# The balance between education and respect



## pamamidwife (May 7, 2003)

Alas, there have been many threads on this board from women who are well educated in birth, passionate about women's healthcare and the increasing rates of unnecessary surgical intervention across the country. Still, in every thread, there seems to be a voice that reflects anger towards birth activists from women.

We currently live in a country that has a high cesarean rate, with little or no improvement in overall maternal and infant mortality rates over the last ten years. The cesarean rate is getting higher, with more and more doctors being enticed to do cesareans by their malpractice insurance in exchange for lower premiums. Even a current presidential candidate believes that cesarean births are safest across the board. The 23 countries ahead of our own that have better infant/maternal outcomes have much lower cesarean rates than we do. I consider this a huge reflection on how we are treating our mothers and babies in general - and it's something that I would love to see change.

How do we continue to empower and facilitate trust with women while offering, sometimes, an alternative to the model of care that most women receive? And, if we do so, why are we deemed as being horrible people?

Are there birth activists that do not understand that cesareans are sometimes warranted?

Do we need to have a disclaimer with every post that says, "and yes, I know that sometimes cesareans are warranted"?

For those women who have felt that cesareans were the best choice in their pregnancy/birth, why would they get upset that there is growing concern over the rate of UNNECESSARY cesareans? Do they believe that this high rate of cesareans is actually something that is better for us as a nation? Why are they so angry at us? Surely, if you felt a choice was solid for you, why would you be so angry at someone for wanting women to have solid choices and care in childbirth?

We cannot go back and pick apart people's birth stories. We SHOULD NOT do this. Hindsight is 20/20 and this serves no purpose.

However, if I had a dollar for every woman that said to me, "If I was at home, I [or my baby] would have DIED."

Then they tell a story of highly managed inductions or labor patterns, a diagnosis of "failure to progress", which is more like "failure to be patient" with hospital "protocols" not based in evidence, drugs in labor, etc.

Does anyone not feel that the nearly 25% of cesareans that are being performed across this country (and this rate is growing) is something that should be viewed as a warning sign?

Women are walking around believing that they "cannot dilate" or "cannot birth a big baby" or "cannot go into labor on their own". They are told by the medical model repeatedly that their bodies have failed them. NOW, this is different from women with serious health issues or anomolies that warrant surgical birth. These are women who are relatively healthy - they just didn't fit into what a certain linear mode of thinking wanted them to. Still, it's about how their bodies are less than - and they carry that failure with them, often times, into mothering ("I cannot make enough milk", "My baby just won't latch on", etc.)

Empowerment and informed choice in any situation is a positive thing. If women are not told anything but one side of the story, how are they to make informed choices?

And, in light of empowerment, how can we birth activists get along without all these disclaimers for people who have had a different experience? Where does the anger from these people come from? Do they not feel heard in general? Surely we live in a culture that is more supportive medicalized and surgical birth than, say, home birth. Is it just on these boards that they feel alienated?

Please, there has to be some willingness on both parts to communicate openly and honestly. We are great at posting "reactive" posts - where we react to something that someone has said, rather than taking the time to listen to what our intention is with posting.

I am asking this with an open heart and an open mind. As a midwife, I am bombarded by stories from women who are feeling betrayed by their births. This is surely a not so good sign -

I have had a number of clients (and in the past two years, I have a higher cesarean rate than most midwives in my area) who have had surgical births. Does this mean that I look down on them? Hardly! Do these women feel that they are less than empowered or encouraged about their birth? Not from what I hear. Nearly all of them are still fighting for birth choices and normalcy in birth - even with their cesarean histories.

Where is the balance? Why is their so much anger and opposition?


----------



## Greaseball (Feb 1, 2002)

I don't know. I have posted a few times on the VBAC forum in the past and some people told me they thought my posting there was inappropriate since I had not had a cesarean. VBAC is a subject I am interested in; that's why I was posting there. You don't have to have surgery to feel passionate about the rise of unnecessary surgery. I quit posting there because I was tired of writing "Please forgive me; I haven't been cut" before everything and wondering if I was going to offend someone.

I know I have a lot of knowledge that is worthy of passing on. But the fact that I have not experienced the issue I am posting about, or that I'm not a birth professional, is seen as a sign of disrespect to those who have been through it.

I know what you mean about "my cesarean was necessary!" I think if people are really secure about their decisions, they will not get defensive. We do not co-sleep and we vaccinate. Those are just the decisions we thought would work best in our family. I don't feel the need to explain them more than that and I don't reply to all the co-sleeping threads with "well, it doesn't work for everyone, you know!" I'm secure with my decisions.

I think women don't want to believe they have been unnecessarily operated on. They listen to the reasons why the doctor wanted to operate and they believe them so they don't have to admit they were basically assaulted for convenience sake. For the first year after dd was born, I went around telling everyone that I was so glad I had gone to the hospital, that I "wouldn't have been able to give birth" without assistance, that I would surely have been in labor for 3 days, that I'd most definitely go to the hospital next time, and that I probably would have had to transfer anyway. I didn't want to admit I had put myself and my baby at greater risk for no reason.

There are some formula feeders who go to the breastfeeding forums, and I really don't want to say "But I know breastfeeding isn't for everyone!" after each post.


----------



## TurboClaudia (Nov 18, 2003)

Quote:

Empowerment and informed choice in any situation is a positive thing. If women are not told anything but one side of the story, how are they to make informed choices?
This seems to be the crux of the issue of education and respect. I would hope that all people feel empowered to take responsibility for their health and the maintenance of it. However, this is not necessarily the case. And if the prevailing culture of our society is "the quick-fix," i.e. pop a pill, have surgery, etc., than pressure to take responsibility for one's own care lessens. Our litigiousness and sense of entitlement only adds to this. And a foundation of our culture is the right to speak out, about injustice, inequality, untruths and so on. But respectful listening to another's point of view is not an overt foundation of our culture.

That said, I do think the anger and opposition I've observed online (here at MDC and elsewhere) is rooted in the anonymity of web communication. Some people become less fearful of retaliation when sitting in front of a computer and write things they might never say to a person's face, friend or foe.

Regarding birth activism, I am more of a one-on-one activist, getting to know a person and then gently planting the seeds that there might be a different way. To my closest friends, my passion for natural, intervention-free, unmedicated birth stems from an educated background. I have learned to temper my passion when speaking with people who trust our medicalized birthing culture, but it makes me inordinately sad to do this sometimes. However, if a person is not accepting of my thoughts or my advice, then it is more important that I listen to their concerns and respond to them wherever they are coming from.

warmly,
claudia

p.s. Pam, we really need to have tea together sometime. Love and hugs to you...


----------



## LiamnEmma (Nov 20, 2001)

I see what you're saying, and I agree with this argument when the light is shined on any hot topic. For example, breastfeeding...for women who bottlefeed, why feel the need to explain and rationalize, whatever? Because they feel crappy about not having breastfed. Rightly? Maybe. So I say, shine the light back on yourself too and ask yourself why it bothers you if someone rationalizes her cesarean...if you feel comfortable with your beliefs (and I really do agree with them, I promise), why does it bother you that some women haven't worked their way through the whole process yet? Because I see it as that. Some women who have had cesareans--necessary, unnecessary, whatever--haven't processed it yet, and to me, that speaks to a larger issue all around, and yeah I agree that it's about empowerment. But denial is very powerful and some people don't work through every trauma. So now, for me, when I hear someone rationalize why they didn't breastfeed, or why they needed pain meds during birth, or why they had cesareans, I just listen. Every person's experience is different amd we come to them based on our past experiences, and just because I was able to a, b and c, doesn't mean that someone elses life experiences also allows them to a, b and c. Maybe they e and d.

The older I get, the more I realize that there are reasons, often far more emotional than physical, for everything. I can totally see why a survivor doesn't bf. I can also see why a person has a c-section or has an epidural, or vaccinates, or has an abortion. And once we allow one reason in, we have to allow for the others as well. Do we agree with them all? No. Absolutely not. But I do think that's where the education part of it comes in. And education does not have to shout unnecessary csection here!!! It can quietly teach about the birth process, and the way hips are meant to open up for big baby heads, and the way transition makes you feel, and how pushing in different positions helps, and how a water birth can decrease pain, and all that other stuff, without ever once putting a cbirth momma on the defense. kwim?


----------



## stayinghome (Jul 4, 2002)

Well said, Pam!

I think about this a lot. I don't have any answers though.


----------



## anothermama (Nov 11, 2003)

That is THE BEST post I've ever read on an online board. Period.

To address your post.....

For one, we are a nation of individuals. Our "American Spirit" is all about being yourself, being unique, being different....and people don't like to admit that they are part of an "average" or part of the "norm". We've made this an insult to say "Your birth was very average". Our children are all "special", our births are all "unique"....even if the reality is our kid is pretty normal and our birth was pretty average. And so.....every woman in birth is conditioned to talk about HER unique circumstances that are totally unlike anyone elses...(except they are JUST like everyone elses...). And it's culturally ingrained in us to be insulted when someone says "Well, actually...no, this situation is really typical".

And another thing...it's a parenting issue. Women seem to feel inherantly defensive with OTHER women when it comes to parenting and mothering. It's a subtle competition almost. And to be ANYTHING less that completely supportive of a womans birth choices means you are critical of her mothering skills. I know ...I know..thats not what it REALLY means, but many many women seem to take it this way. And I know that I've really defensive when someone critisizes my parenting....who woulnd't be?

It, sadly, has nothing to do with the facts or how the medical establishment is keeping women in the dark.....the first thing that strikes in the personal thing...and thats a womans individuality and her mothering. When someone feels *personally* attacked, they'll block out the "bigger picture".....I've done it, and I'm sure you have too.

And I don't know how to change that other than to just be consistant in what I say to other women...and hope that maybe along the way I hit a nerve with a woman or two.


----------



## anothermama (Nov 11, 2003)

Quote:

_Originally posted by LiamnEmma_
*Rightly? Maybe. So I say, shine the light back on yourself too and ask yourself why it bothers you if someone rationalizes her cesarean...if you feel comfortable with your beliefs (and I really do agree with them, I promise), why does it bother you that some women haven't worked their way through the whole process yet? Because I see it as that. Some women who have had cesareans--necessary, unnecessary, whatever--haven't processed it yet, and to me, that speaks to a larger issue all around, and yeah I agree that it's about empowerment.
*
For me, it bothers me because it rarely seems to be about working through it. It's about justifying what happened to them, probably in order to make them ok with it in themselves...and thats it. It doesn't seem to go further. It seems like, especially with birthing issues, the "working through" is really just being ok with what they did...and then they want to make everyone ELSE ok with it.

I don't know if I'm explaining that right. But it's not usually about working it out to learn...it's about working it out to be ok with where they are right then, and not grow or learn. And...often then spread misinformation.


----------



## Laurel (Jan 30, 2002)

Just a few thoughts...

I haven't given birth so I can't comment on that specifically, but I have experienced inability to bf, despite huge efforts to induce lactation. I guess I can comment on human nature.

I keep hearing people say that if you made a confident, informed choice, you shouldn't feel defensive. But for many women, including me in my situation, it wasn't a choice--the choice was taken from me. For a woman who had a c-section for a legitimate reason, it probably wasn't something she chose--it just happened. I think that makes a difference in how you feel about it. When we use words like "empowerment", that really stings, because even though it may have been the right thing for the situation, how can one be empowered if one didn't have a choice?

I think there is just a lot of grief and pain involved in things like this, and it sometimes makes people's reactions more emotional than they would otherwise be. I can know rationally in my head that my situation was the exception, and I can wholeheartedly support the right and best way of doing things, but it still hurts, and sometimes that emotional pain screams louder than the rational brain, even in discussions like we have here. I don't agree that defensiveness is always because a person is insecure in their decision. I think defensiveness is a natural reaction when a topic is emotionally painful for us and we wonder if anyone really cares to understand. I do think that we can get so caught up in discussing "issues" that we forget that the people behind those issues are real individuals with real feelings. No mother is a stereotype, but we talk in stereotypes a lot.

I think there are discussions that do cross the line from advocacy to downright meanness. (Maybe not the entire discussion, but certainly individual posts.) I rarely post on bf'ing boards but there are times when I have felt the need to explain my situation because sometimes it really does get out of hand. And many more times it doesn't get out of hand at all, and I don't post, but it still stings. I do feel the need to explain (some would say "justify") my situation. Why? Because I don't want to be misjudged--I want to be understood, and I want people to appreciate my experience. I think that's a very normal, human thing--to want to be loved and valued and understood. The fact is, without the explanation, I would be judged here. Probably I am even judged by some *with* the explanation. No matter how much I know that I did my best and did the right thing, it still hurts to think that I am lumped into a stereotype called "formula feeders". And like I said before, for me I think the reason it is so touchy is because I did not choose it.

LiamnEmma, I loved your post! I think I'm rambling here and not making any sense, but just wanted to put forth the idea that emotions do strange things at times, and I think that's what most of the defensiveness being discussed is about--people's (not always rational) feelings.


----------



## LisaG (Feb 23, 2003)

It's really weird and kinda creepy when ya'll crawl into my head and listen in to my private conversations with myself









I was pondering a lot of this on my drive home tonight. What creates so much division and antagonism and how can we create an environment that honors and supports women and their birth experiences while at the same time empowering them to become educated about their choices?

And then I wondered why am I so bothered when I hear stories from women who think they would've died had they not had a c/s for x, y, z reason? Why do I care?

It bothers me that women who have any experience with birth in a natural, non-intervention manner are becoming an endangered species. It bothers me that we as a society are so NOT bothered by the current labor and birth environment.

Yes, we need to come to a place of moving on from our experiences. I wouldn't want anyone to continously beat themselves up for making difficult choices. But I do wonder (and I'm glad I'm not alone in this) - why when I (or anyone else) shares info that suggests things could be different next time is it perceived as a tearing down rather than all of us beautiful, wonderful, strong, courageous women coming together to reclaim our power - however that might be done and in the variety of ways that it will be done.

I hang out on the ICAN list a lot. I am continually amazed at the courage, wisdom, compassion and openness on that list. Those women are awesome! And while we certainly don't all agree, there is the common goal of improving birth for all women and decreasing unnecessary c/s.

Nobody wants to hear that a choice they made didn't have to be like that. Does that mean we refuse to say things could've been different so others don't feel bad? How can we use our less than ideal experiences (birth, life or otherwise) as a catalyst to create positive change?

In my personal experience I had large uterine fibroids and a nearly complete bicornuate uterus. Women in both circumstances have successfully gotten pregnant and given birth without surgical correction. Some have managed this without any difficulty, others have had tremendous difficulty and complications. After much researching and soul-searching I realized that MY best decision was removal of my fibroids and reconstruction of my uterus to join the 2 uterine cavities. Certainly not the "right" decision for everyone, but it was for me. I was in the fortunate position of having time and good resources to support me as I made my decision. And where am I going with this?? I'm starting to wonder myself







. I guess my point is that there can be many "right" choices - but let's be educated, empowered and conscious! And let's support each other in this process rather than getting hostile and defensive. We certainly can all learn something from the process.

Alright, I think I've rambled on long enough. Hopefully, it's somewhat coherent.

LisaG


----------



## Greaseball (Feb 1, 2002)

Quote:

And then I wondered why am I so bothered when I hear stories from women who think they would've died had they not had a c/s for x, y, z reason? Why do I care?
For me, it's because it shows yet another way the male-oriented medical system is overpowering women. If you can make a woman not trust her own body, and believe that you can make her body work right, you've got a lot of power over her.

Also, it doesn't just stop with the individual women. Having a cesarean makes it more likely that your daughters will as well. Pretty soon doctors will forget how to do anything else. They already forgot how to deliver breeches...

And I also care about their babies. Cesareans are risky for babies when done for elective reasons. It makes me sad to see babies' lives risked for convenience or money issues.


----------



## miserena (Dec 16, 2003)

Perhaps the cesarean issue is just too highly emotional for use as a focal point for birth activism. Maybe you could focus on the general notions of empowering mamas and improving maternal/infant outcomes by promoting practices which could or do lower c/s rates, such as:

-medical malpractice reform
-educating that pregnancy/birth is a natural process, rather than a disease
-promoting the midwifery model of care
. . . the list could be endless

Just some thoughts,

Michelle
mama to Eileen 11/04/01, unplanned c/s


----------



## SamuraiEarthMama (Dec 3, 2002)

Quote:

_Originally posted by anothermama_
*For one, we are a nation of individuals. Our "American Spirit" is all about being yourself, being unique, being different....and people don't like to admit that they are part of an "average" or part of the "norm".*
and yet, we are a nation driven by peer pressure. starting at an early age, children in schools are subjected to tremendous amounts of pressure to stay in line, not rock the boat, parrot the right answer, and above all, NOT be a square peg!

to deviate from the mainstream is considered freakish, bad and unamurrican. to question authority is strongly discouraged and punished.

yes, our "american spirit" was founded upon independence, but that spirit has been beaten down, homogenized and diluted to the point of nonrecognition. as long as people are treated like sheep, they will continue to follow the herd, and be uncomfortable and wary of anyone who chooses to be different.

people who hit their kids say "my folks hit me and i turned out ok." people who were forced into the humiliation of compulsory education subject their kids to the same coercive treatment believing it's necessary. and people who were raised to believe doctors are gods will submit to the knives and drugs.

it's frustrating. you want to scream "wake up!" to people stumbling along in their dreamworld. but you can't. all you can do is be patient, and work quietly with those who are beginning to ask questions, and raise your children to reject the mainstream.

it's about conditioning from a very early age. as long as babies are bunged into childcare, children are warehoused into schools, professions are packed into cube farms and the elderly are squirreled away in convalescent hospitals, the focus on the family and community will continue to dissolve and fade.

jessica mitford, legendary muckracker, said "follow the money." we also have the incredibly powerful influences of corporate interests driving the directions of that conditioning (witness channel one and coke's influence in the public schools). we've allowed the power to shift from the individual to the corporation, and it's not going to be easy to get it back (maybe impossible). drug and insurance companies drive the policies of medical service providers, and we won't be able to change that without a massive paradigm shift.

maybe i've become cynical after years of work on the california midwifery legalization campaigns. i don't think change can happen anymore at that level without huge amounts of cash. i believe our hope lies in raising a generation of kids who are secure enough to stand up for themselves and their families.

so, subvert quietly when you get the chance, and raise hellraiser kids. that's my solution!

katje


----------



## OnTheFence (Feb 15, 2003)

I may be the only csection mama posting on this thread. Excuse the typos this morning.

I am going to tell you why I am angry (and not particulalry at one person but in general) with the activisim I often see going on with people I know in real life and on these forums. The activism that some portray is often time with a holier than thou attitude. Comments are made repeatedly about the empowerment of women, educating women of the evils of the medical establishment, and the constant judgement on others birth experience whether they have had a csection or augmented birth or even a birth in a hospital for that matter. There is a lot of "empowerment" to boost ones on ego and try to help some poor umsuspecting woman, with the attitude that we are all like sheep being led to slaughter. There is a message of mistrust sent out to women when ever they discuss their OBs opinions, etc with others on this forum or medical intervention that took place if they had hospital births. Often times when I read the VBAC forum or this one particulalry about interventions or surgical birth the tone comes across like this "I mistrust what you are saying. Your doctor is a fool but next time I hope to beat it into your head that the next time you can have a baby in your living room with no problem." Of course this is said with sugar and delight but the under current is a sarcastic tidal wave.

