Sunday, November 11, 2007

Birth in a culture of fear

Okay, so I'm pregnant, and birth is something that's been on my mind lately. Like you couldn't tell. :p

I had an interesting experience Saturday. Not unusual, just an experience that brought back the "oh yeah, I forgot." In the past few years, I've been reading and researching a lot about childbirth. I've gone from being afraid to being amazed and in awe of the whole process. I've surrounded myself with lots of positive stories, and have been able to associate with women who view birth as a normal physiological process that can be a very positive experience. I have personally gone from experiencing birth as scary to experiencing it as amazing and empowering. I guess being around so many "crunchy hippies" has made me forget that I'm part of a very small minority. Yesterday morning, we had a church activity where all the women got together, worked on some craft projects, ate some good soup (and pumpkin squares!), and did a lot of talking. Naturally, the topic of pregnancy and birth came up. And I was struck by how some of these young girls who had barely gotten married, and weren't even pregnant, were so scared of birth they were already planning on getting an epidural to hopefully experience as little of the natural process as possible. There was an overwhelming fear of pain. I mean, I understand some people saying 'why go through the pain if you don't have to', but these girls were just plain freaked out. Then there was a young woman, pregnant with her first child, who said she'd like to try and 'go natural' (i.e. not have pain meds). Immediately, she started getting horror stories from all sides. Including from women who hadn't even given birth themselves! She asked them to stop, and I spoke up and asked them to stop, too. It made me wonder just what it is that makes us so afraid. The perceived pain, I'm sure, is part of it, but there has to be more. In the olden days, I think a lot of fear associated with childbirth came simply from the fear of death. Both infant and maternal mortality rates were high. While there is still some risk involved with birth, these days I don't think death in childbirth is a big fear factor. So what exactly is it that causes women to be afraid? Is it the 'unknown'? Is it seeing all the wires and tubes coming from women in labor that makes us shiver? Is it the stories of excruciating pain? What can be done to help women NOT be afraid? Ironically, the more afraid women are, the more tense they will be, and the more pain they will be in. The general environment in which women birth has a huge impact on the perception of pain, as well. A relaxed, low (or no) intervention atmosphere is going to be a lot more soothing to a mom in labor than the high strung, machine beeping atmosphere encountered in hospitals. Is it treating pregnancy and childbirth as a disease that adds to the fear? What would happen if we treated birth as the normal physiological process that it is, rather than a pathological one? What if all women took an adequate childbirth preparation course (I'm not talking run-of-the-mill hospital class here...)? What if we set up the birthing environment to be non-threatening, non-fear inducing? What if we actively encouraged women to move freely, to eat and drink, to keep lights low (anyone else find bright fluorescent lights irritating?)? What if we made sure women, throughout their pregnancies, are surrounded by positive images and stories about birth? Would we still have an 80% epidural rate? Or would that rate drop to 10-15%, where it is in countries where women are provided with lots of support throughout pregnancy and birth? I'm not saying get rid of epidurals, I think they need to remain a choice for women. I'm just wondering what impact shifting from a culture of fear to one of continuous support and encouragement would have. Feel free to comment, tell me what you think, and share your own stories. :o)


Kermit~the~Frog said...

You live in an uphill battle state for that kind of "radical" thinking! There's an OB practice in Happy Valley that will not accept you as a patient if you plan to use a doula. "No doulas allowed, they interrupt our carefully controlled birth! How can we make her lie down and be still with constant monitoring if she has an advocate? How can we give her an episiotomy if some harpy is telling us it's against the &$&^#^#^@ birth plan?"

I think some women use the epidural as a revenge against the masochism of men: "I actually don't have to suffer to bring a child into the world. Haha!" Masochism all around!

Also, I think every woman is well aware that her life is in danger when she births:

"A woman's womb is like an engine. With conception, that engine is turned on. At first it barely idles...but as the creative cycle nears the climax of birth, that engine revs up and up and up. Its idling whisper becomes a steady rumbling hum, and then a rumble, and finally a bellowing, frightening roar. Once that engine has been turned on, every mother-to-be understands that her life is in check. Either she will bring the baby forth and the engine will shut down again, or that engine will pound louder and harder and faster until it explodes, killing her in blood and pain." ~The Breathing Method, Stephen King.

