Recently, Karla over at We're Having A Baby shared her thoughts and feelings here about pregnancy and how things started out for her. This is the first time that I've ever made a post out of someone's previous comment on my blog, so I hope that I don't violate any rules of blogging etiquette or step on any toes while I get on my soapbox share my opinion and experience.
I am not a fan of ACOG (American College of Obstetricians & Gynocologist). I am not a fan of AMA (American Medical Association). I deplore what they have done to women, how they make excuses and justify their actions, all in the name of "helping" women. I would like to preface this by acknowledging that there are exceptions to every rule and women in many and various places are having satisfactory birth/pregnancy experiences because of a good relationship with their caregivers. I'm happy for these women; I really am. Unfortunately, happiness and success is not always what a woman carries forward with the birth of her child and they fail to recognize that the very "emergency" that they were rescued from was in fact caused by the system that eventually saved them.
In my line of work (doula and VBAC support leader for 7 years), I had the opportunity and burden of listening to women tell of their birth traumas stories. The words and feelings that kept resonating were "If someone had only told me" and "If I had only known then what I know now". If I had a dollar for every time I heard those words - I could feed a 3rd world country for a month.
These same women were the ones who origianlly knew more about their home appliances and their vehicle's accessory packages than they did their birth options. You know what?
If you don't know your birth options, you don't have any.
And even when you do know of your options, if you don't speak up - then someone else will choose for you. It is very naive to think that the person making that choice for you has your best interest as the only and main priority. Often, they have their liability as the main priority, the Dr. & staff convenience and their protocols/procedures next and then your safety and comfort comes in right after that.
Why does all this happen? I have a few theories; however, we don't have the time for me to tell everything that I think. After all, this has been my soapbox for over 17 years now and I've accumulated quite a collection of stories and anecdotes and opinions.
I want to focus on a particular point with this entry and that is in relation to this part of Karla's comment:
In the end, my decision to go with OB was based on fear of the unknown in pregnancy (all those "what ifs") that, like you mentioned, perhaps more patient education would have helped resolve and change my decision making process.
I believe it would have. I also believe that it goes MUCH deeper than this.
Think back, as far as you can remember to when you were a little girl (or boy - because I do have male readers) and the first exposure that you had to pregnancy and birth. It may have been through a personal experience with your mother and the birth of your siblings, another family member, a relative, a neighbor or through something that you were exposed to through the media. Our society as a whole has some weird and obsessive perversion towards the dramatic and the traumatic factor, as if 'plain ole normal life' isn't ever good enough. This makes for good television drama - but it makes for problems and VERY poor outcomes for pregnant women and their families. Pregnancy is not an emergency nor is pregnancy an illness (in MOST cases). We are not more valuable as an individual because we claim to have suffered more than the next person.
We, indoctrinated by the media and their false sense of reality, are exposed daily to the "worst case scenarios" through the television and print media. We learn from an early age that all kinds of problems and potential disasters lay in wait for us, for our unborn babies and we are so overwhelmed with the "what-ifs" that we surrender our authority over to a medical provider under the assumption that they know everything there is to know about anything and that they have our best interest as their ultimate goal. We do this and then we learn......sometimes, the hard way.
The media and the medical profession try to 'put one over on us' regularly too. Recently, there was a study claiming to US women that having an epidural in place before 4 cms does not increase the risk of cesarean section delivery. Did anyone actually READ that report that they were featuring? Some did. I did. What I found interesting, and saddening at the same time, was that the story that the media communicated was NOT what the actual report claimed. The actual report claimed that availing the use of an epidural before 4 cms did not increase your risk of cesarean WHEN COMPARED to the use of narcotic drugs. Did any of you hear mention of narcotics when you heard/read the media exposure to that recent report?
What did the average listener hear and take with them from that report? I know that Brian Williams of NBC Nightly News was making jokes about how if we had only "known" that "women suffered for nothing and could have had the epidural at the very first sign of pain (or discomfort)" that we would have chosen differently. The listener heard exactly what the obstetrical and anesthesia association wanted them to hear - get an epidural as quick as you want because there is no risk.
Never mind the countless research studies released in the past decade that claim/prove that epidurals increase the risk of surgical delivery, lower apgars, cause blood pressure problems with the mother, and spinal problems for mommy well into the first few years of your baby's life.....the list goes on.