I am not sure which poster in this thread said what, but I wanted to tell you why I defend my two csections. For one they were necessary. No one can debate the necessity of it more than I can. I spent years recovering emotionally from the first one I had. I've done more research and spent countless hours studying mullerian anomilies and birth than I can recall. Fortunately I have had resources available to me living near a medical school and being active in web forums where there is a lot of sharing of information. Did I have to justify my surgical birth? Yes. I needed to know it was necessary that there was nothing I could have done differently, that the outcome would have been the same had I been with a midwife or a physician TO MOVE ON. And why did I have to go to such great lengths to do this, because of women who call themselve activists for women said and judge otherwise. (the sad thing is I WAS ONE OF THESE WOMEN) And it still happens 7 years later. For some reason some crunchy homebirthers believe that my weird transverse baby hooked in some strange position through two different sections of my uterus, me with broken ribs could have given birth vaginally in some magical way and we all lived to tell about it. That my multiple attempts to have my baby turned holistically and medically must not have been done right by me or the practioner I saw. It gets old.

Should activists for natural vaginal childbirth put disclaimers? No. Should they qualify all their statements about surgical birth? Maybe. Do I have a problem with the csection rate? Yes. Do I think there are too many unnecessary csections? Yes. My problem is when one assumes that a woman who comes on this forum and says they had to have a surgical birth immediately its thought that either she or her doctor did something that led to it. (or heck midwife) This is what I find wrong with some of the "activists" I have met here on this forum or in real life, they are the ones who truly lack balance. They cant see past their agenda to see a woman and her child. They cant see past their own knowledge and experience to see that other persons knowledge and experience.

In the past year I have seen too many women attempt natural vaginal deliveries at home or in hospitals risking their babies and themselves to prove that they can have a vaginal delivery. They discount real risks and take faulty advice from people on the internet or because they read the Silent Knife and think that the medical establishment is wanting to gut them like a fish and steal their young from the womb. Some women think that having a natural vaginal birth is the end all and be all as an introduction to become a mother of a child. It isn't. There is much more to mothering than that. I dont think much of a woman who puts her life and child at risk to try to prove something to the rest of the world, medical establishment or even herself. I have read time and time again about fear based medicine, well there is a flip side to that as well and its here running rampant through these forums and in other circles.

If you want to advocate for women, children and their health, do it without judgement or superiority.

(excuse the typos, toddlers running wild and cant check)


----------



## Missgrl (Nov 18, 2001)

I think it is sooooo important at this point to remember that we are all humans with feelings and we all walk in different shoes. The old saying of "don't make judgements until you've walked in my shoes" seems to fit perfectly here. It is hard as a moderator *and* a c/birth mom to try and be partial and to not interject personal feelings. In this forum it is ok to discuss the high c/s rate and the curse of the medical doctors pushing c/s and the fear of malpractice etc. *But* let's remember that doing so hits home with alot of us here, and in discussing these things sometimes it sounds as if you are passing judgement on the way our beautiful babes were brought into this world. It is no secret that most c/birth members here carry alot of baggage about their deliveries. We are very open to discuss them either to vent, support or get passed feelings. We open ourselves up in order to heal. It is difficult to talk about such deep rooted feeling with people that have not been through the same situation. No two c/s's are the same just as no two vaginal births are the same and to make blanket advice is sometimes turning the knife in the wound. Continue the discussion....just remember their is a loving, caring woman on the other end of the keyboard.


----------



## pamamidwife (May 7, 2003)

Yes, I agree about respect.








It's important.

And, to figure out what your intention is behind posting anything. Are you just reacting or is there something that you feel is important and pertinent to the discussion? These are rules that I'm trying to abide by - I don't always succeed, however.

It sounds like women get most upset when their cesarean births - or heck, any birth! - are picked apart by others when they have not asked for feedback on it. (I'm guilty of this, too!)

Am I right when assuming that this is the biggest piece that many women have with "birth activists"?


----------



## OnTheFence (Feb 15, 2003)

Quote:

_Originally posted by pamamidwife_
*Yes, I agree about respect.








It's important.

And, to figure out what your intention is behind posting anything. Are you just reacting or is there something that you feel is important and pertinent to the discussion? These are rules that I'm trying to abide by - I don't always succeed, however.

It sounds like women get most upset when their cesarean births - or heck, any birth! - are picked apart by others when they have not asked for feedback on it. (I'm guilty of this, too!)

Am I right when assuming that this is the biggest piece that many women have with "birth activists"?*
Not entirely.
I think one thing that has bothered me over the past seven years (and guilt of as well) is that someone else interjects that they know differently about your and your body or your situation. In the past six months two of my friends had surgical births. One was looking and actively preparing for a natural vaginal birth. After her water broke she went to the hospital on her husbands demands. In fact he got very angry at the two of us laughing and cutting up before she went to the hospital. Well when she got there, they discovered her baby was a footling breech and they decided to do the csection. Well while they were waiting for the spinal the baby started have decels and finally just vanished. The nurse checked her and realized there was a prolapse cord. My friend woke up in recovering over an hour later not knowing what had happened. Was her csection necessary. I believe so!
Now four weeks later, my best friend had plan for a natural delivery. She was 2 weeks over due when her water finally broke. She called me and told me she was on the way to the hospital. After six hours there she let them give her pit even though she was progressing. Then she got an epidural. Then labor stalled out. Then her baby started getting distressed with the additional pit. So she had a csection. Now I personally believe that this was unnecessary. My friend made decisions not thinking clearly, but all in all made choices that led to this. I never said anything to her about it, even though I clearly felt that had she not let them give her that pit she would have had her baby in due time. One night after he was born and she called me and talked to me about the emotional decisions she made and choices that made that led to her surgical birth. She admits she handed her power over to a doctor and that her surgical birth could have been avoided. I *knew* that this was something she would come to terms with later. She didnt need me to tell her.

I think when you want to be an advocate for women, you need to allow them to tell their story and give them some time to process their own choices. And sometimes, like Laurel said, we have no choices. You just end up where you are at because that is what fate had in store for you. If a woman comes here and says "what could I have done differently?" then by all means help inform her. I think a good example of this recently is IOF. She did all the research, made plans for a VBAC and a surgical birth, and then in the end went with her gut. I believe following your instincts is just as important is knowing black and white facts. (and why some people chose repeat surgical births, or epidurals, or induction methods) I hope you understand what I am saying Pam, my kids are all over creation today and I am not sure I am thinking straight.


----------



## 2BMamaof3 (Oct 13, 2003)

I just wanted to add my voice to this thread.

I don't have anything to add at the moment.

I am a birth activist, but am very interested in pamamidwife's original thread questions.

I appreciate LiamnEmma (??)'s perspective and thank you OnTheFence for your experiences and advice.

I have been "bitten" by the sting of birth activists as well...even though I had a homebirth!! My homebirth was deemed too medical or not holistic enough....I didn't listen to my body enough....my midwives were to medical. Sigh. So I'm interested in finding that balance between informing women, empowering women and being an activist for birth.

Abby


----------



## LisaG (Feb 23, 2003)

First off, Kim thank you for contributing to this discussion. I appreciate that you take the time for this.

Quote:

In the past year I have seen too many women attempt natural vaginal deliveries at home or in hospitals risking their babies and themselves to prove that they can have a vaginal delivery. They discount real risks and take faulty advice from people on the internet or because they read the Silent Knife and think that the medical establishment is wanting to gut them like a fish and steal their young from the womb.
Next, at the risk of stepping on toes - can I very gently, and respectfully add in that the opposite concerns me too? In terms of women who think that a c/s (or c/b - never quite sure which terminology is more preferred) guarantees a safe outcome that a v/b can't? There are risks, very real risks, to both. And it really, really concerns and bothers me when I hear of women who had a crappy v/b decide that a c/s/b is the answer. Not because of their choice, but because of the assumption that things shouldn't have been/couldn't have been different with their v/b and therefor their only option in order to avoid the traumatic vaginal birth is to have a c/s/b. It saddens me that that's the environment of birth.

On a more personal note, I would venture to say, based on a couple previous posts by you in another thread, that given my bicornuate surgery history I would fall into that group you consider are taking the unnecesary risk of self and baby for a vaginal birth. While I'm sure some women do feel it necessary to "prove" they can have a vaginal birth (and I'm not sure why that's always a bad thing), I'd also like to suggest that some of us have arrived at that decision informed and have decided that the risks are worth it, just like other women have decided the risks of a c/s/b are worth it. I've decided that my risk for rupture increases the more incisions made in my uterus and therefore choose not to create another one if at all possible. Nor do I want to increase abdominal adhesions, risking my future fertility. Nor do I wish to once again recover from major abdominal surgery, or any of the other risks/side effects of c/s/b. I have decided what risks I am most comfortable with, and I suppose some could argue that it's completely stupid to be concerned about risk of adhesions when we're talking about the risk of the life of a baby. But there is no risk free option. Having a c/s/b doesn't mean something catastrophic couldn't happen either.

So here we are, back to freedom of choice, back to education, back to making choices with eyes wide open. Back to having compassion for our choices, our situations that brought us to those choices.

Which also brings me to a question - why does suggesting that a women could be better educated somehow get translated into "so you're saying I'm stupid and dumb"?







:

When a woman has a doc tell her that her baby is gigantic and it couldn't possibly fit through her pelvis and the woman doesn't know that u/s are notoriously inaccurate for predicting fetal weight, that even if the baby is big - small women are usually able to birth big babies given proper support and positioning which hardly every happens when a doc won't catch a baby in any other position besides lithotomy, that pelvimetry is a crock, that position and proper support are just about everything in that equation - WHY does suggesting that something could be different next time get translated into "you were a stupid woman that was duped by your doctor"? Why does suggesting that your doc is misinformed get translated into "you didn't go to medical school, therefore how could you possibly know more than my doc?"

Do I trust doctors and birth? No, not really. Not because I think they're bad people, or out to get me, but because the entire system of birth and medicine sees birth as a medical emergency and what could possibly happen "normally" with that attitude?

So yes, I do feel obligated morally and ethically to say something when I hear stories of CPD or other scenarios that have a high likelihood of being mismanagement related rather than defect related. I also feel obligated to say this the gentlest way possible and to be compassionate in my suggestions. Did I like it when a friend suggested that my surgeon might not be accurate when he told me I'd have to have a c/s/b - especially right as I was starting to get somewhat ok with the idea? Nope. I'd asked a couple of people, I'd been told by the holy grail of medicine, and so here I was, one of the "unlucky" ones who couldn't have a v/b. Well, she wouldn't shut up. So I said, alright, I'm going to dig deeper, see what I can find and then know that regardless of my decision I've found out what my real and true options are. I think we owe that to each other. We owe it to each other to help open eyes - and that goes both ways, I've had my eyes opened as much, if not more, by women's c/s/b experiences as well as v/b.

Well, I think that's enough from me for now







Again, I hope it's reasonably coherent.

LisaG


----------



## stafl (Jul 1, 2002)

Quote:

_Originally posted by pamamidwife_
*
And, in light of empowerment, how can we birth activists get along without all these disclaimers for people who have had a different experience? Where does the anger from these people come from? Do they not feel heard in general? Surely we live in a culture that is more supportive medicalized and surgical birth than, say, home birth. Is it just on these boards that they feel alienated?

...

Where is the balance? Why is their so much anger and opposition?*
I really want to take the time and read and re-read all the replies, but am limited in the amount of time I can spend on the computer with an active toddler and a newborn.

Pam, I love reading your posts, and cannot for the life of me recall ever reading anything offensive that you have written.

I did have a c-section with DD1, and understand the defensiveness some "birth activists" stir up inside me and other women.

I remember reading Henci Goer's book during my first pregnancy, and I just knew nothing like that (a medicalized birth) was ever going to happen to me. I knew that all I had to do was be educated and strong and stand up for myself. It didn't work out that way, though. In reality, the hospital and doctors and nurses took all the fight out of me. I was told that my baby would die if I didn't obey and bend to their rules and procedures. Instead of the empowered woman, I became a statistic. I personally experienced that unecesary c-section I had read about, that certainly was not going to ever happen to me! And I remembered that it wasn't long before that I had been looking down my nose at women who gave in, who were naive enough to believe what their doctors had told them. (edited to add - that is sarcasm, but I have seen this sort of attitude when this issue comes up)

And when I read a post on this board or others about how horrible c-sections are...well, it does sometimes strike a raw nerve. It's like telling me that I'm weaker or somehow less of a woman that I allowed them to do that to me. Some posts have actually left me in tears. I know I can't be the only one. It can be just like certain activists are twisting the dagger the surgeon left in my heart, telling me how I could have avoided what happened to me when they weren't there, they really *don't* know what I went through.

I think it all comes down to being supportive without judgement, respecting other women regardless, and not trying to put yourself in their shoes because you will never ever hear the entire story of what happened at their birth(s).


----------



## Greaseball (Feb 1, 2002)

I try not to give unsolicited advice IRL, but on one of these boards it's more likely that I will. Anonymity helps. IRL when a woman tells me she had an epidural and then a c/s, I just think, well, that's probably why...

The thing is, I'm probably right. I probably do know more than the doctor does. The WHO estimates that 50% of sections are unnecessary, so if someone has one there is at least a 50% chance they didn't need it. If they had an emergency, there is a good chance that is caused by the doctor as well.

When a baby's life has been risked by surgery that has a 50% chance of having been unnecessary, I care about that. I'm sure people who have never even been pregnant would care too.

If someone says "Your baby probably would have been safer if born at home" there is a very good chance they are right. Most babies and mothers fare much better at home.

I see it going both ways. I read posts from people who have had hospital births saying to other people, "Why in the world would you want an unassisted birth" or something similar. We all judge each other.

If someone tells me that I'm making a dangerous choice for my baby, I try and open my mind to the possibility they are right...if I still think they are wrong, I just stop listening to them.


----------



## LiamnEmma (Nov 20, 2001)

Of course I thought about this post last night and most of today, and thinking about what else I wanted to bring to it. I really appreciate this thread in general....

Anyway, while I'm thinking about it, what keeps popping into my mind is the secretary for my department. She and I had babies at the same time. I was on baby #2, she was on baby #1. I don't remember ever being rude or offensive, but I was still very rigid in my beliefs about birth...having had a csection with baby #1, I was of course determined not to have that happen the second time around. She couldn't have cared less outwardly how it all went. She seemed to give it all minimal thought actually. I found that disturbing and irresponsible. And I'm sure I made several, well meaning and pointed remarks with the intent of "educating" her. I had another cbirth and she had a completely unmedicated vaginal birth. So much for me and my angst.







: (you're not alone here Kim, I just don't always mention how my kids were born, it seems to decrease my credibility...and others--honestly ask yourself, did your opinion of my previous opinion drop just a little now that you know? I bet for some of you it did. That's okay, I'm just pointing out that we're all biased)

Since then I've relaxed a lot of my rigidity. I pumped for and breastfed my kids--I personally take credit for the pumping room installed in my district office following my unrelenting pursuit of a suitable place to pump that did not include a toilet--the secretary pumped for awhile then quit. I never said a word. I learned that we all have different lives and experiences and my reality is not hers. Recently she and I have begun processing our early relationship (i.e., when we were pregnant) and several times she began the conversation by saying something about how our pregnancy hormones didn't work together well. Finally she spit out what she really thinks. She said, "You made me feel like I was doing everything wrong." That sounds about right. I never once said that. I never once told her she made a poor choice or whatever. But I thought it. A lot. I completely disapproved of so many things, and in my effort to "educate" her, I just made her averse to me. I thought I was being enlightening. I was just obnoxious. I find she listens to my opinions far more now that I treat her as if her opinions and life experiences matter too. Because they do. Now we share our individual thoughts, it's not just me teaching her about her rights and abilities...

Honestly, I don't see birth anymore as much different than any other right to choose any other thing. If the consequences of an action are known, the risks involved weighed, why can't a woman elect to cbirth, or birth vaginally or any other of the choices? If we're talking about empowerment, and making people aware, then we have to respect that sometimes their decisions will not be ours. And by the same token, not everybody processes their grief, their trauma, their pain at the same rate in the same way. To me, _that's_ AP--recognizing the individuality of lives, and _that's_ what's truly not mainstream--being open to the ideas and actions of those that don't agree with our own.









Leah


----------



## cottonwood (Nov 20, 2001)

Stafl wrote: "And when I read a post on this board or others about how horrible c-sections are...well, it does sometimes strike a raw nerve. It's like telling me that I'm weaker or somehow less of a woman that I allowed them to do that to me. Some posts have actually left me in tears. I know I can't be the only one. It can be just like certain activists are twisting the dagger the surgeon left in my heart, telling me how I could have avoided what happened to me when they weren't there, they really *don't* know what I went through."

This makes total sense. I can see how well-intentioned advice, even if is right on, can cause pain. I can also see how activism can be a vehicle for moralistic judgement against the victim, and how moralistic judgement can be _inferred_ by the victim even when it is not meant.

Given all that, I still don't know what that means about how I should conduct myself as an activist. For whatever reasons, not all women will find the information that will benefit them. And I don't always know which women these are. So this is my own moral quandary: if I have information that someone might be appreciative of, something that they might not otherwise learn on their own, something that might help them avoid pain and suffering -- how can I not tell them what I know? To open my mouth means to take the risk that they will be offended, that they will misinterpret my distress that people are being hurt, misinterpret my intense anger at those whose who do the hurting, and that they will think to themselves about me, "Of course this is said with sugar and delight but the under current is a sarcastic tidal wave," that I am only in it to boost my own ego and play the hero. But to not say anything means to risk that they might never find out -- and any future suffering they are subjected to because of the lack of the knowledge would be on my head, because I had a chance to give it to them and didn't. It is all well and good to offer advice only if it is asked for; but what if the person doesn't even know that there is anything to question? What then?

Here on the boards it's even more complex because there are a lot of people reading. A lot of them are here to learn. So if I have information to share about some issue, wouldn't it be wrong of me to stay silent out of fear of offending the person whose story brings up the issue? I could start a new thread, but that would be awfully transparent. That person would probably still see it and know that it was prompted by their story. But if I don't say anything I've then lost the chance to give something to someone else (one of those many people reading) that they might appreciate or that might benefit them. I know that often I read about issues here on the boards that never once occured to me until someone brought them up -- and I was thankful to be made aware of them.


----------



## cottonwood (Nov 20, 2001)

LisaG wrote: "And then I wondered why am I so bothered when I hear stories from women who think they would've died had they not had a c/s for x, y, z reason? Why do I care?"

I think for me it is at base the horror that I feel thinking about myself being in that situation -- doing my best to be informed, but missing some things that end up causing me a lot of pain and trauma. The thought that my inaction could be indirectly responsible for putting someone else in that same position is too much for me to bear. It eats me up.


----------



## cottonwood (Nov 20, 2001)

OnTheFence wrote: "I dont think much of a woman who puts her life and child at risk to try to prove something to the rest of the world, medical establishment or even herself. I have read time and time again about fear based medicine, well there is a flip side to that as well and its here running rampant through these forums and in other circles."

