Thursday, March 12, 2009

Me and my big mouth...

So went to visit a friend today. She's about 4 weeks away from giving birth to her first child. Naturally, we got talking about things birth related. We talked about different birth choices, and it was a pleasant discussion. Until she stated she thought it was crazy to have a home birth. Now, I don't think she meant to imply that I was crazy for having one, but she thought the idea of it sounded crazy to her, and apparently she could not wrap her mind around why anyone would want to NOT birth at a hospital. So, I told her about my experiences with hospital birth, and with home birth, and the difference between the two. I also explained to her that I did a lot of research before choosing to give birth at home, and it most certainly was not a decision made lightly, just because I thought it would be fun or whatever. I told her about some interventions that are fairly routine at hospitals and that I didn't agree with (based on the fact that there is no scientific research to back up these routine practices, in fact, plenty of evidence to suggest they may do more harm than good). One of those interventions is cutting episiotomies. I briefly mentioned how I'd had one with my first baby, and I didn't think there had been any medical indication for one. And I was a bit bitter about that. After all, who really wants their private parts cut up when there is no reason for it? She immediately jumped on me about how episiotomies are a good thing, because they are so much better than tearing. Because, you know, you get a straight cut, and how much better is that than a rugged tear? I told her I didn't agree with that, and neither did the several people who researched episiotomy and came to the conclusion that it actually did more harm than good unless it was used in emergencies. She totally wouldn't even let me talk, and I got so upset. I took out a piece of paper to give her the visual. See, try and tear the paper. It won't, it's pretty resilient. Then give the paper a little "controlled" cut. Now try and tear it apart. Wow, look at it rip! She still wouldn't hear any of it. Which was rather frustrating to me. Of course, I can't just go and keep my mouth shut. I have to argue with the pregnant woman (big no-no, isn't it???). I told her that if left untouched, her perineum would have about a 50/50 chance of tearing. If that. With an episiotomy, you're guaranteed an injury. And yes, the cut itself is controlled, but the possible extended tear is not. At all. In fact, generally the most severe tears follow an episiotomy. While they do happen naturally, they are very very rare. It just really bothers me when doctors make women think that since it's their first baby, they may as well be prepared to be cut. Ugh. Yes, some women tear, no matter how carefully they push, or what position, or whatever. Looking at the research, though, it has been shown that tears actually heal better than episiotomies, and an episiotomy really should only be performed if it's absolutely necessary (i.e. in an emergency). Now seriously, why did we even need to argue about this? Couldn't I have just let her live with the belief that if she got an episiotomy, then that's just because it was her first baby, and it's the way it is? No, I couldn't have, because then I wouldn't have been me. We finally moved on, and talked some more about home birth versus hospital birth. She brought up the risk and what if's, and I just told her that in a hospital setting, there are risks, as well. She's planning on just getting an epidural, which of course isn't without risks, either. The risks are just different. And really, if there had been an emergency with my home birth, I could have been at the hospital under the knife within probably 10 to 15 minutes. My midwife was highly qualified, has been catching babies for 30 years, and knows quite well what she's doing and what to look for in potential problems. We were very open to transfer if there had been any indication at all that one was needed. Simply being at the hospital does not guarantee nothing is ever going to go wrong, or mistakes aren't going to be made. With each intervention a woman accepts (IV, pitocin, epidural, having the water broken, etc.), there are risks involved. The risks may be different, but they're there nonetheless. I told her as much. The whole experience discussing these issues with her has made me double guess whether I want to still go into childbirth education. I just have no patience, I'm afraid. Sometimes, my mouth just runs away from me, and I say something before I've really thought about it. I think it's great when women trust their care providers. That's the way it should be. What's frustrating to me is when women completely hand over their care, do no research on their own, don't question, just take whatever they're told and are good little patients. I realize not everyone wants to birth at home, or have a natural birth. Maybe to some, ignorance is bliss, and they don't want to know anything beyond what their doctor and hospital tour guide tells them. Great. But don't tell me I'm crazy for actually doing my research, and making a choice that doesn't involve submitting to hospital procedures and doctor convenience...

