her second ended up in such a severe PPH that she saw the tunnel of light and everything. And let’s not go into the pelvic floor problems she developed immediately after the second one.

          Pain is a powerful motivator and in no other circumstances are people recommended to just suck it up.

          • Maya Markova

            I don’t understand the dichotomy “vaginal birth + pain – c-section”. Isn’t it possible to have a good pain management in vaginal birth, so that women are not forced to choose a c-section just to avoid pain?

          • Amazed

            Looks like pain is almost inevitable after a birth – but with a c-section chances that you’d be expected (by others or yourself) to just suck it up are considerably lower.

            By the way, I’m glad you decided to visit today. Just two days ago, I was at your site. I was translating a popular book for children. Human body. And it was very nice to have somewhere to look about those damned chromosomes. I mean, a place where I knew the author knew what she was talking about. Thanks!

        • Fallow

          I’m sorry that your c-section went so pear-shaped, but I honestly don’t see what that has to do with what someone else has decided is right for their body. You’ve said a very presumptuous thing, not to mention you’ve decided what’s right for CharlotteB based on your life (and your very uncommon complication), not her life and what she knows about her own body’s response to labor.

          And like everyone else said, people go through surgeries all the time “just” to alleviate or avoid causes of severe pain. Do you judge them, too?

        • moto_librarian

          I was in a wheelchair for the 24 hours following my unmediated birth. Having a cervical laceration and a pph that nearly required transfusion is not a fun recovery. Nor are the pelvic floor problems that I have at the ripe old age of 37.

        • CharlotteB

          Um, not that it’s any of your busisness, but a c-section wouldn’t be my first choice. Considering I was told that second labors can be even shorter than first labors, if I have another child, my primary concern will be making sure that the baby is born in the hospital, not at home. If the best way to ensure that, as well as ensure pain relief for me, is a planned c-section, than so be it. The cnm at my 6-week appointment told me that they usually tell moms to figure that second labors will be half the length of the first–for me that’s 90 mins, and if I were alone, I wouldn’t be able to drive myself to the hospital.

          So, I’d say that indication for induction or c-section. But even if it’s “just” for pain relief, why should that matter?

        • Something From Nothing

          Would you think having knee surgery to relieve pain is reasonable?

      • SporkParade

        I actually wanted to run during contractions. My guess is that it was a psychological response saying, “Something is causing you pain; you should get away from it.”

      • theadequatemother

        I think those are both reasonable options (see my comment above)

    • Riverside

      I gave birth to my third with an oncologist and a paramedic standing in the doorway because my screams had brought them running, sweaty and breathless to labor and delivery assuming a massive emergency was underway. I screamed like I was being ripped in half. No stitches, healthy baby. I yelled “I’m not an ffing hippy!!!” When I got told I progressed too fast for an epidural. No one gave me a trophy. Suffering has no achievement value.

      • Medwife

        I once delivered a precipitous labor and the mom was so shocked, she kept asking for an epidural after the baby! (No tearing or other complications, she just had had a complete expectation of an epidural and her mind was blown, poor lady)

      • KeeperOfTheBooks

        I am so sorry it was like that for you. 🙁
        That being said, I hope you don’t mind that “I’m not an effing hippy!!!” made me giggle out loud.

    • The Computer Ate My Nym

      My labor was similar in terms of the pain from start to finish thing* but, unfortunately, the pain was due to obstructed rather than percipitous labor so I got the pain and the c-section. The pain is one major reason that there is no baby #2 for me. The only thing that, for me, saved the experience from being sheer torture is the fact that those around me (my midwife, the nurses, my support people) were sympathetic to the fact that this was PAIN and weren’t trying to ignore my pain or talk me out of it with a “but it’s good pain not bad pain” pep talk. Then I would have felt alone, ignored, guilty for not agreeing, and in horrible pain. YMMV and I suppose there are women who feel better for being told that their pain has a purpose or that it’s good, but…I don’t get the NCB insistence that that’s everyone.

      *Actually, start to epidural, but left to nature it would have been constant pain until the end.

    • theadequatemother

      that was my baby #2 too. Except faster and with the need for neonatal resusc (bag mask ventilation), a second degree tear from an emergent vacuum extraction (kid probably had a massive vagal decel and his HR was not detectable) and a PPH after. I guess that doesn’t get me a warrior badge because we needed medical help.

      Husband and I were back and forth to the OB office about 5 times in the first few weeks – mostly because we were traumatized and looking for reassurance. In the light of day I want another child. At night I mostly cry if I think about it.

      The worst part for me wasn’t the pain…it was the helpless out of control feeling that the pain resulted in. It was a feeling of complete dependence and vulnerability. It was especially bad because when I lost it, and I really really lost it, it was in front of colleagues. And I work in a profession where you are never supposed to lose it. I am expected professionally to be calm when the blood hits the OR ceiling, when the fecal material is pouring out of the mouth, when the BP is 50/25. Birth dealt me a big hit to my professional sense of self and makes me wonder every day how my colleagues view me now and if they think I am the weak, panicky anesthesiologist that they wouldn’t want their loved one treated by.

      There are two reasonable options should we decide to have a third and I’ve discussed both with my OB:

      1) epidural prior to term induction (https://theadequatemother.wordpress.com/2012/08/22/a-perfectly-reasonable-request/)

      2) scheduled CS

      He supports both.

      • The Bofa on the Sofa

        The worst part for me wasn’t the pain…it was the helpless out of control feeling that the pain resulted in. It was a feeling of complete dependence and vulnerability.

        So not so empowering, it appears…

      • NoLongerCrunching

        Can you ask a colleague you trust? I can’t imagine anyone judging your professional skills by your emotional response to your child’s and your own lives being in danger. And if they did, just wow. I’d never want someone so idiotic and anti-patient attending me.

        • theadequatemother

          well…I’m pretty sure its a irrational feeling I have and no one is actually judging me. We’ve all seen and participated in those precipitous multip deliveries sometimes with an acute event that means you have to hold legs down as mine were held down and ignore screams etc. Mostly I am judging myself and projecting that. I know that. But I also know that if I ran into the ane that was in the room prepping the epidural tray when my water broke and the kid rocketed out I would *turn and run* and pretend i didn’t see him. Thankfully I work at a different hospital.

          • Something From Nothing

            It seems to me what you are mostly dealing with is the vulnerability aspect of all of this. You didn’t do anything that your colleagues haven’t seen before with labouring patients. But you are a physician, a specialist and we are used to being emotionally solid, professional, and all of that bullshit. Doctors are not supposed to be vulnerable. I found labour and delivery to be the most difficult time for me as an obstetrician and is was entirely because of the feeling of vulnerability. I hated it, being helpless and vulnerable. And I had a functioning epidural for both of my births. The amazing Brene Brown has helped me deal better with vulnerability and even embrace it. If you haven’t seen her TED talk, it is totally worth a watch.

      • CharlotteB

        Ack!!!
        For what it’s worth, I’d appreciate having a doctor who really, really understands the pain.

      • AllieFoyle

        I’m sorry you had such a bad experience and that its impact has extended to your professional life as well. Bad enough to have to experience it, but in front of your colleagues… ack!

        Is there someone you could talk to about all of it?

      • Ceridwen

        This is one of the reasons I’m asking for induction at 39 weeks this time (also the fact that my family are all 3000 miles away and we’d like to have some help around when I deliver). I liked my epidural and was quite happy to be able to have it. My first labor was slow enough that I felt like we got to have a lot of control over how things went. But who knows how it will be this time, especially if baby isn’t OP like last time. I feel a little crazy for being worried about such things after having a 40+ hour labor the first time though.

        • KarenJJ

          The lack of family was a big decision for me to opt for an elective repeat c-section, instead of waiting for labour to begin. I know this stuff gets dismissed as “mother’s convenience”, but having Granny there for my clingy toddler and being able to schedule work completion for projects for both my husband and myself made a huge difference to our feelings of readiness when our second baby came.

          • KeeperOfTheBooks

            If I end up scheduling either induction or an ERCS, it’ll be for that reason, too. I’d argue that the difference, medically speaking, between recovering from major abdominal surgery while lying on a couch/bed vs coming home from said major abdominal surgery and jumping straight into cleaning/cooking/toddler-chasing is a good deal more than “convenience.”

      • D/

        “Birth dealt me a big hit to my professional sense of self and makes me wonder every day how my colleagues view me now and if they think I am the weak, panicky anesthesiologist that they wouldn’t want their loved one treated by.”

        Guarantee you that your colleagues think no such thing!

        Although I completely understand and remember a vague worry during my second pregnancy about “losing it” in front of colleagues if something happened (to the point of considering delivering at a different hospital to just avoid the possibility entirely). All that worry was just wasted energy though.

        What I came to realize after being on the professional end of several co-workers come-aparts in response to delivery room/ NICU crises (and even to breastfeeding disasters) is that I *never* actually think of them as my colleagues in those moments (nor are they in my memories of those crises). Truthfully, I see those kind of events as making everyone even better professionals and figure your side of the experience gives you a perspective for providing the kind of care I would actually *want* for my loved one when their “blood hits the ceiling and their BP is 50/25” … and the kind of compassion and understanding I would *need* for myself in the aftermath of their disaster!

      • FEDUP MD

        As a fellow physician and mother, I would never think less of anyone who fell apart during their own medical event. I would actually really wonder about their ability to face reality if they didn’t react as expected.

        I had an emergency c-section under crash GA and my own baby had birth depression and was resuscitated by one of my own residents. I was completely hysterical screaming and crying when I woke up and found out, and I am well known for being calm under all circumstances professionally, I doubt people even knew I could raise my voice. People realized that it is obviously different when it is you and your own kid, which is probably why we don’t treat our own families. Heck, I just woke up last week in the PACU from surgery that ended up being more extensive than expected screaming in pain in front of someone I trained with.

      • fiftyfifty1

        ” It was a feeling of complete dependence and vulnerability. It was especially bad because when I lost it, and I really really lost it, it was in front of colleagues.”

        You see, this is where they should have stepped in and dry humped you and taught little uptight you to “dance” through your labor.

        • NoLongerCrunching

          Great, now I need a new keyboard. Thanks a lot FiftyFifty!

        • theadequatemother

          Fiftyfity1 that’s the kindest thing you’ve ever said to me

          • fiftyfifty1

            I hoped it would come across that way. It was said with a lot of affection. You have my 100% permission to be 100% a patient whenever you are a patient. And then the next day, I will look you in the eyes and make some sort of awful joke about it. And I would like to think you would do the same for me.

        • D/

          The. Best. Laugh. In. Ages!!

          Gonna go dance myself through the labor (and delivery) of the chili bean in my right lung now! 😉

      • LK

        I was 36w 5 days with #1 and 36w 4 days with #2. Chances are I wouldn’t make it to term and wouldn’t be a candidate for either a cs or induction.

  • Trixie

    That description of her birth dancing with the woman in labor is creepy.

    • Elizabeth A

      Really, seriously creepy.

      Also, it completely negates the variety of labor experiences. A woman who is enjoying herself in labor will do whatever, most of us don’t enjoy that. When I was in unmedicated labor, I did not feel like dancing.

      • Sarah

        I felt like dancing in agony…

  • WordSpinner

    I HATE the “Oh, NCB is all about supporting women’s choices.”
    No. It. Is. Fucking. Not.

    NCB is an ideology that claims the IDEAL birth is vaginal, without pain relief, and with as little medical assistance as possible, that this is the goal that all women should strive for in their births, and if they do not achieve it, either they or their care team are failures.

    You can’t exaggerate the risks of epidurals and ignore the risks of homebirth to convince women to use your services and then claim you are supporting women’s rights in childbirth. And when called out on you, you can’t claim that we’re for forcing women to have epidurals. No–we’re about allowing women the correct information about the risks and allowing them to make a decision about pain relief in labor without having to worry that they failed as a mother if they choose the most effective way to eliminate pain.

    • yugaya

      “NCB is an ideology that claims the IDEAL birth is vaginal, without pain
      relief, and with as little medical assistance as possible, that this is
      the goal that all women should strive for in their births, and if they
      do not achieve it, either they or their care team are failures.

      You can’t exaggerate the risks of epidurals and ignore the risks of
      homebirth to convince women to use your services and then claim you are supporting women’s rights in childbirth”

      BUt they can – how many times have they said/implied that natural physiological childbirth is

      -the way birth should be
      -the way our ancestors did it for thousands of years
      -what our bodies were made to do
      -the most empowering experience a woman can go through…

      Each and every time the person saying this, be it a parachuting troll NCB believer on this blog or off the rails NCB advocate like dr. Sarah Buckley in a mock scientific paper, will forget to mention the price tag attached to this “ideal birth” – natural unmedicated physiological childbirth without any interventions in its most ideal form will kill 1 000 -1 500 women per 100 000 births, and that is the original size of the bullet women are dodging every time they try to adhere to it.

  • Claire Eyles

    The whole dancing (hip thrusting, pelvic rocking, foot stomping) your way through labour schtick was something the ‘Mamas’ on a number of Pregnancy forums kept trying to shove down my throat (before my husband and I discovered we were infertile and accepted that we would most likely never have children) when they found out I was planning to have an elective C-section without even considering giving vaginal birth a chance. This in spite of the fact that I was practically capslocking from the roof top, in sheer frustration, that all the grunting, sweating, and grapevine stepping praises to ‘Mother Birth’ in the world were still not going to allow my (twice confirmed, correctly diagnosed, caused by severe malnutrition due to childhood onset anorexia) cephalopelvically disproportioned body to just ‘trust birth’.

    • I’ve heard the very same regarding my decision not to risk another broken tailbone.

      • Claire Eyles

        But you’d be robbing yourself of such an empowering and beautiful experience. Can you not think of any endeavour more worthy of a fractured coccyx than to twerk your way through the birthing process?

        • A champagne and Pop Rocks enema, for one.

  • araikwao

    Having read through the comments below, it brings to mind the story of a woman whose file I was auditing for my research project. I read the midwife’s notes from her labour – what position she was in, she was coping well, went on to have that wonderful NVD. In another section was the summary of her complaint about the trauma she suffered from being denied an epidural after multiple requests, the 3a tear requiring repair in theatre.. Quite the contrast. I wonder if midwives documented each request for pain relief and their response I’d it would make them think differently about how they work. It would certainly be a good quality control measure.

    • Mattie

      they should be doing that, and if it goes to the NMC (this is all a UK situation) and the notes are looked at and they didn’t, it does not bode well for them

      • araikwao

        This is a story from Australia, the public hospital system. It’s probably only somewhat less NCB-dominated than the UK.

        • Mattie

          awful! Does Australia have some kind of midwifery/nursing regulatory body, that licenses and sanctions bad nurses and midwives? Because at least here, women can complain direct to them if care has been sub-standard.

          • araikwao

            Yes, and also directly to the hospital. I wonder how many do actually complain, or how many are just flat-out terrified of childbirth thereafter..

  • Bombshellrisa

    Anybody else reading the comments below and remembering Jane the NZ midwife advocating “support” for labor pain (then insisting her IV was “excruciating”)?

    • SK

      I had an IV for MgSO4 when in the hospital for pre-eclampsia, and it was actually excruciating. But. Saved my life.

      • Bombshellrisa

        Yeah, I can relate. Some veins were not meant to have anything infused into them.

      • moto_librarian

        Jane was suggesting that her I.V. was on par with the pain of the manual e animation of my uterus without analgesia.

        • Ardea

          Jane, Jane, so silly…

    • Dr Kitty

      I had a student midwife mistake my brachial nerve for an antecubital vein. That was pretty painful.
      I got over it though.

      • The Computer Ate My Nym

        OUCH! My antecube on the right runs under a ligament. It feels like it should be reachable but when someone goes to get it, bad things happen. Nowhere near as painful as childbirth though. (Of course, digging through a ligament is nowhere near as painful as hitting a nerve.)

  • guest

    Dr Amy, (and other commenters) I am going to bed. but still waiting for your evidence, Dr Amy. it has been silent since I asked for an actual quote proving your point. but maybe you are busy.

    thank you for discussing.

    • Amazed

      Night! I’ll be waiting for your reasoning why we should worship SK who so loves extrapolating invividual cases and lying (after all, where I am children were NEVER encouraged to be present at births until WWII and you seem to think that not mentioning something must mean the thing had happened. SK lied about my part of the world ot didn’t take it into account because it didn’t fit her agenda!) when you are against extrapolating individual cases and so concerned about mispresentations.

    • Amy Tuteur, MD

      There’s nothing that would change your mind; I’ve known all along that you are an academic prominent in the homebirth community.

      I am surprised that given your specific area of study you are willing to excuse what you know to be grossly unprofessional behavior on Kitzinger’s part. That shows me that you are willing to dismiss anything to hang on to your beliefs.

      • yugaya

        ” an academic prominent in the homebirth community.”

        Wow. What a sad bunch they are if that is the level of communication/argumentation someone that high in NCB hierarchy displays.

      • Amazed

        Are you surprised indeed? I am not. Their ilk is just like this.

        So I was right about her. What can I say, my instincts get better with practice, just like nature intended.

      • guest

        I would not describe myself as prominent. But thank you – though it probably isn’t a compliment;)

        It is not true I don’t change my mind. This blog has made me realise even more than I already did how varied people’s evaluation of birth modes. processes and outcomes are, and how legitimately different people weigh and value risks. Which is WHY we should expect different choices, and provide for them.

        It has also brought into much sharper focus something I was already very worried about, which is that a more positive attitude towards less-medicalised birth can ALSO create serious misinformation, with disastrous results, as you often document here.

        But that is exactly why I get so irritated. I am the first to grant that there are all sorts of nutty views out there – and I regularly try to correct them – but there are also reasonable ones. at both sides of the divide, so to speak. Surely our task is to sift the reasonable from the nutty. By including all the reasonable views with the nutty, though, I think you contribute to the problem: it polarises enormously and promotes extremes on either side.

        I read your blog and I am willing to engage with you and your commentators. Look how difficult it is. How so much that is said is given its worst, most extreme interpretation – how little effort there is at understanding what another person is coming from.

        Re: SK. I am only cautioning at reading a lot of things in her views that I don’t believe to be there. that does not mean I endorse everything she has ever said or done. Your ideas about sexual predation are interesting.

        • NoLongerCrunching

          “I read your blog and I am willing to engage with you and your commentators. Look how difficult it is. How so much that is said is given its worst, most extreme interpretation – how little effort there is at understanding what another person is coming from.”

          I admire people who come here and engage. I know it is not easy. But don’t you think it’s worth it? Staying in echo chambers where everyone thinks the same gets really boring. I think debating these issues forces each side to reexamine their assumptions and question whether what we think we know is actually true.

          I started out a fierce NCB advocate and came here to enlighten everyone as to why they were wrong. It has been a really amazing journey for me of learning things I never would have learned. I’m an IBCLC and it has helped me understand my patients better and provide better care.

          I admit I still can’t help feeling that there is something special about a natural birth, but only if things are uncomplicated and the pain isn’t causing suffering for the mother or baby. I now recognize that that belief is more of a “religious” type of belief rather than a conclusion based on scientific evidence. I would fight for a woman to have an epidural or elective c-section for any reason she wants, and be thrilled if she gets what she wants, not secretly sad. It’s her body and her birth experience.

          • Amazed

            But why should you help feeling that there is something special about natural birth? Each of us has something that they feel is special. Two friends of mine feel that there is something special about a new book. I always smile when I see them sniffing it. They claim it smells different, better.

            As long as we don’t impose this “specialness” on others, it’s one of the things that make life worth living.

          • NoLongerCrunching

            I appreciate that and thanks for the analogy. I’m a rational-minded person so it makes me uncomfortable to just have random beliefs with nothing to back it up. My mother (a scientist) was really into natural childbirth and breastfeeding, and I grew up hearing about it. She (and I) had all easy, uncomplicated births. I suppose I would feel very differently if I had pain I couldn’t handle.