What exactly is your point? Are you trying to give the birth "extremists" a taste of their own medicine? Because this is a pretty harsh, judgemental, hurtful (and IMO off-the-wall) statement -- wasn't the making of such statements exactly what you were railing against in the first place?

(edited for clarity)


----------



## anothermama (Nov 11, 2003)

Quote:

_Originally posted by blueviolet_
*OnTheFence wrote: "I dont think much of a woman who puts her life and child at risk to try to prove something to the rest of the world, medical establishment or even herself. I have read time and time again about fear based medicine, well there is a flip side to that as well and its here running rampant through these forums and in other circles."

What exactly is your point? Are you trying to give the birth "extremists" a taste of their own medicine? Because this is a pretty harsh, judgemental, hurtful (and IMO off-the-wall) statement -- wasn't the making of such statements exactly what you were railing against in the first place?

(edited for clarity)*
Thank you, BV. Thats what I was thinking in a much less coherant way.....

To be really frank....I see lots more insta-defensiveness from c section or high intervention moms. They seem ready to jump with out the slightest provocation to defend THEIR UNIQUE circumstance, which kind of comes around to what I said...its insulting to people to insinuate that they are somehow average.

While I understand that defensiveness, I honestly think it's a case of "me thinks thou dost protest too much". And I think much of it is not really warranted. I'm sure there have been harsh words thrown out and I'm sure it was hard....but it doesn't mean everyone who is against the rising rate of c sections is against YOU, and I think maybe people have a hard time detatching themselves...it is such a *personal* surgery. If I'm being REALLY REALLY honest...and who knows, maybe I shouldn't be...I think that the reason so many high intervention moms get so so defensive and so insulted is because they have something deep down telling them that maybe it could have been different. And, when you are talking about parenting issues and something makes you doubt yourself...that is HARD to deal with. We've all dealt with it in some way, but this is SUCH a truly personal thing....

A lot of it, though, I don't understand. I can only defend the things in my first birth in so far as I didn't know better. Now I know better. I don't know if that makes any sense.

I think part of it does need to be a hard line, though. How many times can you turn your head, bite your tongue, and say "Oh you poor thing!" and not be contributing to the problem? I don't really expect to make that big a difference with someone online...but with women I KNOW, I just don't think it's ok for me to just smile and nod and go blindly along with their "I had to because every single thing about my birth was DIFFERENT!" because....well, I know that most of the time, thats not true. And I know that a large reason they think that is because a "professional" told them that. I know lots of moms who HAVE been like "lambs to slaughter", and is it really helping the problem to just ignore your knowledge and education and let them tell their story to another mom who will think it's ok???

I dunno........I really don't.


----------



## LisaG (Feb 23, 2003)

Blueviolet wrote

Quote:

I think for me it is at base the horror that I feel thinking about myself being in that situation -- doing my best to be informed, but missing some things that end up causing me a lot of pain and trauma.
You hit the nail on the head for me







As much as I'd love to say my intentions are entirely altruistic, beneath it all is the thought "what if I were in this situation, what if that woman were me?" And I learn from women who have made "mistakes", I learn from women who have been through birth trauma - vaginal or c/s/b, I learn from women I piss off. I learn that no matter what happens, there have been others who have gone there before me and hopefully they'll help me find my way.

Leah wrote

Quote:

If the consequences of an action are known, the risks involved weighed, why can't a woman elect to cbirth, or birth vaginally or any other of the choices? If we're talking about empowerment, and making people aware, then we have to respect that sometimes their decisions will not be ours.
Absolutely! I just have a little glitch with the "consequences of an action are known, the risks involved weighed" because I think that information is hard to come by. Or that the expectation is that your doc or your midwife is the ultimate source of information. Personally, I don't find anyone to be the ultimate source of information, and that's when I frequently get triggered. The "my doctor told me" so it's the law. They might be right, they might not be and I feel that we are so used to birth professionals being the ultimate authority that we forget there might be other information out there. I do find it a lot easier to let go of scenarios where I feel a woman is fully informed and made her own decision even if I might have done something different. Of course, that's also my judgement of what qualifies as "fully informed". Sigh. I'm sure someday this whole letting go thing is going to get easier, right?









LisaG


----------



## captain optimism (Jan 2, 2003)

This is a really great discussion! Thank you to all the people who are open to rethinking how we talk about this stuff!

I came to this forum, I think it was last month, to process what was for me a disappointing birth. (Not disappointed in my baby, God forbid, who is the most wonderful imaginable baby--and was so from the first moment!) To summarize that whole story, I had my waters break and then didn't go into labor. AFter 44 hours of trying to induce non-pharmacologically, I went to the hospital and agreed to pitocin. Another 24 hours of no progress on the pitocin, I agreed to an epidural because the practitioners thought it might help me to have a LOT of pitocin and some sleep. I was then able, with a lot of patience, to dilate and finally, after pushing 8 hours, to give birth. My baby was never in distress, but I had every intervention: pitocin, pain meds, monitors (external and internal) birth lying down (and man that sucked) and finally an episiotomy.

When I wrote about it here, I asked what I could have done differently to make my labor go without all those interventions. here's what I noticed: some people talked generally about what causes that kind of labor and what sorts of conditions a pregnant woman should seek out to make labor go normally. Other people wrote me saying essentially that *I* did it wrong, that *they* would never have agreed to those interventions.

So there are two things that I was thinking about what feels bad about that judgement.

#1: It makes it all about the woman giving birth. As everyone who has given birth or watched someone give birth knows, you don't have total presence of mind in labor. (Or even in pathetic non-labor.







: ) How "empowering" is it to be _blamed_ because someone took your power? Or even because you made the best decision you could with the situation you were handed?

#2: sometimes a non-professional person (non-midwife, non-doula, non-OB, etc.) responding to the thread is assuming that they know more about what was going on with the mom's body than the pros on the scene knew. That might be true, but it's a hell of an assumption. I think I would ask some questions about what the pros said was happening before I decided that I knew better? Or even, to ask, "well, they said X, but what did it feel like to YOU?" Before you say, "oh no, it NEVER happens that way."

Here's how I have been thinking about this in connection with breastfeeding: I don't want to blame a mom for not breastfeeding if she tried, encountered obstacles, and didn't get good information about how to overcome them. That seems like kicking a sister when she's down. Shouldn't activism be about giving women what they need to make it work?


----------



## Greaseball (Feb 1, 2002)

I think who we are really "kicking" are the professionals that take power and rights away from women, and it can sound like we are blaming the women. (I know some people do blame the woman as well.







) If a mom tells me she tried to have a natural birth but then goes into how small her pelvis is and how she hadn't made any progress for 4 hours and then guess what, of course I want her to know that it was all crap and she probably could have done what she wanted if she had been able to go at her own pace. But it could be she will intrepret that as me judging her.

Birth activists have information that doctors do not have (or do not want to share







: ). I think women have a right to that information.


----------



## LiamnEmma (Nov 20, 2001)

Quote:

I just have a little glitch with the "consequences of an action are known, the risks involved weighed" because I think that information is hard to come by.
Agreed! And so maybe activism should be played out in the medical arena instead. Lobbying for doctors to give out more information, going to conventions and conferences where there are medical personnel and telling the stories, hitting the colleges where future practitioners are being trained...making a change in the established practice. I do believe women also bear responsibility in their births and so on, but, as I said on another of these posts about a year ago, just because the information you have is true, does not mean that the appropriate time to introduce it is when the woman is talking about her last birth, kwim? It just kind of rubs salt in the wound and decreases how much of the information is going to be heard.


----------



## Greaseball (Feb 1, 2002)

Even on a discussion board, there are things one just doesn't have to look at. If you see a thread titled "stupid unnecessary cesareans" or "my dumb sister had an epidural, can you believe her" you could always not look at it. I think this board even has a feature where you can block the view of all posts from a certain user, so if you know someone is a birth activist and don't want to hear anything they have to say, you could just use that feature.

Or there is always the c-section support thread. Threads like that are a good idea.


----------



## OnTheFence (Feb 15, 2003)

Quote:

_Originally posted by LisaG_
*First off, Kim thank you for contributing to this discussion. I appreciate that you take the time for this.

On a more personal note, I would venture to say, based on a couple previous posts by you in another thread, that given my bicornuate surgery history I would fall into that group you consider are taking the unnecesary risk of self and baby for a vaginal birth. While I'm sure some women do feel it necessary to "prove" they can have a vaginal birth (and I'm not sure why that's always a bad thing), I'd also like to suggest that some of us have arrived at that decision informed and have decided that the risks are worth it, just like other women have decided the risks of a c/s/b are worth it. I've decided that my risk for rupture increases the more incisions made in my uterus and therefore choose not to create another one if at all possible. Nor do I want to increase abdominal adhesions, risking my future fertility. Nor do I wish to once again recover from major abdominal surgery, or any of the other risks/side effects of c/s/b. I have decided what risks I am most comfortable with, and I suppose some could argue that it's completely stupid to be concerned about risk of adhesions when we're talking about the risk of the life of a baby. But there is no risk free option. Having a c/s/b doesn't mean something catastrophic couldn't happen either.

LisaG*
Dear Lisa,

Thank you for your comments, I have a moment, its late but I wanted to take time to respond to you. I dont want you to think that I am judging you or think you are making the wrong decision about any future pregnancy. I just want you to be fully informed and be fully prepared for what might actually happen should you get to the end and realize that a surgical birth is necessary or that things dont go as planned and you end up having a surgical birth. I think its great that your mindset is for a vaginal delivery at that you are aware of the risks.
I was totally unaware of my uterus until after the fact. I prepared for a natural vaginal delivery. Even after I was told I had a transverse baby Jan 15, 1997 I still believed that I would have a vaginal birth. By this time I had broken ribs and looked lopsided, I went home called everyone I knew and laid upside down on a ironing board for the next three weeks, not to mention all the massages, meditation, beggin god, etc that took place. I showed up at the hospital on Feb 3 1997 with the thought that I would still have a vaginal delivery. Its hard to explain but that was one of the best and worst days of my life. And part of the reason it was the worst day of my life was because of this thought "its not going to happen to me, I am not going to be one of those women with a surgical birth". I never once entertained the idea, EVER that I would be the woman in the operating room and what happened to me was gruesome, life threatening and emotionally scarring. Of course that part wasnt my fault!
I just hope, and pray that when the time comes, and you are pregnant with your little one, that you not only listen to your head but also to your baby and your gut. I hope you prepare for what could possibly happen, not because it will, but because it might and why be unprepared emotionally and spiritually for that event. I hope you will trust me when I say that being prepared, having a backup in no way means defeat or that it will lead to that outcome, but can provide you with peace of mind.
I did consider VBAC with my son. He was even head down from 27 weeks onward. I entertained the idea and discussed it with my doctor who would have given me the opportunity (though closely monitored). She made articles readily available to me and even medical text books with great information about mullerian anomalies. She let me know that she didnt have the answers and that she had not had many patients with my condition. I was not willing to take the risk, at all. I believe and still do that my csectoin was far less risk than a VBAC. I had worked too hard to maintain my pregnancy (one I might add thought I would not ever have) and have another biological child to risk his life or my reproductive organs. This is not to say that I didnt secretly wish that my water would break and I would go into labor and he would slide right out LOL I did however know in my gut that it was the right thing to do. I planned and worked with my doctor and hospital to achieve something in the OR that not many have experienced. What happened in that OR restored me in ways I cant even put words too and I never ever regret.
It will be nice to follow you over this time to see where you may end up! I just hope you dont think I am unsupportive, far from i!

Kim


----------



## OnTheFence (Feb 15, 2003)

Quote:

_Originally posted by Greaseball_
*

The thing is, I'm probably right. I probably do know more than the doctor does. The WHO estimates that 50% of sections are unnecessary, so if someone has one there is at least a 50% chance they didn't need it. If they had an emergency, there is a good chance that is caused by the doctor as well.

*
This is the kind of comments I think that bothers me the most. They are arrogant and said with suoeriiority where there is none. It is these comments that turn me off.


----------



## OnTheFence (Feb 15, 2003)

Quote:

_Originally posted by LiamnEmma_
*

Since then I've relaxed a lot of my rigidity. I pumped for and breastfed my kids--I personally take credit for the pumping room installed in my district office following my unrelenting pursuit of a suitable place to pump that did not include a toilet--the secretary pumped for awhile then quit. I never said a word. I learned that we all have different lives and experiences and my reality is not hers. Recently she and I have begun processing our early relationship (i.e., when we were pregnant) and several times she began the conversation by saying something about how our pregnancy hormones didn't work together well. Finally she spit out what she really thinks. She said, "You made me feel like I was doing everything wrong." That sounds about right. I never once said that. I never once told her she made a poor choice or whatever. But I thought it. A lot. I completely disapproved of so many things, and in my effort to "educate" her, I just made her averse to me. I thought I was being enlightening. I was just obnoxious. I find she listens to my opinions far more now that I treat her as if her opinions and life experiences matter too. Because they do. Now we share our individual thoughts, it's not just me teaching her about her rights and abilities...

Honestly, I don't see birth anymore as much different than any other right to choose any other thing. If the consequences of an action are known, the risks involved weighed, why can't a woman elect to cbirth, or birth vaginally or any other of the choices? If we're talking about empowerment, and making people aware, then we have to respect that sometimes their decisions will not be ours. And by the same token, not everybody processes their grief, their trauma, their pain at the same rate in the same way. To me, that's AP--recognizing the individuality of lives, and that's what's truly not mainstream--being open to the ideas and actions of those that don't agree with our own.









Leah*
Leah I want to hug you!!!!!!!! You say it all so well and I have had similar experiences, not just with childbirth, but with breastfeeding and attachment parenting issues as well. I later learned what an ass I was to people trying to enlighten them (of course I was always a good southern belle while doing it) Thankfully one of those women forgave me for my arrogance and is now one of the best friends a woman can have.


----------



## OnTheFence (Feb 15, 2003)

Quote:

_Originally posted by blueviolet_
*LisaG wrote: "And then I wondered why am I so bothered when I hear stories from women who think they would've died had they not had a c/s for x, y, z reason? Why do I care?"

I think for me it is at base the horror that I feel thinking about myself being in that situation -- doing my best to be informed, but missing some things that end up causing me a lot of pain and trauma. The thought that my inaction could be indirectly responsible for putting someone else in that same position is too much for me to bear. It eats me up.*
I love what you said above and I wanted to add to it.








When I was planning for my natural unmedicated vaginal birth in 96 and 97 I didnt do my best to be informed. My lack of information was not about the risks of epidurals or interventions, or the right position to birth a baby, etc etc etc it was that I never thought "what if" I had a surgical birth. What happens if I do need a csection. I was so pigheaded and judgemental that I just knew it would never happen to me. ( I think god smiled when I got knocked off that pedestal) Can you imagine the pain and trauma I suffered, the fear of the unknown as they took me down the hall to that OR. No one, not my crunchy homebirthing friends, not the midwife I spoke with during my pregnancy, not my birth educator once ever prepared me for what could have happened -- however there was plenty of discussion about how not to end up in the OR, why surgical birth was so unnecessary, etc. And that is why I am here today, trying to voice and support women who may be that woman having the surgical birth or preparing for a second surgical birth or needing to heal from a surgical birth because no one gave me that. Once I came home, do you think my homebirthing friends came and embraced me? No. In fact when they did come around and listen to my story one of them actually said "You could have had a vaginal birth if you would have just waited." The sad thing is I have read that same sentiment here. I remember the depression I felt during that time, wondering, "what if I had waited". Torturing myself. I have to ask, in general "Is that the kind of pain you want to leave with another woman?"

Kim


----------



## OnTheFence (Feb 15, 2003)

Quote:

_Originally posted by blueviolet_
*OnTheFence wrote: "I dont think much of a woman who puts her life and child at risk to try to prove something to the rest of the world, medical establishment or even herself. I have read time and time again about fear based medicine, well there is a flip side to that as well and its here running rampant through these forums and in other circles."

What exactly is your point? Are you trying to give the birth "extremists" a taste of their own medicine? Because this is a pretty harsh, judgemental, hurtful (and IMO off-the-wall) statement -- wasn't the making of such statements exactly what you were railing against in the first place?

(edited for clarity)*
My point is that this is what often goes on that people are unaware of. Pam put something out there to be discussed and I am pointing out how *I* see and feel about things I have read and experienced on this forum. I dont believe its off the wall at all -- not from my seat at least. My statement may be harsh and I am sorry if it offends but in my belief it is truth.


----------



## OnTheFence (Feb 15, 2003)

Quote:

_Originally posted by anothermama_
*While I understand that defensiveness, I honestly think it's a case of "me thinks thou dost protest too much". And I think much of it is not really warranted.
If I'm being REALLY REALLY honest...and who knows, maybe I shouldn't be...I think that the reason so many high intervention moms get so so defensive and so insulted is because they have something deep down telling them that maybe it could have been different.
And, when you are talking about parenting issues and something makes you doubt yourself...that is HARD to deal with. We've all dealt with it in some way, but this is SUCH a truly personal thing....

*
The above two statements is the arrogance and judgement that makes some of us angry here. Because we defend our choices doenst make us any less right than you defending or advocating your decisions to do something different.
I KNOW my surgical births were necessary. I KNOW that it wouldnt have been any different. I am insulted that someone can be so arrogant to think they know what is best for me, my child, and can make medical claims about my body they have never seen.


----------



## OnTheFence (Feb 15, 2003)

Quote:

_Originally posted by captain optimism_
*
When I wrote about it here, I asked what I could have done differently to make my labor go without all those interventions. here's what I noticed: some people talked generally about what causes that kind of labor and what sorts of conditions a pregnant woman should seek out to make labor go normally. Other people wrote me saying essentially that I did it wrong, that they would never have agreed to those interventions.

So there are two things that I was thinking about what feels bad about that judgement.

#1: It makes it all about the woman giving birth. As everyone who has given birth or watched someone give birth knows, you don't have total presence of mind in labor. (Or even in pathetic non-labor.







: ) How "empowering" is it to be blamed because someone took your power? Or even because you made the best decision you could with the situation you were handed?

#2: sometimes a non-professional person (non-midwife, non-doula, non-OB, etc.) responding to the thread is assuming that they know more about what was going on with the mom's body than the pros on the scene knew. That might be true, but it's a hell of an assumption. I think I would ask some questions about what the pros said was happening before I decided that I knew better? Or even, to ask, "well, they said X, but what did it feel like to YOU?" Before you say, "oh no, it NEVER happens that way."

Here's how I have been thinking about this in connection with breastfeeding: I don't want to blame a mom for not breastfeeding if she tried, encountered obstacles, and didn't get good information about how to overcome them. That seems like kicking a sister when she's down. Shouldn't activism be about giving women what they need to make it work?*
First of all {{{HUGS}}} I am have been where you are in reguards to the treatment you recieved. I think your post was right on the money and very thought provoking.

I will probably post more later on what you had to say. Its approaching midnight and I must get some sleep!