18 comments:

3in3mom said...

To be honest with you, if I'd been her I'd have been glad to have you 'argue' with me. I love to see others' point of view and experience. It's good to see what others have gone through and their research. Then go on with a decision--more informed. I wish I'd been a bit more informed before my two deliveries--but now I can look back with experience. If I had had a friend like you say what you did, I'd have been more aware of my options.

I am grateful for friends like you and Kelley and Rixa who have opened my eyes to birth research--and so if and when I do have another child I'll have great resources to turn to.

Don't fret to much.

Keith and Nicci said...

I can picture the whole thing! I probably shouldn't laugh, but I've had a few of those conversations myself, and while so far they haven't ever been too heated, I can sense the tension... My personality is different than yours so I usually change the subject or back off when it starts getting too much for me. But sometimes I wish I was as strong as you are, or more like I wish I could remember all the facts during the moment because sometimes when I get worked up I go blank!

I agree though - people should definitely be able to do what they choose, but I wish more people would do their research first.

Keith and Nicci said...

Oh yeah - and I have torn both times (this is without an epidural) and I would take it over an episiotomy any day still. I've healed very quickly and just fine both times, and I am in agreement with the whole paper tear analogy too. This is coming from a girl who got queasy during her first pap smear, and didn't ever use a tampon until college. There you go - fun personal details. Man Doreen, you always bring this stuff out of me!

Doreen said...

That's why you really need to move to Houston Nicci, just think of all the fun late night talks we could have. ;o) And trust me, sometimes I wish I could just back off and let stuff go...

Chalice, thanks for the vote of confidence. :o) I hope this girl is as forgiving as you are. I told her at the end I was sorry, and I didn't mean to sound preachy. She said she enjoyed the discussion, even if we had differing opinions. I hope she really meant that!

Mom's Sewing Vault said...

Oh, Doreen, I can totally relate. I had the exact same tendencies when I first started doing breastfeeding counseling. Then I mellowed, with experience, and with the awesome "active listening" and NVC-type training LLL offers Leaders, so we don't step on too many toes! lol Keep your passion. Figure that each discussion with a person does not have to "accomplish" anything more than planting a seed (of questioning the norm and thinking for ones' self) and compassionate listening. Don't be hard on yourself, you have the best interests of mothers and babies at heart!

Besides, when you teach childbirth education, it's a different setting, and they usually seek you out, you know?

:) sally

Doreen said...

Ah, Sally, you're right. People who take childbirth ed WANT to be there to learn. I suppose that would make a difference. :p I've actually contemplated doing the LLL training. I think it could really benefit my, um, conversation skills, haha. And it's something else I'm passionate about. I just love to learn. :o)

Shannon said...

Wow! Must have been some conversation! I have to admit that I was one of those patients who took their doctor's advice on most things. I never did have the desire for an epidural-free birth, but got two of them anyway. There are pros and cons and inherent risks both ways. You have impressed me again and again with the amount of time and research you put into this topic. Like 3in3 said, it's nice to have such a good resource to turn to if questions ever come up.

Science Teacher Mommy said...

On the upside, I quite like your new look.

Kelley said...

Yeah, I've had frustrating conversations like this, too. I sincerely hope she is forgiving, though personally I don't know why she'd be so adverse to such a reasonable argument.

corey said...

"What's frustrating to me is when women completely hand over their care, do no research on their own, don't question, just take whatever they're told and are good little patients.... Maybe to some, ignorance is bliss, and they don't want to know anything beyond what their doctor and hospital tour guide tells them. Great. But don't tell me I'm crazy for actually doing my research, and making a choice that doesn't involve submitting to hospital procedures and doctor convenience."