            I had a turning point about breastfeeding when a baby in my family was formula fed from birth. He is a preschooler now and is the picture of health and intelligence. He is especially close to his dad, who did at least 50% of his feedings. I still adore helping mothers and babies breastfeed, but it doesn’t ruffle my feathers in the slightest if they want to combination feed, or if they decide breastfeeding is not working and they want to wean. I am just happy to help that family achieve their goals and enjoy their baby. I give a lot of credit to this blog for helping me along this journey.

          • Amazed

            Well, I happen to believe that the curse of the disturbed tombs is real – and I’m not talking only about the Egyptian ones. In fact, I’m talking mainly about our tombs here. I am generally a scientifically-minded person and science points at it not being quite so. I have my reasonings but the fact is, they are just mine.

            Doesn’t mean I go around shoving my beliefs down the throats of everyone around me – although I do warn the friends I visit tombs and temples with that the ancient thrones cut in the rock were not meant for our backsides, IMO. And yes, I know it’s stupid and irrational. And I feel embarrassed as I’m doing it because I KNOW it’s just my feeling.

            I certainly don’t throw myself trying to bodily stop them from sitting there.

          • guest

            amazed, why do you think i stuff my beliefs down everyone’s throat????? why do you think i am of that ilk????? at every point i say there are lots of reasonable approached to birth. that i want people to get what they want – be it (informed) epidural , (informed) HB – whatever.

            All I came to point out is that there is serious misrepresentation and jumping to conclusion. what i am repeatedly faced with is misrepresentation and jumping to conclusion.

            I am just curious.

          • Amazed

            I was not talking about you, Guest. Not in this post, at least. I was actually thinking about women like our Doula Dani here who “was obsessed and totally convinced that every mom-to-be needed to watch that
            movie. Hello, we need to know what we’re getting into at hospitals! Or even
            better, opt out of a hospital and give birth at home, because it’s (apparently)
            safer!”

            http://whatifsandfears.blogspot.com/2012/12/the-business-of-being-misled.html

            That’s a MILD case of shoving your beliefs down everyone’s throat. That’s how it starts. Fortunately, Doula Dani who’s an incredibly caring person got away from that. And I think the responsibility of the NCBers and those who support natural agenda over everything (yes, like you trying to distort SK’s explicitly written words about wanted and unwanted children that were so incredibly out of order there that I cannot believe she even mentioned such a thing in this context, no matter of her stand of the issue) is far greater than mine because rationally, I recognize that nothing bad is going to happen because someone sat down on a rock throne. No one is going to die. Danielle Yeager, though, begs to differ. In her case, someone did die because everyone was busy shoving the natural agenda down her throat.

            I don’t have prejudices that I need to be careful about because they are related to life and death. You do. SK did. She might have done much good but nowadays, in the current setting of childbirth in modern world, she failed.

            Please don’t fail because it isn’t just about you, your superstitions and perhaps you being right (as it is for me.) It’s about real people’s very real life, death, and pain.

          • NoLongerCrunching

            I love it, Amazed! Human psychology is so interesting. I once showed my mother the research against episiotomy (for some reason she thought it was the bees knees) and she barely glanced at it before proclaiming it “rubbish.” This is a woman with a PhD in a hard science.

          • Amazed

            I agree. It’s very interesting. And I cannot believe how I came to where I am. I’ve always felt uncomfortable at the way science totally denies the possibility of the ancients knowing something that we forgot because we’re now too “learned” and “accomplished” to need it. But that was the extent of it.

            Long story short, one day I went to see the newest artifacts that had been just discovered in a very interesting place here. I have education that partially covers this topic and I’ve always had interest in it, so I was one of the first people to ever go there, not waiting for the exhibition to arrive in the capital.

            It was all good and amazing. And then, I saw him.

            http://www.cleves.bg/en/cleves-news/278/king-seuthes-iii-flying-to-london

            And I immediately felt scared, intimidated, sick. I could simply feel him glaring at me and asking, “Why are you here? Why are you gawking at me? I am not here to entertain you.”

            I’ve seen many artifacts and works of art – and it was one of the best works of art I’ve seen, as well. I’ve never had such a reaction. Never. A few people around me also fell faint. I believe that the sculptor was a man who had more than talent. I know how stupid it sounds but I really believe it. He caught something of the king’s spirit. It was the last straw for me. The feeling of being uncomfortable turned into a firm conviction.

            And here I lay the crown of a rational-minded person. Does any of it make sense? So I thought. And what of that?

            Doesn’t the specialness of natural childbirth look like a piece of good rationality in comparison?

          • NoLongerCrunching

            Nah, I think it’s weirder to believe there is something beautiful and spiritual about lying around groaning like a tortured moose for hours. Not to mention that most people would gag at the idea of not giving your newborn a bath for days… But I couldn’t get enough of her heavenly aroma — I swear it was like smelling happiness.

            We’ll just have to be nutjobs together I guess! So… what is your favorite brand of tinfoil?

          • Amazed

            Anything new and shiny. Give me parti-coloured, and I’m the brand’s most devoted slave.

          • Maya Markova

            OT, but have you seen these frescos, from the same culture?
            http://whc.unesco.org/en/list/44/gallery/
            For me, it’s also a mystery. You can see e.g. in Italian museums how artistic technique and ideas developed gradually over centuries. This perfect art comes out of nowhere.

          • Amazed

            Oh yes. I was first there many years ago. I remember people feeling disappointed that it was so small and that it was just a replica. I was so happy that I could see it and that the original was being preserved.

          • guest

            Dear NoLongerCrunching.

            Thank you. Do I think it is worth it? Well – up to a point. It takes an awful lot of time. That I don’t really have.

            I can read and get what I want – a ‘broader perspective’ or ‘other side’. And i to that a lot, exactly because I am not into echo-chambers. But when I try to interact, I do get the feeling that this place is often an echo-chamber too. Not everyone (not you, clearly) but if you look at quite a few of the other commentors I am engaging with, I think you can see what I mean.

            Here’s the thing. I almost word for word agree with your last paragraph. I think there is something special about NB – in the way that I think there is something special about climbing a high mountain. Some people are into that and find it an amazing experience, worth (or perhaps even because of ) the effort and pain and difficulty involved. Others couldn’t care less – or think it is crazy (and would certainly hate it). I respect both – I think both are reasonable.

            I too would (in fact: do!) “fight for a woman to have an epidural or elective c-section for any reason she wants, and be thrilled if she gets what she wants.” And that is why I also fight for women who want, say, a home-birth. Yet I constantly have put words in my mouth here that makes me some kind of crazy nutcase. it is THAT that I find so worrying. Polarisation and wilful misunderstanding helps noone.

            what is an IBCLC? breastfeeding and lactation?

            I must add, every time I do engage here i also end up ‘meeting’ really great commentators – people that it is very worthwhile to interact with – like you. Thank you for your nice words

          • NoLongerCrunching

            IBCLC = International Board Certified Lactation Consultant. We help moms learn to breastfeed.

            The culture on this blog is not to mince words. The reason for that IMO is because babies’ and mothers’ lives are at stake, and if you stick around, not a month will go by where you don’t see a baby (or several babies and the occasional mother) die in childbirth because the mother was trying to a achieve a natural birth. Almost always this is because she has been told it is better for her and the baby, and she has been scared away from hospitals and OBs or “medwives.” Thanks to people like SK. (I think NCB leaders did some good…but they could have done it in a cooperative rather than adversarial way).

            So when someone comes here defending SK and her ilk, it hits a very, very raw nerve. I agree that it may be counterproductive to pile on a newcomer and eviscerate her …then again, there are a huge number of us here who went through what you’re going through and stuck around with open minds…and ended up better for the experience.

          • guest

            But you have to take SK and her ilk for their package – they also did good – they got women of their back, contributed to reduction in episiotomy rates, etc etc.

            You also have to ask why it is so adversarial. I come from probably the one place where it is relatively unadversarial, the Netherlands. and whatever you may think of their perinatal mortality, IF you are going to respect people’s wishes to have midwifery-led care (which I think you should – otherwise you don’t treat women as people who can make their own choices and you decide FOR THEM what physical sacrifices they should make for their abies’ lives) then the NL model of integration is probably one to go for.

            So why is it so adversarial? Is that all due to NB people? historians tend to credit adversariality in part to historical power struggles between the (at the time entirely male) medical profession, and female midwives. We know who won, almost anywhere.

            I think one reason that it is become increasingly adversarial (and NCB is pushed extreme) is that women still feel unheard and unrespected in main-stream medical care. I don’t advocate because I want everyone to do an unassisted birth; the opposite.I advocate because I want women who want, say midwifery-led care to do it as safely as possible within a system where the midwife has a direct line to the ambulance, a good hand-over arragnemtn with hospital, and good training. I want the person who want home-birth to get the same. What I don’t want (and what is now happening) is that medical system dismisses the person who wants, say, VBAC as crazy selfish and irrational, which means she then turns to home-VBAC with an insufficiently trained midwife.

            And the problem is – I feel this blog contributes to the adversiality, rather than attempting to reduce it. it does not say ‘this is crazy information – but that is not to say that there aren’t reasonable grounds, or reasonable disagreement’. I feel it too often claims ANYONE who might want e.g. home-birth is insane, that anyone who cares about ‘birth experience’ is selfish or stupid – and it only justifies (some of) the medical system’s dismissal of women’s concerns; and drives people into the arms of polarising NCB extremes who (understandably) feel threatened.

            does that make sense?

            I have to go in 5 minutes but will try to come back.

          • guest

            adding quickly – if find this conversation very worthwhile. please do respond if you have time.

          • NoLongerCrunching

            “women still feel unheard and unrespected in main-stream medical care”

            This is a common trope by NCB advocates. It may have been true in the 1950s, but it is no longer the case. The Childbirth Connection (ironically an NCB advocacy group) does surveys called “Listening to Mothers” in which they interview mothers about their maternity care experience (in the US). From their most recent survey: “Thirty-five percent rated the U.S. maternity care system as “excellent,” 49% as “good,” and 16% as “fair” or “poor.” That is, 84% said their care was excellent or good.

            In the hospital I work, the most common complaints have to do with the temperature and size of the rooms, the comfort of the couches the father/partner sleeps on, and the food. The most common direct patient care complaint is that a nurse was brusque or there was a language barrier. I have literally never seen a complaint about being pressured into medical intervention.

            For an interesting look at the Childbirth Connection, see this previous post:
            http://www.skepticalob.com/2012/06/childbirth-connection-is-not-listening.html

          • NoLongerCrunching

            A lot of people think that Dr Amy’s sharp tone is deliberate, because controversy gets eyeballs on the page. Her mission is to save lives, so the more people that read her, the more potential lives saved. There are other similar blogs that are more gentle (Doula Dani’s), but they don’t have the traffic that the Skeptical OB has.

            I chose midwives for my births. But now I wonder, did I do that based on accurate information, or because I was taught to fear the “cascade of interventions” that would surely happen to me with an OB? if a woman wants a midwife, great. But if there is a policy to manipulate women into seeing midwives to save the system money, that is wrong.

          • Cobalt

            http://www.skepticalob.com/2014/03/the-dr-amy-paradox.html

            I think being willing to be famous for being meen, and having to deal with the constant assault on one’s character because of it, in order to build a wider platform from which to spread unpopular truths that save lives, is pretty admirable.

            Everyone needs that one brutally honest friend who is going to tell you exactly how it really is. Dr. Amy is that friend for any woman who needs it.

          • AllieFoyle

            Ugh, the NL maternity system? No thanks. The home visits and postnatal care are great, but otherwise it is a system set up with midwifery (and home birth) as the default settings. It’s very difficult for a woman to get OB-led care without a midwife’s referral; there are serious systemic, logistical, and cultural barriers to getting an epidural; and maternal request c-section is pretty much impossible. It’s a system that very much values a certain type of birth–natural, midwife-led, at home, if possible–without regard for women who don’t share those values or who would be better served with a different model of care. It’s ironic that you seem to be in favor of having many choices available, but the NL system offers very little real choice to the woman who isn’t interested in NCB.

          • Cobalt

            Why is it so adversarial?

            Have you seen The Business of Being Born? Because it, and the ideologies behind it, create a false sense that modern obstetricians are money grubbing, golf worshipping, cut happy surgeons that care more about indulging their hobbies than getting mothers and babies safely through the birth process. It promotes an incredibly misleading view of modern obstetrics, and sees denying yourself access to the emergency care that can make the difference between life/health and death/disability (because that’s the truth of home birth) as a reasonable response to hospital birth not being full of sunshine and sparkles.

            Not all OBs are good, and the bad ones need reporting and removal. There is a well defined process for this, but women are being told that instead they should abandon medical care altogether. The increased risks in choosing to avoid medical care are denied, and bad outcomes are just swept under the rug.

            The thought that women are being lied to about their choices, the risks to themselves and their babies, are being held to an ideology that values “the sacrament of birth” over life, makes me quite adversarial to anyone who would promote such dangerous nonsense.

          • AllieFoyle

            Also, no one here thinks VBAC is automatically a crazy, selfish choice. It can certainly be a reasonable choice, provided it takes place in a facility equipped to handle it, there are no medical contraindications, and the woman is fully informed of the risks and benefits.

            The trouble is when women insist on having a VBAC when it isn’t safe for them individually, or that a facility or provider facilitate their request when they can’t safely do so. Often these women have been encouraged to believe a lot of questionable information about the risks involved, to be distrustful of the motivations of their health care providers, and to believe that a VBAC will be a sort of wonderful, fulfilling achievement. That’s the concern, not VBAC in general.

            And again, you’ll find that most people here support a woman’s right to have a home birth, but are dismayed by the lack of safety or truly informed consent that often accompanies such a choice in the US today. Everyone I’ve met who has had a home birth believed that she was making a safe choice–that home birth was just as safe as or safer than the hospital. It just isn’t the case.

          • KarenJJ

            Can we not celebrate the good and criticise the bad? Do we have to take someone’s opinions – all of them – and propose that they are good? Should we still teach Newton’s alchemy alongside calculus? How is midwifery and feminism to grow if we are taught to admire a person instead of their ideas?

          • Maya Markova

            In the Netherlands, is it possible – and is it easy – for every woman who doesn’t want midwifery-led care, to have a hospital birth presided by an OB?

          • Guesteleh

            whatever you may think of their perinatal mortality

            I love how this is only a parenthetical. NL babies of low-risk mothers are dying at a higher rate than babies of high-risk mothers treated by OB’s, but what we need is to promote midwifery-led care.

          • NoLongerCrunching

            Oh, and another thing — I haven’t seen babies die from an insistence on natural (breast-) feeding, but every single day I see mothers and babies suffering from either severe anxiety, pain, and occasionally medical complications from delayed or low milk production. All this would go away if we relaxed about feeding being best when 100% natural. Mothers are terrified to allow a drop of formula to pass their baby’s lips. The natural birth and breastfeeding community have as much to answer for as those old patriarchal OBs, and we can be just as arrogant and mule-headed.

        • Amy Tuteur, MD

          I’m glad you read the blog and I’m very glad that you are willing to engage, but I am curious about something. Why do you insist on being anonymous? Why are you unwilling to be connected with or questioned about your body of published work? Why aren’t you willing have your name associated with what you write here or to let anyone know that you are participating here?

          As regards Kitzinger, you keep insisting that I am misrepresenting her but you haven’t provided any evidence. I don’t think there is much question that she located a woman’s virtue in her vagina or that she exulted in women’s pain. You want to defend that as progress. I see it as deeply retrograde.

          Moreover, I would be shocked if you thought that Kitzinger’s behavior in the birth “dance” was anything other than unethical. I don’t know if you knew her personally, but you are dismissing her utterly indefensible conduct (a random visitor to the labor ward touching a patient intimately?) because of who she is. I doubt you would find it acceptable in anyone else.

          • guest

            I have lots of reasons for being anonymous (although previously I have only engaged half-anonymously). One is that on a blog I have to cut corners and concede points for the sake of argument and communication that I would not want quoted out of context. My published work I can control and stand by.

            I would be happy for you discuss my published work sometime (not tomorrow please) and talk about it – I will log in under my name in that case (in which case I would also be very careful in my comments and refrain from saying anything that I haven’t completely nailed shut. So expect long sentences!).

            Kitzinger: I have constantly provided quotes in various comments here, and alternative readings and explanations offered of the quotes offered to me. I am still waiting from a clear quote from you.

            Birth dance: so I (maybe over-charitably. But then I am very charitable, because I think it is the only way one can communicate. I even read you charitably, DrAmy; believe it or not, I have actually defended you and your intentions on those grounds repeatedly to people who, you may imagine, hold a much less charitable view of you. But often in this blog, even being as charitable as I can be, I am appalled).

            anyway, maybe over-charitably, I read this as: she got the woman out of bed, presumably asked permission to try this, then placed her hand on woman’s hips and with her made rhythmic circular motions, demonstrating what to do. I am assuming the mother was OK with, this and it worked. I don’t think that is beyond the pale. midwives also rub backs, give hugs, massage perinea (!). This obviously have to come with judgment and probably non-verbal communication.. I am making the leap that consent and everything was in place. you are making the leap that it clearly wasn’t. That seems to me very uncharitable.

            I am still waiting to hear evidence that she thought a woman’s virtue was in her vagina, rather than that many women could have a much better birth experience than they were having. hear-say, or ‘it is well-established’ by your own standards, is not evidence.

            thank you for engaging back, btw. you are good at that , i admire it.

          • Amy Tuteur, MD

            It’s my turn of phrase to say that she locates a woman’s virtue in her vagina, but I think it accurately sums up her views.

            Is Kitzinger a biological essentialist? She most definitely is. She repeatedly portrays both women and birth as having fundamental essences that cross times, places and cultures. She assumes that childbirth is the ultimate fulfillment for a woman and that unmedicated vaginal birth is the ultimate form of childbirth.

            Is Kitzinger matriarchal (patriarchal)? Absolutely, there is no question that she believed she knew what women wanted and needed better than women knew themselves. To the extent that she represented a minority, she asserted that the majority would agree with her if only they were properly educated.

            Was Kitzinger privileged? Extraordinarily so. She created a movement for Western, white well off women and entirely ignored the needs and desires of everyone else except to pretend that they really needed what she was offering.

            We have no way of knowing, because Kitzinger doesn’t say, but I wouldn’t be surprised if the woman in the birth dance episode was neither white, nor spoke English (which is why she fails to mention any conversation). The woman had no idea who Kitzinger was, but she knew that she held power and so whatever the woman “agreed” to do came from a position of subjugation.

            The primary problem for me in assessing Kitzinger is that she and her colleagues moved the goal posts. When they achieved what they set out to do, make sure that women were awake during birth, accompanied by partners, not shaved, no enemas, etc. she and they moved the goalposts. Now natural childbirth is dogmatic, prescriptive and moralizing. In the UK especially it appears to have gone entirely off the rails with midwives literally letting babies and mothers die to achieve “normal birth” and their professional organizations don’t even give enough of a damn to talk about it.

            You probably go to academic conferences with lots of Western, well off white women who think a bad birth experience is failure to have an orgasm during childbirth. Everyday I hear from women who come from very different social and economic backgrounds who are distraught, depressed, and occasionally suicidal because they “failed” at birth. Where did they get that idea? Not from me and my colleagues, but from you and your colleagues.

            I don’t think you appreciate the level of guilt, and self-hatred that is caused by the natural childbirth movement. It meets the needs only of people like Kitzinger, other Western, white, well off women and they don’t appear to care about anyone else.

            There’s a lot of talk in academic circles about human rights in childbirth, but it’s really about the right of the privileged to do what they please. They couldn’t care less about women’s right to have pain relief, women’s right to have a care provider who doesn’t substitute her idea of a good birth for the woman’s idea, and women’s right to have a provider who cares more about whether mothers and babies live or die than ideological purity.