----------



## cortsmommy (Jul 6, 2003)

I dont know the answer. All I know is that I feel that my power was taken away by the doctor that I had. He took away my right as a woman to give birth and wanted that power for himself. I know its silly to say that I feel like less of a woman because of my csection but I truly do. I am Wiccan and so I have a strong spiritual connection with fertility and reproduction and with giving birth and that most precious moment when my son should have entered the world through me and by my power and my will was taken from me. He was yanked out of my birth canal backwards and pulled out of my stomach into the world. Completely unnatural and unnecessary and I can never have that back and can never do it again.

Why did that happen to me? Because I was unsure of myself. I was naive and immature and above all I was afraid. I was afraid of pain, afraid of the unknown, afraid of just letting go. I was uncomfortable and afraid.

What is the final outcome ?? Well, when I looked back on what happened to me and when I cried and cried about it I realized that there was only myself to blame. I realized that I needed to be more strong in my convictions and to be more educated, more self-assured, and more faithful to myself and my spirit. It has been through my pain and disapointment that I have grown. As I became a mother I also became a woman instead of the child that I was before. I know that everything happens for a reason and I am thankful that now my eyes are open. I question everything now. I research everything now. I will not be blind to anything anymore. In the end my child has benefitted because now he has a very vigilant mother.


----------



## miserena (Dec 16, 2003)

Quote:

_Originally posted by OnTheFence_
*I planned and worked with my doctor and hospital to achieve something in the OR that not many have experienced. What happened in that OR restored me in ways I cant even put words too and I never ever regret.*
Could you elaborate on what was different during your second c/s that made the experience better for you?

Michelle
mama to Eileen, 11/04/01, unplanned c/s


----------



## LiamnEmma (Nov 20, 2001)

Quote:

Even on a discussion board, there are things one just doesn't have to look at. If you see a thread titled "stupid unnecessary cesareans" or "my dumb sister had an epidural, can you believe her" you could always not look at it. I think this board even has a feature where you can block the view of all posts from a certain user, so if you know someone is a birth activist and don't want to hear anything they have to say, you could just use that feature.
Greaseball, I'm confused. Maybe this is just coincidentally behind my last post, but is that directed to me? I find that somewhat bizarre. I didn't think I was being rude, I thought I was putting forth some ideas to the group about activism, and how to go about making changes. If it is, I don't understand why I can't put forth my ideas as well.







:


----------



## OnTheFence (Feb 15, 2003)

Quote:

_Originally posted by miserena_
*Could you elaborate on what was different during your second c/s that made the experience better for you?

Michelle
mama to Eileen, 11/04/01, unplanned c/s*
Wow, well so much took place. First of all a little history. My first csection was an emergency after a failed ECV. I had a spinal that did not take correctly and ended up higher in my chest than in my abdomen and it suppressed my breathing. To get to the point, I felt my entire csection. About fifteen minutes into my csection I was screaming, cussing (my OB said she had never heard such fould language come out of woman mouth) and bucking off the table. Two nurses were called to hold down my legs. I was given 250 mg of demoral, verset(sp) -- amneisa medication, phenegran, and zofran, ephedrine, sedatives and multiple other drugs. My csection lasted 75 minutes. That means for 75 minutes I felt someone manipulating and carving my guts. They claim they could not knock me out because he spinal was too high in my chest. My nurse in the OR told my family "She had never seen a more horrific birth in her career", my mother told me that one of the other nurses left the OR in tears, and my husband got kicked out of the OR trying to advocate for me. My recovery was almost as horrendous.

With my second birth child, I knew that things would have to be different. I was plagued with terrible images and memories and even had very vivid dreams of my doctor performing my csection on a concrete slab in a cememtery. For me, I had to have as much control as I could possibly have in that OR, or at least percieved I had.
My csection was scheduled. I had picked my nurses from labor and delivery and requested an assistant. I also chose my own anestesiologist and pain medication. I opted to have no pre-op drugs or sedatives. I had an epidural ten minuted before going to the OR. My arms were not strapped to the table or anything like that. I had my hair fixed and make up on. I had a detailed birth plan that everyone followed. I had two support people in the OR, my sister who stayed with me the entire time and my husband who stayed with our baby while they sutured me up. I had no sedatives during my csection nor did I get any drugs for nausea. I did get three doses of ephedrine for blood pressure problems (Something I expected) I was able to see, hold, and touch my baby after being born. My doctor explained everything to me and talked to me the entire time. She even asked me if she could use the vacuum to unlodge my baby's head. (It was stuck in some cockeyed way in my pelvis) I did feel pushing and I did feel him leave my body which was neat. I got stitches instead of staples. My csection lasted 30 minutes from start to finish. I had my baby in my arms, sitting up in the bed and talking on the phone fifteen minutes later. For pain management, which was key for me, was that I had my epidural cath and line remain for the next 17 hours in which I was administered small doses of a block a few times every hour. I could also dose myself. At no time was my mind in lala land and I had my full faculties. I never experienced drowsiness or any sedating feelings because the drugs were not going in my head. I also ate after I had my surgery and moved, a lot. The nurses I had in the hospital thought I had a vaginal delivery because I was up and out of there in less than 48 hours.
This is the short version, but all in all it was a wonderful experience. I made thoughtful educated choices and I did leave room for the unknown, just not a lot!

Kim


----------



## anothermama (Nov 11, 2003)

Quote:

_Originally posted by OnTheFence_
*This is the kind of comments I think that bothers me the most. They are arrogant and said with suoeriiority where there is none. It is these comments that turn me off.*

Well, then I'd venture to say that THIS is the kind of insta-defensiveness *I'M* talking about. Greaseballs comments wasn't arrogant at all....then again, I don't have anything to feel defensive about in her comment, so theres just no way for me to read arrogance into it I guess. She *IS* right. How much babying does one need to use when presenting what ammounts to really really REALLY basic facts??? How can that be presented without offending????

I totally believe in not TRYING to offend, but there comes a point where you have to kind of shrug your shoulders to it....if you aren't trying to be arrogant and you TELL people that, and they still insist on saying "Oh but you are"...well, they have to own that, not the person who made the statement.

And, I've said this in other posts of mine....I really feel like you can only dilute it so much with pats on the back and "oh you poor baby!"'s before you are really just kinda lying to other women and .... really... does that help anything?


----------



## anothermama (Nov 11, 2003)

Quote:

_Originally posted by OnTheFence_
*The above two statements is the arrogance and judgement that makes some of us angry here. Because we defend our choices doenst make us any less right than you defending or advocating your decisions to do something different.
I KNOW my surgical births were necessary. I KNOW that it wouldnt have been any different. I am insulted that someone can be so arrogant to think they know what is best for me, my child, and can make medical claims about my body they have never seen.*
Kim

There was no arrogance or judgement at all in my statement. I'm sorry you read that into it.
There *is* a difference between doing something "different" as you say and making and educated decision. Just pointing that out.
I don't really see anywhere where anyone claimed to know what was best for you personally, your child personally, or saying they've got the right to make medical deicions for you. So I'm a little confused how you got that.


----------



## Greaseball (Feb 1, 2002)

OTF - I don't make this stuff up out of my head. I am just as educated as any of us here. But if what I say or how I say it turns you off, you are free not to read it.

LianEmma - No, nothing was directed at you. I'm talking about things I hear in general, and not from anyone on this thread. I was also saying that anyone who doesn't like what I or someone else has to say can always choose not to read it. They can scroll past whatever I post, or they can put my username in the ignore feature. I don't understand why people in general often make themselves look at things they would rather not see. Pertaining to this board, I don't know why they read or join threads they know they will not like.

Of course, this thread has an interesting, non-threatening title, but if someone sees a thread whose title gives it away, and knows they will not like it, why not just ignore it?


----------



## LisaG (Feb 23, 2003)

Quote:

I dont want you to think that I am judging you or think you are making the wrong decision about any future pregnancy. I just want you to be fully informed and be fully prepared for what might actually happen should you get to the end and realize that a surgical birth is necessary or that things dont go as planned and you end up having a surgical birth. I think its great that your mindset is for a vaginal delivery at that you are aware of the risks.
Thank you Kim. I can only imagine how hard you tried in your quest for your first vaginal birth, how traumatizing and frightening your experience was, and I am so sorry you didn't have helpful, compassionate support from women afterwards. As much as my medical diagnosis have sucked at times, I'm totally grateful things were discovered before I wound up in the very same situation you described.

Quote:

I just hope, and pray that when the time comes, and you are pregnant with your little one, that you not only listen to your head but also to your baby and your gut. I hope you prepare for what could possibly happen, not because it will, but because it might and why be unprepared emotionally and spiritually for that event. I hope you will trust me when I say that being prepared, having a backup in no way means defeat or that it will lead to that outcome, but can provide you with peace of mind.
Well, now I'm teary and my dh is wondering what's wrong with me







After my surgery, when c/s/b seemed the only possibility, it was a very, very humbling experience. I was born at home, as were 3 of my 4 siblings, I've had the privledge of being at a friend's 2 births, and then I had the eye opening experience of being with a friend at 2 of her hospital births. I had such a hard time with the hospital births - the monitoring, the epidural, the screaming baby while they did all their measuring and foot stamp and pricking and suctioning, etc. I swore that would never, ever be me and I'd learn every damn thing I needed to to prevent it.

Then I found out I had fibroids - well I was going to eat and think my way out of those. Sheer will power was going to make it happen - because the power of my mind could do it. Then there was the guilt - if I was truly a whole person, my uterus would never have grown these weird things. And even with all the vitamins, good food, bodywork, and introspection they didn't change. Then I found out about my bicornuate uterus - can't exactly think, will power or educate myself out of that one. So for the first time in my life I realized there really wasn't anything I could do to fix it. How ironic is it that my mother, Ms. Health Food Vitamin herself grew a baby with a uterine birth defect? And I wound up doing something I never in a million years expected - having surgery in a hospital. And you know, it really wasn't that bad and I made the situation the best I could within that framework. The tradeoff is now I've got a fibroid free, one cavity uterus! And I realized that healing can come in all sorts of packages.

In the meantime I had a couple friends wind up with very unexpected c/s/b - friends who were educated, supported and wound up with non-emergency c/s/b. I learned (as much as I can from my point of view) that birth is unpredictable and that unfortunate shit happens.

So, yes - I promise to listen to my body, my baby and my gut. I promise not to ignore the realm of possibilities in my birth preparations.

Quote:

I believe and still do that my csectoin was far less risk than a VBAC. I had worked too hard to maintain my pregnancy (one I might add thought I would not ever have) and have another biological child to risk his life or my reproductive organs. This is not to say that I didnt secretly wish that my water would break and I would go into labor and he would slide right out LOL I did however know in my gut that it was the right thing to do. I planned and worked with my doctor and hospital to achieve something in the OR that not many have experienced. What happened in that OR restored me in ways I cant even put words too and I never ever regret.
And what jumps out at me the most is that you knew in your gut that was the right thing for you. That is so awesome - and that you listened to it and found such a positive experience from it. I wish that for all of us. That we follow the path of our healing however a twisty, unexpected path it might be.

Thank you Kim for your concern, your experience and your caring.

LisaG


----------



## captain optimism (Jan 2, 2003)

I guess for me, one of the things that is important about a thread like this is that it gives a person who isn't _intending_ judgement a chance to know what _sounds judgemental._ In general, I believe people here operate in good faith and with the intent to help each other.

The thread started, in part, with this sentiment:

Quote:

*
How do we continue to empower and facilitate trust with women while offering, sometimes, an alternative to the model of care that most women receive? And, if we do so, why are we deemed as being horrible people?

Are there birth activists that do not understand that cesareans are sometimes warranted?*
That's the premise of the thread: that we have to learn how to talk to each other respectfully. In this thread, the onus is on the birth educators to be less accusatory--it's not on the mama who had a necessary c/s to be "less defensive." The idea is to learn how to communicate without attacking.

Why is this a good idea?

1. Because I don't know about you, but I think it would be a waste to ignore your posts, Greaseball. You do know a lot! That's clear. This thread is perfect for you because it's all about how you can get your point across without winding up alienating the people you are trying to help.

2. Because moms can't go back and do births over. The baby doesn't go back in! We can only go forward.

3. Because a mom who had an unnecessary c-section was cheated and often harmed by bad information. She doesn't need to be made to feel bad, she already feels bad.

4. Because a mom who had a necessary c/s had a damned difficult birth! Say only 50% of c-sections in the US are necessary. That's still a lot of women with weird birth anomalies that had *abdominal surgery* to recover from when they had tiny babies to care for.

5. Because you are her ally in having future healthy births, not her inquisitor or her confessor.

One thing cool about being online is that you get to meet all kinds of women, including women who had really anomalous experiences of birth. Some women you meet here will have kinds of pregnancies that only 1-2% of women have. So that's something to take into account when you make generalizations. You know? OnTheFence graciously shared her experiences. There aren't many women like her. Most women can have natural, drug-free births. But you still have to take her and her experience into account when you speak to the general case.


----------



## LiamnEmma (Nov 20, 2001)

captain optimism--THAT was a spectacular post! Here here!






























Leah


----------



## anothermama (Nov 11, 2003)

Quote:

_Originally posted by captain optimism_
*I guess for me, one of the things that is important about a thread like this is that it gives a person who isn't intending judgement a chance to know what sounds judgemental. In general, I believe people here operate in good faith and with the intent to help each other.

*
You have an excellent point, and I think that reflection is a very handy tool...

HOWEVER there *does* come a time when you can say it as nicely as you can, reiderate that it isn't personal, and when it comes to THESE issues (mommying things) women will STILL get defensive. Again I ask...how much caudling needs to happen? It seems like so often the whole point ISNT "dont judge me!" its "dont tell me what happened to me could have been different!". And....thats a lie. And, kind of going around to Pams original post...it's defeating the purpose of even getting educated about these things if EVERY TIME you say them, no matter how tactfully and straighforward its done, you are accused of being judging and arrogant, you know?

Sometimes on forums like this, someone will tell me "Hey, that was really offensive" and it makes me think and I go back and re read. And I'll either change what I said or apologize to the person for being offended. But at that point, that person needs to own whatever it is in them that MAKES them so very defensive. And at that point it's not about the message OR the messenger.

Anyways....I've said it a few times....and this thread makes me wonder...can change really ever happen when it's just about impossible to say ANYTHING negative about high intervention birth because so many women will take it all personal. And, because of that...do you stop learning? Do you stop talking? Is that really doing ANYONE any good?

I dunno..........


----------



## captain optimism (Jan 2, 2003)

So here's one thing I think would be helpful to consider: once someone has already had their baby, and has already had lots of interventions, what you say about their choices can be quite hurtful. Because really, what are they going to do about it now? This is especially true if they felt pressured into doing a c/s.

There is also this one element that I must acknowledge, which is that youdon't have the whole picture from one post, even a long one. To comment on their choices (or even, more appropriately, on their medical care) based on that information seems to me injudicious.

On the other hand, if someone comes to these boards and says, "I'm pregnant. My doctor said if my baby is too big I'll need another c/s" --then choice words are timely, and as forceful as you might make them, aren't going to hurt the person's feelings. They can only help.

You can say negative things about high intervention birth. I think that's a good tactic. It's different from saying "and all you women who had high intervention births need to come to terms with the fact that you feel bad about it because you made bad decisions." You don't know that that is true. You can have necessary interventions and feel bad anyway.

earlier, Greaseball commented that 50% of c/sections are unnecessary. If that's true (and I don't know where that figure comes from) that means that 1/2 of c/sections are necessary. Which means that any woman on these boards who had one might have really needed one.


----------



## pamamidwife (May 7, 2003)

CO, your words on this thread have been incredible. Thank you so much for your wisdom, your empathy and your ability to speak your heart.


----------



## ~Megan~ (Nov 7, 2002)

I was like that for a while. I believed that my caesarean was necessary but I was still angry about it. I was angry at women who could birth naturally. I was angry that I never had those experiences. I was angry that my transition into motherhood happened the way it did.
It took some time before I was ready to say that instead of having a medically necessary caesarean I had one because I was ignorant. I was scared and hormonal when I found out that my perfect pregnancy took a "wrong turn".
The way it was presented to me I didn't know I had options and I believed that what happened to me was the only way it could be.
I couldn't understand why I couldn't take the advise of others and "be happy you are both healthy".

Some women have medically necessary caesareans, some have completely unnecessary caesareans, and some will never know.
But the feeling of doubt in ones self is what really bothers me. The future pregnancies and births being compromised by a potentially unnecessary intervention is what pisses me off.

My body is forever scarred inside and out because my doctor didn't know how to deliver a breech baby vaginally and I was too stupid to seek other care.
It is embarassing and it was hard to accept that in my case it was my own "fault" that my birth happened the way it did.
The only thing I can do now is take more responsibility for my own birth and when I find someone else in the position I was I tell them my story so they know they have other options.

Birth is completely personal and like any personal issue it will hurt women when their choices are questioned. Even the perception that we have done something to harm our child will bring out the beast in us.

Yes, we are glad that we "both turned out healthy" and some of are happy enough with that but others aren't.

Keep up your advocacy. Any change that is worth fighting for will cause debate.
I, for one, do not take your advice/information as an attack on our birth experience but rather enlightenment for our future experiences. I know your heart is to empower women to take control and have the births they want. And I know that is your passion.


----------



## Greaseball (Feb 1, 2002)

Quote:

earlier, Greaseball commented that 50% of c/sections are unnecessary. If that's true (and I don't know where that figure comes from) that means that 1/2 of c/sections are necessary. Which means that any woman on these boards who had one might have really needed one.
That comes from the World Health Organization.

Of course, I think a lot more than 50% are not needed, and several others would agree. I doubt that 13% are medically necessary. Other countries have a 5 to 10% rate, which seems to be working for them. I seriously doubt a British pelvis is that different from an American pelvis.


----------



## anothermama (Nov 11, 2003)

Quote:

_Originally posted by captain optimism_
*
There is also this one element that I must acknowledge, which is that youdon't have the whole picture from one post, even a long one. To comment on their choices (or even, more appropriately, on their medical care) based on that information seems to me injudicious.

You can say negative things about high intervention birth. I think that's a good tactic. It's different from saying "and all you women who had high intervention births need to come to terms with the fact that you feel bad about it because you made bad decisions." You don't know that that is true. You can have necessary interventions and feel bad anyway.

earlier, Greaseball commented that 50% of c/sections are unnecessary. If that's true (and I don't know where that figure comes from) that means that 1/2 of c/sections are necessary. Which means that any woman on these boards who had one might have really needed one.*
Good points.

*Re: commenting based on one long post....women CHOSE to put there stuff out there, that I really lack sympathy for. Nothing irks me more than a woman who will, in the midst of a C Sec discussion, post her story and yet be unwilling to discuss it. Its like saying "This is the real deal THE END! YOU SHUT UP BECAUSE THATS MY STORY". I hate that. I know...I know...that sounds harsh. It isn't really directed at anyone in particular...it's just unfair. Its one thing to post in a support group or post in response to someone asking just about the experience....but when you post in the midst of discussion, the words are UP for discussion, so you (general you) need to keep that in mind. I hope that makes sense....