Now - think back to being in the presence of others who have recently given birth and to the *way* they tell their stories. What way are you being persuaded and encouraged to view pregnancy and labor and birth? Are you listening to horror stories of how terrible the pain was? Or how they thought they were going to die untill they got the epidural? And then there started to be decelerations in the monitor and they needed an "emergency" section (45 miutes later)?
Ask yourself: Did the staff encourage other forms of non-medical pain management? Movement. Warm/hot water. Rocking. Deep breathing. Release of fear. The support and company of a doula. Massage. Or did the staff leave the frightened laboring woman flat of her back in a bed while family members made jokes and wrung their hands because they couldn't do anything to "help make the pain go away" and sat fixated on a monitor that entertained everyone with the baby's heartbeat and recorded the activity of the uterine muscle. Was the woman told not to move so the monitor didn't mess up or was she given ways to deal with her labor? Was she afraid or was she confident that the pain had a purpose and signified that her body was working just as it was designed to work and that everything was going right and normal?
Consider this scenario. You eat healthy. You take measures to make sure your body is in optimal shape physically and emotionally. You and your spouse are proactive when considering conception and you are prepared for the pregnancy that you are nurturing. You arm yourself with information (on both sides of the scale) but you view everything through clear glasses (as opposed to rose colored) and with an attitude and assumption that EVERYTHING will occur and unfold just as it is meant to be, perfectly in its own way for your body and your baby and that within you, you have the ability and capability to make the best choices and bring your baby into this world without all the medical intervention. You selected a caregiver who supports the concept that pregnancy is a normal physiological phase that a woman's body goes through and knows how to handle it without problems. Some might think that this is naive or that we can't afford to stick our heads in the sand.
Those people are right. We can not afford to stick out heads in the sand any longer. Except this time, what we can not afford to do is ignore the other side of the information. We can't affort to ignore that 95% of pregnancies will go perfectly when supported by proper nutrition and left to develope on their own.
What would it have been like for you Karla, if the caregiver had told you that over 60% of the kinds of heart condition that was detected with your ultrasound eventually work themselves out? That it is part of the developmental process? Equally important - what would it have meant for you and the emotional distress that you and your husband experienced for those few weeks?
"What Ifs" can be debilitating to people if we let them. We can choose to believe in "the process" or we can succumb to a medical system that has the potential to make things more complicated than they need to be....that can leave us with scars (figuratively and literally) that have permanent ramifications.
You can be paralyzed by the "what-ifs" and make choices (or allow someone else to make choices) out of fear.....or you can arm yourself with information from many and various sources who present both sides of an opinion and issue, educating yourself so that you are the one making an informed choice and decision. When you are informed and educated - you are making a decision from a position of power and strength. When you depend on your caregiver (who makes money off of procedures and complications and who may not believe in the success of the process) then you run the risk of being at a disadvantage when it comes to having the truth, the whole truth and nothing but the truth.
I'm sure there will be more on this topic.
You go girl!!! Great post. The truth will indeed set us free.
Posted by: Cuppa | February 21, 2005 at 09:13 AM
as usual, well said. Hopping up on your soapbox too ;) When I had my first baby, the only options I had were the ones that my ob gave me. I had no reason to question or look further. Why my doctor will do what is best for *me* and would never put me in danger (hahaha, that is such a funny thought now). I wished I had known other options so I could have looked into them and made a decision that was best for *me*. It wasn't a real terrible experience, but it sure could have been a heck of a lot better satisfying experience. With my 2nd I was beginning to learn and have my eyes opened but just wasn't quite confident enough to "go against the grain" and make a good educated decision that was best for me. If I had a few more months, perhaps. I'm more unsatisfied with that pregnancy/birth simply because I was soooo close and did know but yet I allowed someone else to choose for me and it's a shame the danger me and my baby was unnecessarily put in. It's pitiful the attitude towards pregnancy/birth that society has nowdays and to think I used to share it too.
Since then I have researched and researched probably thousands of hours on all aspects of pregnancy/birth. What is normal, what isn't, how to keep normal, how to treat what isn't normal, pros/benefits and cons/risks of ALL options. Let's just say I am taking responsibility for my and my baby's health and not just turning it over to someone else to decide. I will question whatever options/decisions my caregiver gives me and *I* will make an "educated informed decision" as to what is indeed best for me and my baby. I don't expect anything to go wrong since I will be avoiding all the crap they do to you to make things to wrong---however if I do indeed fall within that 5% that do need some intervention at least I will know that it is necessary, I did my best to avoid problems and will be making the best/right decision and I will be content and satisfied with that. I don't want to be thinking "if I only knew about x" again.