            I’m very willing to engage on this topic, and very passionate about it because I see the suffering, most of it completely unnecessary and most of it based on the power that privileged women hold over others. I haven’t read all your work or all the work of your colleagues, but it seems to me that natural childbirth advocates pay precious little attention to anyone but themselves, and I found Kitzinger’s clueless description of violating the rights of a patient in labor to be emblematic of any outdated, retrograde philosophy that no longer helps women, but actually hurts them.

        • Guesteleh

          What bothers me the most about SK and NCB is the belief that women have to suffer pain in order to have a spiritual and meaningful experience at birth. Which isn’t true. I had a deeply spiritual and meaningful experience at my induced birth with epidural. No doula, no birth affirmations or hip rocking. Given that most women will opt for a hospital birth with pain relief, why not focus on supporting them in that environment and making it as good an experience as it can be (as defined by the woman herself).

          What bothers me most about you is your misinformed ideas about epidurals despite research that proves your beliefs are wrong (e.g. no, epidurals don’t cause more forceps deliveries). It’s inevitable that your biases will emerge when you’re talking to women who need objective information about their options.

          • Dr Kitt

            Yup, deeply moving, spiritual, very joyful and totally painless elective CS for me.

            NCB is those studies about hazing writ large.

            If you go through a horrible hazing ritual, the club you’ve joined seems more worthwhile than if you join the same club without the hazing, as you seek reasons to justify to yourself why the hazing was worth it…but that doesn’t make hazing a good idea.

    • yugaya

      Sheila Kitzinger in her own words :

      ” of how pain can be handled and how it turns into suffering when
      women feel they have no control over it…”
      – suggests that feeling of control changes the nature of pain

      “For each woman the birth is associated with body fantasies that define the stimuli that she receives from her uterus”
      – claims if you fantasise the right way your uterus is not sending out painful contractions

      “Labor pain can have positive or negative meaning depending on whether the child is wanted”
      -implies that if childbirth hurts the child is unwanted.

      Bonus quote for context purposes:
      “No other natural bodily function is painful and childbirth should not be an exception”. ~Grantley Dick-Read, M.D.

      • Roadstergal

        “No other natural bodily function is painful”

        Outright lie, or serious disconnect from reality?

        • The Computer Ate My Nym

          My first thought: Has the man never been constipated?

      • guest

        We clearly read this very differently.

        – I don’t think that it is crazy to think that control matters in how pain is experienced. that doesn’t mean the pain goes away, but it can make a difference between managing/coping and suffering. Saying that does NOT mean that you HAVE to deal with your pain in this way, or that you are a failure if you won’t/can’t/whatever.

        – I take it just to mean, again, that your mind can affect (not eradicate) how pain is experienced. Not that it will just ‘poof’ go away.

        – can = not MUST. I am sorry, but a friend of mine had to give birth to an unexplained in-utero death at 33 weeks. She was drugged up the hilt (thank god!!!!). OF COURSE her labour pain would have had very different meaning than it would had she been pushing out a live baby at 40 weeks. this statement does not say the pain goes away, just that the pain CAN (not must) have positive meaning.

        None of this seems nuts (though we can debate that). importantly, none of this supports Dr Amy’s claim the Sk thought a woman’s worth was her vagina, or was all about shaming women. she makes it very clear that she is NOT about shaming women and setting impossible standards that women will fall short of for that is exactly what she accuses the existing system of: “Even now, some doctors and midwives take it for granted that a woman will be on her back during labour and delivery. […] it becomes a kind of contest, with cheer-leading teams urging a mother on to ever greater effort.This makes her feel that she’s falling short of a standard that’s impossible to attain.”

        If you think that mind has no influence on pain or how it is experienced, immerse yourself in sports-psychology for a bit.

        Finally: I grant you immediately that there are SERIOUS issues with dick-read.

        • yugaya

          “- can = not MUST. I am sorry, but a friend of mine had to give birth to an unexplained in-utero death at 33 weeks. She was drugged up the hilt (thank god!!!!). OF COURSE her labour pain would have had very different meaning than it would had she been pushing out a live baby at 40 weeks. this statement does not say the pain goes away, just that the pain CAN (not must) have positive meaning”

          You deliberately ignored the clearly worded second part of that statement made by Sheila that the positive/negative meaning of pain is caused by child being wanted/unwanted. I’ll repeat it here for the sake of clarity:

          “”Labor pain can have positive or negative meaning depending on whether the child is wanted”

          Her statement I quoted has little to do with the anecdata about your friend’s traumatic experience, and everything to do with NCB advocates claiming mother’s inadequacies to be the root cause of all birth evils. When birth fails, blame it on the mother. If your childbirth pain did not take on a positive meaning, Sheila Kitzinger says you did not want that child.

          Are you ok with that statement as a whole and Sheila’s conclusion in it? Are “negative meanings” of childbirth pain caused by mother not wanting the child?

          • KarenJJ

            That’s the thing. Even these “Reasonable” NCB thought leaders like SK say outrageous things. It is right to call them out on it.

          • yugaya

            It would be even more right if sane, decent NCB advocates like our guest realised that it is their duty, not mine to call that BS out.

          • KarenJJ

            Exactly! Guest is defending a person, because she’s nice and popular. The “sisterhood” is more important than the health of women and babies. Accurate information for women is substituted for what “feels” right to an individual based on their past experience.

            If someone says something that is incorrect, then they should be called out. Telling us we’re not nice and are difficult to discuss with – well is it because people like guest has gotten to used to “warm and supportive” discussion instead of rigorous defense of their opinions like many other professionals have to give every day?

          • yugaya

            “The “sisterhood” is more important than the health of women and babies.”

            I don’t get that mindset, I’m like the world’s most vicious critic of the things I believe in. There ain’t no sisterly apologist love reserved for anyone, not even the people I admire the most.

          • KarenJJ

            When I was a young adult I read a book by James A Michener called “The Drifters” and at the very end it said something like needing to “see things for what they really are” (in relation to one of the character’s family member always wanting to visit Fiji but never having actually gone).

            It’s so easy to extrapolate from your experience in other areas and to romanticise and build a fanciful narrative about something. To confront the reality of the situation and embrace everything – the good, the bad, the indifferent – is very important to me. Root cause analysis, understanding someone’s perspective even if it is critical, what does the evidence show, am I looking at an image over the substance of something? All that is important to me and how I try to understand things.

            I don’t get invited to a lot of parties 🙂

          • guest

            “can have negative or positive meaning on whether the child is wanted” does not mean that whenever it has negative meaning, the child is unwanted.

            compare: reading a book can be pleasurable or unpleasurable depending on whether you are stressed

            => that does not meant that WHENEVER you are stressed a book must be unpleasureable, or that a book must always be pleasurable whenever you aren’t stressed, or that when a book is unpleasurable it must be because you are stressed.

            besides: CLEARLY SK didn’t think that labour pain must be due to the child being unwanted as she thought everyone was having awful labour pain due to the medical system at the time.

            finally: she is talking about negative and positive meaning of pain – not about having pain or not having pain. when i run a marathon (well IF I WERE to run a marathon) I am sure pain would have very different meaning from if same pain was just randomly inflicted on me now.

          • yugaya

            It was a simple yes/no question. You are OK with Sheila en general, so everything, even this blatantly outrageous statement must somehow be made acceptable. You CLEARLY know what she was thinking and I only know what she wrote.

            It was nice talking to you.

          • guest

            I think I am very clearly basing myself on what she writes – quotes and all.

            But yes, I also know her larger opus and the historical context (and have read some of the historical work on it) and she was constantly railing against the birth system that was not supportive – not against women for ‘getting it wrong’.

          • The Bofa on the Sofa

            she was constantly railing against the birth system that was not supportive – not against women for ‘getting it wrong’.

            Yet, the statement quoted above EXPLICITLY does that! (blames the women for getting it wrong). You also dismissed her sexual molestation.

            Jeez, at some point, how much bad stuff does she need to do for you to criticize her?

        • Wren

          Why don’t we approach other pain the same way?

          I can’t think of an equivalent for men that is routinely done.

          • guest

            Sports???? how do you think those guys climb up alpe d’huez. [Ok – bad example – on drugs!!!!;) sports without doping then…….

          • KarenJJ

            Doping in sports is for performance enhancement. It has nothing to do with how women cope during labour and nothing to do with them receiving legal pain relief.

          • AllieFoyle

            Athletic achievement is voluntary. It’s under your control; you can stop at any time. Not so with childbirth. It will happen (or not happen) whether you want it to or not. You don’t control it, and you can’t stop it.

            Climbing a mountain is something that some people choose to do. It is about the experience. It’s challenging and requires preparation and willpower and fortitude. You choose to stop or to go on. It generally doesn’t involve 10/10 pain.

            Childbirth is about having a baby. If you want to have a child, it has to be born. Some women care deeply about this experience, others simply want to get through it safely. It doesn’t matter how much you prepare or how much strength of will you have because it’s largely an involuntary process. You don’t control your uterus or your pelvic bones or the baby’s position. Yet women are told again and again to view this process as an athletic event, a desirable achievement, a test of their strength and will.

          • guest

            and you can voluntarily choose to have an epidural, or go for it without. when you go without, you can change your mind. (not easy to get of slope of mount everest once your half way, btw). I am NOT saying you should view it as an athletic event. i am saying one CAN view it that way, if you want. and that that analogy might help understand other circumstances in which people choose voluntarily to seek out and manage pain, rather than avoid it.
            It is tiring. i am trying to engage here. but every time i answer a question, someone reads the statement as a completely independent claim, and in the worst possible interpretation. please read what went before. the question was: do we ever manage pain in ways other than by anaesthetic? the answer is: yes we do – we even seek it out in sports and other ‘fun’ leisure activities.

          • AllieFoyle

            I do appreciate your patience, but please do me the courtesy of not accusing me of not having read your previous posts. I have. I just disagree or have a different perspective on certain points.

            I think it’s really easy to say “Oh, you can choose an epidural, no prob” when that isn’t true for a lot of women. I wanted an epidural and didn’t get one — multiple times right here in the US, with labors that were plenty long enough for it to have been possible. I’ve read of lots of other women having the same experience, and especially so for women in countries with midwife-led systems like the UK and NL. The problem with telling women that it is like an athletic event is that for many of them it won’t be. It will be out of their control, much more painful than any sporting event. It may cause them or their babies physical harm. What of the women who go into it expecting it to be like a marathon, but then find it’s more like being swept up in an avalanche? You can’t always just change your mind and get an epidural, especially in situations that are influenced by people like SK, who deny that childbirth pain is suffering and believe that what worked for them is appropriate for every woman.

          • guest

            Ok. i stand corrected. I am sorry. Yes. people should have access to an epidural. They should never be barred from one. I am sorry if that wasn’t clear.

            (unless they want to. I add that because I don’t want it a stick to outlaw e.g. birth centres with, or small hospitals that might not have permanent anaesthesiologist on site, but that do make home birth possible and safer (as a bigger hospital is much further way) . For women should have those options too.

            I appreciate your patience too.

            lots of people seem to have impression i am anti-epidural. I am really not. I am anti-not-giving people also access to options other than epidural. I had the impression that that is the core of the reasonable NCB, and the kind of thing that motivated SK and such. I am sure they had some crazy views as well

          • KarenJJ

            “I am anti-not-giving people also access to options other than epidural. ”

            Is this an actual problem in any hospital anywhere? Or these days is it an imagined problem from people trying to drum up their doula business? I know people that have given birth without epidurals by their choice in fantastic birth centres that are attached to major maternity hospitals and had very positive experiences with their midwives. I know people that have had epidurals delayed via the public hospital system that have turned to the private system in order to ensure that access to an epidural is more likely to happen. I just don’t know anyone that got an epidural when they didn’t want them?

          • guest

            i think options other than epidural includes e.g. well-supported home birth. that certainly isn’t available, or not available as safely as it could or should be in lots of places.

            also: a lot of what you describe is partially achieved by people like SK. so why be SO against her. it isn’t all black and white

          • KarenJJ

            I’m not against SK, I’m just not going to give her a free pass on all her ideas. There’s a difference.

            I actually live where I can access free government provided home birth integrated with the tertiary maternity hospital here. For screened low risk women that are given informed consent and a government that chooses to provide that option, then I think it’s great that women have options like that to choose from.

            You’re right, things aren’t black and white – why do you choose to characterise me like that?

          • KarenJJ

            You take criticism of the things SK says awfully personally… I don’t understand, if you are an academic as Dr Amy believes, can you not get some academic distance and look at these issues and the ideas that SK has in a rational light? What if you try to come from the perspective of having given birth recently in a hospital with all the trimmings that SK and people like her advocated for and found that a lot of the information you based your decisions on was false? What if you’d suffered intense pain because you turned down an epidural because you believed it was best for your baby and then found that it actually matters very little? Or if you repeatedly asked/begged for an epidural and it was stalled and denied by the midwife?

            So many midwifery advocates seem to be trying to fix the issues of the past still? So many women are now obgyns too. Who is advocating for the issues that women are currently facing when they go to hospital to give birth? How many women have had epidurals that they didn’t ask for?

          • The Bofa on the Sofa

            so why be SO against her. it isn’t all black and white

            Not speaking for Karen, but just a reminder of the first line of Dr Amy’s post

            Sheila Kitzinger was a brilliant and incisive cultural anthropologist and remained so until the very end.

            Does that someone who is “SO against her”?

            The whole theme of the blog post is based on her being admittedly brilliant and incisive. So the starting point is certainly not black and white.

          • Cobalt

            A well supported home birth just makes an epidural nearly impossible, while simultaneously making emergency care nearly impossible, and limiting emergency prediction options to levels that triple (at best!) the perinatal death rate.

            Why on earth would that sound like the best option for supporting women who would like to labor without an epidural?

          • guest

            here we go again.
            first, e.g. low-risk multips in UK – no detectable change to perinatal mortality rate.
            second, a woman may legitimately decide to triple her perinatal death rate, in favour of halving her rate of c-sec, forceps, etc.halved . that is a reasonable choice (as baseline rate of latter is much higher), and should be open to her.
            if you don’t think that should be a choice that is open and that the health care system should make as safe as possible, then you are neither a feminist, nor do you truly care about women’s experience – but (like many accuse the NCB), you only care about women’s experiences that you approve of.

            and for the records, before i am misunderstood again: yes, elective caesareans should be available too, in absence of ‘medical indication’

          • Cobalt

            Given that there are so many safer options than home birth for women who prefer an unmedicated birth, I think it is extremely unethical to promote them as a reasonable choice. Some women will choose them anyway, and strong regulations on provider standards should exist so women aren’t being lied to about the care they are receiving, but to present home birth as “just as safe” or “a reasonable choice” is just plain wrong because it’s not true. That’s feminist- truly informed consent, respect, and the right to ethical medical care.

            And I haven’t seen a study yet that reduced cesarean and forceps rates without increasing deaths. There’s a reason those tools were developed, and it has nothing to do with golf.

          • KarenJJ

            I should add that even though home birth is free here it is not taken up much. Not many women choose it and there are other options, like the birth centre at the tertiary hospital or the private hospitals that take your baby for an evening so that you can go out for dinner, that are much more popular.

          • Roadstergal

            Yes, it is true that if you look at a small sample of the lowest of low-risk women, there’s little ability to see a difference in outcomes – much like looking at the risks to not wearing a seatbelt if you restrict your sample to driving 25mph in a quiet neighborhood in mid-afternoon in clear weather. However, expand that just slightly to _low-risk_ primps, and you have almost double the risk to the baby (as per the Birthplace study).

            And I think what gets lost in the ‘risks’ of interventions at a hospital is – women consent to interventions. Unless there’s a dire emergency/woman is unconscious, women can turn them down. If you tell a woman that she has x% risk to her baby, which is why you’re recommending y, then she has the option to consent. What the numbers show is that by and large, women _do_ want to avoid risks to their babies, and when they ‘avoid’ interventions at home, it’s because they’re avoiding the monitoring that lets them know there’s a risk coming up.

          • NoLongerCrunching

            I think hospitals could do a better job of understanding and helping mothers who are coping with labor pains unmedicated by choice. My hospital had a policy of putting you on electronic fetal monitoring 20 minutes out of every hour and nurses varied a lot and how they let me position myself for what I found to be a painful 20 minutes.

            Most of the nurses told me which way I needed to be so that they could set the monitor up; one nurse told me to get in whatever position was comfortable for me and she would do her best to arrange the monitor around that position. I don’t think for a second that those other nurses didn’t care; just that they may not have been aware how big of a deal it is to let an unmedicated laboring mother pick her own position when at all possible.

          • Cobalt

            I had three painkiller free deliveries, all in hospitals, never once had to fight off an anesthesiologist. That’s even AFTER I signed the consent forms for the epidural and cesarean upon arrival (if it went bad, I didn’t want paperwork slowing response times for a moment). I just said “no, thanks, doing fine” and that was it.

          • Amy Tuteur, MD

            I’m not sure if you are familiar with the creationism controversy in the US, but the characterization of your views on epidurals sound suspiciously like their views on evolution. They want creationism taught in public schools and they say things like, “I’m not opposed to evolution, I’m just opposed to not giving people access to other theories like the biblical theory of creation. They need to know all the options.”

            But we all know that what creationists mean is that they ARE opposed to evolution and want to undermine it. Similarly, most NCB advocates ARE opposed to epidurals and want to undermine women’s desire and ability to choose them.

          • guest

            Thanks for this and the other post. both will get proper response but i now have a mountain of other work I HAVE to do. I will get back, but it may take a while.

          • The Bofa on the Sofa

            Athletic achievement is voluntary

            Moreover, athletic competition is COMPETITION!!! You have winners and losers. The reasons people dope is to WIN.

            Birth is not a competition. You don’t win or lose.

            The comparison to sports is a sign of the problem.

            Climbing a mountain is a different question, but as I’ve said, whether you climb Pikes Peak or ride the trolley, the view is the same at the top. And if you want to proclaim that you climbed to the top, fine, but don’t think for a second that, while standing at the top and looking at the view, I am impressed. Some people climb mountains for enjoyment. Others collect stamps. Neither impresses me more.

          • NoLongerCrunching

            I thought as a kind of competition between myself and a force of nature, like scaling a mountain. I understand why there are problems with the comparison to sports, but that is my view for myself and I’m sticking to it 🙂

          • The Bofa on the Sofa

            I thought as a kind of competition between myself and a force of nature, like scaling a mountain.

            Isn’t it more like falling down a mountain? Because you know, it’s not like the baby’s not going to be born if you quit. Unlike climbing a mountain, if you quit you can’t get to the top. But with a baby, jeez, you can be unconscious and it still will happen.

            And falling down a mountain doesn’t have to hurt, if you do it right. Find the right path and roll, and you might get a little dizzy, but hey, you don’t HAVE to break any ribs or crack your head against any rocks.

            Meanwhile, others take the cable car down. We all get to the bottom.

            Think about this: the easiest way to not have a medicated birth is to not have pain meds available. Do it in a place where there are no options, and you WILL have an unmedicated birth. That doesn’t work with climbing a mountain. The default is not to climb the mountain, and you can intervene or not. OTOH, gravity says you will get to the bottom, the question is how do you get there.

          • NoLongerCrunching

            I think that makes sense, except that the joy of meeting your baby compares more to reaching a beautiful summit and seeing that breathtaking view, whereas at the bottom you probably just feel relief that it’s over.

          • Cobalt

            There’s a lot of women who do just feel relief that it’s over, and bonding with the baby comes later, after they’ve had a chance to process and cope with what their bodies just did to them. They would probably have been better served with a more medicalized birth, with scheduled delivery and solid pain control.

          • The Bofa on the Sofa

            How about getting to the bottom of the Grand Canyon? You can just step off the edge, you can follow a trail, or you can ride a donkey?