* Just to be clear, I NEVER said that "and all you women who had high intervention births need to come to terms with the fact that you feel bad about it because you made bad decisions." Focus on the word ALL. I don't think ANYONE said that. I do, however, firmly believe in instinct and emotion. And the incredibly strong knee jerk reactions I see often (again, not just here, but everywhere) make me think. The vast majority of the time when *I* have a knee jerk reaction like that, that is THAT strong and THAT emotionally charged...it's usually because the thing I'm being accused of has some ring of truth. Humans are humans and we aren't that complicated...we all kind of work the same. Just in my personal experience, I know moms who really honest to God DID HAVE to have their interventions in their birth, whatever they were. I'm sure we all have a friend or two like that. And you know what? Most of them get *a bit* irked at stuff like this, but deep down they know they have nothing to defend...they honestly had no choice, so whats to argue? And I have some friends who are UBER high interventionist and will FREAK out on you if you even MENTION something *sorta* related to natural birth. I used to be on a really mainstream board and there were a couple women who were ALWAYS the first to reply to birth questions with all sorts of "Dont let the wackos talk you into naturl birth! Intervention birth is FINE!!! See? My baby turned out just fine so it must be ok!!". They'd also admit to NOT reading up, to blindly listening to their docs, etc etc etc. I know it's not PC to say and it's not nice to say maybe but it's honestly what I believe...if you have that violent a reaction to something, maybe it's because deep inside you know you could have made better choices. Again, I TOTALLY sympathize with that...its HARD to be questioned about your parenting...its one of the most personal things you can be called on the floor about. I didn't say it was EVERYONE, but I bet it's a significant ammount.

I had some interventions in my daughters birth that, looking back, I wouldn't have chosen. I was younger, single, and totally new and learning. I thought I made the best choices at the time but now I realize I could have done things differently. I've been there. I remember I was BREIFLY at AMU and got the crap FLAMED out of me for some of the things that happened with my when I birthed and when my dd was young. And I was OUTRAGEOUSLY defensive about it......because I knew there *was* a thread of truth to some of what was being aimed at me. But it wouldn't have helped me or my child or future children to just staunchly stand by my mistakes and do them over and over again.

I knew better afterwards and resolved myself to DO better the next time. And now I kind of think I am.

Which brings it all back around for me.....sometimes it's hard to take a really honest look at yourself and your life and often times its VERY hard to resolve to change. Very.

But, say back when I weaned my dd, everyone would have said "Awww....You poor thing.....you did what you could and you made the right choice" without giving me ANY info.....that would have been detrimental to me and to any other children I may have had, you know? And, it could have been detrimental to my friends, because what if I then went around spouting that what I did was just fine and so whatever THEY wanted to do what fine, too.

Also, I think the IMPORTANT number to keep in mind is that over 90% of women in the US (93-97 depending on the studies you read) can give birth normally. No interventions. So when you start talking about who NEEDS interventions, it's not especially likely you are talking to them online. It's POSSIBLE and I'm sure there are a few....it's just not as common as you'd think reading various online forums.

So anyways.....I don't mean to be offensive.....in the context of this discussion, nothing I say has been aimed at anyone. I think about what Pam said almost every day and I see it as a very hard thing to do, advocate for better births.....because too many women are too defensive. And we have this notion that if you don't just smile and nod then you aren't being supportive. And if you bring up ANYTHING negative or you bring up ANYTHING that *may* make a mom question her circumstances, you are a militant wacko and out to sabatoge women. It really feels like you CAN'T say straight forward facts, like Grease said, because it can *possibly* be construed as negative and then you are slammed for being insensitive. Honestly...is it asking to much of women to develope a little tougher skin?

The reality is that when you talk about online forums such as these, when a woman asks the "my doc says my baby is too big" question, when someone chimes in with "Well mine really WAS too big so you should get the section!" then your doomed....you can't say anything to that because you're a bitch for critisizing their birth choice. There *has* to be a way to approach the situation as a Monday Morning Quarterback. And, I've said it a few times, there really does have to come a point where some women own that their defensiveness is theirs alone and not the product of what anyone else said.

This discussion is discouraging for me. I feel like it's a brick wall. Theres nothing you can do because no matter what, you'll offend someone and thats a no-no. We women can't be honest with one another because feelings get hurt and then that negates what was said. I can't go protest C Sec rates because it means I am questioning the choices of someone I don't even know. I can't tell a mom on a board that she should try for non med birth because someone who HAD it will chime in and say it's perfectly fine and if I say anything about THAT, I'm insensitive, arrogant, and judging.

I keep asking and I think I'm getting my answer....you can't win. You can't speak out unless it's in private. You can't be an advocate because it automatically makes you arrogant, judgemental, mean, a bitch, etc etc etc.

I don't know how to be an advocate and still make everyone else happy and I'm begining to think it's just impossible. I don't know how to make other moms understand I respect them as mothers, but I don't respect the medical establishment, because no matter what you say, people still say "Well! Your words were very judging and who are you to judge!".

I just don't know.


----------



## mamallama (Nov 22, 2001)

I want to thank you all for your honesty and your willingness to participate in this discussion. As a birth professional (I'm a doula), I have found that the psychological and emotional aspects of giving birth--and we all shout about their importance--are completely lacking in the available reference materials, and even in the support groups/discussions I have participated in. I want to support women--whether that means supplying information, or just holding their hand. It is crucial that I know what is most appropriate at any given time.

So, thank you, Kim and Leah and Captain Optimism and amarasmom and cortsmommy, and those who have posted previously. Thank you for putting your stories and your perspectives out there.


----------



## captain optimism (Jan 2, 2003)

Quote:

_Originally posted by anothermama_
*
Humans are humans and we aren't that complicated...we all kind of work the same.*
No. I don't agree with this. I think humans are very complicated and we don't all work the same. there are generalizable principles about birth and lactation, but there are also lots of documented exceptions. This is why I think it makes sense to put out what you know to be generally true, as that. That can really help women reading what you write.

This is why reading people's birth stories (including c/s stories) is rubbing you the wrong way. People aren't looking for you to validate their c-sections, they are looking for you to validate the individuality of their experience. I think a lot of women would like to know that their bodies were actually capable of giving birth, but not with the implication that they were foolish or immature for not having known that.

Quote:

*I used to be on a really mainstream board and there were a couple women who were ALWAYS the first to reply to birth questions with all sorts of "Dont let the wackos talk you into naturl birth! Intervention birth is FINE!!! See? My baby turned out just fine so it must be ok!!". They'd also admit to NOT reading up, to blindly listening to their docs, etc etc etc.*
This is not that place, however. Most people here are committed to learning as much as they can.

Quote:

*
Also, I think the IMPORTANT number to keep in mind is that over 90% of women in the US (93-97 depending on the studies you read) can give birth normally. No interventions. So when you start talking about who NEEDS interventions, it's not especially likely you are talking to them online. It's POSSIBLE and I'm sure there are a few....it's just not as common as you'd think reading various online forums.*

What are you going to do, diagnose who really needed one and who didn't, through the computer? And when you have made your diagnosis, and you tell the woman that she was wrong and didn't need a c/s, what's she going to do about that? Thank you? Or is she going to tell you the specifics of her experience--which you will naturally find defensive.

Sometimes people really didn't need a c-section and knowing that can help them avoid another. Sometimes letting people know about birthing classes, yoga, whatever can help them avoid an epidural. But it seems kind of cruddy to me to to say, "Well, I had a baby once myself and that's how I know more than your midwife/doctor/doula."

Quote:

*I see it as a very hard thing to do, advocate for better births.....because too many women are too defensive. And we have this notion that if you don't just smile and nod then you aren't being supportive. And if you bring up ANYTHING negative or you bring up ANYTHING that *may* make a mom question her circumstances, you are a militant wacko and out to sabatoge women. It really feels like you CAN'T say straight forward facts, like Grease said, because it can *possibly* be construed as negative and then you are slammed for being insensitive. Honestly...is it asking to much of women to develope a little tougher skin?
*
Yes, of course it's asking too much. For goshsakes, you are talking about the birth of people's beloved children here.

Is the reason that women don't have better births that they are defensive? Or is the reason that they don't have good support at the moment that they go into labor? Or good information during their pregnancies? It just seems like you aren't going to accomplish much by "questioning her parenting" by accusing a woman of making a dumb mistake during her labor. What is she going to do about it? Feel bad, I guess. Maybe for some women it's empowering to feel bad.

The time to advocate for better births is before and during pregnancy and labor, not after. Advocate for VBAC by giving information. Advocate for no c-section by telling people which interventions can lead to them--_before_ they are in the L and D room!


----------



## Greaseball (Feb 1, 2002)

Someone mentioned about not saying things after the birth when there was nothing that could be done - I think that's a good point. I remember once when I first started posting on MDC a woman was talking about her c/s and I posted something like "I had the same thing happen and didn't have a c/s" and what I was trying to say was "Doctors don't know everything" but I could see how she thought I was bragging or saying she did it all wrong.

A friend was telling me she had two c/s because of herpes and then she "didn't have enough milk" and of course then it was too late to tell her that she had been lied to the whole time, but if she were pg again I would tell her about vbac and bfing.


----------



## LiamnEmma (Nov 20, 2001)

Quote:

The vast majority of the time when *I* have a knee jerk reaction like that, that is THAT strong and THAT emotionally charged...it's usually because the thing I'm being accused of has some ring of truth. Humans are humans and we aren't that complicated...we all kind of work the same.
Well, in some respects yes, but also, some people knee jerk because they have not yet worked out the emotionality of an event. An example. Years ago I was with some friends and they were skeet-shooting. We were at an area that was generally used for shooting by people in the area (went to college in a rural area), but was not an official range. While we were there, a man was shot by a young boy through the heart three or more times. I no longer remember the number of times. I talked and talked and talked that through with people. The first several times I got winded, cried, a little hysterical, actually. As I worked through the emotions, and habituated to it a little, the hysteria and emotional part of the response died down. I very rarely discuss it now--it's been more than a decade, so I sometimes get a little freaked when I find myself with reason to bring it up, but the point is, that when trauma is new, or has not been worked through, the emotionality of it is very very high, and defensive, knee-jerk reactions, etc., arise. I do agree that sometimes it is because of the ring of truth, but not in every case, and that's the thing anothermama, there will always be exceptions. Everything is not black and white. There are shades and even colors.

Quote:

I don't know how to be an advocate and still make everyone else happy and I'm begining to think it's just impossible
Well, you can't. But the person you're supposed to be angering is not the one who had the csection. It's the one who is not allowing women to make decisions during birth, not encouraging them to learn beforehand, etc.

Here's a miriam-webster dictionary definition of advocate;

*one that pleads the cause of another; specifically : one that pleads the cause of another before a tribunal or judicial court*

So, following that, in theory you'd be pleading the case of the csectioned woman, not dragging her to the trough to drink from the knowledge. Really, especially on this board, we cbirth mamas know those statistics. You're preaching to the choir here. I don't think anyone refutes the statistics, people are refuting the way the message is being delivered, not the message. That's very different. kwim?

I'm so sorry you find this discouraging. I, for one, find it encouraging. I think all discourse, especially that which maintains civility and listening, educates all involved. I think there have been lots of great posts in this thread and that most of us here are going away thinking, hmmmm, and yeah, and ohIsee. And that's important. It means that the activists on all sides are making gains.

I still say that the way to get the message out to people is to do it in large groups. It takes the personal out of it. Say you speak at a symposium, or to a high school classroom, a college class on sexuality or human development. They welcome guest speakers generally. And that's how you get the message out and get people thinking. It's hard to get the abrasive out of a message. I don't think anyone expects coddling. But I do think that people expect advice when they ask for it, and sometimes it's okay to just give a noncommittal, "Man that sucks." or a "mmm, sounds hard." when they aren't asking for advice, just empathy. We all have to pick and choose our times to deliver messages. I don't think it's too much to ask that people develop thicker skin. I also don't think it's too much to ask that people exhibit a little discretion. It's give and take, you know?









edited for typos


----------



## miserena (Dec 16, 2003)

I'm not a birth activist, but I am interested in the subject because I had the unfortunate experience of discovering that even talking about my c/s birth experience could negatively influence another's woman's birth. My interest in exploring how the personal can be political as regards birth led me to your message board.

When I offered the details of my daughter's birth to a friend who was TTC at the time, I had no idea of how deeply my story would effect that friend. I lost touch with her for nearly a year (we lived several states away from each other at the time). In that time, she conceived and gave birth to her daughter via c/s. Turns out that her OB gave her the option of an induction or a c/s at 37 weeks because an ultrasound suggested macrosomia (!). She took the option of c/s because, in her words, "I didn't want to go through the hell that you did." I felt awful in realizing that I helped cause what was probably an unnecessary c/s. I felt great guilt in hearing that when she saw her 9lb15oz daughter for the first time she cried not tears of joy but of relief in thinking that she'd been spared the "agony" of a vaginal birth of a "big" baby. She didn't even have the chance to experience labor.

I don't know what to say to this friend regarding the dubious circumstances of her c/s and the probable influence my story uttered months earlier to her had on her birth. Had she called me for my opinion before the c/s, I probably would have urged her to refuse a c/s w/o a trial of labor and even consider switching doctors.

When I confided in her about my c/s birth, I didn't anticipate that my story would influence her so negatively. She is a well-educated public health professional. On the personal side, she was a vaginally-born footling breech, her mother's first child. Her mother-in-law vaginally birthed two 10 lb. babies (not a bio relation, but still living proof of the possibility of avoiding a c/s for a "big" baby). Why oh why did she latch on to my negative birth experience?

I am not ashamed or regretful of my c/s, even though my c/s may have ultimately been unnecessary. However, considering the role I inadvertently played in my friend's elective c/s at 37 weeks, I am wary of sharing my birth story, especially with nulliparous women. I may as well relate the basics in this forum, for I strongly doubt that in doing so I'd influence anyone here toward an unnecessary c/s.

I don't remember all the details of my daughter's birth, due in part to unresolved "issues" about choices I made once I reached the hospital. While I'm at peace with the c/s itself, I do have some post-traumatic stress about my experience in the hospital prior to the c/s. BTW, I decided against a home birth because of odd medical issues which could have had an unpredictable impact on the pushing stage (had I ever reached that point). One of my ears is in poor condition due to previous tumors and resulting surgeries, bad enough that had I built up excessive pressure while pushing, I could have sustained disabling vertigo or permanent one-sided facial paralysis due to a perilymph fistula and a damaged facial nerve, respectively. My ear conditions didn't contraindicate a vaginal delivery, but they made pushing inadvisable. I know that it is possible to have a vaginal birth with little or no pushing; my doula had a past client who did so because of a past severe head injury. I felt that a hospital birth would be safer for my daughter in the event that I needed the assistance of the dreaded forceps or vacuum during her birth (and if my OB had suggested their use purely out of impatience, I would have refused).

Onto the birth . . . after several days of prodromal labor, I went to L&D after a few hours of regular contractions which were four minutes apart lasting 45-60 seconds each. I had hoped to delay my arrival at the hospital until I was close to transition, but I had also developed continuous, seemingly bone-deep pain in my pelvis, a pain which was worse than my contractions at their peak. When I was examined at the hospital, I was demoralized to discover that I was only 3 cm, 50% effaced, and that my daughter had turned posterior (she'd been anterior at my OB appt two days before). My OB suggested that I walk for an hour to see if I made any progress. I didn't progress at all during that hour, but my daughter shifted around enough that I was relieved of the continuous pelvic pain, a pain which would appear again twice before her birth. My contractions became irregular, so my OB suggested that I could go home or stay to augment my labor w/pitocin. I left the hospital and tried some of my doula's suggestions for turning a posterior baby. Pelvic rocking on all fours did turn my daughter, but only temporarily. For the next three days, I had contractions that seemed like active labor but stalled a few times for 2-3 hours.

On the third day away from the hospital, the continuous pelvic pain returned, worse than the last time. I returned to the hospital to discover that I was 4 cm, 50% effaced. I accepted an offer of "therapeutic rest" with morphine. When I awoke, I was 5-6 cm, 80%, free again of the odd pelvic pain. I had 8 positive hours of coping med-free with my doula's help. My fondest memory of labor was walking on the sidewalk outside the hospital and having my doula proudly announce that I was 6 centimeters and coping like a champion to anyone who inquired.

When we returned to my room for periodic fetal monitoring, the odd, constant pelvic pain returned. Between that pain and discovering that I hadn't progressed at all during the previous 8 hours, I lost all of my resolve. In short order, I consented to AROM, which revealed mec, and fentanyl. I regret the fentanyl because it did nothing for me aside from frying my judgment and memory. I next remember consenting to an epidural because pitocin felt like hell on earth to me (I don't remember consenting to the pitocin, but I assume that I must have because my doula insisted that the medical staff explain all procedures and receive clear consent from me). The anethesiologist quite possibly had the world's worst bedside manner, and I won't give examples of what he said because thinking about him still hurts. I don't know what went wrong, but I had a massive back spasm while he was administering it. Thank God I couldn't feel the pain of the spasm for long; just feeling how my back muscles were undulating out of control was scary enough.

The epidural relieved the pain, but I felt intense pressure in my pelvis. Ten hours after AROM, I learned that I had progressed to 7cm, 100%, where I stayed for five more hours. After an intrauterine pressure catheter revealed my contractions were actually very weak despite the abdominal monitor's readings that indicated strong contractions (go figure), my OB offered a c/s, which I accepted in desperation since my epidural had worn off a couple hours beforehand. All in all, I went from 4cm on a Friday at 8 pm to 7cm at 2 am on Sunday (when I opted for the c/s).

Dr. D*ck, the epidural man, conveniently couldn't be bothered to top off my epidural until he heard I was getting a c/s. The c/s itself wasn't troublesome to me, probably because I had the comfort of my doula's presence. I had also had previous ear surgeries (including 2 mastoidectomies) which seemed much harder to handle than a c/s.

What a great relief and joy it was to meet my daughter. I was impressed with her alertness and strength. One of the pictures my doula took in OR shows that Eileen's eyes were open in a seemingly purposeful gaze before even all of her head was delivered out of the incision in my uterus (she was definitely sunny side up). My doula claims that Eileen was smiling and could hold up her head w/o assistance right after birth. Eileen didn't go into distress during labor. AROM had shown that she'd passed mec, but that may have happened because I was overdue(41w1d).

I don't remember what station she reached before the c/s, but I do recall that she was -2 when I entered the hospital 30 or so hours before her birth. Upon birth her head showed no molding and her ped remarked that her skull was ossified as if she were quite postmature but otherwise didn't seem "overbaked" (again, go figure). Her measurements were 7lb5oz, 19", head circumference 14.7 in.

Sorry I wrote a "book" about my c/s . . . that was actually the first time I attempted to write Eileen's birth story.

What do you think caused my c/s? I'm open to hearing opinions, as long as you refrain from calling me selfish, foolish, or idiotic.

Michelle
mama to Eileen, 11/04/01, unplanned c/s


----------



## ladylee (Nov 20, 2001)

"Honestly...is it asking to much of women to develope a little tougher skin? "-anothermama

Oh my. I believe it is asking too much. Why should anyone have to "develop a little tougher skin" about the experience in their lives that probably puts them in their most vulnerable state? What is this, boot camp?


