February 10, 2010

You Deserve Better Than Cattle-Drive Obstetrics

This post is part of the 2010 API Principles of Parenting blog carnival, a series of monthly parenting blog carnivals, hosted by API Speaks. Learn more about attachment parenting by visiting the API website.
Every month, I attend my local La Leche League meeting. I really enjoy meeting other breastfeeding mothers, always learn a little more about breastfeeding, and – I hope – get the opportunity to influence, oh so gently, expecting and new mothers to parent their children in a more conscious way. 

This month, one expecting mama, a few days past her due date, told the story of how her obstetrician told her he wanted to induce her since she was a few days past due. She told her doctor that she, herself, had been two weeks late, as was her sibling, and that she didn’t want to be induced. She said that his very serious response was, “Who do you think is running this show, anyway?”

Maddening. Obstetrician-mentality like this is just maddening. But the story elucidates the reality that in the United States, obstetricians and hospitals ARE running the show. And the truth of the matter is – they do so because women let them.

I hear woman after woman at LLL meetings blithely accepting as normal this kind of treatment from their obstetricians. They accept impersonal prenatal care – 15 minute office visits after an hour long wait in the waiting room. They accept not knowing which doctor will be on call for the visit, or even which doctor will deliver their baby. They accept as normal being bullied by doctors, and nurses, and lactation consultants even – at the hospital when they deliver. They accept as normal that birth is wildly painful, and must be remedied by body-numbing drugs. They accept doctors’ determination that a caesarean section must be performed because their baby has not been born with a hospital-determined set amount of time or because an ultrasound indicates that their child is too big to deliver vaginally. They accept that pregnancy and birth is, on the whole, a medicalized, unpleasant experience that they must endure in order to have a baby.

They accept these indignities, and many many others, with little – if any - question. And to find solace, they share their pregnancy and birth war stories with other women who cluck, sympathetically, and then share their own.

Every time I hear one of these conversations, I wish I could say “It doesn’t have to be that way. You deserve better than cattle drive obstetrics. And so does your baby.”
But - it is rare that I can intervene in one of these “misery loves company” conversations because I don’t have a horror story to share. So I am telling you, dear reader, what I wish I could tell them. If you are contemplating becoming a parent or if you are already pregnant, you and your baby deserve better care than given by most obstetricians and hospitals. And you can get it.

How? Hire a midwife, and have your baby at home.

If this is a new concept to you, let me reassure you. Yes – people still do that!

The care provided by a good homebirth midwife is second to none. When you are in the care of a good midwife, you feel like you are the only pregnant woman in the world. You feel loved, and nurtured, and safe.
Most prenatal appointments with midwives last an hour or more. During this time, the midwife will talk with you about how you are feeling physically, mentally and emotionally, will ask you about and advise you about nutrition, and will perform the typical examination procedures with a loving, tender touch. She will weigh you, measure your belly, test your urine for glucose levels (should you choose to), and listen to the baby’s heartbeat with a Doppler or fetoscope. She will ask you if you want to have prenatal tests performed, such as blood testing for venereal diseases, ultrasounds, the AFP, glucose tolerance test, Group B strep. She will not force them on you, but will instead make her recommendations as to their import. And if you do not wish to have these tests, she will likely allow you to waive them.

Many homebirth midwives will come to your home for one or more visits close to the time of birth. My midwife with my second child came to my home for the 36 week check up, the 30 hour labor and birth, and then the 2, 4 and 6 day postnatal visits. What doctor these days does that??
A good homebirth midwife will work with you holistically throughout your pregnancy to help ease your mind about the upcoming birth. She will discuss your fears with you to help you release them. She will direct you to read helpful and inspiring books. She will enroll you in a childbirth education course that will get you ready for your birth. She will tell you in no uncertain terms that YOU ARE MADE TO HAVE BABIES and that there is no reason to fear birth.

Giving birth at home – with a midwife - is the ultimate in luxury care. You are in your own safe haven – and the only people present are the ones you want to be there. You can move around as you please. You can wear what you want. You can labor sitting up, laying down, in the shower, the bath, on a birth ball, on all fours – however and wherever feels right to you. You can eat and drink what you want. You can birth by candlelight.

You are not – as you are in many hospitals – chained to a bed by a fetal monitor. You do not have unknown people performing needless pelvic examinations on you to determine how dilated you are. You do not have people looking at the clock to tell you that you must dilate by X centimeters by Y time or else they will “move things along” with Pitocin. With a homebirth, your baby is allowed to be born on his own schedule, in his own way. As it should be.

And when your baby emerges, he remains on your body, unaccosted by gloved medical hands. No one takes your baby away from you to clean him up, or vaccinate him, or put goop in his eyes. You, your partner and your baby – and any others you’ve chosen to be present – just bask in the quiet of your birth space.
In my experience, and in those of countless other families who have birthed their children at home, midwife assisted homebirth is by far a gentler, more loving way to have a baby. Very few women who have chosen homebirth would ever go back to a hospital.  

Here are my favorite resources if you’d like to investigate homebirth further:
  • Ina May Gaskin’s Spiritual Midwifery (this has a ton of great positive birth stories)
  • Ina May Gaskin’s Guide to Childbirth
  • Frederick LeBoyer’s Birth Without Violence (a personal favorite of mine about the vital import of a quiet, dark, preferably water birth) 
 Here are a few others I have heard good things about:
  • Gentle Birth Choices by Barbara Harper
  • Homebirth by Sheila Kitzinger
  • Having a Baby Naturally by Peggy O’Mara
How to find a midwife?