            Regardless, you are going to get to the bottom, and I am told it is absolutely wonderful there.

          • Cobalt

            I get it. My unmedicated deliveries gave me a feeling like that. There have been few events in my life where that particular blend of hormones, endorphins, and whatever else is going on chemically has hit my brain with such force that I had the sense of feeling “the heartbeat of the earth” or like I could “touch the stars”. The others have mostly been while horseback riding, riding at the edge of my skills and limits. That feeling reflects on my particular neurological response to environmental, physical, and chemical stimulus, not on anything to do with my motherhood.

            The point though, is that medical needs are more important. And even if everything is going just peachy medically, not everyone can feel or wants to feel that way, and there is nothing whatsoever wrong with that. The moralizing, the shaming, the lies, the false claims, it all needs to stop.

          • The Bofa on the Sofa

            wrong place for response

        • fiftyfifty1

          “but a friend of mine had to give birth to an unexplained in-utero death at 33 weeks. She was drugged up the hilt (thank god!!!!). OF COURSE her labour pain would have had very different meaning than it would had she been pushing out a live baby at 40 weeks”

          Yes, I’ve never understood this double standard. People who tell us that we should “warmly encourage” women to deliver med free change their minds and “thank god!!!” for pain meds when the woman is delivering a stillbirth. I guess because they have decided that a mother with a dead baby has already suffered enough…but a mother with a live baby hasn’t?

  • namaste863

    Jesus, what has this woman been smoking? Whatever it is, pass it to me, please! It sounds like fun.

  • Kerlyssa

    I am not understanding how to visualize this. Was she humping the laboring woman from behind? Because her ‘dancing’ sounds like grinding. Jesus.

    • NoLongerCrunching

      I imagined it as her teaching the woman to rock her own hips like a dance instructor might do.

      • Mattie

        yeh I imagined side-to-side movement, rather than forward and back, sort of like a dance instructor. Helpful, maybe, with consent.

    • Bombshellrisa

      Ugh. I am a belly dancer and I can’t imagine doing a hip roll or any kind of shimmy during labor. And I especially can’t imagine having someone touching me and telling me to dance during labor. Although I am
      Wondering if it’s because the poor woman needed something, and I have read about how hard it is to get the midwives to help you get an epidural in the UK.

      • Bugsy

        Yep. Prior to my dear epidural, the only thing I was doing during contractions was curling up in a tight ball and wishing I were anywhere else. Movement, dancing and random stranger caressing my body? Ummm, no thanks.

    • yugaya

      I think Sheila developed and documented her own brand of twerking birth support. TWERK THE BIRTH!

      • CharlotteB

        I feel like you should make bumper stickers with that slogan…so hilarious.

        (Except it’s not)

        • yugaya

          What Sheila did to that woman is a perfect example what NCB did to childbirth – merely replacing obstetric abuse with midwifery abuse.

          In both case the abuse goes on under the alibi of claiming to be acting in labouring woman’s best interest.

          • Amy Tuteur, MD

            And what’s worse is that she wasn’t even a midwife. She was a random stranger visiting a labor ward.

          • KarenJJ

            “Step aside people! Know-it-all coming through! I’ll save the day!” yuck.

          • moto_librarian

            Maybe she slept at a Holiday Inn Express the night before…

  • MaineJen

    If Sheila had tried that little maneuver on me during the worst part of labor, she would have gotten a black eye for her trouble.

    • yugaya

      And a lawsuit.

      • Bombshellrisa

        Maybe Improving Birth would set up a gofundme for your legal costs : )

        • Amazed

          I can be yugaya’s lay lawyer. That might just settle the tiny matter with being allowed to practice (or not). We’re neighbours, after all, I’ll just cross the border (legally or not so much.

          • yugaya

            You could just call yourself a lawyer and we can get you some online certificate from somewhere. I trust you and I trust justice so that way I am going to be able to avoid all complications anyway!

          • Cobalt

            For a very reasonable price, you can study at the online Cobalt Lawifery School. All courses come complete with certified certificate of certification (you’ll be not bona fide but triplified!) and one year membership in the Lawife Alliance of Everywhere (motto: Everything Is A Variation Of Legal).

          • Who?

            Perhaps I could open a branch around here? I take it it is very expensive to get such a degree, though of course the successful will have doors of opportunity opened to them?

            Maybe we can get into lending students the money to pay for their degree? At very reasonable (nod, wink) rates.

          • Cobalt

            WhoNet Student Lendery:

            Your Interest Rate Won’t Grow A Loan Too Big To Pay Off!

          • Who?

            Better get it going before my conscience kicks in.

            But seriously for a moment, there are law students here and in the US with big debts who will likely never get lawyer jobs. The universities keep pumping out the graduates despite demand for lawyers being dead in the water.

          • Bombshellrisa

            Hey, I wanted to be a lay lawyer! Ok, maybe I can be your law doula?

          • Amazed

            I’m sure we can think of something. As long as it doesn’t involve malpractice insurance…

        • yugaya

          I notified them of the abuse documented by honest midwife. Guess what? No reply and no, they have not shared that story of abuse at all. Only when OBs do it or when abuse happens in hospitals is something worth improving according to them.

  • guest

    There is something weird about this blogs’s commenters obsession with ‘adequate pain relief’. When someone likes SK says ‘women should also be offered supported in other ways that JUST epidurals’ everyone is like ‘NOOOOOOO. Women must all have access to adequate anaesthetic pain relief’.

    Which I agree women should have. because women’s experience and respecting their wishes and choices in that matter.

    But when NCB’ers say ‘women’s experiences matter’ everyone is like ‘BAAAA, selfish!!!!!’.

    No you can’t have it both ways. either women’s experiences and wishes matter – and we should have anaesthetic pain-relief for those who want it, and massages, hypnobirthing and god-knows-what for women who want that.

    But what is hypocritical and definitely anti-feminist is to only care about women’s experience when they choose what you endorse – namely drugs – but not when they choose what you don’t endorse – gyrating pelvises (or anything else).

    It is of course just as hypocritical when and NCB-er ‘cares about women experiences’ when she chooses the birthing pool, but lambasts her when she chooses the epidural. And you regularly call out NCB-ers for that, and that is fine.

    But it is not called out when people on this blog make the exact same mistake – though in the opposite direction. And I find that really bothersome.

    of course some of you felt pushed into NCB – and hated it and went for the epic. good for you – and i hope you got the epid fast fast fast. but for every story like that there is a person who felt her hospital based birth was a disaster and wished she’d tried a more NCB-style route.

    women’s experience matter, their wishes and choices should be respected AND THEY ARE ALL DIFFERENT and will therefore value different things, making different choices right for them. By all means call out NCB-ers for falling foul of realising this. But stop making the same mistake here. the fact that you liked the epidural, doesn’t mean all women do and should want it, just as little as the NCB-ers empowering natural birth should mean that everyone does or should want that.

    ps this follows on from a discussion below

    • yugaya

      “There is something weird about this blogs’s commenters obsession with ‘adequate pain relief’. When someone likes SK says ‘women should also be offered supported in other ways that JUST epidurals’ everyone is like ‘NOOOOOOO. Women must all have access to adequate anaesthetic pain relief’.”

      Start with acknowledging the fact that MOST women in our world today have no access to adequate pain relief during childbirth. Once you realise the extent of your own privilege, maybe you will stop finding ” this blogs’s commenters obsession with adequate pain relief” to be “weird”.

      • moto_librarian

        We have regular commenters here that have had multiple unmedicated births. There are reasons that some women do not want pharmacologic pain relief. Some people do not like to be immobilized, others don’t like the idea of a needle in the back, and others have manageable pain. Yes, they should have adequate support from nurses and access to non-pharmacologic coping mechanisms (hot showers, birthing balls, squat bars, etc.). The issue with people like Sheila Kitzinger is that she trivializes the pain of childbirth with her nonsense about “dancing” through labor (and don’t even get me started on how inappropriate her contact with that laboring woman was). I guess I don’t understand the mindset that giving birth without pain medication is some sort of achievement when women in the developing world do it every single day out of necessity. If a woman expresses the desire for pain relief, why should we try to talk her out of it?

        • Amazed

          The problem is also that at the hospital, it would be good if the staff knew how to tell women who were really determined and willing to have an unmedicated birth from those who very much wish to cave but cannot because they’ve been brainwashed that they’d damage their baby, because they’ve got it into their family’s heads that they should not let them cave in and now the family thinks they’re doing what the woman really wants but she has changed her mind and they still guilttrip her into refusing…

          Ah, I have a dream…

          • guest

            yes. and i think giving good care is hard and these judgments can go wrong either way. it will never be perfect (if only it was!!! and surely good communication and continuity of care would help a lot here).

          • JJ

            Yes. I did not get pain relief because I was taught it was dangerous so in my mind my only perceived options were these other natural techniques. So the NCB mindset essentially took away my options making them akin to drugging/hurting my baby. What mother wants to do that!? I was in so much pain with my first I asked if I was going to die and screamed for hours. Now that I know epis are not dangerous I am open to using an epidural during my next delivery even though I have technically been able to cope trough 3 other unmendicated births.

            I do have ONE friend who hated the numb feeling and had her next child without an epidural. She is the only person I know that chose not to have an epidural even though she knows they are safe. Everyone else I know is afraid of them or did not get to the hospital in time. That is telling me most women are forgoing epidurals based on false information just like I (regretfully) did. That is one of the things Dr Amy and other commenters on this site are so angry about. They are not mad that women want good experiences or unmedicated births.

          • Amazed

            Good luck with your epidural, JJ!

          • guest

            I confess I am not wholly convinced that epidurals don’t lead to more interventions later on. and they do have (rare) side-effects. I (personally) am happy to err on side of not having them. Little to loose (only pain. I don’t mind the pain that much).

            but people obviously judge this, and the evidence, differently. that’s ok with me. i think there is space for difference.

            look – for every person who says ‘i was tricked by NCB into trying NB and now i feel cheated’. I know someone who says ‘i thought all this NCB was hippy claptrap, and i had an awful hospital experience and i am going NCB next time and I wish someone had told me’.

            I try not to extrapolate from individual cases.

          • Amazed

            That’s what SK does, though. Extrapolating from indivudual cases. Her grandson was present at his baby sister’s birth and it was magical, so older children should be allowed to be present at birth! Wonder what her opinion would have been if her grandson had seen his baby sister dying while being birthed at home.

            Oh, prior to the WWII children were present at homebirths because all births took place at home. I don’t know enough about UK to name her a liar but I can tell you that in my part of the world older children and husband were shooed away from the birthing woman – and it was not because the mother didn’t want them to share in the magic.

          • Amazed

            And then you tell them, “Hey, you’re almost GUARANTEED to have a better experience this time around, if only because second births tend to be easier regardless of the place of birth”, I guess?

            Or… you don’t mind keeping silent and not correcting their misinformation?

          • moto_librarian

            So what if you aren’t “convinced” that epidurals don’t lead to more interventions. The evidence demonstrates that they do not. “Other ways of knowing” don’t change those facts.

          • Elizabeth A

            Pain may be not an issue to you, but higher levels of pain are associated with higher levels of post-partum depression. Pain did quite the job on me – during the time that I labored unmedicated, my ability to communicate my needs, preferences and desires was severely limited. The epidural helped me communicate with my doctors and avoid a number of interventions.

            My personal best guess is that I needed the epidural because the baby was in an odd position, which was the same reason I eventually needed a ventouse delivery.

            I wasn’t tricked by NCB. I don’t feel cheated. There’s definitely some issues with hospitals (why are post-partum nurses all so grumpy?) My experience has shown me that I should not plan to give birth in any building that doesn’t have a blood bank.

          • Cobalt

            Deciding to forgo modern medicine because of one bad hospital experience is a bit like deciding not to wear shoes because one pair didn’t work out. Figure out why and fix it! Be open to both idea that there was something wrong with that pair (some running shoes are crap), and the idea that you had unreasonable expectations (don’t expect heels to be good for running).

          • Bombshellrisa

            Enjoy that epidural! It will be awesome even if you have had other births without one. The first woman I was a doula for in my “gonna be a midwife” days had her first epidural with her 5th child. She kept raving about how she couldn’t feel the pain of the contraction. ((Her husband had hired me because he heard that having a doula reduced the need for epidurals and interventions, he felt that epidural drugged babies and that women are supposed to feel the pain of childbirth. He was angry at me for not talking her out of the epidural)

        • just me

          This exactly. Sure, if someone REALLY doesn’t want novocain the dentist won’t force it. But with childbirth these proponents act like we should start from a place of no pain relief and only those who REALLY want it can get it. Plus all the propaganda of how it’s less natural, impacts bf, etc.

          • JJ

            Yes, imagine if vasectomy pain relief was presented in the same way as childbirth! “Come on and be a strong warrior dad! Just do breathing exercises and use visualization. Protect your penis from the evil drugs. Oh, I guess you can have drugs, just at least try it without first.”

            (I actually knew a guy who tired to get a vasectomy without drugs..yeah that did not last long.)

          • Mishimoo

            My husband was surprised at the lack of post-op pain…then 8 hours later, the anaesthetic finally wore off and he regretted waiting to take his pain meds.

            We were quoting NCB woo at each other about him being a warrior and such, but had to stop because the laughter started hurting too much.

          • The Bofa on the Sofa

            (I actually knew a guy who tired to get a vasectomy without drugs..yeah that did not last long.)

            At the pre-vas consult, the doctor gave me a pack of two little pills and said, here, take these two hours before you come in.

            I was glad to.

          • Cobalt

            The dentist won’t do it, or at least mine wouldn’t.

          • Mattie

            without wanting to get too OT, really, my friend had loads of fillings without anaesthetic because the needle terrified her

          • Cobalt

            Mine were extractions, and the dentist said he wouldn’t. Others may do differently, I was in a rural area at the time and didn’t shop around. My fear issues with local anesthetic were interfering with my health and ability to eat. I buckled down and dealt with the fear, got it done, and was glad the dentist didn’t mock me for my oddity.

          • Mattie

            aw, fear is hard, my fear was so extreme I hadn’t gone to the dentist in almost 10 years and was petrified when I did go, fortunately my dentist offered sedation and that went so far in helping the fear to go away 🙂

          • Who?

            Oh that’s so difficult, well done for getting there in the end and getting the treatment you needed. I had a horrible dentist as a child and years of lovely dentists hasn’t completely dealt with my anxiety about it.

            We do love pain free dentistry! Though I always have a sore mouth and jaw for several days after a big needle, but so worth it to be in and out fast, and once the needle kicks in, painfree.

          • Mattie

            thank god for the sedative, highly recommend that…not just for dentistry, it’s really pleasant and should be offered for everything lol because local anaesthetic doesn’t work on me…so I had to have 9 injections to numb my mouth completely, stupid genetic disorder *grumble*

          • Monkey Professor for a Head

            I’ve had a couple of fillings without anaesthetic – one because the local hadn’t kicked in yet (apparently it takes a bit longer to work on me than most people) and I didn’t know any better until the dentist moved on to the second filling, another time it was the dentists choice not to do it (not sure why but the tooth was already broken and rotted out so maybe he figured I didn’t have many nerves left).

            And both times it was bearable (although better with anaesthetic!) but not because I’m a strong warrior woman or because I’m better than anyone else. It’s because of whatever quirk in my body has left me with a very low ability to feel pain in my teeth – which makes me lucky, nothing else. I’m 8 months pregnant with my first baby right now, and my plan when it comes to pain relief is to see how things go. If I don’t need pain relief, then it’ll probably be because I’m lucky to have a labour that’s not too bad, and I see no reason why I should be proud of that. If I need an epidural then I’ll carry no sense of shame for that.

          • Bugsy

            The novocain needle is pretty intimidating, I have to admit…

          • Roadstergal

            Oh god, I hate the sting of the needle and that swelling pressure. Once it’s done, I can breathe, it’s all fine, but I’ve had a number of dentists and that needle always just wigs me out.

            Tattoos, piercings, nerve blocks, blood draws, IVs, vaccinations – I don’t mind any of those, but the one that goes into the gums…

          • Bugsy

            There’s just something about it, I don’t know what it is. I fell on one of my (permanent) front teeth in second grade, and it’s caused a lot of issues over the years – root resorption, partial root canal, second root canal, followed by an extraction and implant. Even knowing that it was necessary and that my dentist was taking extreme care to ensure I’d have no pain, the thought of that novocain needle still makes me cringe…I can still feel the exact nerve they used so many times for that poor tooth.

          • The Bofa on the Sofa

            There’s just something about it, I don’t know what it is. I fell on one
            of my (permanent) front teeth in second grade, and it’s caused a lot of
            issues over the years – root resorption, partial root canal, second
            root canal, followed by an extraction and implant.

            Can I make you feel better? Consider yourself lucky…

            When I was in third grade, I fell on my two front teeth. Both broke in half. Consequently, I wore SILVER crowns on my front two teeth from 3rd grade until 8th grade.

            Fortunately, I had them replaced in 8th grade, but that’s still a good chunk of puberty. With silver front teeth.

            I would have been a lot happier with root reabsorption, a partial root canal, second root canal and extraction and implant.

          • Bugsy

            Oh my gosh, I can’t imagine it!! Glad they replaced them, but to have had 5 years and a good chunk of puberty with silver teeth? Wow…

          • Mattie

            my needle phobia is a lot better than it used to be, but needles in my mouth are still a big no, I was sedated with (I think) IV lorazepam or similar, so I decided the IV was the lesser of two evils 🙂

          • An Actual Attorney

            My father really hates novocain. He prefers root canals with no meds and just grips the chair. Even he admits that it’s nuts. The dentist will try to convince him, he says no, and that’s it. No whining about empowerment or trying to convince every one else to do it. He is just odd.

          • Dr Kitty

            Yeah…my mother is the same.
            She doesn’t like the palpitations from the adrenaline in the local, so she has dental work, including root canalsm without it.

            But this is the woman who had her second CS (of four) under GA because the spinal failed, and told them just to keep cutting (yeah…no..that wasn’t going to happen), and was back to driving a car and walking the dog two weeks after every baby…

            She STILL says that the hours of induced labour she had with me is the worst pain she has ever felt BTW.

            I think part of my own mindset about birth has been shaped by my mother, who is totally unphased by unmedicated dental work, being cut open while able to feel it and all her CS recoveries found labour to be unbearable.

          • Daleth

            FYI, your mom could request dental anesthetic without epinephrine (I’m thinking that’s what you mean by adrenaline). They have it to do work on pregnant women, as I discovered when one of my teeth broke (!) during pregnancy. It doesn’t last as long as the anesthetic with epinephrine, so they might have to top it up, but at least it’s THERE.

          • Liz Leyden

            I had 2 wisdom teeth extracted with only local anesthesia. I left that office so traumatized that I avoided dental care for 7 years. My last 2 wisdom teeth. which were sideways and rotting, came out 2 years ago, under general anesthesia.

          • Who?

            I get that, big dental work is an incredible invasion of personal, not space so much, but autonomy. You’re basically held down by your head and worked on, with faces and hands and bodies looming over you the entire time. Glad you have it sorted now.

            I just had a crown a few weeks ago, my first procedure with a dentist who owns the practice I go to-his staff are all great, and so was he. He talked me through it beforehand, and I told him that if I cried a bit he was just to press on. I’d make it clear if it was hurting, but the personal insult might be just too much to bear without a few tears. He thanked me for telling him, and I swear he worked like the wind, I was out of that chair in half an hour. No tears!

          • Bugsy

            Yep. When I was 12 or so, I had to have four permanent teeth removed to make room for orthodontic work. On the first set, the dental surgeon completely missed the nerve. I felt every painful rip as the teeth were pulled out, and the idiotic dentist’s reply? “You’re a kid, and you don’t know the difference between pain and pressure. If you don’t stop your screaming, I’ll send your mom to the waiting room.”