----------



## Peppermint (Feb 12, 2003)

I wanted to say that OTF, LiamnEmma, and esp Captain Optimism have really said so much of what I wanted to say, and said it so very well, so to those with questions like the OP, read and re-read these people's responses- they HAVE answered your question so clearly- if you really want the answer- it is there









A few random thoughts as I nak with my 3rd c-birth baby
















First, my problems with some of the people attempting to "educate" all of us c-birth mamas. I take high offense to the idea being repeated by one poster here (can't remember the name right now) that b/c we defend our c-births we must have some inkling that it was unnecessary, that's simple crap IMO







. I always hate to hear the, "If it upsets you so much, maybe you should look at WHY it upsets you". Maybe it upsets us b/c of any of the reasons PPs have mentioned, and not b/c we have it somewhere inside that we made the wrong choice. OK, had to get that off my chest









Now, I also am VERY bothered by people who feel that they know more about an individual mama's body than she and her OB or midwife do. I find it a very bad idea for any medical professional especially, to give online advice, beyond- "this may be the case, and here is how you can look into it", as opposed to "you could've done it this way", as, if you have not examined the woman's body- you do not know, and it is dangerous and I think completely unprofessional to tell a woman you have not seen IRL how they could do things. Telling them how to look around for another practitioner or questions to ask their own practitioner, etc. are great though.

I think in general, the way to educate while remaining respectful is not to expect mamas to "get a thicker skin"- you will truly win very few people that way, and also you will not manage to educate many- people have to feel respected to listen to anything you say. But, to truly seek out people who can be helped. People who can be helped are- pregnant women, women who are TTC, and women who ASK how they can do things differently. It is not at all helpful to tell a woman who has just delivered how she was duped by her OB or midwife.

If I saw a woman post about a birth which clearly could've gone very differently (from my POV







)- I might post or PM and ask her if she is looking for any information on how things could be done differently in the future. I would be careful to realize that I do not know all that she does about her birth, how she feels about it, how her body actually is, etc. I think asking a woman if she wants my opinion, or would like to hear about similar circumstances handled differently, would be very respectful.

I also think the main thing is not to assume that you necessarily are smarter, more educated about birth, etc. than the woman you are hearing from, reading from. It is always a bad thing, IMO to assume that other people are uneducated and that they "need" someone such as yourself to "set them straight".

I also think that while the c-birth rate in this country is unecessarily high, it is not productive to assume that all OBs are these horrible people who are out to get women, who don't care about their patients as much as getting to their golf game, who are knife happy, who know nothing about natural birth (my OB was/is a midwife as well), etc. I think a healthy suspision of health care providers (of all kinds) is a good thing, but an outright distrust of all in a certain group (OBs in this case)- is silly, IMO.

I would just like to say as a disclaimer that I am a well-educated about birth woman who has had 3 necessary c-births with 2 seperate OBs who are very loving, caring, knowledgeable practitioners with very low c-birth rates- I am educated enough to have chosen my OBs very carefully









I think if you really want to be a natural birth advocate- you can do so with respect for the women you are speaking to, you have asked how to do that, and have gotten great answers, esp from CaptainOptimism














so, ignore what I said, and read hers again:LOL she said it all so very well


----------



## Peppermint (Feb 12, 2003)

ladylee







glad to see you here









ITA with what you said


----------



## LiamnEmma (Nov 20, 2001)

T Hi Lee! Nice to see you!

Leah


----------



## anothermama (Nov 11, 2003)

As I went to sleep last night thinking of this thread, I was in tears.

The answers are spelled out.

You can't be honest because people willl WRONGFULLY accuse you of being judgemental, knowing more about their body than their OB, etc etc.

You can't make statements about the medical establishment because no matter matter how much you tell women its NOT about them, it seems that most high intervention women WONT LISTEN and will still accuse you of trying to judge them personally.

You cant win. C Secs and high intervention births are bound to go up. And anyone who sees the benefit of having natural birth needs to shut up. Anyone who educates themselves needs to shut up because they don't have the holy letters behind their name.

I went to sleep last night feeling like everything I learned in the past 5 years is for nothing. All the work I've done is worthless. It's all pretty meaningless because so many women have so many interventions, they are the majority, I'm the minority. And in America, majority rules (well, except in presidential elections I guess).

I'm squashed and I give up. What a waste.


----------



## captain optimism (Jan 2, 2003)

Quote:

_Originally posted by anothermama_
*As I went to sleep last night thinking of this thread, I was in tears.

The answers are spelled out.

You can't be honest because people willl WRONGFULLY accuse you of being judgemental, knowing more about their body than their OB, etc etc.

You can't make statements about the medical establishment because no matter matter how much you tell women its NOT about them, it seems that most high intervention women WONT LISTEN and will still accuse you of trying to judge them personally.

You cant win. C Secs and high intervention births are bound to go up. And anyone who sees the benefit of having natural birth needs to shut up. Anyone who educates themselves needs to shut up because they don't have the holy letters behind their name.

I went to sleep last night feeling like everything I learned in the past 5 years is for nothing. All the work I've done is worthless. It's all pretty meaningless because so many women have so many interventions, they are the majority, I'm the minority. And in America, majority rules (well, except in presidential elections I guess).

I'm squashed and I give up. What a waste.*
GEEZ LOUISE. I've been responding to your posts as thoughtfully as I can and I am getting the impression that you don't understand me! Please dry your eyes and don't throw in the towel.

I have another idea about how to explain what I mean to you.

Okay, I'm at work. There are two women at work who are pregnant, and several who have had babies. Of the women who have had babies, two had c-sections--one with a breech baby, she then "couldn't nurse" (said her doc) and she had a hellish recovery. She's in her early 30s might have another baby. The other one is past childbearing age and it sounded to me like her c/sections were unnecessary, but I haven't drawn her out about it. (I know who had a c/s because people tell you everything about their births when you are pregnant.







: )

One of the pregnant women told me she didn't really like her OB. she also doesn't like the u/s tech in the OB's office. She has had trouble eating during this pregnancy, she hasn't put on much weight, and is a little afraid of having no pain meds during her pregnancy. I work with her closely and she ranks me in the organization. I like her a lot.

Now, go to work, Anothermama. (Or anyone else who likes the exercise.) To whom should I say what? How do I talk, IRL, with mamas who are not committed to natural childbirth (as the folks on here *are*, even those who had high-intervention births) and help them not to have unnecessary interventions? I can talk to people at length on the lunch hour, and I can also give them books or articles. How would you educate them?


----------



## Peppermint (Feb 12, 2003)

I am sorry that you feel that way anothermama.









I hope other birth advocates reading this thread have been able to take the advice given on how to advocate/educate without offending, I think it is pretty clear that it CAN be done, if one wants to learn how







I can think of one mama from another board who is a great example of how to do this, but she doesn't post here









So, has the OP or anyone else gotten useful advice from this thread, or was it a complete waste?


----------



## cottonwood (Nov 20, 2001)

Quote:

OnTheFence wrote: "I dont think much of a woman who puts her life and child at risk to try to prove something to the rest of the world, medical establishment or even herself. I have read time and time again about fear based medicine, well there is a flip side to that as well and its here running rampant through these forums and in other circles."

Blueviolet wrote: "What exactly is your point? Are you trying to give the birth "extremists" a taste of their own medicine? Because this is a pretty harsh, judgemental, hurtful (and IMO off-the-wall) statement -- wasn't the making of such statements exactly what you were railing against in the first place?"

OnTheFence wrote: "My point is that this is what often goes on that people are unaware of. Pam put something out there to be discussed and I am pointing out how *I* see and feel about things I have read and experienced on this forum. I dont believe its off the wall at all -- not from my seat at least. My statement may be harsh and I am sorry if it offends but in my belief it is truth."
So you can make assumptions (that women on this board put themselves and their babies at risk, and that they do so to prove something to the rest of the world, medical establishment or themselves -- this is a HUGE assumption) and judgements (that you don't think much of women who do that.) Yet you don't like it when others make assumptions and personal judgements about things that _you_ do.

This is awfully hypocritical.

Plus, it appears that you are the only one we can be sure is doing the judging here, because you admit to it. ("I don't think much of all the women on here who...") I (and other birth activists on the board) often say things like, "your complications were likely the result of unnecessary interventions." I have _never_ said "I don't think much of women who put their babies and themselves at risk by agreeing to unnecessary medical intervention," and I don't recall anyone else here doing so either. (Not that it hasn't happened, but it's hardly the norm.) For me, and for all the birth activists I know, the mother who has a traumatic birth is regarded as a _victim_ and the intention is to _help_ her, by offering information that may prevent her further suffering. So your judgement of birth activists of my ilk as judgemental can only be inferred, assumed.

Why not give us the benefit of the doubt? Why assume that we are out to get you? And how can you complain about that when you yourself are offering up judgements of others you don't agree with?


----------



## Peppermint (Feb 12, 2003)

I'm not the poster who wrote that quote, but I would like to say, that I think she is making a point about how she feels, but I can say, I have never heard her say that to someone in that position, YK? I think we are all very judgemental (Ok, I am, I'll admit to that), the key is one's ability to keep the judgements to themselves, and not force them upon people who never asked our opinion.

I have (recently even) had posters on here tell me that my c-sections were not necessary, I have had people question my judgement to have my c-sections, I have had people who know little to nothing about me, say that chances are my last c-birth was not necessary at all, which is completely untrue, if they bothered to ask for the whole story- or even admit that the person who opened me up *might* just have a better idea of what my insides look like. That I might have an OB who really does care about what is best for me and my babies, and who may actually be right that c-birth was best for us.

Yes, we are all somewhat judegemental, but we should all try to keep our judgements to ourselves, and be loving and supportive of other mamas and the choices they make.

If we want to "educate" there are good ways to do it, which have been mentioned by many on this thread.

I guess it all comes down to whether you really want to change people's thinking, or if you want to be right. If you want to change thinking, then you have to listen to what people who have been on the "other side" are telling you about how to do it. I know this from being a pro-life activist (which I know is OT), but I have learned a lot more from how to discuss the issue, by talking kindly to women who have been there, and asking them what is effective. Isn't effectiveness what matters in education? I reiterate- if people don't think you respect them, they will not be listening to what you have to say.


----------



## cottonwood (Nov 20, 2001)

Patty wrote: "So, has the OP or anyone else gotten useful advice from this thread, or was it a complete waste?"

Not for me. I have not participated much in this thread, but I have read just about everything.

What I have come out of this with is an understanding of the pain that people sometimes feel when their birth choices are commented on. The whole point of me being a birth activist is to _prevent_ suffering, so if I have inadvertently caused suffering with my words, I am just working against my own goal.

I think for me the solution involves just asking first. To say, "I am intensely interested in birth issues and in empowering women to have satisfying, healing, healthy birth experiences. Are you interested in feedback on your own situation? If so, please understand that when I say you could have done something differently that this does _not_ mean that I am blaming you." Etc. Of course, this works well for one-on-one encounters; it would get a bit cumbersome on a message forum. Like Pam said, do we have to offer a disclaimer every time? Is there any way around that? Maybe not.

But certainly I think it would be fair for those who are in fear of feeling judged to take on some of the responsibility of keeping the discourse feeling mutually respecting, simply by stating that they do not want their post to be dissected and analyzed, that they want only support. Or whatever. To just be clear about that.


----------



## mamallama (Nov 22, 2001)

Quote:

_Originally posted by jess7396_
*

So, has the OP or anyone else gotten useful advice from this thread, or was it a complete waste?*
What does this mean? Maybe I'm wrong, but it sounds to me like you are asking people to gang up on anothermama.

She is passionate about something she believes in. By the fact that she has continued to thoughtfully participate in this discussion, I think we can assume that she is trying to become the most sensitive and effective activist that she can be.

This is a discussion about the generalities of activism. Whether you agree with her or not, her words here are not out of line.

I have found this discussion very valuable, and I would hate to see it derailed by an unwarranted personal attack.


----------



## Peppermint (Feb 12, 2003)

That is far from a personal attack. I don't see how asking if anyone got anything useful from this discussion is somehow asking people to gang up on anothermama







: She simply made it clear that she has gotten nothing but bad feeling from this thread, and I want to know if anyone got anything useful, b/c I believe that there were a lot of very useful to the OP things said here.

Maybe you should re-look at what she wrote which prompted my question:

Originally posted by anothermama
As I went to sleep last night thinking of this thread, I was in tears.

The answers are spelled out.

You can't be honest because people willl WRONGFULLY accuse you of being judgemental, knowing more about their body than their OB, etc etc.

You can't make statements about the medical establishment because no matter matter how much you tell women its NOT about them, it seems that most high intervention women WONT LISTEN and will still accuse you of trying to judge them personally.

You cant win. C Secs and high intervention births are bound to go up. And anyone who sees the benefit of having natural birth needs to shut up. Anyone who educates themselves needs to shut up because they don't have the holy letters behind their name.

I went to sleep last night feeling like everything I learned in the past 5 years is for nothing. All the work I've done is worthless. It's all pretty meaningless because so many women have so many interventions, they are the majority, I'm the minority. And in America, majority rules (well, except in presidential elections I guess).

I'm squashed and I give up. What a waste.
-----------------------------------------------------------------------------
You see- it sounds like she has not gotten anything good from this thread, but I hope others have, that is all I want to know- Blueviolet says she did get useful things, and what she wrote was beautiful, IMO, about how she could better talk to women who have been through a high-intervention or c-birth. I do not think that it is only applicable IRL, I don't think it would be too hard to do online. I think sometimes you do have to be wordy(to be poilite and to be heard)- and maybe have some kind of disclaimer every time you intend to criticize someone's birth experience, even if the criticism is meant to be aimed at the mismanagement of the Dr, etc. I also agree with Blueviolet that maybe we c-birth (or other high intervention) mamas should disclaim that we do not want people's opinions on our births when we do not, I think that would help







and is a useful suggestion.

I think the OP was a good question, and if Natural Birth advocates want to know how to better do what they do, there are lots of useful suggestions here- it's all about taking the time to be respectful of each individual woman and her birth, and educating in an effective way, which anything that offends is not effective, IMO.


----------



## pamamidwife (May 7, 2003)

I hope that the dialogue continues - there are so many wise voices on this thread.

I have learned alot. I know that I cannot control how any one person will respond to me and my words (I should not censor myself, however, to meet the expectation of how I fear someone will respond).

BUT, what I can do is this: Before I post anything, I can ask myself: what is my intention? is someone asking for my advice? are they needing support? encouragement? And, if I cannot think of anything helpful to say that is not sincere, I should not respond at all.

I have felt the same way as anothermama many times - overwhelmed with complete frustration. After talking to an OB that is an acquaintance (we end up at the same parties together), I know that it's not always the OBs that are to blame. For sure, there are great OBs, there are horrible midwives. It's human nature. I cried the night he told me that his partners were coming down on him for having a low c-section rate (cheaper malpractice premiums with higher c-section rates) and how they were routinely inducing women at 39 weeks. This is not because his partners are horrible people - to them, a c-section is not a big deal. I've heard many wives of OBs and female OBs themselves have been electively choosing C-sections for years to preserve "pelvic floor integrity". It's a matter of different belief systems altogether.

And, granted, it's easy to be a midwife when I have no one to answer to except my clients and no malpractice insurance premiums eating up all my salary.

I have a huge amount of compassion for those that practice in the hospital. I stopped being angry long ago - it was eating me up. Instead, I pray for them - that they may feel protected and not react out of fear, but with wisdom. I pray for the ones who are pioneering and trying to do the right thing, against all the political pressure. They are out there, I know this.

The one thing that keeps me sane in this world is focusing on what I can do - and how I live my life. I try to re-examine my motives all the time....am I acting for an ego reason? Am I doing this for the good of everyone involved? Am I listening to my intuition? Am I respecting a woman's right to choose?

It will continue to be a struggle, for sure.


----------



## Peppermint (Feb 12, 2003)

Well said pamamidwife, I am glad you are getting something useful from this discussion









I think you are right, that we all need to think before we post more often. I visit a Religious AP board where you pray before you enter, and part of the prayer is about protecting our posts from ill-intent, etc.

Just wanted to comment on that, carry on.....


----------



## KKmama (Dec 6, 2001)

I'll speak for myself (answering the OP's original question). I educated myself before my ds' birth, and I took really great care of myself. I did a ton of prenatal yoga, and I took 2 different natural childbirth classes. My ds was 2 1/2 wks late and in a poor position. I did everything under the sun (go ahead, ask me--I did it) to try to shift his position and/or get labor started. Eventually, things took a turn for the worse--he was really tangled in his cord, and I frankly don't believe there was enough cord length left for him to get out alive--I feel this way because it seems that he *did* start to move down and cut off his own oxygen. So I had an emergency cesarean, as recommended by my CNM (who has done thousands of births and has a very low C %age). I was fine with it--I tried everything I could, and in the end, ds was okay.

However, since then, I've had a number of people look down on me, pity me, or tell me that my cesarean wasn't necessary. Some have been IRL, some have been here or elsewhere online. Even though, yes, I was fine with the C, and I'd do it again in the same situation, of course I would have preferred a vaginal birth, and of course the recovery from surgery wasn't fun. But I'm shocked, saddened, and angry at the approach some have taken with me. And of course, it makes me defensive and careful even when I run into someone who is truly curious about what happened in my birth, who is willing to listen and be courteous. I'll be really honest--it pisses me off that *I* know that my C was needed, and *I* am fine with it, but too frequently, I'm simply put in a position of defending myself to people who don't know better and just aren't being very *nice*. Why does it occur to these people to criticize me? It sure isn't the way *my* mama brought me up. (And I never point out that they are rarely "perfect" AP mamas, either...)

Something else to consider... there are a lot of women who are between a rock and a hard place. Midwives (both CNM and other) generally have lower rates of cesareans and other interventions, but many women simply do not have access to them, because there are none in their geographical area and/or there are none covered by their insurance and they can't afford to pay for a birth out of pocket (a very real limitation). So these women have to do the best they can with the existing medical system (mainly OBs and hospitals). You can do a *lot* of pushing within the medical model, but you can only go so far, and you generally only have so much choice. Maybe instead of targeting the women giving birth, birth activists should take aim at the doctors and hospitals who do the majority of the births? I really, really mean this.

And I will add, as gently as I can, that yes, some of you could write with a little more sensitivity and compassion when you are posting at MDC about VBAC or cesarean, especially if you haven't been there yourselves. Just think about it--it might be hard for you to *truly* understand unless you've been there yourselves. It's not theoretical or statistical or whatever to those of us who have been cut--you're talking about *our* birth stories and our lives. Some of us would prefer to advocate for ourselves! I also don't think it's fair to compare V vs. C and formula vs. breastfeeding, either, because frankly, most women have a lot more control over feeding method than they do over how their births will proceed.

I really appreciated LiamnEmma's first post...CaptainOptimism's posts... Ladylee, and Jess7396... also OnTheFence's posts... and yeah, I'd appreciate it if some of the people already posting here would perhaps write a little more sensitively... if people are being defensive about your words, perhaps it's a signal to think about how you're saying what you're saying.

And I have to say that I'm posting because I'm frustrated... I'm still not sure people are getting it. Be respectful. We're not talking about numbers here... we're talking about real live women in our midst (like me!).