    1. Amen to that. I really enjoy reading your blog :)
      Another thing about the safety of homebirths vs. hospital births is that your home only contains bugs that your body and thus your baby's body as well, is already used to. Hospitals nowadays have so many antibiotic resistant super-bugs that can't possibly be good for a tiny newborn or mom, who needs her body's strength to take care of the little one and not fight diseases that she should have never come in contact with in the first place.

      I firmly believe that our world would be a completely different place, if women would reclaim their birth experiences as they were meant to be: Empowering, earth shatttering, amazing; knowing that after this, nothing is impossible anymore --> I am woman, hear me roar!

    2. Hi and thanks for your comment! Glad you enjoy the blog. You are exactly right - I feel so good knowing that my babes are safe in my home away from all the scary bugs that travel in hospitals. I too believe that our world would be so peaceful if babes were born more gently. We who know this must ROAR, I agree :)

    3. Amen sister! I was good acquaintances with a nurse who I looked up to and found to be really smart. Then she got pregnant and had a doctor attend her birth. Everyone else we knew in common, including me, was having or did have a midwife-assisted birth. I was really surprised by her decision. Afterwards though, I realized that she was just living up to her training and education as a medical professional and the fear that comes along with that. Now she's pregnant with #3 and will be having her 3rd c-section. So sad.

    4. Please tell me how I might convince a worrying hubby that a home birth would be ok. I would so love to have a home birth, but he gets caught up in the "what if we need medical intervention..."

    5. Melodie, thanks for posting! That is so very sad, isn't it? I have a friend who did the exact same thing with the exact same result (3 c/s). I always have a bit of a hard time when someone who I look up to and is highly educated makes that choice.

    6. Ah, Jessica! I actually wrote an article a few years ago on that exact question. I'll have to re-post it soon. But in short, here's my thoughts: 1) make sure YOU really want it. I personally feel that if you're sure, your husband will get behind you. 2) take your husband on visits to midwives and have him ask the midwives every "what if" question he can possibly think of. Here's a quick reference to some what if's: http://www.homebirth.org.uk/whatif.htm. 3) send him and make sure he reads the two major recent studies on the safety of homebirth... 1) http://www.cmaj.ca/cgi/content/full/181/6-7/377 and 2)http://www.bmj.com/cgi/content/full/330/7505/1416. 4) watch The Business of Being Born together and if he will, have him read stories of positive homebirths (Ina May Gaskin!) and/or homebirth statistics like - http://www.naturalbirthandbabycare.com/farm-statistics.html. On a personal note, regarding "what ifs," I had a birth center birth with my first, and after, had a post partum hemorrhage. Midwife called ambulance, transported to hospital (10 min away), had D and C, and while all unpleasant, turned out fine. Midwife did all she felt she could do so she did a hospital transport. With my 2nd, different midwife, homebirth, I also bled a good deal, but my midwife had the whole arsenal of drugs and was able to get the bleeding to stop. Bottom line - midwives come packing - training, medical supplies, etc. - and when they know they can't solve the problem, they transport you. Homebirth is amazing... I look back at mine with the utmost gratitude and joy... the best experiences of my life. I sincerely hope you'll be able to have one too.

    7. Can I just tell you how MUCH I am LOVING your blog. You just rock. :)
      My dream was a home-birth. It's all I wanted. I dreamt of it for a very long time. It was going to be my son's birth story after all and I wanted it to be perfect. Sadly, I had a very rare condition in my pregnancy (choleostasis- thanks Mum.) where my liver was failing and I had to have my care transferred to an OB. "They," of course, told me I had to have my baby in the hospital. I can't even tell you how much I cried. I couldn't even get out of the hospital before having a full emotional breakdown. It was the worst possible thing that could have happened. (at the time.) Then I had to be induced two weeks early because worst case scenario was a stillbirth...and no one wanted that. (least of all me.) But it was AWFUL. They broke my water with a giant crochet hook, and hooked me up to oxytocin which meant I couldn't walk around. SUCKED. The induction changed Isaac's positioning and I ended up with INSANE back labour. OMG! And when they wanted to check how dilated I was I had to lie on my back...which threw me into convulsions. Then...oh this gets good...because the OB delivering my babe was next door doing a C-section ...the nurse told me to BREATHE through my pushing contractions. YUP! I had a few very choice words for her. They wouldn't help me AT ALL. I had to do all the work by myself. Luckily my husband and our dear friend, Deb, were there and they were life savers. They gave me tons of reiki and therapeutic touch and really helped to keep me grounded. When the OB finally came in, I had been pushing for almost FOUR hours. Isaac was out in a matter of minutes. But yeah, it was so sad because I couldn't hold him because he had been stuck in the birth canal (head born...body not born) for four minutes and they "needed" to check him out. I still get sad when I think of how I couldn't hold him right away. What a story, right? On top of all this I was un-medicated. YAY! The one good thing that still went my way. Three hours after Isaac was born we left the hospital and came home. Oh, that felt so good. SCREW YOU HOSPITAL! Thanks for letting me get this out. I hope if nothing else, my awful experience will help some of your readers choose home-birth over hospital birth. I wish I could have. And you know, his birth was still the most beautiful experience of my life...but I can only imagine how much more beautiful it could have been. -Debbie

    8. Debbie, thanks for the love about my blog! I have not heard of the condition you mention... that sounds scary!! I think you're amazing for having powered through, unmedicated, your son's birth - and ultimately, it's true, that the end result - your son - is the blessing to focus on.


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