            I haven’t forgotten the pain – or the helplessness – to this day. I’ve since had 7 additional permanent teeth pulled, and you can bet that I was completely numb for all of them before they came out. Four wisdom teeth, an injured front tooth…didn’t feel a lick of pain from any of them. However, the fear of dentists has remained to this day.

            Pain in medical/dental procedures? Not interested, thanks very much!

          • D/

            Yeah, I have a secret wish for pearly gates accounting from the dentist that filled every molar in my head as a teenager. Felt every bit of every one of them with him saying “There’s NO way you can be feeling that with the medicine I’ve given you … Just be still” while holding my head tight against his rumbling-ass gut. I swear hearing bowel sounds still makes me break out in a cold sweat and my teeth throb!

            Never had a comfortable dental procedure until my last dentist finally figured out my nerves must cut some crazy circuits through my jaw after my temple became perfectly numb in response to the prep for a crown on a lower molar. It was almost surreal to have a completely pain free experience with a dentist.

            Feeling pain in dental/ medical procedures? Not interested here either!

            Had a real gem of a recovery room nurse as a kid too. Five-year-old me wakes up crying after my tonsillectomy to the heifer hissing in my ear “If you don’t shut up right now you’re not going to see your mother again!”

            Unfeeling assholes adding unnecessary torture to dental/medical procedures definitely deserve a special sort of hell!

          • Bugsy

            Ouchhhh….not fun at all. Yes, they do deserve a special place in hell.

        • yugaya

          ” The issue with people like Sheila Kitzinger is that she trivializes the pain of childbirth with her nonsense about “dancing” through labor (and don’t even get me started on how inappropriate her contact with that laboring woman was).” The guest seems to mistake people considering that to be unacceptable for people being against unmedicated birth. And for the record: I’m also one of those regulars – all my births were “unmedicated”, even when epidural was available and offered.

          • Amazed

            I’m starting to wonder whether Guest really makes this mistake. In the beginning, I took her at face value but it looks like she’s going down the path recent anti-vaxxers dug here: starting with being the moderate voice of reason and quickly going to “both sides are equally right and wrong”. Just like the vaccine issue. I have yet to see someone gone down this path here who has not turned out to be an anti.

        • Bugsy

          “I guess I don’t understand the mindset that giving birth without pain medication is some sort of achievement when women in the developing world do it every single day out of necessity. ”

          Bingo. The first time I heard a friend repeatedly brag about her son’s unmedicated vaginal birth, I was floored. The only way I can describe it is that she appeared to want a constant trophy (in the form of validation) for her awesomeness in fighting through the pain. She was the first of my friends to give birth, and her smugness at her “achievement” – as well as the fact that her smugness didn’t seem to stop – was one of the markers that turned me completely off from NCB.

        • The Bofa on the Sofa

          I don’t understand the mindset that giving birth without pain medication is some sort of achievement when women in the developing world do it every single day out of necessity.

          This is something that I never have understood. On one hand, we hear that women have been having vaginal births for thousands of years, to the extent where we even hear that “women were designed to give birth.”

          But then we also hear that giving birth without pain medication is an achievement, and women want to “prove” to themselves that they can do it.

          It doesn’t make sense.

      • guest

        most of the discussion on this blog is NOT about taking pain-relief to the third world. it is about the choices available to privileged people.

        i acknowledge my privilege – but we are both focussing on the privileged here.

        third-world care is another issue – and I fear there are more urgent issues there than pain relief (witness mortality rates of mothers). which is not to say PR is not also v important.

        • yugaya

          This is not merely “a third world issue” – there are several recent reports from UK stating how midwifery there overstepped its boundaries and is responsible for numerous incidents where women were (among many more horrible things) denied adequate pain relief in childbirth. One judge identified the reasons behind midwives being guilty of providing inadequate care to be ideological. I agree.

          Pushing your indecent rubbing type of support agenda, while at the same time failing to be equally fervently advocating for more anesthesiologist to be made available in maternity hospitals results in women in first world countries being denied pain relief on regular basis because their Sheila-inspired midwifes believe “natural is best” and abuse their position of authority to enforce that “choice” on their patients.

    • Bombshellrisa

      Please define “support”. Giving a back rub, doing counterpressure and holding a laboring woman’s hand can be seen as support and can distract (to a point) from pain. But why offer those things instead of something that can take away the discomfort? Someone could also bite a stick to cope with any manner of discomfort, yet nobody would offer support in place of adequate pain medication for an appendectomy, ingrown toenail removal or root canal.

      • Cobalt

        It would be wrong to offer a stick to bite, or hand holding, or breathing exercises or whatever in place of pain relief. But for a patient who has declined (medical) pain relief, it may well be appropriate.

        The medical option should always be an option, this is first and foremost.

      • guest

        and funnily enough we have adequate evidence that there are plenty of people who don’t WANT pain relief in labour – or at least prefer to go without.

        (and plenty who don’t prefer to go without. and that is fine too).

        • Bombshellrisa

          Plenty of people may also choose to forgo pain relief for dental work. It’s still offered routinely.

          • guest

            noone says pain-relief should not be offered!!!!!!! I certainly did at no single post. just that other options should be available too.

            read before you write. it is basic courtesy, just as i have the courtesy to reply.

          • Bombshellrisa

            Your post took object to the comments that women should have “access to adequate pain relief”. To have access to adequate pain relief in any circumstance,it had to be offered with the risks and benefits discussed. I don’t understand how you take “offered routinely” and turn it into “no one said pain relief shouldn’t be offered”. If someone chooses NOT to take something, it should be after the option is given and of they understand the benefits and risks. The problem with NCB is that the belief that natural is better is not limited to the idea that *I* should be able to turn down an epidural in favor of counter pressure. It’s that testing, ultrasounds, IVs, pitocin and epidurals are wrong and should be turned because they are HARMFUL and to routinely REFUSE them.

          • guest

            I have been saying over and over that anaesthetic should be there who want it. – and other stuff for those who want it to.

          • Bombshellrisa

            And that is reasonable. The problem is that most NCB advocates, midwives and doulas take what SK said and turn it into an argument to avoid interventions of all kinds.

          • guest

            do they? ‘most’ ? or is that what Dr Amy says? for i find her misleading.

            I am sure some do, but many don’t. they are just the extreme. (especially the unassisted birthers, the high-risk home-birhters, etc. all extreme. not representative of normal midwifery)

          • Bombshellrisa

            No, I didn’t hear any of this from her. I have a long history with NCB and trained to be a doula and midwife.

          • Sullivan ThePoop

            This is what I hear from all NCB advocates.

          • Bugsy

            I’m sure many don’t, but Bombshellrisa correctly describes my experience with a close personal friend turned NCBer, from birth classes at a “Baby Friendly Hospital,” from chatting with other moms around the community, as well as from thousands of interactions on birth boards. In modern discourse, anesthesia/pain relief has often become viewed as the gateway to further interventions of all sorts.

          • Sarah

            Actually, there are a few of your fellow passengers who say just that.

          • AllieFoyle

            Don’t they though? The big buzzword is “support” which roughly translated from NCBspeak means “give all sorts of useless distracting backpats and empty affirmations and encouragement, but never ever ever offer effective pharmacological pain relief because that would be unsupportive.”

        • namaste863

          Ugh! My last dentist denied me pain relief. Not even laughing gas. I got through it, but you’d better believe that (Once I had the courage to go to the dentist again) I found a new one and told him not to touch me before administering a double dose of every kind of dope he had.

        • The Bofa on the Sofa

          and funnily enough we have adequate evidence that there are plenty of
          people who don’t WANT pain relief in labour – or at least prefer to go
          without.

          And how much of that is because of bullshit they’ve heard like “epidurals lead to interventions” and “epidurals prevent bonding with your baby” or some variation of “natural birth makes you superior to others” (explicit or implied) or otherwise praising the “virtue” of the vaginal birth?

          When you have SK peddling crap like how giving birth without pain meds is a manifestation of the womanly power of the vagina, it’s true that there are those who are going to go along with it. However, it’s baseless nonsense, putting a value judgement on something that does not have value.

          I don’t support misinformation and deceit as a means for influencing behavior, but that’s what this is.

          • Sarah

            Bingo.

          • Chi

            Yeah, in my antenatal class, that’s what we were fed. The ‘teacher’ got out all the interventions and basically laid them out on the floor and said that’s what epidurals lead to.

            After a 13.5 hour labor that culminated in an episiotomy, I’m kicking myself for not demanding the epidural. I managed to get through it on just the NOS gas, and indeed was praised for it, but next time I am SERIOUSLY getting those pain meds.

            Just because we CAN doesn’t mean we should. And next time I am definitely opting for the pain relief because honestly the pain was so bad that I’ve literally blacked out parts of that labor in my mind. I cannot remember huge chunks of time.

            So yeah. And a NVB doesn’t make me better than anyone else. I was actually getting ready towards the end to demand they just cut me open and get the kid out because I just WASN’T coping. One of the hospital staff wanted to get me a mirror so I could see my daughter crowning so it would inspire me to push harder (at this point I had burst a blood vessel in my eye from how hard I’d been pushing) and I was like NO FREAKING WAY I DON’T WANT TO SEE THAT.

            Yeah. Definitely meds next time.

          • demodocus’ spouse

            I debated writing a birth plan. It would have been on a post-it note and would have said “No damn mirrors!” Nothing else.

        • Maya Markova

          I was one of these people. I had swallowed some NCB claims, plus anecdotal evidence of back complications from epidurals, so if pain relief had been offered to me, I would have declined. Actually, while I no longer have these views, they were helpful for me back then, because no one ever offered me pain relief until the babies were born :-). But my point is: few reasonable people would want severe and manageable pain unless they are told that this pain SHOULD not be managed; and since there is no evidence that labor pain should not be managed, pain relief should be the default.

    • MaineJen

      Some of us don’t want our experiences to include horrible pain. Most of us have been through labor; we know how painful it is. We don’t want anyone to suffer that without relief if they don’t have to or want to. That’s all. We don’t want midwives or doulas to have the power to override women’s wishes for pain relief. That’s all!

      • guest

        OK. then we agree. But a lot of your colleagues feel a bit more strongly, I think.

        SK was not overriding – she was advocating better support.

    • NoLongerCrunching

      There is nothing intrinsically wrong with gyrating pelvises. What is wrong is that she did not get the patient’s consent to try this experimental technique. You don’t just start doing something to a persons body without having a discussion about it and getting consent first.

    • Mattie

      I think the difficulty comes when applying some kind of moral superiority to any personal choice. Assuming the choices you make don’t result in harm (when really some kind of judgement is sort of expected) then you should be free to make them, but you can’t go round saying you’re better than anyone else.

      Like, for example, I have a condition that means that local anaesthetic doesn’t work all that well. I’d probably not bother with an epidural because it’s a lot of fuss for probably nothing, however were I to need a c-section I’d probably get them to try an epidural because I’d like to be awake for my (future) child’s birth, Will I be bragging about my nice natural birth? No…it’s luck, good or bad depends on your viewpoint but for me it would be nice if an epidural was a real option. Also it would be nice if local anaesthetic injections worked =/ I had to have 9 injections to numb my mouth for a root canal once, not super excited at the prospect of stitches from birth 🙁

      • guest

        fine. I agree. i don’t endorse bragging. but i think quite a few (not all!) ncb-ers don’t brag. SK doesn’t brag. they want other people to have nice experiences like them, too!!! (and yes, it is a bit naive)

        • yugaya

          “SK doesn’t brag”

          Try again:

          ” A WOMAN WHO’S ENJOYING HER LABOR will swing into the rhythm of contractions as if birth-giving were a powerful dance. As the mother of five children, I’VE NOT ONLY EXPERIENCED THIS MYSELF but seen it happen time and time again…”

    • Cobalt

      It’s not an obsession with adequate pain relief, it’s an insistence on ethical medical care, which includes informed consent, respect for the patient, and evidence based medical practices. Offering the most effective and safest pain relief options is under that umbrella. Dancing through labor is not.

      Now, if a person declines an epidural after being truly informed, that is absolutely their choice. However, it does not mean that medical professionals should offer whatever random unproven technique is currently en vogue in NCB circles. If you want woo in your delivery room, bring your own. Don’t expect a medical professional to provide it for you. They should absolutely respect your right to choose, but are obligated to only provide options that are proven to be safe and effective and to inform you of all your medical options.

    • AllieFoyle

      Look, do you not get that SK and others of her ilk portray birth in an idealized, romanticized way? They downplay or ignore pain, and describe it as something that is under a woman’s control and should be experienced as sensual, spiritual, and empowering. Sometimes they give a little nod to epidurals, but their main focus is on AVOIDING epidurals–the implication being, of course, that epidurals are harmful or undesirable, and that preventing women from accessing them is a good.

      Oh yes, they say, epidurals should be available to women who want them, but then everything else they say contradicts that statement. How is a woman free to access adequate pain relief when she’s been led to believe that it is harmful or unnecessary? Or when her providers give “warm approval” for laboring unmedicated? Or when the system is run by people who believe that unmedicated childbirth is a worthy goal in and of itself; that their role is to support a woman so that she doesn’t get an epidural; that childbirth pain isn’t that bad or is a rite of passage?

    • Maya Markova

      If epidurals were really harmful/dangerous, I guess there would be a discussion here about what place they should have in birth, rather than an unanimous “offer them to everybody” opinion. If homebirths were as safe as hospital births, few would find anything wrong with valuing a mother’s experience in choosing homebirth.

  • JJ

    Such an interesting post Dr. Amy. This quote really struck me:

    “It wasn’t merely women’s purpose to utilize their vaginas, uteri and breasts to bear and raise children, it was their glory.
    Life had handed them lemons, so they made lemonade.”

    I see a lot of parallels between NCB and the far-right/patriarchal/fundamentalist “Christianity” and I have experience with both. Within that brand of Christianity women try to live up to the highest of what they are allowed to “achieve” in the subculture:by having the most children, the most obedient children, being the most modest, the most submissive, the most godly, working the hardest without complaining ect. They win the crown of godly glory. Then they foist the same standard on other women thus participating in their oppression as well. *

    I would see this in natural circles too. If intervention/medicine/technology ect. is bad, then women thought they had to live in the natural/NCB way. It became a competition of who could be the most natural in that subculture.If you have a totally unassisted birth/pregnancy, never need a DR/antibiotics, and radical unschool, then you become the queen of natural. Women would ask, “If my midwife did not make it in time can I say my birth was unassisted?” or “If my kids do only math workbooks can we still be called unschoolers?” so they could see if they were eligible for the crown of natural glory. They were questions about the title, not “is this what is best/working for my family?”.

    *PS: I am a (progressive-ish) Christian and I don’t think lots of kids, homeschooling ect is inherently wrong. What is wrong is feeling like you have no choice or that these things are somehow making you better than other women. Just like in NCB ideology.

    • namaste863

      I’m about to start my Ph.D. This fall. Any general PH.D. survival tips?

  • guest

    Lording it over other women how you birthed without pain medication would be like me lording it over other women that I have a PhD while they have “only” a BA or perhaps no degree at all. It’s gauche, and it’s ugly, and it’s completely unnecessary. I wanted to try for a PhD, so I did – and I was successful. I wanted to try for an unmedicated vaginal birth, and I did – but I was unsuccessful in that endeavor. And both things are totally fine. What isn’t fine is that not all women have the ability to make the choices I did.

    • Amazed

      This. Plus, you never know when another woman will be able to lord it over you. Fresh example: I was sharing with a friend that I couldn’t get chocolate to stick to my cookies. She looked at me and said, “Next time, try not to wash the spoon in vain attempt to control all this chocolate.” I looked at her, wide-eyed, and said, “So, THAT was it?” Turned out that water and melted chocolate led to said chocolate being unable to stick.

      Lots of good did my esteemed intellectual profession did me when I wanted to make something nice for someone (everyone knows that whatever yummy things I give them come straight from the shop). She knew what she was doing because she makes her living by making the best cakes in the whole wide WORLD (she’s promised me a Bloodraven (A Song of Ice and Fire) birthday cake for the first birthday I get to spend in my home city!) Good thing we don’t try to lord it over each other.

    • namaste863

      I’m about to start my Ph.D this fall. Any general survival tips?

      • The Bofa on the Sofa

        What’s the area?

      • First Time Mama

        Pace yourself. It’s a marathon, not a sprint. Make sure you take time for yourself so you don’t lose your mind. And keep your eyes on the prize–don’t let minor setbacks drag you down for long. What’s the field? Mine is in immunology, so a lot of my advice is tailored for lab sciences.

        • namaste863

          Social Work

          • First Time Mama

            Good luck to you! 🙂

      • Roadstergal

        Get support from your department, get an advisor who has time for _you_. I regret not doing that. Politics exist and can be ugly; I regret not getting better at that sooner.

        I had two bad grad school experiences in a row, and a wonderful post-grad school experience – nothing turned out the way I expected, but I’m glad in the end…

      • demodocus’ spouse

        I’d recommend making sure you have some sort of extracurricular support and/or stress reliever. My husband was working on a PhD in Philosophy, but he kind of freaked out with homesickness and stress. (We were 800 miles apart). One med student used to be a regular at our local yarn shop. Once or twice a week, she’d come and knit for a few hours, then back to the grindstone. She probably still does when she is off-duty at her hospital down east.

      • guest

        First piece of advice, don’t get into competition with your cohort. If your department culture fosters competition, do whatever you can to stay out of it. Competition between graduate students kills.

        Take out as few loans as possible.

        After that, it’s really hard to be general. I agree with the other person who responded that it’s important to have a life outside of school, even if you’re full-time. Just *anything* that can take you out of it for a while.

    • anh

      completely agree. I got pregnant SUPER easily. I hit that genetic jackpot. go me. How shitty would it be if I lorded that over someone? Some women hit the genetic jackpot of having manageable labours. great. but why lord it over me who has a super low pain threshold?

      • Cobalt

        Yup. Just wanted to add that different people define their “jackpot” differently. Getting pregnant easily is only a blessing if you want to get pregnant. Fast, easy labors are a blessing if you don’t mind the risk of not getting your epidural in time (the woman across the hall who has been in labor all day and is screaming in pain is probably going to be ahead of you in the anesthesia line).

    • Pamela

      Yes exactly. I feel so blessed- got pregnant super easily, had the world’s most boring pregnancy, an easy induction with an epidural placed basically the minute I asked for it. In addition to that, my baby is healthy and has slept through the night since five weeks old, has no colic and basically never cries unless she needs something. So yeah, I hit the jackpot for sure! But does that make me any better than someone who has not had those experiences? Heck no!! And bragging about those things or taking credit for them would just make me an asshole.

  • yentavegan

    For so long I wore as a badge of achievement the epidural-less , no pain meds 3 vaginal births I endured. For so long I actually sneered in my heart my friends and relatives who “gave in” and did not fight the good fight. I am embarrassed to look back at the judgmental sactimommy I used to be. Dr.Amy opened my mind and I am a better human being for it.

  • Cobalt

    “Why? Because they claimed it was every woman’s right to give birth painlessly.”

    They might be on to something there…

  • just me

    Yeah, I still just don’t get it. Voluntarily undergo pain when I don’t have to? No thanks. That’s why I won’t be getting any tattoos.

    • Roadstergal

      To be fair, tattoos don’t really hurt. They just sting and get annoying after a while. I’m thinking childbirth generally hurts a shit-ton more…!

      I’d consider three hours a long tattoo session, and it’s a short labor.

      • Cobalt

        I don’t know anyone who has had both without painkillers to give their impressions but, on average, you’re probably 100% correct.