----------



## KKmama (Dec 6, 2001)

deleting accidental double post


----------



## ladylee (Nov 20, 2001)

if people are being defensive about your words, perhaps it's a signal to think about how you're saying what you're saying.

Well put, KKMama.

I appreciate this discussion-it's a learning opportunity for everyone.

If I may-when I was training in Reiki many things stuck in my mind that I think are applicable to this situation:

Never feel pity for anyone, nor assume they need you to "educate" or "enlighten" them.

If they do need you to enlighten them, they will find you.

I think the process of self-monitoring for ego-based intentions that pamamidwife mentioned is right on! You usually can't go wrong with that, and if you do, someone will surely point it out to you! :LOL

Leah & jess-really good to see & hear you both, too!









And pamamidwife-your senior title is my very favorite one!


----------



## Peppermint (Feb 12, 2003)

Ladylee, and KKmama-

You two said what I have been thinking so much better than I have been saying it


----------



## mamallama (Nov 22, 2001)

Thank you for the clarification, jess. I agree that anothermama's most recent post reflects frustration, however, through the several previous pages she has clearly "heard" many important points. Anothermama's passion shines through very clearly; I hope she continues to follow this thread.


----------



## OnTheFence (Feb 15, 2003)

Quote:

_Originally posted by blueviolet_
*So you can make assumptions (that women on this board put themselves and their babies at risk, and that they do so to prove something to the rest of the world, medical establishment or themselves -- this is a HUGE assumption) and judgements (that you don't think much of women who do that.) Yet you don't like it when others make assumptions and personal judgements about things that you do.

This is awfully hypocritical.

*
I didnt make an assumption about anyone in this forum. You are jumping the gun and taking what I said WAY out of context. I actually know women in my day to day life who have taken unnecessary risks to have natural vaginal childbirth, at home and the hospital. Without going into much detail, their actions were negligent. I in fact advocate for natural childbirth, and have been since before I had children. I am not against homebirth or the use of midwives at all. I think you are the one assuming.


----------



## citizenfong (Dec 24, 2002)

I've been following this thread and I have something to add that might be constructive.

First, let me say that I think there have been some excellent points made from several perspectives. And I believe the thread in general has been instructive.

One thing that I have had trouble with is that there has been referrence to lots of really insensitive remarks made by "birth activists", and that is not something I've seen personally. I have, I guess, missed those threads somehow. So I am working from second-hand knowledge that there HAVE been offensive posts, without first-hand knowledge of the nature of those kinds of posts. There! That's my disclaimer!









Now:
I would like to put forth that we examine the difference between responsibility and blame. This is something I think we, as a culture, have a hard time distinguishing. I think that there is a common perception that if you are responsible for something and it does not go well on whatever level, then you are deserving of blame. And I think that people are more likely to assign blame on themselves than anyone else is likely to.

Responsibility is something we grow into. None of us had parenting (or substitute any other responsibility) down cold when we had our first tiny, dependant infant gazing up at us for the first time. Therefore we will all look back at choices we made and determine that there are things we would have done differently, had we had the resources (knowledge, different external circumstances, whatever).

Okay, I'm sitting here typing and erasing. I want to be as gentle as I can but I can't figure out any other way to say this. So please take it as gently as it is intended.

What I have seen is that many people hear facts or acedemic discussion in a post and take it to mean that the poster is attacking them personally. I've been very surprised at times to read what I though was a DISCUSSION about birth issues and suddenly 1 or 2 people have thier feelings hurt, when I didn't see anything directed at them personally.

Here's an example that I just made up, didn't actually read this. Someone posts something like, "epidurals are known to slow down labor and that can be the start of the cascade effect." Then I see a response on the order of, "well I HAD to have an epidural, because of x, y, and z. And not only that but it sped my labor up" And I think, well that person is obviously offended now. But no one was invalidating their personal experience, and no one said that it always works that way, and no one is denying that she may well HAVE had to have that epidural for whatever reason. So why does she now feel blamed or judged? And even at times when I have seen someone post there were other options, etc. I've yet to see it done with blame or judgment (not saying at all that it hasn't happen, just don't think it's the norm). But I've seen people take offense nontheless several times.

So I guess what I am saying is that just because someone questions a choice you made, ESPECIALLY if they don't even know that they are doing that until you respond, it doesn't mean they are judging you.

If I read OTF's story and it motivates me all the more to try to pass on info that might protect someone else from that kind of torturous birth, do you really think judgment and blame is at the heart of what I say?

Now, granted, it is true that any of us to try to be gentle in what we say and how we say it. And I think it is great to remember that none of us is a statistic. It can be hard to identify with each individual horror story after a while, because, personally, I've read SO many of them in my research. It's like when I took a class on Holocaust literature in college. Between the reading and the films and the instructor who was a survivor, there came a point when I can remember plugging my ears and averting my eyes during one whole film. It can become to much to hear of and see the same horrors committed again and again and again. So, yes, I think that those of us who want to "spread the word" may get a little distant from the individuals from time to time. But I think it is a shame to mistake that for lack of caring or for blame-finding.

On a side note, just a little personal irk. I can see why Greaseball's comment early on may have been irritating, so I'm going to qualify my remark. I DO think I know more about <childbirth the way nature intended> than most OBs. Certainly more than any OB I've ever met. And it is not because I've given birth (though that is a good place to start...I wonder what the percentage of OBs is that have given birth?). It's because I have done 2 years of research on the topic. You know how we always talk about how OBs don't know much (as a group) about nutrition or breastfeeding, simply because it's not required in their schooling? Well neither is learning about normal, healthy pregnancy or childbirth. I'm not making this up, ask any OB. So if I've done tons of research on a topic that an OB has done maybe no research on, yep, I know more then he/she does. That doesn't mean that I know the individual circumstances of YOUR birth but my comments are based in something other than speculation, conjecture or wishful thinking.

I would like to go back and edit for softening any potentially explosive remarks, but I will have to trust you all to mentally do it for me. I simply cannot put off getting my 2 y.o. his apple turnover any longer!


----------



## Greaseball (Feb 1, 2002)

Quote:

I DO think I know more about <childbirth the way nature intended> than most OBs. Certainly more than any OB I've ever met.
Yes, that's what I meant by "I'm smarter!" And it's not just me - I'm sure any MDC members, or any person who has read a Mothering magazine, knows more about natural childbirth than doctors do.

Doctors are smarter than me in many ways - biology, chemistry, math, surgical technique (you should have seen the ways I tried to reattach bugs' legs and wings in my "bug hospital" when I was 10!) but unfortunately, these areas of expertise are useless in normal birth.


----------



## cottonwood (Nov 20, 2001)

[deleted because part of other person's post it was referring to has been edited out]


----------



## 3_opihi (Jan 10, 2003)

First, I wanted to say Pamamidwife, what a great thread. Maybe its through open discussions like these that we can really start to open a dialogue -- and work through the issues. So thank you, it really means alot to me on a very personal level.

I want to relate to you my own story. I don't mean to generalize for anyone else - I just want to tell you where I was coming from and why I felt the way I did. (I'm sorry if I repeat anything. I haven't had the time to read all the threads).

To make a long story short, and without getting into all the gory details, I had a very long, traumatic first labor. It ended up with a brow presentation, pitocin drip, level 4 episiotimy, and a massive hemmorhage...Although it was the best day of my life, it was also, traumatic, painful,scary...and a whole host of other emotions.

I don't know how to express the level of pain, in words, that I experienced, both physically, and emotionally with this. The closest I can relate it to is a sexual assault. Please, I don't mean to get into a philisophical debate about what sexual assault is. I am just talking about me, and my feelings, and personally I feel that when someone cuts through your genitals without your consent -it is an assault. What I'm trying to get at is that there are a whole host of feelings that go along with this kind of trauma -guilt, fear, anger,denial....

For a long time, I felt I had to defend my story to birth activists. I felt their anger was directed at me, instead of the medical profession. I felt there was no validation of me, the woman, and the pain and raw exposure, helplessness, and sorrow I had experienced as a new mother. Instead I felt like all I got was you should have done this...and you should have done that...I knew what I should have done. So, I lashed out in anger, in defense. I think alot of it was misdirected. For me, lashing out at someone was a chance to *finally* defend myself, and my body. I convinced myself that I had a choice (when I never did). Instead of lashing out at the medical profession, the male model of medical care - I lashed out at those who I *thought* were constantly throwing the experience of my trauma back in my face. I lashed out at those who I felt weren't validating my pain, or listening to it---but instead were lashing back at me with anger of their own, statistics, and articles and such...

I think for both mothers and activists there is a tendency to have misdirected anger. We need to start looking at each other, holding hands and saying "I hear the feelings of anger and powerlessness in your words." For activists, I mean the powerlessness and anger to change the system.

Now, does that mean we have no power. Egads!!! Of course not!! We can change the system! We just need to start listening to each other. Maybe its not so much about education, but COMMUNICATION. I feel like education is so one sided, like its just throwing facts at someone. But communication entails listening and compassion, and in turn, leads to education, and respect.

I don't know...I have so much more to say, but can't find the words. I suppose the point of all this rambling, is what someone else already said : We should question our anger, and where it stems from. Please, I hope no one takes no offense to my post. Like I said, its just my story and my feelings.

(By the way, I did have a beautiful homebirth with my second baby. I even got to catch him myself. A very healing birth.







)


----------



## ladylee (Nov 20, 2001)

Maybe its not so much about education, but COMMUNICATION.

MM-this is such a great point.

No one likes to feel like they're being talked "at." And I completely agree with you about the displaced anger-totally counterproductive.

I'm glad your second birth was a healing experience for you-I felt my second birth was also a tremendously healing process.


----------



## Missgrl (Nov 18, 2001)

_moderator's note: This thread in temporarily closed until some requested editing can be done.~missgrl_


----------



## Missgrl (Nov 18, 2001)

_The thread is now unlocked for further discsussion, and so members are free to complete the requested editing. Please remember the User Conduct
Agreement when posting._


----------



## mamabutterfly (Jun 23, 2002)

[







T Thanks Missgrl... Hooray for MDC mods







]

Just spent an hour I should have been sleeping reading this thread. Thanks to all for your thoughtful words, and to those who shared personal experiences.

Hmmm... what do I want to say? I'm a doula-in-training. Very aware that this greatest place of growth for me in this work will be cultivating non-judgement and learning to support and nurture in a way that is not about me (or even about what I think I know!), but about how I can offer support in another woman's experience. That experience will be uniquely her own. We can talk prenatally, maybe I will have an opportunity if asked to share from my library of books and birth videos. But like all of life the "outcome" will be out of my control, of course. At best I think I will strive to help the woman to have a positive birth memory, whatever the details.

However I do have a lot of information from my studying over 4 years. I do have very strong passions abotu the current state of women's health care and the country's dominant views on birth. It is painful for me to know how inadequate a lot of health care options are. But my judgement is entirely of systems and not of women.

I'm realizing that in the long run I want to become an advocate for changes in maternity care on a societal level (or a local level like increasing access to birth centers). In the mean time, when a friend & I are talking about her previous birth experience -- and especially when I'm reading a post on MDC (for heaven's sake, I know next-to-nothing about another user's life, for all that I spend hours & hours here, lol!) -- I see my role as offering all the hugs and encouraging words I can.

Have I made sense? For me the focus is on creating improvements in on the large scale, and nurturing relationships on the small scale.

hugs, mb


----------



## LiamnEmma (Nov 20, 2001)

anothermama, I hope you come back and read some more, because your last post just made me sooo sad. I've been musing about it on and off all day. I really don't think you're awful or that your research is wasted, and I do agree with your message! I think that's what lots of people are trying to say, that your message is fine! We're just trying to communicate, as people who have had high intervention births and also as educated women ourselves, what might help you get your message out more broadly and deeply. I feel badly too because I recognize your passion for a topic and your need to have others feel as passionately as you do, and I know how hard it is to have that/those moments hit when you just think, "Is no one *ever* going to hear me?!" Anyway, I hope you come back. We all learn from each other....hopefully.









Leah


----------



## Peppermint (Feb 12, 2003)

mamabutterfly

Sound like you are going to be so great as a doula







. I think you have the perfect balance with your intentions, I was very happy to read you post.


----------



## mamabutterfly (Jun 23, 2002)

Aww, Thanks, Patty!


----------



## Missgrl (Nov 18, 2001)

Thanks mamabutterfy!








I think this is a worthy discussion and hope it continues.


----------



## eilonwy (Apr 3, 2003)

Quote:

_Originally posted by Greaseball_
*
I know what you mean about "my cesarean was necessary!" I think if people are really secure about their decisions, they will not get defensive.*
Okay, I haven't read this entire thread (I'm working on it!) but *this* is the attitude that gets me so upset. So-called "birth advocates" (and I'm really not sure who you're advocating for) say really nasty things to people, imply that you don't love your babies if you make different decisions from theirs, and then wonder why you get defensive about it. "If the total numbness of your body is more important to you than your baby having the best possible birth experience, you go right ahead." (Not an exact quote, but close enough). How am I *not* supposed to feel defensive after reading that? I'm just sick and tired of people saying things like this, implying that I don't want to learn the truth, that I'm some kind of cheerleader for the medical establishment, or worst of all that I don't love my babies because I choose to give birth in a hospital. (Please don't say no one has ever said that, because it would only mean that you've never read the responses to my posts). Hell yes I'm defensive, and it's not because I'm not "secure about my decisions" it's because people keep implying that they know more about my birth experience than I do.

I have only seen two posts (though I'm sure there are more) where people said things like "You're crazy to try an unassisted birth." More often, it's "Unassisted childbirth is not for me." I have seen *dozens* of posts saying things like "You're crazy to plan a medicated birth/cbirth/go to a hospital" and very few posts saying simply "Hospital birth is not for me." I would ask why "birth advocates" are so defensive, if they're so secure in their decisions.

(And now I'm going to finish reading this thread)


----------



## Peppermint (Feb 12, 2003)

I guess it all depends on the person, but when I am secure about something, I take the time to defend it, and when I am not I do not spend time defending it.

For example- I will defend my c-births b/c they were right for me and my babies. I will not defend the fact that I only BF my first dd for 4 months, and was supplementing by 2 weeks. In the instance of the BF, I was "duped" by a staff pediatrician- I was severely doubting my body's ability to do something that it COULD do. I am not at all defensive of my BF, but am very sad and regretful about it. So in either instance, the c-births or the BF, I don't need anyone's opinon unless I ask for it- which I did with BF, I joined LLL during my 2nd pregnancy, and I asked the women what I could've done differently, and b/c I was open to hearing what they were saying, they made a huge difference in my life









So, for me the defensiveness is a sign of when I know I am right, not a sign that I am insecure in my decision







-to each their own on that though- maybe some people are as Greaseball suggested


----------



## eilonwy (Apr 3, 2003)

Okay, I have read this entire thread, and I have a few things to say before I begin:

1)I really wish I'd found it earlier because this is wicked long! :LOL

2)There are lots of incredibly excellent points here, and I'm really impressed at how civil this thread has been over all five pages. It sounds like people are actually communicating and that's a nice change of pace. I enjoyed reading it.

My own birth story is somewhat similar to Captain Optimisms; my water broke before labor began. In my case, it was *long* before labor began, and I wasn't absolutely positive that it had broken. My son was born 4.5 days after my water broke, and then he spent a week in the NICU. I won't go into details here, I don't think this is the right place for it.

I have some questions:

1)What does it mean to be a "birth advocate"? I'm really confused about this. What does it mean to be an advocate for babies or laboring mothers?

2)What are your motivations for this? Are they altruistic, or do you just like being "better" than other people (this is the impression I get from most self-proclaimed "advocates" of any cause).

3)What is it that you want to change, or see change?

4)Who is responsible for causing these changes to happen?

5)What outcomes are you hoping to see? Natural births, homebirths, unassisted births, what is it that you are looking for?

I think it's unrealistic to expect women to be thrilled when you pick apart their birth story and tell them what they/the doctor/the midwife/etc should have done differently to produce the outcome *you* think is best. I think it's exceptionally rude for women to say "Oh, I've never been through what you have but I know why you were wrong and what I would have done in that situation." I totally disagree. I have been told some very negative things on these boards (and I don't think I'm allowed to quote them) implying that my decisions regarding my son's birth and my upcoming birth are selfish and heartless. What could you possibly be hoping to improve by saying such things? All I can see it doing is boosting your ego.

It's one thing to post "having an epidural increases your risk of a, b, and c". It's another thing entirely to tell lies "If you have an epidural, you won't be able to nurse your baby" or "Your baby *will* be born drugged if you choose to have an epidural" or "If you love your baby then you can put up with the pain of labor."

I've noticed that people here tend to assume that if you didn't have a homebirth and/or you aren't planning one that you are wholly uneducated about normal childbirth, or that your doctor is. There's also an assumption that if you see an OB instead of a midwife, for whatever reason, then you are automatically going to have problems, that even if you want an intervention-free birth you probably won't get one. These things aren't true. I've done the research, honest. Just because you want to have a homebirth and I want to go to the hospital and get an epidural does not mean that I'm completely unaware of the potential risks. Whatever it is that you're advocating for, please keep in mind that not everyone out there is ignorant just because they made/are making different choices from your own.


----------



## Greaseball (Feb 1, 2002)

I guess to me, not being defensive means these things -

I don't feel the need to explain my decisions to other people. If they work for me, that's good enough.

I also don't come into forums I know I will disagree with, such as the vax or family bed forum and tell everyone that they really need to look at both sides of the issue and that what they are saying really doesn't work for everyone.

And I accept the fact that others just aren't going to see it my way.

But I guess it means different things for different people...


----------



## KKmama (Dec 6, 2001)

As far as being defensive goes... (just trying to sincerely help you understand why a c birth mom might feel defensive, Greaseball)... if you get a lot of people questioning your decisions and/or your medical history, you might think (akin to the rationale of the birth advocates) that if you explain to them what happened and why, they'll understand, leave you alone, and maybe be more understanding to others in the future.

Thank you, Eilonwy, you said things more eloquently I did, *especially* in the last paragraph of your 2nd post. Your questions are excellent, too.

I've educated myself, and I've chosen the best options which were available to me and which I felt would allow me the best birthing situation I can get. I appreciate the information that's out there which has helped me come to my decisions--*that* has been really useful. I also appreciate the info which will help me work with my care providers to get what I want. I've had to make some compromises (hey--that's life), in part due to what's available, in part due to what insurance covers/what we can afford. So I'm planning on an unmedicated hospital VBAC with an OB and doula, at the area hospital which has the the best stats and the OB practice that has the best stats. I would have preferred a CNM, but it would have cost more, been a lot farther away, and been in a hospital with far worse stats (don't know that the area CNMs have better stats than my OB practice, either).

The local hospital has some really great things going for it. There are jacuzzis in all L&D rooms,and even bathtubs in the PP rooms (specifically for perineal soaking). Equipment is hidden away and brought out only when needed. Squatting bars and birth stools and balls are available. There is no nursery (not even a NICU)--*ALL* of the babies room in with their parents, in queen-sized hospital beds (and in the "NICU", each baby has its own room, with an adjoining room for the parents). The intervention rates are much lower than the rest of the hospitals available to me. Apparently, there's better nursing success, lactation consultants available to everyone (everyone is charged for a LC visit, so I assume a visit is standard), and they even use cloth diapers. I'm assuming that these changes came in part because parents asked for them, but I'm also assuming that "birth advocates" (who are probably a little louder and more organized with information) have pushed for changes, too. Thus my earnest suggestion that doctors and hospitals might be better targets than birthing women...