Now that's a horror writer's take on it, but I know with each pregnancy I see that line that means I will have to deliver the baby (around 27 weeks for me) one way or another. Birth killed many, still kills too many, and I can understand how women could feel more comfortable when surrounded by all that modern medicine can offer. For me, birth and circumcision follow the same path: there are different choices, and not many are flat-out wrong; but whatever you choose, please do your research, inform and empower yourself. Interview different OBs and midwives and find the BEST ONE FOR YOU. It's YOUR birth, you are in charge, take charge!

Kelley said...

I like your style. Have you seen Rixa's blog? She has done a lot of fantastic research into birth, both medically managed and unhindered. Great read.

I am all for home births. I'm pregnant with #4, too -9 weeks- and this one absolutely will be born at home, barring any unforeseen, insurmountable odds. I actually would love to do an unassisted birth, like Rixa did, but my husband isn't going for that idea. Even so, when I start interviewing midwives, I will be looking for one who knows how to really and truly keep her hands to herself. I'd really like one that will stay in the other room through it all, unless we need her.

Birth is absolutely natural. Our bodies were created to do this. Would the human race have survived this long if women really were that likely to die in childbirth? Yes, it has happened, and continues to do so, but for pete's sake, not all that often in normal, healthy situations.

Birth is beautiful. It can be one of the most empowering, incredible experiences of your life. It can also be one of the most life-changing, disheartening experiences if it turns into a trauma-fest from too much unnecessary intervention. I will never again give the power over my body and my child's birth to someone else, especially someone who is in it solely for the money.

Congrats on your pregnancy!

Doreen said...

Kelley, yes, I have read through some of Rixa's blog. A friend of mine actually emailed me the link to it, and then I found the link on Chalice's blog, too. Come to find out she knows her (and you, apparently, haha). Chalice and I used to be neighbors, she babysat my oldest son for me a lot while I was still going to school. She's a wonderful friend. :o) I have really enjoyed reading Rixa's blog. It's always fun to read about other people's expriences, and what they've learned. Don't know that UC would be for me (never mind my husband would never go for it...), but I love reading the birth stories. :o)

C, radical thinking, lol. Never thought of myself as a radical thinker. :p And yeah, that description of birth by Stephen King would make me freak out, too. Oh, and I absolutely totally agree with your last sentence. Sadly, I think many women just have this blind faith that their doctor "knows best". They don't take charge, they don't realize they're in charge, and they completely hand over all control. Once you're in the hospital hooked up to IV's, monitors, and immobilized by an epidural, what happens is out of your hands. Which some women are okay with, but I know it's what made me research birth and my options more and more. And it's what made me realize that I need to be in charge. :o)

Kelley said...

Have you considered a home birth? If you have, and you are in Utah County, I can recommend an excellent midwife to you.

Doreen said...

Kelley, after finding out at our u/s that all the problems I had earlier this pregnancy have disappeared, we've been looking more into home birth. We've actually interviewed with a midwife already, and are in the process of making the switch. We're in Northern UT, so we don't have quite as many options as we would down in Utah county or the SL area, but there are a couple of great midwives who come up here, and that's really all we need, right? :o)

Kelley said...

I just tried to post this, but I think it disappeared. I'll try again.

Are you in Davis County? I had a fantastic midwife while we lived in Syracuse, UT. Unfortunately she wasn't able to attend the birth because my husband lost his job, we lost our insurance, and Medicaid wouldn't pay for her, yada, yada, yada. If you are interested, the full story is on my blog under the title "My Baby is Fwee!" It turned that that I had an accidental UC anyway, but not in the absolutely technical use of the term.

If you want, I could go find out the midwife's name. It has escaped me at the moment, but I'll find it if you need me to.

Congrats on your pregnancy and planned homebirth. You'll never be a "good" patient again. There is something incredibly empowering and intoxicating in being able to completely call the shots in something this integral to womanhood - birth. So cool. I'm excited just thinking about it. :)

Larissa said...

Yes! I agree with you completely! I'm pregnant with my first child (she is due in Feb) and when I mention that I am planning on having a natural, calm childbirth, I immediately get looks and comments that say, "Oh whatever, you'll end up with the epidural when you start your labor." It's amazing how many girls here in Happy Valley who aren't even married are planning on having such a miserable birth experience that would require them to have an epidural. All my roommates I had before I got married said they were planning on having narcotics injected to their spinal cord as soon as they went into labor in the future. It actually makes me sad that they have such little confidence in themselves and in their bodies, which are designed to bring new life in the world.