        • Jodi Hilla McCormack

          I had labor without an epidural (it didn’t work) and a large, 3 1/2 hour tattoo several years later. My labor was induced with pitocin, so take that as you will, and the bad part of it was only 45-60 minutes, but I would rather endure a full body tattoo in one sitting than go through labor again. It was a 10 on the pain scale and neither my 16 hour gall stone attack 11 days later or shattering my tibia rock climbing 3 years later came close.

      • just me

        Huh. They look really painful.

      • namaste863

        I’ve done a couple three+ hrs tattoo sessions. For me at least, hey hurt like shit, especially once the area was nicely swollen. And there was never any of that “Numbing endorphin rush” I’d heard about. I still don’t regret it, but if there’d been any way to forego the pain I would have without a second thought.

        • Who?

          My friend has half a tattoo-could’t bear the pain anymore, had the guy stop, and never went back.

          • Roadstergal

            Definitely an advantage a tattoo has over labor – if you’re getting a tattoo and it hurts too much, you can just say, “Stop, I’m done.”

      • Fallow

        Yeah, I have three and none of them hurt that much at all. Even though I was warned they were all on especially painful parts of the body to tattoo. They weren’t comparable to labor in the least.

    • MegaMechaMeg

      People say that labor pain is bearable because there are breaks between contractions. I feel like I would just spend the time in between locked in dread awaiting the next one. That feels less like relief and more like psychological torture.

      • SporkParade

        Yeah, that’s basically what I did until I was far enough along to be admitted to a delivery room.

      • perpetual lurker

        I actually loved the breaks in between just for the sheer relief. But the thing was, I didn’t get them reliably with my second labor, and I think this happens more often than people think. The contractions came close together from early on and any moving around or position changes I attempted seemed to bring on horrible pain between them. When I got to the hospital I kept asking the nurses and midwife why the pain wouldn’t stop. I had expected it to, and it didn’t, and that to me felt like torture. (And the epidural? Amazing.)

        • moto_librarian

          Yup. My contractions did not space out during pushing. I still remember trying to breathe through one just to get a break, and feeling my body involuntarily push. I don’t know if they were more spaced out the second time, but it didn’t matter since I had an epidural and felt no pain.

      • luckymama75

        Yes yes yes! That is exactly how I felt with my first kid. I had no idea the pain was going to be like that and when the nurse jokingly said, ” you think this is pain, wait til you get to 7 cm.” I just started crying. They weren’t breaks in between they were pauses for the pain to build up again. It was totally psychological torture.

      • Kelly

        Me too. I could never relax. It was awful.

  • guest

    Quote from article: “Of course, it’s up to the individual if she chooses to have drugs during labour. What concerns me is that freedom of choice comes only with knowledge of the alternatives.” — seems like you and SK agree, DrAmy: choice, and choice based on good information.
    It also seems you are doing some serious mis-representation.

    • Amy Tuteur, MD

      Are you denying that Kitzinger claimed that women achieve true fulfillment through vaginal birth without pain relief? That’s the sexist part of her philosophy not whether she “allowed” other women to choose pain relief.

      • There’s more than a little masochism in some of her writing.

      • guest

        I am sorry, but I don’t read that in her article. (Though, no – I have not just combed through all of her work).

        She writes “Giving birth can be an intense and joyful psycho-sexual experience” => ‘Can’ , not ‘must’ or ‘is always’

        What she describes is how someone who clearly wasn’t having a good time ‘moaning and tossing in pain’ could be helped quite easily to have a much better experience. And her point seems to be that that help, and that support, was not available.

        She writes: “Yet studies have shown that when staff give warm approval to a woman’s determination to cope without drugs, this boosts her morale. And that, in turn, makes it much more likely that she won’t need them.” => again she doesn’t say that noone should get pain relief, she doesn’t even say that there aren’t people who need pain relief, she just seems to say that with better support, fewer people might want it; people might make different choices.

        So no, nowhere do I read her saying something about ‘ultimate fulfilment through vaginal birth’.

        I read your blog a lot, DrAmy, but I get increasingly frustrated that you paint and often misrepresent EVERY person saying something in support of home- or unmedicated birth, as making a claim about ultimate female fulfilment, or about dictating what women should do. I immediately grant you that there are idiots out there who do think and say such stupid stuff. But there are also lots of sensible people who say moderate and intelligent things such as ‘women who want to try unmedicated birth should have better support in doing so’. It bothers me that you seem to wilfully misrepresent them.

        • Amy Tuteur, MD

          Natural childbirth is and has always been about keeping women in their place. The man who invented it did so because he feared women’s political, legal and economic emancipation, and the women like Sheila Kitzinger who championed it did so (consciously or unconsciously) to bring glory to traditional female roles.

          Sheila Kitzinger herself acknowledges that natural childbirth is anti-feminist. If she is willing to admit it, you should take her seriously on that point.

          • guest

            No. She does not admit that.

            She registers ‘surprise’ that it is seen as anti-feminist. From the article: “To my surprise, it wasn’t just obstetricians who dismissed what I had to say. I also found myself in conflict with feminists.”

            And she does not acknowledge that it is anti-feminist; she considers herself to be a feminist. same article:
            “I was appalled at how my sister-feminists could fail to support woman-centred birth. Polly Toynbee, writing in The Guardian…..”
            => sister feminist.

            See, this is exactly the kind of misrepresenting you do that i am talking about!!!!!!!!! So frustrating!

            What is and is not feminist is of course a matter of internal disagreement, and the internal feminist disagreement between ‘getting for women what men have and do’ and ‘reclaiming/re-valuing the (traditionally seen as) feminine’ is an instance of this. But as you well know – and pinpoint in your description of the mommy wars, this is only a faux disagreement, and fuelling it is a ‘divide and conquer’ anti-feminist strategy. Woman should BOTH have access to all that men have AND we should re-claim/value the feminine; women (and men) should BOTH have the choice to and be valued in a home-maker role AND have the choice to and be valued as career-makers (or any combination).

            Giving a woman who wants it the kind of support that Kitzinger describes and has championed, rather than strapping her to a bed and giving an epidural as the only option (for that was, when Kitzinger wrote, pretty much the procedure) – you tell me how that is anti-feminist.

            Here, again, I find you frustrating. I agree that the kind of NCB-er who thinks that people shouldn’t be allowed pain-relief is anti-feminist. But that is a (mostly) charicature. It is like describing the person campaigning for a women’s right to work as arguing that no mother should ever be allowed to see her kids again.

            The kind of NCB-er who laments that a choice that some people clearly want and value very highly, is not structurally available and supported FOR THOSE WHO WANT IT. Is not anti-feminist. that is feminist. I find it problematic that this type of position is consistently misrepresented on your blog.

          • Roadstergal

            “Giving a woman who wants it the kind of support that Kitzinger describes and has championed”

            In what other area of medical care is ‘supporting’ someone rather than giving them pharmacologic pain relief the standard? Yes, people have reactions to various meds and personal feelings on others which are taken into account in each individual case, and individually can choose to accept or forego pharmacologic intervention, but if you have a broken bone or a kidney stone, the approach starts with “how can we best minimize the pain?” rather than “can we gyrate against you to help you bear it because meds are antifeminist?”

          • guest

            eeeehm once again. there simply are people who would like to do without the meds. supporting people in their informed choice of treatment plan IS the standard.
            If someone wanted, say, no or little morphine at end of life because, for example, they wanted to be ‘present’ as much as possible with loved once. Would you say ‘well, fuck that – where in medical care is ‘supporting’ rather than pharmacological pain-relief the standard’. or would you say ‘how can we best help you achieve what you want.’. And if they say ‘It’d really help if you held my hand and sang this nursing rhyme to me until my loved once arrived. my mother sang it whenever I was in pain and it calms me’. I would sing. And i bloody well hope you’d too!

            People have all sorts of things they might care about besides pain-relief. and in birth this appears to be not-unusal. that should be supported.

          • Monkey Professor for a Head

            If a patient of mine wanted little or no morphine at the end of life, I would try and find out why. If the reason why they didn’t want pain relief was based on misinformation or a misconception on their part then I would try to make sure they were given accurate information. If they still declined pain relief after that, then I would respect their decision, but make it clear that they had the option to change their minds.

            I don’t have an issue with women choosing to have an unmedicated childbirth. I have a major issue with women being given inaccurate information by people trying to influence that decision. I also have an issue with people who place a moral or social value on unmedicated childbirth.

          • JJ

            YES!

          • Roadstergal

            I was going to respond to guest, but you clarified exactly what I was trying to get at. The idea is that pain relief should be a priority, the person should be fully informed, and their wishes should be respected. In any scenario that involves pain.

          • Cobalt

            I’ve had a lot of ER visits for impact injuries. I routinely decline opiates and typically can’t have NSAIDs until certain bone injuries are ruled out.

            Blessed are the nurses who don’t roll their eyes, act like I’m offending them by refusing narcotics, and make an effort to be supportive (which really means just being pleasant and non-judgemental). It matters. Not as much as having a doctor to make sure I get appropriate medical treatment, but still.

          • guest

            exactly!

          • Mishimoo

            As I’ve gotten older, I’ve lost my patience for being asked “When you say that you’re allergic to codeine, do you mean that your tummy hurts?” in a condescending tone, and have begun responding with “No, I just think that not being able to breathe properly isn’t much fun.”

          • Roadstergal

            I’ve declined pain medicine in the ER, and I’ve been so grateful to have it at other times (the collarbone was a bad one). I would rather have some snootiness at refusing pain meds (to be fair, I haven’t gotten that) than not having them be offered, or being given a “Well, we’ll get you pain medication if you really think you want to give in, but…”

            In non-emergent situations, yes, I am wary of opiates in the surgeries I’ve had, due to the potential for addiction – and my doctor doesn’t say, “Well, let’s just support you psychologically instead.” They’ve gotten better and better at a nice strong nerve block that numbs me up for the worst of it, so I can control the pain with minimal opiates and ice as it wears off.

            To me, that’s the appropriate way to think about it. “Here is pain, and we want to abolish it as much as possible in a way that works for you.” If someone doesn’t want any pharmacologic pain relief at all, that wish should of course be respected, but I just don’t agree that the pros and cons of the various methods shouldn’t be offered to a woman in pain from labor, free of moralizing, as much as they would to a woman in pain from a broken bone.

          • Amy Tuteur, MD

            She believed herself to be a feminist and within the constraints of “women’s issues” she was. But feminism moved beyond women’s bodies to women’s minds and she didn’t move with it. Any philosophy that locates a woman’s virtue in her vagina is anti-feminist by definition.

          • guest

            you misrepresent again. the question isn’t whether “Any philosophy that locates a woman’s virtue in her vagina is anti-feminist by definition.” — of course it is.
            The question is whether SK was advocating that a woman’s virtue is in her vagina (WTF does that even mean?), or whether she was advocating that women could get better support in childbirth then they did, or rather should be offered more options. As I pointed out: the latter.
            There can’t be any question that there are women who want options other than an epidural, just as there can’t be any question that there are women who just want the epidural. Both should be well-supported in her choices. this blog criticises NCB for only supporting the former and lambasting the latter. But this blog does the opposite, it wants support for the latter (FINE! GREAT!) but not for the former. Both those positions are anti-feminist.

          • moto_librarian

            “Here, again, I find you frustrating. I agree that the kind of NCB-er who thinks that people shouldn’t be allowed pain-relief is anti-feminist. But that is a (mostly) charicature.”

            No, it is not a caricature. There are lots of hardcore NCBers who really and truly do believe that they have found the one true way to give birth, and that anyone who does not adhere to their proscriptions has failed. These are the women who claim that women who had c-sections did not actually give birth. Who lie and tell women that epidural anesthesia will “drug” their babies, cause them to have c-sections, and fail to bond with their children. I have seen every single one of these claims made repeatedly.

            Of course earlier feminists were perplexed and horrified by Sheila Kitzinger! Treating childbirth pain as a human right was a major tenet of feminism!

          • guest

            I already granted that there are some idiots out there who do just that what you describe: “hardcore NCBers who really and truly do believe that they have found the one true way to give birth, and that anyone who does not adhere to their proscriptions has failed”

            My point was that DrAmy misrepresents ANYONE who says ANYTHING positive about the possibility of or support for unmedicated birth as such a hardcore NCB-er. That is misleading and wrong, and is the case in her discussion of this article.

            That was very clearly my point – and now I am the one being misrepresented. This blog claims to all be about good frank and open evidence based discussion. That includes accurately quoting your sources, not quoting misleadingly out of context and reading people carefully – and replying to what they say, rather than some misrepresentation.

          • Amazed

            So Dr Amy misrepresents herself since she’s HAD unmedicated births? The difference is, she wasn’t goaded, encouraged and straight magicked into them (what the hell is this weird “dance” including SK’s OWN pelvis?) into them. She simply wanted them, so she chose them. Without summoning the village vodoo witch.

          • guest

            fair enough. I stand corrected. she doesn’t misrepresent absolutely anyone. but she often misrepresents – as she did in this case – and as I demonstrated.

          • Amazed

            I don’t think you have. I think SK demonstrated that in HER quest to co-live the best birth (according to her) she went past what is acceptable. The scene where she engaged her own pelvis in the birthing game strongly reminded me of the time I let a much older boy put his hand between my legs. It wasn’t particularly nice or not nice. I didn’t feel it like a sexual assault. The reason? I still thought babies came through your belly button!

            This scene gave me the creeps. It was as close to a sexual assault to someone who wasn’t in their normal state of mind as it could be without actual sex involved.

            P.P. Later, the older boy DID try to rape me. This time, I recognized it was an attack. I still didn’t recognize it was a sexual one. After all, I was still 8.

            This tiny look into SK’s mind was creepy.

          • guest

            I recognise your awful experience. I am very sorry.

            Look, what SK does would not be my preference either – I have a lovely partner who can rub my back. But again, people differ. Lots of people hire a doula to do precisely this kind of thing. not what I’d do, but people clearly have very different attitudes here. it is a brief description, I am assuming that there was some form of consent – i mean she went on for half an hour. I hope (but I can’t know) the woman was OK with it, and would have told her to fuck off if she wasn’t. she does describe the woman to be very happy.

          • moto_librarian

            I don’t know about you, but when I was basically out of my mind with pain, I wasn’t able to advocate for myself very well. The pelvic circles and rubbing are completely inappropriate. What person in their right mind would even think to do this to someone in labor? It is predatory behavior, and it should disgust you. Ina May is also know for doing awful things like this. She has written about how she would rub a laboring woman’s clitoris without consent to aid in the birth process. These are some sick people.

          • Amazed

            Thank you.

            SK was not acting as a doula, though. She entered a room of suffering women she had never seen before, chose one and gave her what SHE wanted to give. No options, nothing. That’s taking control out of someone’s hands, as much as the doctors she decries did.

          • guest

            again: we don’t know what happened re: consent. we do know she was very popular to a lot of people.

          • Amazed

            We know. She described it. She even asked the senior midwife and not the woman herself.

            I sure hope she at least thought of introducing herself, just so, between the dances.

          • guest

            sorry – i must have missed that, can you post the quote?

          • Amazed

            Sure.

            “One woman was moaning and tossing in pain from side to side. ‘The cervix isn’t dilating — there’s no progress,’ I was told.

            I asked if I could get her out of bed. The senior midwife looked surprised, but gave her consent.”

            And also this gem, “If you really want to help a
            woman in labour, try not to manage, conduct or coach. What she needs
            far more is someone to help boost her strength and confidence.”

            Why, thank you, Dr Kitzinger. Middle Ages and modern times could have used your sage advice, up to the 20th century. I am sure the problem was that the women weren’t helped to boost their strength and confidence.

          • guest

            it doesn’t say she didn’t also ask the woman.

            it does tell you how shit the care was that you had to ask to get out of bed, and could only hope you could consent.

          • yugaya

            “we do know she was very popular to a lot of people.”

            So was Hitler. Stalin too. Kim Jong-un is.

            Does unethical behaviour somehow become less unethical if a person “popular to a lot of people” is the one who is behaving unethically?

          • Amy Tuteur, MD

            Kitzinger was the original hardcore natural childbirth advocate who really and truly believed that she had found the one true way to give birth and that anyone who does not adhere to that prescription has failed.

            If you are going to insist that she wasn’t, please provide some evidence that she wasn’t. And “allowing” that some women might want epidurals is not that evidence.

          • guest

            eeeeeh – no. you assert. you provide the evidence. All you have given us is misrepresentation on the basis of this article. I have given you quotes that correct that misrepresentation from the same article.
            demonstrate very clearly your point, and I will agree.
            and to be clear what your burden of proof is. you have to both demonstrate:
            1) that SK thought hat she had found the one true way to give birth
            and
            2) that anyone who does not adhere to that, failed.

            the latter, especially, i think will be a hard task. SK and many others were all about blaming the system for lack of support. NOT the women. It is very clear, in this article, that she doesn’t think ALL will be find without epidural, but that more might not want it.

            tomorrow’ post, perhaps?

          • Amy Tuteur, MD

            Kitzinger disparaged pain relief in labor:

            http://www.azquotes.com/author/22313-Sheila_Kitzinger

            And you haven’t addressed her egregious violation of professional boundaries in using her own body to give a woman the “support” that SHE wished to give.

          • guest

            re: quotes – i need to check that out.

            re: violation (i can only type so fast!) :
            Look, what SK does would not be my preference either – I have a lovely partner who can rub my back. But again, people differ. Lots of people hire a doula to do precisely this kind of thing. not what I’d do, but people clearly have very different attitudes here. it is a brief description, I am assuming that there was some form of consent (I HOPE THERE WAS) – i mean she went on for half an hour. I hope and assume (but I can’t know) the woman was OK with it, and would have told her to fuck off if she wasn’t. she does describe the woman to be very happy at the end.

          • Amy Tuteur, MD

            Consent or no, there is NO universe in which that is appropriate provider behavior, especially because of the sexual overtones and especially because Kitzinger describes birth as sexual.

            It was wrong, wrong, wrong, and it borders on sexual predation. The fact that Kitzinger didn’t see that is a terrible indictment of her views.

          • guest

            look, i also find ina-may’s descriptions weird. but there are clearly people who go in for it. I am not there to judge. what we don’t know is what the consent deal is here. what we do know is that people DO hire doula’s do to stuff just like this. I wouldn’t want anyone other than my partner to hold me during labour – other people don’t want to be held at all, or want their mother — this all seems to be very individual.

            what we do know is that SK wasn’t widely accused of sexual assault.

            we are also veering from my original point: you were misrepresenting her. do you deny?

          • moto_librarian

            You find Ina May “weird?!” If a male OB admitted to fondling a woman’s clitoris during childbirth, what do you think would happen? You are Alan apologist for sexual abuse.

          • Daleth

            In May wasn’t WIDELY accused of sexual assault? She was just occasionally accused, here and there? Oh, well I guess that’s ok then.

          • guest

            i have just read all those quotes. please quote the one you refer to her in full. i can’t find the one where she is disparaging all pain-relief. but perhaps we interpret things differently. please respond by listing quote.

          • Guesteleh

            In achieving the depersonalization of childbirth and at the same time solving the problem of pain, our society may have lost more than it has gained. We are left with the physical husk; the transcending significance has been drained away.

          • moto_librarian

            Guess what? I had an unmedicated delivery with my first child by choice. I made that decision based on information that had no basis in evidence. What is so wrong with a woman changing her mind once she is actually in labor? I had no idea what the pain would be like, and had I known that pushing would be such agony, I would have asked for drugs. If a woman expresses the desire for an epidural, no one needs to try to talk her out of it. That is the problem here.

          • guest

            nothing wrong with changing minds – i am all for it. noone knows in advance what labour is like for them.

            re: the problem:

            we don’t have that information.it is not clear whether the woman wanted an epidural.

            what is clear is that SK fears women are routinely given epidurals (this is 4o years ago!) without really giving proper information or alternatives, and aren’t really supported. And that is something everyone should worry about.

