Monday, November 05, 2007

Pushed

The Painful Truth about Childbirth and Modern Maternity Care. Just got this book today. I've only made it to page 35, and I can tell it's going to be an interesting read. So far, Jennifer Block has been talking a lot about the history of medically managed childbirth. I knew some of the things she's writing about, but I'm amazed at just how much I didn't know. The best part? She has gazillions of references. Everything is backed up by research. One example, electronic fetal monitoring. I knew that there's ample research that shows that continuous electronic fetal monitoring during labor does not change fetal outcome, but has, in fact, been shown to double or even triple the woman's risk of ending up with a c-section. What I didn't know was that this research first started showing up 30 years ago! Just a few short years after the monitors were introduced to labor and delivery units in hospitals. 30 YEARS! Yet it is part of the "standard of care", and women often have to put up a fight if they don't want to be monitored continually. Another example is the liberal use of pitocin. One thing I didn't know is that pitocin use during labor can actually increase a woman's risk for post-partum hemorrhage, in turn requiring another injection after birth. As far as I can tell, after 35 short pages, this book should become required reading for women who are pregnant, or are considering becoming pregnant. So many times, we talk about "choice" in childbirth. There is lots of debate about whether women should be able to choose induction for non-medical reasons, or even elect to have a c-section. There is a general consensus that women should be free to choose pain medication during labor, including the epidural. But when it comes to choosing FEWER interventions, women often fight an uphill battle (I experienced this myself when giving birth to my daughter 2.5 years ago). Furthermore, choice should be based on informed consent. All too often, "informed" means "my doctor said it's safe". Few women are truly informed about risks vs. benefits of medical procedures routinely used in hospitals. By being strapped to their beds, hooked up to IV's and monitors, their water artificially broken, labor becomes a daunting task for women. No wonder we so often hear "I loved my epidural", "the epidural saved my life", "I wouldn't ever want to give birth without an epidural". Giving birth without pain medication is not a heroic act, neither are women who birth without pain meds martyrs. They're not stronger than other women, and they don't have higher pain threshholds. What makes a natural (pain-med free) birth successful is the support a woman receives. It's the preparation she puts into getting ready for birth. It's the environment she births in. When women are allowed to move freely, and are not subjected to routine procedures like amniotomy or supplemental pitocin, labor becomes much more manageable. I didn't get suddenly stronger between birthing my first child and birthing my third. My pain threshhold didn't change. Yet the births were like night and day. With my first, I was strapped to bed, my water was broken, and I was in excruciating pain (ending with me getting an epidural). With my third, I was free to move around as I wished. I had learned some deep relaxation techniques to help me breathe through contractions. I had a supportive midwife who spent the last three hours of my labor right by my side. My water wasn't broken until the end of my labor, and only after I had given my consent. Not once was I in excruciating pain. It was an intense experience, but not painful. It was empowering. It was exhilarating. It was wonderful to feel my "natural chemistry" do the work. I had been able to overcome my fear of childbirth, and welcomed it instead. Both experiences I will never forget. Both births ended with a healthy baby, but this mom felt much more healthy after birth #3 (both physically and emotionally).

Now, I need to get back to reading. There's lots to learn. :o)

5 comments:

KarateMommy said...

great post doreen. i'll have to read that book when you're done. after i finish my book club reads, and monk. and and and!

oh. and p.s. no matter what you say, i still think you're tougher than me

Jeannie said...

Wow. I never really questioned the things my doctor had me do while I was pregnant. With the girls, I thought (and enjoyed seeing them ) all the ultrasounds were normal, to check on their growth. I did have a scheduled c section with them, Maggie was breech and Cassie was transverse.
I asked about a VBAC with Nate, but it was discouraged and I didn't really push for one.

I love that you are so passionate about this. And I have learned so much from your blog, and I haven't even been reading it for long!

miranda said...

i agree. it's ridiculous that women have to fight to have LESS intervention.

while i had an epidural, I wasn't strapped down. and i was glad of the monitoring when my oxygen level dropped. but that was because of the epidural, i well know.

my main complaint is that we had to argue AGAINST having gavin delivered to my chest and josh had to tell the doctor three times that he DIDN'T want to cut the cord.

we're the poster people for sterile, medical births. but i know they're not for everyone, so i think it's silly to pressure women into having them. just as i think it's silly had to convince the nurse that i REALLY, REALLY, REALLY DID NOT want a mirror positioned so that i could watch the birth...

Doreen said...

Haha Miranda, you remind me of my sister-in-law (hi Beth!), who was completely grossed out when I told her how cool it was to catch Kaylee all by myself. :p Just one minor detail, medical births are NOT sterile (MRSA anyone? Antibiotic resistant E-coli?). ;o)

Karatemommy, how could you even think I'm tougher than you? Name says it all... Oh, and that cool video you put on your blog. :p

Jeannie, as you can tell, I am quite passionate about this topic (among others, lol). Though I have to say even I would have a c-section if I had one breech and one transverse baby. :p The VBAC is another issue altogether... It's not that it isn't safe (the risk of uterine rupture is very small, especially if labor isn't induced or augmented), it's that malpractice insurance companies are looming over the medical profession. All too often, women aren't given the choice at all, or are scared into repeat c/s. Even though there are significant risks associated with those... Anyway, another topic for another day. :p Glad you're enjoying my blog. :o)

Kelley said...

Because of circumstances completely out of my control, though not health-related, I lost the opportunity to birth my third child at home and had to go to a midwife in the hospital. I was told, much to my dismay, that external fetal monitoring and having a hep-lock were mandatory and that I would not be able to get out of having them. I told myself that there was absolutely no way that I would allow that to happen, so I decided to stay home for as long as I could.

I did. I stayed until my water broke, and my doula "encouraged" me to go to the hospital. I apparently had waited long enough. My son crowned in the car during a wild, 85-mph ride down the highway, and was born in a wheelchair being pulled backwards down a hallway less than 2 minutes after we got to the hospital. All because I would rather do that than have to fight for my right to not be strapped to a stupid machine and get poked with a needle I wouldn't need. I feel the trade-off was worth it.

By the way, I'm one of Chalice's old friends/roommates from college. Just so you know. I was Rixa's roommate, too.