Sounds like the same argument people give me when they question my religion. I'm just saying, give your friend a break. I'm a hospital birther all the way, rarin' for my fourth, and I just want to stand in defense of those who have studied and done research and still choose something other than what you've decided. There's plenty of logic on both sides. Fundamentally, you should be where you're most comfortable -- and for some, it's definitely home, and for some, it's where an anesthesiologist and NICU nurses are standing at the ready. I'm just saying there's plenty of logic on both sides. But I'm with you on episiotomies -- tell your friend that she can state clearly to her doctor that she wants to avoid one at all costs. I think you're great, Doreen, just wanted to give a little food for thought... and I can tell, you enjoy a good argument! :)

The Streiffs said...

I agree with Nicci, I have opinions but am too timid to express them, so more power to you. I also agree that whatever is choosen, the subject should atleast be well researched. I've had a few home birth conversations with you and while I'm not up for home birthing, you have atleast given me some things to think about. And have atleast leaned me towards a less invasive birth. So, you did do something.

You rock, don't lose your dream over one bad conversation. Learn from it and move on.

We love you, Meri

Doreen said...

Corey, I'm not saying people shouldn't want to birth in the hospital. If you are informed about risks and benefits of the standard procedures that are usually involved in hospital birth, and then choose to birth there, who am I to argue that? What bothered me was the bias against homebirth, based on nothing but fear. It was the attitude that somehow, nothing could ever go wrong at the hospital, because, you know, the almighty staff would never let anything happen to you or your baby. Or, likewise, never use a procedure that could somehow harm you.

Thanks for your comments, everyone!

chicagosapps said...

Your "big mouth" helped me a ton when I was pregnant with Kevin. But of course, I was eagerly seeking for advice from everyone who had experienced natural childbirth. Good communication skills go a long way with people who have different opinions, or who don't WANT to know enough to have an opinion. And it's hard to have good communication skills when you feel strongly about something.

Doreen said...

Lajuana, unfortunately, good communication skills are something I'm sometimes lacking. :p But you're absolutely right!

Mimi said...

People learn through experience. I think with my 3rd (in the future) I will do everything perfectly right. why not with the first though???

(1. Hospital, natural, tiny tear) (2. almost in the parking lot, standing, baby fell out, no tearing). 3. I will just stay at home. It made me anxious to "get to the hospital" ...that was the only time the contractions hurt. If I stayed at home it would have been a 100% breeze.

I would love to "chat" childbirthing with you. Want to come to my next birth? Can you birth in German??? lol

corey said...

Whew! I can breathe a sigh of relief. Doreen, you are the best. After I posted, I panicked that I should have edited my comments, that I was a little reactionary and you would take my comments badly, (me and MY big mouth) and you've been a trouper. I really value our friendship and I like that even though we haven't seen each other in a while, and were friends for a short time, we 'get' each other, and can withstand a little banter, because I love it -- and I don't get to do it often with my friends here. It's definitely something I miss from Cambridge. BTW, I have many many dear friends who home birth, or have their baby at birthing centers, and more power to all you ladies!! AND I want you to know that I do have a midwife here -- but with my hip replacement it's pretty much my birth plan to have an epidural. Is that TMI?? Sorry for the comment topic hijack. Point being: You're fabulous.

Doreen said...

Mimi, I don't know that I can birth in German! All of the lingo I learned in English, I have no idea what half the words are in German, lol. Well, at least I'd have to think really hard!

Corey, no stress, haha! I do like a good argument from time to time, but usually I end up being accused of being blunt or tactless, so I don't do it very often. :p I was wondering how birthing went for you with a hip replacement. I'm sure it adds a whole new dimension to the process.

tearese said...

I know if I feel that someone is treating me like I'm dumb, then I get super defensive and I won't stop arguing, even if I know they are right. Sometimes even if I actually share their opinion in the first place!
So maybe she felt like you were invalidating her opinions or saying she was stupid.
Also, I am the type that believes most people have some truth to their side of the argument, and if they are reasonable about the way they present their side, I am respectful and open to their opinion. Its when people talk in absolutes-that theirs is the ONLY truth- that I get incensed and won't agree with them, again even if I thought they were right to begin with. Just my point of view.