          • Guesteleh

            What’s wrong with routinely giving epidurals? Childbirth is one of the most painful experiences a woman can have, so routine pain relief would make sense as the norm. As for “proper information,” there is so much misinformation pushed out there by the NCB crowd: epidurals increase your risk of CS (nope), they increase your risk of tearing (wrong), they interfere with bonding (bullshit), they make it less likely you’ll breastfeed (bullshit again). Epidurals are incredibly safe and effective and the alternatives are valued mostly because women fear mythic side effects that don’t exist in reality.

          • guest

            second point: “Treating childbirth pain as a human right was a major tenet of feminism!”
            => the point is not about pain. it is about support. evidently there are people who want to try the drug free route. I do think they have a right to care that is right for them. you think not???????

          • Lizzie Dee

            Kitzinger was at her most influential around the time I had my children – and as far as I know, here in the UK women were not strapped down and epis forced on them.

            There was some truth in the idea that women were treated like brainless sheep by a very patriarchal system, and early NCB was partly responsible for some good changes there – though I think other strands of feminism would have affected that anyway.

            However, as NCB has got wilder and a lot more dangerously fanciful, have women really benefited that much? If they have to fight for pain relief, have midwives making their decisions for them and regard the benefits of modern medicine as some kind of anti-woman plot? How many births can actually take the weight of the expectations of bliss that now go with it?

          • Sarah

            Yes. NCB has wrought some positive changes and some terrible ones.

          • Cobalt

            It was turned to profits instead of patient advocacy, and was rapidly ruined by the change in goals.

            Stockholders: sure-fire good thing killers.

          • NoLongerCrunching

            Calling NCB “woman-centered” just illustrates the anti-feminist agenda she has. “Woman-centered” should mean “whatever the woman wants” not whatever Kitzinger thinks she should want. It’s insulting to women who want medically managed births.

          • guest

            eeeeh – and see my quotes, she advocates better support, NOT that everyone should have an NCB. that is just DrAmy’s consistent misrepresentation of a lot of things people say who advocate for better support for unmedicated birth

          • Amy Tuteur, MD

            You still seem to be missing the central point. Kitzinger’s philosophy was NOT based on giving women what they wanted since most of them did want and continue to want pain relief. Kitzinger’s philosophy was that women reach their fulfillment as authentic women by having an unmedicated vaginal birth. That’s the part that’s anti-feminist.

          • guest

            Provide the evidence.

            It is not clear to me, at all, that that is what SK thought. I thought she thought that lots of women (including herself) find an unmedicated a worthwhile experience, to be preferred above various other birth experiences. THat seems true – you can hardly know better than her about her experience, and there are lots of women who do go for unmedicated birth, and say it was good. for them. as there are women who don’t.

            all fine by me. as long as everyone gets support.

            the issue about wanting – SK did worry that people wanted medicated birth based on poor information and lack of alternatives. just as you worry about people choosing home-birth based on poor information. choice or want based on poor information is a legitimate concern – very legitimate, especially for a feminist. in both cases.

          • Guesteleh

            Medicated birth aka pain-free birth. But calling it medicated birth makes it sound so much more dangerous, doesn’t it?

          • NoLongerCrunching

            I just googled quotes by Sheila Kitzinger and this came up: “All that is needed for the majority of labors to go well is a healthy, pregnant woman who has loving support in labor, self-confidence , and attendants with infinite patience.” I find it interesting that she makes this assertion even though she has no personal experience in obstetrics/midwifery.

            It sounds to me like she thinks she has found the one true way and if labor does not go well, it is because the woman did not have enough self-confidence or emotional support. How does self-confidence, emotional support, or patience help treat obstructed labor, shoulder dystocia, postpartum hemorrhage or severe pain from back labor?

            Btw I had 3 NCBs and I’d do it again in a heartbeat. (Pregnancy not so much lol). I just resent the attitude people like her have that other women are doing it wrong or are too delicate to simply say “no thank you” if offered pain relief.

          • guest

            ‘majority’ — not all. and the majority of births in a healthy pregnant women do go well. [I REPEAT: majority = NOT all]

            it is also clear that a lot of this is about support, good attendance, and self-confidence – which she makes very clear is a lot about the support given to women.

            I don’t see here any blaming of the woman. it was all about blaming (and changing) the system.

            also – googling quotes is not the same as reading someone’s work. context matters.

          • Cobalt

            Forced (or coerced, or whatever) NCB is anti-feminist. That doesn’t mean every woman that chooses one is, though. I vote for free choice, and if that means 99% of women opt for an epidural, I hope they get a good one and as quickly as the anesthesiologist can get it done. I disagree with reflexively shaming the 1% who decline.

            Eating corn flakes does not necessarily make someone a follower of Dr. Kellogg’s notions on health and wellness. Sometimes, some people just like corn flakes.

          • guest

            of course coerced NCB is anti-feminist. as is coerced non-NCB. any coercion is.

            The whole point I made is that SK is being misrepresented as being anti-feminist and mandating vaginal birth for all, where as evidently (read my quotes!) she is not.

          • Amy Tuteur, MD

            Frankly, Kitzinger’s proud description of how she interacted with a woman in labor is a terrible indictment of her view of women. She grossly overstepped professional boundaries, she engaged in behavior that could be viewed as sexually predatory (imagine if an obstetrician had done the same thing), and at no point does she demonstrate any awareness of her breach of professional ethics.

            That’s not feminism; it is adherence to a theory of biological essentialism that is thoroughly antifeminist.

          • The Bofa on the Sofa

            of course coerced NCB is anti-feminist.

            So making up bullshit to try to convince women to do a NCB is not coercion?

            How about misrepresenting the extent of pain? To say that “it can be orgasmic” is about as much of a deceitful marketing ploy as convincing people to play the lottery because they CAN win.

            As has been noted, childbirth was recognized 3000 years ago as being so painful that it was attributed to punishment from God, so don’t give us this bullshit about how it is all sparkles and unicorns.

        • Lizzie Dee

          Giving birth can be an intense and joyful psycho-sexual experience

          Maybe. But who for? The midwives who attended my daughter certainly gave her “warm support” – for THEIR determination that she should have a natural birth – not hers. She was high risk – history of pre-e, precipitate labour, Group B positive , happy with the epidural she had the first time. The midwives thought a natural birth was just what she needed – and it took some persuading for them to give her antibiotics. The actual arrival of my rather grey grandchild was joyful – and still is a source of joy. But the midwives enjoyed it a lot more than my daughter.

          As for me, some bonkers Earth Mother who wanted to dance and have me celebrate my womanliness would not have made me very happy. A cerebral person, I found the physicality of childbirth interesting. The idea that it would define me I would have regarded as insulting.

          If people want to approach childbirth that way, then fine. Gets to be a bit of a problem for the fairly large number who end up feeling like failures.

        • moto_librarian

          “She writes: “Yet studies have shown that when staff give warm approval to a woman’s determination to cope without drugs, this boosts her morale. And that, in turn, makes it much more likely that she won’t need them.”

          I didn’t need my morale boosted – I needed anesthesia. I had plenty of support during my unmedicated delivery. It did nothing to ease the pain, and I still feel that the helplessness that I felt in the face of such overpowering pain was the most disempowering experience of my life. Also, if you keep delaying a woman’s requests for pain relief, she will eventually give birth without it. Doesn’t mean she found it to be a good experience.

          • guest

            The question is not what you want, the question is whether people can get what they want: anaesthesia for you and all others who want it, ‘support’ for those who want that. Giving people what they want is feminist. Only wanting to give people what you want is not.

            what irritates me about discussions on this blog is that you claim to criticise NCB-people because you think they proclaim that unmedicated birth is the ONLY way, and fail to make space for the possibility that people might want other ways – such as anaesthetic pain-relief. But you are doing just the same thing. You aren’t making space for the possibility that there might be people who want something different from what you want.

            Kitzinger does not appear to be making that mistake in this article – she talks about support being available where it is not – she does not talk about drugs being banned.

          • NoLongerCrunching

            A huge number of women on this board–including Dr. Amy herself–have had unmedicated childbirth by choice. Damn right we support that option. Where are you getting the idea that natural unmedicated birth is unsupported here?

          • guest

            in the above article SK is misrepresented for being anti-feminist when clearly (see my quotes) she is just advocating better support for unmedicated birth. – she is not saying it is the only option, or even that everyone should want it. what, then, is your bone to pick?

            my worry, i repeat again is that this blogs claims to rail against crazy, dogmatic NCB-ers who impose NCB on everyone (or something like this). those exist. but regularly people who say sensible, fine, feminist things that include advocating support for unmedicated birth, get selectively quoted and swept up/misrepresented as the crazy/dogmatic type.

            that is problematic and polarising. it is that that I worry about.

            for further about advocating medicated birth, see new reply to the blog (right at top of comments). i do see a certain hippocracy in a lot of the comments in that respect.

          • Amazed

            In which world does behavior that comes borderline to sexual offense is labeled “support”, let alone “better support”?

            FFS, when I am having my examinations, my doctors ask me to lift my own breast. That’s because their hands don’t belong anywhere near my private parts when it can be avoided.

            The fact that SK thinks the behavior she displayed a normal method of support is a cause for worry, not lauding her as a champion of women’s rights.

            If things have progressed so far that she needs to use her own fucking pelvis, perhaps she should have suggested the damned drugs if she couldn’t think of a better way to support her than this disturbing “dance”.

            It isn’t an unmedicated birth she’s describing, it’s her medicating the birthing woman with the drug of her unappropriate closeness.

          • guest

            as i said elsewhere, the consent process isn’t detailed-ly described. people are willing to PAY doula’s to do just that. not my choice, but everyone their own party.

          • Amy Tuteur, MD

            But this patient was NOT paying a doula and she didn’t even know Kitzinger. How could this ever be appropriate?

          • guest

            see above: neither of us was there, it was 40 years ago. I am not willing to pronounce either way. That SK writes so confidently about it makes me think this was very OK with the woman. We DO know some women want this. Do we have any reason to think she didn’t say ‘it might sound a bit weird, but we could try this, it might help – would that be OK?’

            I once burst into tears in the GP office. she gave me a hug. professional violation? or good caregiver judgment? I assure you it was DEFINITELY the latter, in this case

          • Amy Tuteur, MD

            Sexual predators are often confident that their inappropriate behavior was wanted. That tells us nothing.

            If a man did what Kitzinger did, you would recognize it for what it is: a violation of ethical boundaries. The fact that Kitzinger was a woman, and that you admire her, leads you to give her a pass. You shouldn’t.

          • guest

            Confidence that it was wanted, and writing publicly about it in a book, for something that went on for half an hour in a public space and the woman is very happy with at the end and involvers not physical overpowerment – these are not the same thing.

            I repeat: we don’t have the full description of the situation, but very little reason to think she didn’t ask for and get consent.

            when you describe a caesarean ‘I recently did a caesarean and this surprising thing happened ‘ – do you include a detailed discussion of every step of the IC? come one.

            where is the detailed quote i asked for? the evidence? you are still derailing – this was about misrepresentation, not ethical violation.

          • Poogles

            “Sexual predators are often confident that their inappropriate behavior was wanted. That tells us nothing.”

            Exactly! The number of pedophile predators who claim the child “seduced” them is downright sickening. Or like the grandfather who justified sexually assaulting his very young granddaughter by explaining that she still climbed into his lap, gave him hugs etc. afterwards so obviously he wasn’t doing anything wrong.

          • Guesteleh

            There are some behaviors that are always prohibited by caregivers because patients are not in a position to give true consent. For example, doctors can never ethically enter into a sexual relationship with a patient even if the patient consents because the power differential between the two parties is so big. Just because the woman may have consented doesn’t make Kitzinger’s behavior okay.

          • Amazed

            The problem comes when we have women who are so convinced that “their own party” can only be an unmedicated birth because everything else is bad for baby, bad for bonding, bad, bad, bad all around. There are women whose mind is blown with pain but they don’t want any pain relief because it’s been hammered into their mind that it’s bad.

            I don’t see why the woman in question wouldn’t be happy. Looks like she hadn’s been offered any pain relief – neither of the women was, as far as I could glean. Of course she’d be happy and grateful for anything that helped her dilate and presumably helped her with the pain somewhat – even if the last part was only in her head.

            SK wasn’t concerned that women were not offered pain relief. She saw her chance to co-live a “good and right” birth and jumped for it. Nowhere did she say to the senior midwife, “Perhaps some drugs might help with pain?”

            When a doctor behaves this way, even if the patient was compliant, he can be accused of inappropriate behavior. Look at Fischbein! When it’s a NCB advocate, suddenly it’s all spiritual, dancing, nothing sexual at all!

            In fact, I stand corrected. Fischbein isn’t derided by the NCB community, he’s their bloody idol. I suppose he and SK would have found they had a lot in common.

            SK

          • guest

            a lot of your co-commtators do seem to think the women has serious reason to feel unhappy – violated in fact. 😉

            we agree on crazy OTT NCB believes. but my point is that often on this blog people with sane views get misrepresented as crazy

          • Amazed

            I also happen to think that the woman has a serious reason to feel unhappy and violated.

            And I don’t think it’s weird that she doesn’t. After all, the perception of the moment matters more than many of us would have liked. I still don’t FEEL that the boy I was talking about was trying to sexually assault me, yet with his story of pushing his hand where it didn’t belong (never initiated by me, BTW), pushing me down on the bed, spreading my legs apart and trying to open the zipped of my jeans, what else could it have been?

            That’s why I disagree with “sexual violation is what the victim perceives she felt!” notion. He was a bloody child molester. I know it. The fact that I still don’t FEEL it doesn’t change a thing.

          • moto_librarian

            Did I say that every single woman should be forced to have an epidural? Certainly not. I resent the lies that are routinely peddled as facts by NCBers. I know that some women find labor tolerable – I actually found my first labor tolerable up until I started pushing, which was sheer agony. I had been told that “pushing would feel good,” and that if I could “just get through transition,” I would be golden. I was extremely unhappy to discover that much of what I had been told had no basis in evidence.

          • guest

            I just find it SOO interesting how birth is so very different fro everyone!!!! I am one of those ‘contractions was hell, pushing was fine (until crowning – OUCH) people……..

            you responded to my ‘support should be available’ with ‘I didn’t want that kind of support’. well – sure. that’s fine. I presumed you would only say that if you thought it was an argument against that support being available. because i am already at pains to emphasise that people should get what they want, anaesthesia or otherwise.

            but it seems we don’t have much disagreement. i also dislike lies. but i feel they come from both sides. i find a lot of misrepresentation here too. and the thing with birth just is: it is very hard to say what it will be like. it is different for everyone. (WHICH IS WHY THEY SHOULD ALL BE SUPPORTED IN WHAT THEY WANT!)

            I do think some (not all) NCB’ers wellmeaningly don’t realise that, and wish their (genuinely) wonderful experience on everyone. equally i think that some anti-ncb-ers don’t realise that there HORRIble experience of excruciating labour pain is also not universal.

          • moto_librarian

            What lies are you hearing from those of us who prefer medicated labors? Do you think it’s coincidental that the Bible states that Eve’s punishment for original sin was pain in childbirth? There are some women who don’t find it excruciatingly painful, but they are in the minority.

            The lies about labor and delivery are coming from the NCB side. Here are just a few:
            1. That epidurals cause the “cascade of interventions” that result in a c-section. Studies have demonstrated that even early epidurals do not increase the c-section rate.
            2. That epidurals drug your baby and impede breastfeeding. While I.V. pain meds can make your baby sluggish if given too close to delivery, epidural anesthesia does not cross the placenta.
            3. That inductions cause c-sections. Studies show that induction at term actually results in fewer c-sections than expectant management.
            4. That episiotomies are routine, despite the fact that the current rate of episiotomy is 12%.

            I could go on, but you get my drift. Other than your claim that not all women find labor excruciating, what exactly do you claim we are lying about?

          • guest

            as i indicated in original reply: for example mis-representing what SK (and often) others write.

            systematically denying/not mentioning the well-established higher rates of interventions in hospital.

            (and yes i have head that discussion at length before. result: commenters just didn’t mind ventouse, forceps, epi, c-sec. that is OK with me (although I was surprised – but it was informative. i learnt).

            Thing is: I, and some (not others) do – I like my body preferably without cuts. I, on the other hand, find labor pain excruciating, but manageable. it is just a sensation (to me) – it leaves no mark.

            I find both positions reasonable. i wouldn’t dreamt o lecture people what to feel or how to evaluates such things that are different to everyone. but if bothers me that only one position is often portrayed as reasonable here. not two.

          • moto_librarian

            Um, yes, there are more interventions done in the hospital because many of them cannot be done outside of the hospital. Of course fewer women have c-sections, forceps deliveries, and episiotomies because these aren’t things that can be done on your kitchen table by a lay midwife. For the record, I did not have forceps, vacuum, or an episiotomy either time that I gave birth. The only cuts that I got were au natural – my older son tore my cervix and I had second degree tears with both, and I now have the joy of pelvic floor problems at the ripe old age of 37. I also had a totally unmedicated birth with my first. No one asked me if I wanted pain medication, not even once. I regret not having a heplock to this day since it meant experiencing a manual examination of my uterus with absolutely no pain medication. I wouldn’t wish that on anyone.

            You know what else happens far too routinely at home birth? A baby unexpectedly born dead because there was no EFM to pick up on the signs of distress too subtle to be discerned on doppler.

          • guest

            so this is the long argument I don’t want to repeat but i had a long argument about the birthplace study before – second-time low risk mums, still massively more interventions, no measurable better outcomes to baby. I wouldn’t fancy that.

            also: unmedicated birth is not necessarily home birth is not same as midwifery led unit birth, etc.

            either way the point is that women who want to avoid said interventions are routinely lambasted as crazy and selfish here – and that seems to me inconsistent with proclaimed pro-feminism and pro-women’s experience stuff.

          • NoLongerCrunching

            “women who want to avoid said interventions are routinely lambasted as
            crazy and selfish here – and that seems to me inconsistent with
            proclaimed pro-feminism and pro-women’s experience stuff.”

            No. Women (and men) who want OTHER women to avoid interventions are lambasted, and rightly so. The only people who should have a say in what interventions a woman gets are that woman and her chosen provider. Everyone else needs to butt the heck out.

          • guest

            then why is this blog (there were several posts in the last week) directly addressing women who were home-birtihng or in the process? they were criticised for being selfish, etc.

            this does routinely happen on this site.

            though i am glad you disagree with it.

            Personally I don;t want other people to do anything other then SUPPORT what other people want to do. that includes offering anaesthesia. it also includes supporting e.g. home birth. I don’t hear much about the latter on this blog. I have the impression that a lot (not all) of NCB-ers are about better supporting people to do what those people want for themselves. but as i said, they are routinely misrepresented.

          • NoLongerCrunching

            Good question. Many women go into homebirth because they have been taught that it is as safe as or safer than hospital births for low risk women. Those women are not selfish in the slightest; they are just trying to do what is best for their babies based on the information they have. Their stories are chronicled on another of Dr Amy’s sites, http://hurtbyhomebirth.blogspot.com

            There are some other women (recently discussed on this blog) who have very high risk situations and have even had previous babies with birth injuries or near misses, who refuse to deliver in the place that has the best chance of saving their baby’s life and brain cells. Some people think those women are selfish and I can understand that. Personally I think they have some kind of psychiatric issue. The midwives who consent to attend these women at home are absolutely predatory and should be prosecuted.

          • guest

            Dr Amy only chronicles the stories of those that regret it – not those that don’t . that is hindsight bias. it is not doing statistics. if we want accurate risk depictions, we need to look at the data. and for some subgroups, choosing home-birht is entirely reasonable.

            i feel on this blog the people for whom it is reasonable too often get lumped wit the women from your second paragraph – whose choice i find baffling, and i would not advocate – but whose right to choose what they do i defend (with a heavy heart). as to their midwives – I do think these women are entitled to care, they can’t be left alone, but i think their midwives should attend with a heavy heart, too.

            i have to log of soon. way past bedtime, battery also gone. but i hope we meet again!