I have had one prenatal with my midwife and already I have spent more one-on-one time w/her than I did a total of two pregnancies w/my ob! DH is extremely pleased with all the info that was given in that first visit---he knows more now just from that one visit than he has learned going thru 2 pregnancies/birth w/me. Knowledge is power! Now he is beginning to understand why I believe that a hospital is a scary place for a normal pregnancy/birth.
Posted by: trisha | February 21, 2005 at 09:41 AM
The river is high and flowing swiftly today.
Posted by: Anvilcloud | February 21, 2005 at 10:01 AM
All I can say is Ahhhhhh......it is so good to read this from you. I have missed it :)
And I'd like to say thanks for being able to say it the right way to get women's options out there. In all three of my labors and births I'd say you had great influence on the last two. By that I mean you left the door open for me to walk thru and really *see my options, even with my health. Now, I know that even though I will be induced again, I have options. My ob did a good job of mentioning them, you did a great of explaining them.
Much love.
Posted by: jan | February 21, 2005 at 12:31 PM
Well versed post! I think you have a wonderful ability to voice your opinion without coming across as hostile or aggressive. Not many people I know who feel so passionately about something who can speak with such eloquence!
I can’t help but even take your points of view a step further and suggest that it’s not just the Obstetricians who can “rescue one from an emergency the system caused” but many other specialty doctors as well. You’re point is well taken. My husband and I have always joked about those C-Section happy doctors because it’s just more money in their pockets as they perform a major surgery.
I still will maintain however, even with everything that I have gone through and know to this day that I am happy and comfortable with my decision to use an OB for my caregiver. As I mentioned in my post, yes once we finally got the diagnosis for the baby’s hear, the cardiologist did in fast tell us that Premature Atrial Contractions only have a 1% chance of developing into something terrible. Yes, that was wonderful news to hear, yes, we were still nervous, but I was happy we found them all the same, even if they can be a common occurrence. IF something went wrong, continual monitoring put our minds at ease that our baby was being taken care of and in the event the PACs developed into something more dangerous, we would be able to take action. Contingency planning and peace of mind settled better with me than doing nothing at all.
I certainly do agree that more patient education would be beneficial to discuss woman’s fears and concerns around pregnancy whether she decides to journey through her pregnancy with a Midwife or an OB. Both have their own tendencies and beliefs, and in a perfect world, it would be nice to be able to talk to both to hear both of their opinions and then come to your own conclusion. I have asked the same question to both my family doctor and my OB and have received different opinions (who’da thunk it eh?) You’re absolutely right, It’s all about asking the questions, understanding the different opinions and advice you will receive, self education and looking within yourself to find what works best for you and your family. I couldn’t agree more. It’s just important to remember that information is subjective, and what one medical community suggests or provides as fast, another will argue otherwise.
I have to tend to disagree however, that women who choose not to have a natural birth can be at some sort of disadvantage. The ultimate goal of childbirth is the delivery of your baby, and the paths each of take to get there will be different depending on our backgrounds, personal beliefs, upbringing and access to various medical facilities or midwives (we have very few here in Ontario, Canada), but our common goals to love and cherish the new life we are bringing into this world are the same. THAT is a beautiful thing.
Thanks for you great post. It’s so refreshing to listen to someone speak with such a passion and vigour. You sound like an absolutely marvellous Doula. Anyone who works with you should be proud to work with someone who is so passionate about what they are doing. I wish I could say the same about my line of work. Kudo’s to you!
Posted by: Karla | February 21, 2005 at 02:21 PM
Karla,
I'm trying to figure out where I might have communicated that women who do not choose natural birth are at a disadvantage. Can you point that out to me?
Thanks:)
Jan,
It was a honor to witness your birth journey.
Trisha,
We all have our story and where we go from here is up to us.
Everyone else,
Thanks for the affirmation :)
Posted by: Wash Lady | February 21, 2005 at 02:30 PM
Hmm...I think I misunderstood your last paragraph...
I understand what you mean now...not that having an un-natural childbirth puts woman at a disadvantage, but depending solely on a caregiver puts you at a disadvantage. That makes more sense.
My bad..
Posted by: Karla | February 21, 2005 at 04:11 PM
No apology necessary.
I think it is always good to seek clarification so that there are no misunderstandings.
I appreciate the opportunity to share with you.
Be well.
Posted by: Wash Lady | February 21, 2005 at 05:00 PM