          • Jodi Hilla McCormack

            Dr. Amy has repeatedly asked for statistics and data from MANA, who apparently do not require good enough record keeping from their members to provide decent numbers. What they have provided shows home birth is not as safe as hospital birth.

            Statistics go the other way too – it’s irresponsible to tell a first time, low-risk mother she has a 33% chance of c-section if she gives birth in a hospital when it’s more like 11%, but that’s an NCB/homebirth scare tactic as well.

          • Guesteleh

            Also irresponsible not to tell first time mothers that they have a 30-40% chance of transferring to the hospital.

          • Amy M

            Well, I can’t speak for others, but I support a woman’s right to have a home-birth. But, I wouldn’t cheerlead and tell her she’s doing the safest thing, because I think homebirth is dangerous. If a friend of mine was dead-set on having a homebirth, I wouldn’t get in her face and try to change her mind, but I don’t have to agree with it either.

          • Monkey Professor for a Head

            I’d modify that slightly – I support a woman’s right to choose a home birth if she has been given the necessary information to make an informed decision. If a woman chooses a home birth whilst being aware of the risks involved, then whilst I think it’s a bad choice, I respect her right to make that decision. If she’s choosing a home birth because she’s been mislead into believing that home birth is as safe or that hospitals are evil, then that’s different. I guess my main ire is towards those who spread misinformation, in particular those who should have a professional responsibility not to do so.

          • Amy M

            I agree–the spread of misinformation is highly frustrating and I think its atrocious behavior.

          • Sullivan ThePoop

            Well, if they do not want the interventions at the cost of their child then they should be lambasted.

          • NoLongerCrunching

            Guest, you seem like a smart woman, and I hope you stick around here. I came to this blog to argue also, but after a few months, I realized that I had learned some things I didn’t know (or rather, thought I did know, but was wrong).

            On your first point, I don’t think it’s true that anyone here or on similar sites would deny that the rate of interventions is higher in the hospital — no one’s putting IV’s in or doing c-sections at home after all. There are probably interventions done that were unnecessary in hindsight, but when you are not sure which way things are going, it makes sense to err on the side of keeping the baby and mother safe rather than providing a more natural birth experience.

            On your second point, *most* people prefer their bodies without cuts. It comes across as a little condescending to say that, as if we get to somehow make the choice to have a manageable labor without the need for surgical intervention.

          • guest

            Thank you. Trust me, I have been around for AGES and sometimes engaged in discussion. I haven’t learnt much new – but some snippets. well, I have learnt a lot about misrepresentation. 😉

            but really, thank you for the kind compliment!!!

            re: 1 – as I say above or below to, i think,moto-librarian, I have had a long discussion before about interventions – it would take to long to repeat. but i have spoken at length about their being subgroups of women for whom the risks make theme reasonably sway away from labour ward (e.g. birthplace england, low-risk second timers).

            re: 2. of course. we can’t choose. but we can choose what risk we take. and some (I, others) prefer more risk of labour pain against lower risk of cuts; others prefer higher risk of cuts against lower (or absent) risk of pain. that is a choice we have – between risk profiles. and i think there are many reasonable ways of choosing. that is too little acknowledged here. (although i say: several commentators are also very sensible, I think!!!!)

          • theadequatemother

            Evidence shows that’s not a real dichotomy – you state that treating pain will result in “cuts” but treating the pain does not increase cs or episiotomy. If your conception starts with false information then your choice is not informed. And you know maybe I wouldn’t care it’s your life do what you want but when you start to use public platforms to spread misinformation that is going to increase suffering you will find people here will push back quite stringently against your bs.

          • AllieFoyle

            Perhaps your choices simply reflect your own experience, which was not that painful or difficult. I might make the same choices if I were guaranteed no cuts or tears and manageable pain, but not all of us are that lucky.

          • Amy M

            No one denies the higher rates of intervention at hospitals. That’s what hospitals are FOR. Women can’t get those interventions (pitocin, ventouse, Csection) at home. I don’t consider epidurals or continuous monitoring interventions—the monitoring is merely tracking what is going on, and the pain relief will certainly interrupt the pain, it doesn’t seem to have other effects on labor/delivery. People get epidurals for pain relief, not to prevent an emergency, which is what the other so-called interventions, are there for. I don’t understand why “interventions” are viewed as the worst possible outcome by the NCB crowd—if used in a timely manner, they PREVENT the worst possible outcome (death or brain damage).

          • AllieFoyle

            Do you think other people make different choices from you because they like cuts on their body? If you get through childbirth without some sort of cut, tear, or tissue damage, simply consider yourself lucky because it was not under your control. Some people avoid being cut only to tear, sometimes badly or with lifetime consequences. Some (me, for example) will have to undergo surgery to have this damage repaired. The idea that there is a choice to be physically damaged or not is a falsehood.

            I’ve been reading this blog and other sources for a while and it’s become clear to me that people have very different experiences, and they often have a hard time realizing just how unrepresentative their own n of one or two or whatever is of the great range of possibilities.

            You’ve said earlier that you didn’t think the pain was that bad and didn’t justify the risks of an epidural, that contractions were hell but pushing wasn’t very painful. Here you say it was excruciating but manageable. I found contractions painful but manageable, but pushing EXCRUCIATING. Three hours of unremitting contractions with no breaks in between, constant screaming, feeling that I was being ripped apart (which actually, yes). I was offered nothing more than “support” and a m*therf*cking comb to hold as counter pressure. Oh, and a midwife doing some horrible perineal massage that I didn’t ask for or want.

            You had an easy time, great. Be quietly grateful and stop insulting those of us who didn’t by pretending that you can choose not to be damaged or that your pain is the same as someone else’s pain or that it’s not completely absurd when people like SK want us all to dance through labor, when many of us simply can’t or don’t want to.

          • SporkParade

            No one here denies that interventions are more common in a hospital. What a lot of us object to are interventions being treated as adverse outcomes. A dead or disabled mother or baby is an adverse outcome. A C-section, while it may not be everyone’s first choice on how to deliver, is NOT an adverse outcome. Yet, because the NCB rhetoric has gone mainstream, doctors and hospitals are trying to reduce their rates. What has been the result? Women being denied the choice of having a medically unindicated C-section (note: these women often have a psychological reason to avoid vaginal delivery, such as a history of sexual abuse or previous traumatic vaginal delivery). Babies are suffering neurological injuries because the OB chose forceps or ventouse over C-section. In other words, women and babies are being harmed because NCB treats interventions as an outcome rather than a medical procedure.
            And this is true for all sorts of interventions. Refusing a heplock means that it’s much harder to save a woman who is hemorrhaging. Refusing induction after prolonged rupture of membranes turns a vaginal delivery into a C-section. Refusing Pitocin for a slow labor or a long pushing stage turns a normal delivery into a postpartum hemorrhage. Until we have a better way of determining how a fetus is handling labor, reducing interventions will increase mortality and morbidity.

          • The Computer Ate My Nym

            The “warm approval” may boost her morale or it may make her fear disappointing her caregivers by “giving in” to an epidural and therefore be less likely to ask for one when she’s hurting.

          • Bombshellrisa

            Especially if they are midwives who take away her cell phone and block the cars into the driveway, then tell the woman horror stories about the cascade of interventions at the hospital.

          • guest

            so the couple rogue midwives represent all? do the couple rogue doctors represent all? For then we should run from hospital like HELL

          • Bombshellrisa

            Why do you assume these were rogue midwives? Certified Nurse-Midwives with licenses and years of schooling are not immune from NCB ideology.

          • guest

            nor are well-trained doctors immune from sometimes doing dreadful things – behaviour makes you rogue, not (just) unlicense.

          • Bombshellrisa

            And?

          • guest

            and what?..

            explain what your point was, if it wasn’t ‘sometimes midwives do crap stuff.’. what was your point. how was it relevant to the discussion.

          • Bombshellrisa

            When those with a stake in natural birth praise a woman, it is for making a choice that aligns with their beliefs, not necessarily the one that is best for the woman. That may include talking her down from her request for an epidural, not helping her with a hospital transfer or not counseling her on the risks of refusing certain tests during pregnancy. Now, what exactly was YOUR point?

          • guest

            Ok. thank you that helps.
            People can only act from their belief set. the doctor who keeps offering the epidural to the woman who then feels unsupported in her unmedicated birth, and is upset about that, is also attempting to act in best interest of patients – but not succeeding – as acting legitimately from within own belief set.

            but this is kind of veering of my original topic. i can’t respond to everything

          • Bombshellrisa

            You have to wonder why the epidural is being offered (although I don’t feel that this a problem in the UK, from the comments student midwives make about withholding epidurals from patients). If a woman is screaming, crying and doesn’t seem to be tolerating the pain well, it is wrong to keep offering “comfort measures” and not offer something more and you might have to offer more than once.

          • guest

            again, people’s experience differ. i also hear from peop[le who were doing fine and kept being asked ‘would you like some gas and air” shall i get some pethidine’ and they were like ‘shut up, i am trying to labour here, OK! – I have a mouth I can ask for it’

          • AllieFoyle

            Your comments read as though you equate being offered pain relief when you don’t want it (an annoyance at worst) with not receiving pain relief when you want it. A person who doesn’t want the pain relief that her doctor is compassionately offering can say No, thank you. Not offering pain relief when a woman wants or needs it is cruel and unethical and causes unnecessary suffering. Let’s stop pretending that these two scenarios are equivalent.

          • Sullivan ThePoop

            Or practically kidnap an underage girl as I have witnessed

          • Bombshellrisa

            And there is that too.
            Then there is the midwife who delivered the baby she was going to adopt at her birth center, after meeting the mother as a client. No agenda there.

          • An Actual Attorney

            What the actual fuck?

          • Bombshellrisa

            Yeah, it’s many many shades of f&$?ed up. ((Of course, her baby was “breast fed” because she asked her colleagues, doulas, clients and god knows who else to donate pumped milk for her. If my midwife or OB asked me to donate milk to her baby, I would dump them and file a complaint. Professional boundaries and ethics just don’t exist within the NCB world))

          • KeeperOfTheBooks

            YES. Being in labor can be a very emotionally vulnerable experience, one in which you desperately want warmth and approval. Getting warm approval for choice A can make you much less likely to go for choice B, even if choice B is what you actually want.

        • just me

          But this implies it’s better to go without: “fewer people might want it”.

    • DaisyGrrl

      After reading the article, I thought Dr. Amy was being too nice.

    • yugaya

      Choice between effective, safe pain relief applied by professional people acting in a professional manner and a weirdo birth junkie who clearly jerks off on seeing other women in childbirth pain rubbing herself all over you? Well, that should be easy.

      • guest

        evidently it isn’t — evidently there are plenty people who DON’t want the anaesthesia, and who do want the ‘birth junkie’. The question is not what you want, the question is whether people can get what they want: anaesthesia for you and all others who want it, ‘birth junkies’ for those who want that. Giving people what they want is feminist. Only wanting to give people what you want is not.

        • yugaya

          Medical professionals have ethical boundaries that will prevent them from “giving people what they want”. That’s why no medical professional is ever gonna give you what Sheila had on offer.

          Being treated in an ethical and professional manner when in childbirth is feminist.

          Claiming how not being given access to unethical medical care is unfeminist is stupid and insulting.

          • guest

            Sorry???? lots of midwives give (don’t force!!!) that kind of support and work within medical professions and ethical boundaries in various health care systems. you think they should force pain relief on a woman who doesn’t want to? they aren’t allowed to encourage her or let her change position? because that appears to be your implication?

          • yugaya

            Lay midwives do not work “within medical profession”.
            There are tons of examples how they tricked, lied and manipulated women who were requesting transfer for exhaustion into remaining in their care, thus forcing the lack of adequate, chosen pain relief upon their vulnerable clients.

            If any proper midwife or an OB in a hospital did what Sheila did ” to give a woman pain relief” they could ( and should) have been arrested.

          • guest

            i am not saying anything about lay midwives. nor is it clear that SK was. she was talking about women being better supported within the NHS in England. Nor is it clear to me that she things everyone should go into pelvis-rocking – what is clear from her larger work is that a lot more could be done to support women in choice than putting them on their back and offering an epidural. (which is not to say tat those options shouldn’t be available too).

          • Lizzie Dee

            Back in the day when Kitzinger was dreaming all this up, I was supported through two very high tech births by professional caring midwives.

            To be honest, I thought the young pair who attended my daughter were dangerous idiots. Very keen on “supporting” though, In London, things can get very hairy when support is all they want to offer, as it can be rather difficult to get past them.

        • Amy Tuteur, MD

          “Only wanting to vie people what you want is not.”

          Exactly. That’s why Kitzinger isn’t really a feminist.

          As someone noted above, at no point to Kitzinger ask the woman’s consent for “dancing” with her in labor. And I didn’t see that the woman asked for Kitzinger to dance with her in labor. So Kitzinger gave the woman what SHE wanted to give, not what the woman wanted.

          • guest

            we have too little info to judge that. it also seems the woman wasn’t being offered an epi. it is clear that she is in pain and is not happy.

            and let’s face it – SK’s point isn’t that everyone should be gyrating with their midwife. (really – it is not. you know that – even if not all your followers due). it is about support, encouragement, being able to move around, bla bla bla.

          • Amy Tuteur, MD

            But it was WRONG of her to violate professional boundaries in the way that she did!

            Patients trust us to see them and touch them in intimate moments. That is a privilege that we have to be very, very, very careful not to violate. Kitzinger violated that privilege by placing her body next to the patient’s body. There is NO justification for that abuse of trust.

          • guest

            You are still completely side-tracking from the issue I originally raised – and that you originally raised.

            do you deny misrepresenting her?

            neither of us was there, it was 40 years ago. I am not willing to pronounce either way. That SK writes so confidently about it makes me think this was very OK with the woman. We DO know some women want this. Do we have any reason to think she didn’t say ‘it might sound a bit weird, but we could try this, it might help – would that be OK?’

            I once burst into tears in the GP office. she gave me a hug. professional violation? or good caregiver judgment? I assure you it was DEFINITELY the latter, in this case

          • AllieFoyle

            You know, maybe that woman was totally happy with whatever the hell it was SK did, but maybe she would have been happier with an epidural. We’ll never know. But why did SK write about that event if not to suggest that such techniques were what women really needed? She’s pretty clear that she feels kind of meh at best about epidurals, and that this wonderful woman-woman bonding during labor is a valuable thing that is being lost when women get epidurals. Which to me seems like a pretty unfeminist attitude in its failure to consider that many women may not want or enjoy such an experience, or indeed, that the idea of “dancing through your labor” is dismissive to women who have extremely painful or difficult labors, and can set up women to have unrealistic expectations that labor will be easy or controllable or empowering, when for many that will not be the case.

        • Lizzie Dee

          I think it matters why people want what they want. I have an intelligent young friend who is absolutely convinced that epis are dangerous, birth is far superior if it is natural, and it doesn;t hurt much anyway.

          If you want to dance and that works for you, then fine. How oftn does it?

  • PrimaryCareDoc

    She’s rocking and circling her pelvis against a laboring woman, and they accuse OBs of birth rape?

    • Roadstergal

      Her and Ina Mae, the tit-grabber and clit-twiddler…

  • Amy M

    I like the bit where she compares the position that animals give birth in, to that of humans, completely ignoring the fact that 1)those animals have 4 legs and 2)animals often lie down in labor/to give birth, just not on their backs, because those animals NEVER lie on their backs. If there are women reading that and thinking “Wow! I should give birth the way a sheep does!” then she’s pretty ignorant of basic anatomy.

    And why don’t we give animals painkillers when they give birth? Mostly because they can’t ask for it, I think. If a sheep could have walked up to Sheila Kitzinger and said “This hurts like a mofo, please give me an epidural” I would hope she would have trouble ignoring that. Turning a deaf ear to a woman who is in agony, possibly begging for an epidural is cruel and that whole “they don’t get told all the information” is a bs cop-out. I imagine that back in the 1970s/80s, when epidurals were newer and that wave of women’s lib hadn’t completely taken hold yet, its probably true that women weren’t completely informed of their options and the risks/benefits of said options. However, things have changed in the last 40-50yrs, even though these biological essentialists still think they are fighting the same fight.

  • demodocus’ spouse

    Does “Once we were alone, I lifted the woman off the bed. Holding her lightly, I started to rock and circle my pelvis. As each contraction ebbed away, I gave a long breath out and was still; when I sensed another was coming, I danced and breathed my way through it with her.” sound like soft core porn to anyone else?

    • The Bofa on the Sofa

      “…and then the pool boy came in, with long, flowing blonde hair and wearing nothing but a speedo, which was unable to conceal all that was beneath.”

      • Liz Leyden

        Fabio cleans pools?!

        • The Bofa on the Sofa

          I ALMOST described him as having “Fabioesque flowing blonde hair…”

    • Amazed

      Me.
      I think I found the problem of the NCB anties. They want to have their mojo-jojo participate in some sacral dance, so an OB who sees it simply as a functional part of their body rapes their feelings of self and worth. Those who push their own pelvis into the game – oh, it’s magic! It’s respect! It’s an ancient way of knowing.

      Barf.

    • DaisyGrrl

      I was looking for the part where she asked for the labouring mother’s consent to get her out of bed and do this…whatever it is….with her. Not there. What about the mother’s active participation? Not there. This description is all about the author with the labouring mother acting as the passive receptacle. Wow.

      • Roadstergal

        Yeah, it really sounds a lot like a description of a guy raping a girl too drunk to put up much resistance. “Once we were alone.”

    • MegaMechaMeg

      A lot of descriptions of natural birth sound super porny to my ears. I assumed the target audience was women on their first kid who had no idea what they were in for, but I have had friends go for the woo in second pregnancies and they seriously have to know better.
      I remember seeing a video of a surprise twin water birth where the midwife talked about the joy of the twins without the fear that would have come from anticipating their arrival, but I just remember the mother moaning over and over “please not again, it is supposed to be over” and it didn’t sound even a little bit spontaneously joyful to my ears.

      • Amy M

        I freaked right out when I found out I was having twins—but then I had 7 or 8mos to get used to the idea and prepare. If we hadn’t known that we were having twins until they were born, I’m not sure I ever would have freaked back in.

  • Mel

    What irritates me about biological essentialism is that people have been disproving that for centuries.

    One of my favorite authors is George Elliot (pen-name of Mary Ann Evans) and she wrote “Silas Marner” in 1861. A reclusive weaver has an orphaned toddler show up at his house one day. With the help of a neighbor who gives him a quick course on how to care for kids, Silas raises the little girl. The girl’s biological dad is a local member of the landed gentry who doesn’t claim the girl for fear of losing his fiancée. When the biological dad and his wife end up being childless, they try and claim the (now-teenaged) girl. She refuses them because her father is the man who raised her – Silas.

    The overall theme of the story: A child’s parent is the person who raises the child – not the person who births the child.

    • The Bofa on the Sofa

      The overall theme of the story: A child’s parent is the person who raises the child – not the person who births the child.

      A more recent example of such a story: Horton Hatches an Egg

      “It should be, it should be, IT SHOULD BE that way”

    • Poogles

      I guess the movie “Simple Twist of Fate” was based off of this story, it follows the same basic plot – recluse (played by Steve Martin) finds toddler, raises toddler (with a little help from female neighbor), dad won’t claim her because he is part of a wealthy political family and engaged, but wants to claim her when she is older and she wants to stay with the man who raised her. Interesting, it’s always been a favorite movie of mine, never realized it was based off of literature.

  • Cartman36

    “Biological essentialism is the belief that all women have a biological essence and can only find true fulfillment through having children “as nature intended.”

    I threw up a little in my mouth when I read that. It is 2015 not 1815.