----------



## pamamidwife (May 7, 2003)

All the positive changes that have been made in hospital care has come from consumer driven desires.

If the consumers demand change, the hospital will accomodate.

This is just a fact. The hospital is in itself a business, and businesses need to make money. If a hospital finds that it is losing business, they will start making changes.

Another aspect is the political push to change malpractice insurance protocols. It's these protocols that are practiced every day in doctors offices and hospitals. Nearly all of them are NOT evidence-based medicine. It would be great to have a healthcare system that is truly based on full informed choice and evidence-based research instead of fear of litigation.

Where does it start? Where does it begin? It's a circle - it cannot be one or the other. It's everything - consumers, doctors, insurance companies, hospital staff and administrators, attorneys, etc.

I wish there were easy answers on changing birth in our culture. However, I think it's going to get a bit worse before it starts getting better. ?


----------



## OnTheFence (Feb 15, 2003)

<<It's one thing to post "having an epidural increases your risk of a, b, and c". It's another thing entirely to tell lies "If you have an epidural, you won't be able to nurse your baby" or "Your baby will be born drugged if you choose to have an epidural" or "If you love your baby then you can put up with the pain of labor." >>

This irritates me as well. There is one thing to inform, another to exagerate the facts. I know many women who have had epidurals with no side effects, their babies were not dopey, nursed great and the epidural actually helped the woman give birth or speed things up once she relaxed. However, I too have read in this forum from supposed birth advocates that people choosing an epidural must be uneducated or not care about their babies or the outcome of their births.

After my surgical birth with Jack I was asked how drugged he was from my epidural by a homebirth friend of mine. When I told her he wasnt drugged, she just gave me this look like I was full of crap. My epidural was in 12 minutes before his birth and I had no preop drugs or sedatives or any drugs for nausea. I believe I *knew* if he was drugged or not.


----------



## Greaseball (Feb 1, 2002)

Quote:

However, I think it's going to get a bit worse before it starts getting better. ?
Here are my predictions, though I don't necessarily know what years they will happen.

First, some new policies will be written and doctors will pass these along to patients:
1.) Hospitals will encourage mothers to arrive immediately after the first contraction.
2.) Delivery must be complete 2 hours after the membranes rupture, whether naturally or artificially.
3.) A mother must have an ultrasound on arrival at the hospital. Any baby with an estimated weight of 8 lbs or more will be delivered by immediate c-section.
4.) The human gestational period will be considered 38 weeks. One day overdue is grounds for pitocin induction.
6.) Delivery must be completed within 8 hours of checking into the hospital.
7.) Need I say that VBACs and vaginal deliveries of breeches or twins will not happen?

As a result, the majority of births will be surgical. FTP and CPD diagnoses will become more liberal, often being diagnosed before labor begins.

And then...

1.) The national average for c/s births will be 80%. Every childbearing woman delivering in a hospital can expect to have at least one. In many hospitals, vaginal deliveries will happen only by accident.
2.) Insurance companies will no longer pay for them. Later, they will stop covering pregnancy at all.
3.) Women will be looking at home birth for financial reasons alone. They will discover it's the only way for them to have a vaginal birth. Midwives will be in demand.
4.) Women will be astounded at how safe and easy birth can be, they'll tell all their friends, who will then see the same midwives, while obstetrics becomes one of the lowest-paid medical specialties.

Unfortunately, I don't think it will start to get better until we are well out of our childbearing years.


----------



## OnTheFence (Feb 15, 2003)

I read this a little while ago and had to go get a drink before posting a reply to this.

Quote:

_Originally posted by Greaseball_
*Here are my predictions, though I don't necessarily know what years they will happen.

First, some new policies will be written and doctors will pass these along to patients:
1.) Hospitals will encourage mothers to arrive immediately after the first contraction.
2.) Delivery must be complete 2 hours after the membranes rupture, whether naturally or artificially.
3.) A mother must have an ultrasound on arrival at the hospital. Any baby with an estimated weight of 8 lbs or more will be delivered by immediate c-section.
4.) The human gestational period will be considered 38 weeks. One day overdue is grounds for pitocin induction.
6.) Delivery must be completed within 8 hours of checking into the hospital.
7.) Need I say that VBACs and vaginal deliveries of breeches or twins will not happen?

As a result, the majority of births will be surgical. FTP and CPD diagnoses will become more liberal, often being diagnosed before labor begins.

And then...

1.) The national average for c/s births will be 80%. Every childbearing woman delivering in a hospital can expect to have at least one. In many hospitals, vaginal deliveries will happen only by accident.
2.) Insurance companies will no longer pay for them. Later, they will stop covering pregnancy at all.
3.) Women will be looking at home birth for financial reasons alone. They will discover it's the only way for them to have a vaginal birth. Midwives will be in demand.
4.) Women will be astounded at how safe and easy birth can be, they'll tell all their friends, who will then see the same midwives, while obstetrics becomes one of the lowest-paid medical specialties.

Unfortunately, I don't think it will start to get better until we are well out of our childbearing years.*
Frankly I think these predictions are ludicrous. Again I am not into conspiracy theory nor do I think that the first things you listed WILL ever happen. Over the past ten years I have seen things go back and forth. For instance, my SIL wanted a repeat csection in 1996 but her insurance would not allow her nor her doctor, she had to have a trial of labor and attempt a VBAC or else insurance would not pay. She did have a successful VBAC. In fact this was a policy of BCBS int he late 90s and in the year 2000.
At the hospital I gave birth in, natural birth is advocated and advised. I know this because my sister was a birth instructor there for 4 years and we know the lady who heads the childbirth education courses. The childbirth classes are not geared to make patients compliant. I cant say this for other hospitals in the area but I can for this one. More and more women I know, even mainstream mommas are wanting more natural births or little intervention. Some of the things you stated are off the wall entirely, especially the part about 38 weeks gestations and pit inductions. Oregon must be like Mars. I live in a pretty backwards place and I dont see any of the things you mentioned happening here during my childbirth years or my children's childbirth years.


----------



## pamamidwife (May 7, 2003)

In my city, there are TWO large OB practices that are routinely inducing at 39 weeks. The stripping of the membranes and routine vaginal exams start at 36 weeks.

I think that Greaseball was saying that it could get as crazy as that.

Really, even 20 years ago, would we have even guessed that we'd be seeing a 25% cesarean rate? Or a 30% induction rate? That all breech babies would be delivered surgically?

The atmosphere in birth even four years ago is vastly different than it is today. Four years ago, women were still being encouraged to VBAC across the board. Many hospitals and doctors were advised to decrease their cesarean rates. Today, the tides have turned - and it's not from new evidence that is pouring out of the research. It's from malpractice fear.

Some things may sound far-fetched to us now - but don't seem too far fetched for 20 years from now.

I predict that many insurance companies will start questioning covering elective cesareans - although it seems that doctors can always find a reason to do them to get them covered. Still, the cost of health insurance will continue to rise because of the increase in elective cesareans and other health issues (obesity, poor nutrition, etc.).


----------



## captain optimism (Jan 2, 2003)

Quote:

_Originally posted by OnTheFence_
*

Frankly I think these predictions are ludicrous. Again I am not into conspiracy theory nor do I think that the first things you listed WILL ever happen. Over the past ten years I have seen things go back and forth. For instance, my SIL wanted a repeat csection in 1996 but her insurance would not allow her nor her doctor, she had to have a trial of labor and attempt a VBAC or else insurance would not pay. She did have a successful VBAC. In fact this was a policy of BCBS int he late 90s and in the year 2000. At the hospital I gave birth in, natural birth is advocated and advised.*
One thing I have seen repeatedly on these boards and on other internet discussion groups: women's experience of birth, the attitudes of their practitioners and of the hospitals and other institutions involved, vary a lot from place to place. Not only that, and this is a crushing shame to our society in the US, people's birth experiences differ according to their social status. That's why even if in many states there is a push from malpractice insurers for OB GYNs to try to raise the number of c/s births, in other places you may get more support for vaginal and even for drug free births, in hospitals and from doctors.

The first few times I saw women posting that their OBs were putting them on weight-loss diets in pregnancy, that hospitals were regularly encouraging new moms to supplement with formula, etc. etc., I couldn't believe it. But now, having discussed this stuff with a lot of people at work and in my community IRL, I can see that positive change in these areas is not consistent.

It's like other things that relate to women's lives. You might think, "No one ever told ME that 'girls can't do math'." But someone else your age was more than told it, she was prevented from enrolling in Calculus in high school. You think, "My insurer encourages natural childbirth" while someone else is dealing with a hospital who is telling them they have to wear a fetal monitor throughout labor. Maybe at a hospital in the same city where you had a birthing center birth in a tub of water!

That's one of the big values of these boards, that we can learn about what other people's experiences have been.


----------



## Greaseball (Feb 1, 2002)

Many of these things have already happened, just not everywhere.

Pam and I are in the same state, and the routine 39-week induction is true. Planned cesareans usually occur at 38 weeks.

The time after rupture that delivery must be completed is getting shorter. It used to be that 48 hours was standard. Now, depending on the hospital, it's anywhere from 20 to 6 hours.

Some hospitals do use routine 3rd trimester u/s to predict weight, and will section for 9 lbs and up. For a woman under 5 feet tall, the hospital in my city will section for a 7-lber.

Many hospitals do have time limits for delivery, or what they consider FTP. If you labor over 24 hours at a hospital, you will be considered FTP. In some hospitals, the limit is 8 hours, especially for a woman who has already had children. Others stick to the "18 hours for a first-timer, 12 hours for all others" rule. They also have limits for the pushing phase, usually 2 to 4 hours.

Vaginal deliveries of breeches are rare in hospitals, though in the 70s only 10% of them were cesarean. A woman will likely have a hard time finding a doctor who will deliver a vaginal breech. Some will even plan a c/s for a posterior presentation. Some twins are still delivered vaginally, though only if both are head-down, and the hospital will often insist on an epidural and forceps.

Perhaps, OTF, you hadn't done any research? I don't just make all this up for no reason, and I don't just go by what is in my city or state. I'm sure if, in 1970, I had predicted the things that go on today, I would be considered a raving lunatic. But in the end, look who's right!


----------



## OnTheFence (Feb 15, 2003)

I have done research. Lots. I also know how people, websites, etc like to skew things and over dramatize, like I believe you are doing, to fit their own agenda.
My belief at this point that SOME midwives, doulas, and natural birth advocates are so far to the left and are just as bad as the medical establishments they soo oppose.
Nothing is as black and white. Its like do you believe there is no balance?

Where is the statistics to back up your claim that babies are being induced at 39 weeks and surgicall birthed at 38 weeks as routine practice?

Where are the actual articles and statistics for these 7lb babies that are being born surgically or by induction because of their weight?

The only thing to me that has any ring of truth, that I actually have a basis of facts for is that there are less breech vaginal births. And that is for a barrage of reasons. Some I agree with, some I dont. Also, I think you have to break down the types of breech, complications, etc to really get a clearer picture of what is going on. I do agree that doctors are not as skilled in this area as they should be and that a surgical birth is likely to CYA.


----------



## Greaseball (Feb 1, 2002)

Quote:

Where is the statistics to back up your claim that babies are being induced at 39 weeks and surgical birthed at 38 weeks as routine practice?
Where are all your articles that say it isn't so?

If you really want sources for my info, the main one is the Mothering Perinatal Healthcare Index, and just about every other Mothering magazine. I have listed some books in other posts, the main one being Open Season. All this info is, of course, based on those fancy journals and research papers.

You could also check with the midwives here on MDC, if you feel you would believe anything they had to say. Perhaps they could get you some journals and papers.

Some things come from mainstream doctors, nurses, and birth educators. The 7-lb section rule was mentioned in the hospital childbirth class by the instructor. I don't think there will be a whole research paper dedicated to it.

I don't have an agenda. I have nothing to gain or lose no matter how a woman gives birth. If a woman on this board decides to have all her children by elective surgery, it doesn't hurt me any. If another woman has them all at home, how will it benefit me? Maybe if I had a career as a midwife, CBE or doula that would make more sense.

I don't feel I have to "prove" my knowledge beyond that. I'm sure that you would have something negative to say about whatever statistic, website, or journal I showed you, so what's the point? I'll just list the basics (maybe someone else will get something out of them) and accept the fact that we won't see eye to eye.


----------



## pamamidwife (May 7, 2003)

I cannot offer you any published "studies" since these are not done on routine practices by physicians.

I can only offer what is true in my community. And, unfortunately, very little of the interventions that are done in my area are evidence-based (from across the board inductions at 39 weeks - which an OB told me all the women LOVE to automatic cesareans for "big" babies).

I've mentioned before that in the state of Oregon, lower malpractice premiums are being offered by the only two insurance providers here for practices with higher cesarean rates.

This comes straight from the horses mouth, OTF - a local OB in a very busy practice that is frustrated about he is mandated to practice.

(Said OB had a homebirth with a midwife, too, if that discounts his word)

I think that we're getting away from the point here. Yes, there are two extremes that are blind and dangerous on both ends. I hope you're able to hear those of us who feel that a healthy mom and a healthy baby are important.

My "agenda" isn't to get every woman to birth at home. On the contrary, I don't believe that most women in America are good candidates for homebirth for many reasons (social conditioning, poor nutrition, etc.). I am not looking to earn more money through the coercion of women.

However, there are so many great books on the topic. I wish more women had information beyond what their doctor may provide them - or even what their midwife may provide them. A truly informed choice requires more than just one side, right?


----------



## pamamidwife (May 7, 2003)

I just wanted to add, too, that it isn't about being right.

It's about offering women CHOICES in their care.

I just had a memory of about four years ago, on another board, where I ripped apart a woman's choice to have an induction on her 38 week baby after her last baby, at a 41 week checkup, had died.

I cringe to think about this. However, I bring it up to make a point: that sometimes we CAN be judgemental and harsh. That we assume that what is right for us is right for everyone. However, I could NEVER imagine the fear and hurt in this woman's heart. I didn't hear her when she spoke of her grief over not being induced on her due date with her previous pregnancy.

I was under the belief that I was right and she was WRONG>

That is where we get messed up on this issue. We all live in different parts of the world, with different care providers. Some offer full choice, others cannot or will not.

I've heard horror stories from homebirth midwives, from CNMs and from doctors. None of these groups are homogoneous. We are all human and we have our own biases.

Let's reiterate some of the common ground that we've established:

That, before posting, you think about WHY you are posting. What is it that you want to convey? What are your intentions? To tell someone they are wrong - or to offer another viewpoint on the subject? To publicly "one-up" another person or to offer some facts?

Intention when responding is going to be the most helpful for those of us involved in birth activism. I think this could apply to those who do not consider themselves birth activists, too.

What if we all lived like this?


----------



## mamallama (Nov 22, 2001)

I changed my mind...someone else said it better!


----------



## tinyshoes (Mar 6, 2002)

Quote:

_Originally posted by pamamidwife_
*Really, even 20 years ago, would we have even guessed that we'd be seeing a 25% cesarean rate?*
C'mon, Pamamidwife,







--didn't you get your Novermber/December 2003 issue of Mothering? Page 24 has the _correct_ percentage, if I may be so bold as to cite a source and correct you:

26.1%

That's the national average from the CDC, and it is the all-time high.

So when I read Greaseball's predictions, I'm not falling of _my_ seat. Isn't Brazil the place where the c-sec rate is 80%?

_edited to add winking emoticon to emphasis the intended tounge-in-cheeck nature of my 'correcting'._


----------



## pamamidwife (May 7, 2003)

I stand corrected.

Yes, Brazil has a majority cesarean rate. Only the poor women have vaginal births.

Lately, all the publicity about vaginal integrity being saved by cesarean sections is really irking me...

The truth is, prolonged second stages (pushing, usually caused by a command to push before women are ready, epidurals, and poor positioning of babies), episiotomies and instrumental deliveries are to blame for the increase in pelvic floor issues.

Well, that and our sedentary lifestyles.

But, egads, one reason why Brazilian women favor cesareans is pelvic floor integrity.


----------



## lauraess (Mar 8, 2002)

I started reading from the beginning of this thread , thinking it was just beginning maybe yesterday or today and then after coming to points of extreme agreement and places where I wanted to cry over the emotion and relatedness of it all -- i realized there were 6 pages. Couldnt read em all!!

so.. the reason this discussion hit me was not only because i cant believe i didnt see it sooner, but because im personally trying to find a way to deal with this issue involving my young, pregnant freind and her decisions in pregnancy and childbirth and my passionate beliefs that stem from my own births and the education i have given myself over the years. I want her to understand yet i get soo worked up about the drs and the issue of womens empowerment and the whole damn thing i come off like im attacking her. I was trying to keep my mouth shut till i could offer something useful and then today i made a comment and then more and ya-da-ya-da ... she soon made up a good reason to get off the phone w/ me.









I love what EVERYONE wrote ( what i had time to read, anyway) and hope i can be gentle and respectful of her thru her pregnancy.

If anyone has any specific ways i could temper my comments and advice (SOMEONE EARLY ON IN THE THREAD SAID THEY WERE LEARNING THIS)```` PLEASE HELP! I DONT WANT TO HURT THIS RELATIONSHIP, I ONLY WANT HER TO MAKE INFORMED DECISIONS THAT ARE HEALTHY FOR HER AND HER BABY.

tHANKS AGAIN FOR ALL YOUR WORDS OF WISDOM!
laura


----------



## 2BMamaof3 (Oct 13, 2003)

Quote:

_Originally posted by pamamidwife_
*I just wanted to add, too, that it isn't about being right.

It's about offering women CHOICES in their care.

********************************

Let's reiterate some of the common ground that we've established:

That, before posting, you think about WHY you are posting. What is it that you want to convey? What are your intentions? To tell someone they are wrong - or to offer another viewpoint on the subject? To publicly "one-up" another person or to offer some facts?

Intention when responding is going to be the most helpful for those of us involved in birth activism. I think this could apply to those who do not consider themselves birth activists, too.

What if we all lived like this?*
Pam, I think you've really hit the nail on the head with this post. I am a birth activist. But I do not EVER want to make anyone feel bad over whatever has happened in birth (choice or not!).

I believe the changes need to happen at the service level (doctors/nurses/hospitals...and right now...INSURANCE COMPANIES!!!). Informed choice is important...but if the medical establishment is going to force care on anyone, it should be based on evidence based practice!

I guess my "agenda" is to have evidence based practice be the goal...however, if we choose to do something that is not "best" as proven through evidence-based practice...it is still our choice!!!

My confusion is when I've said something or agreed with something like this: "You know the pros and cons of the choice...you are making the choice, that for you, is the best." And whether or not it is a choice based in "best practices/evidence based" is moot to me...because it is her choice! My confusion comes in because that statment is often interpreted in a negative way...and I guess I don't understand why. Because to me it is about choice...informed or not...I support someone's right to choose. I try to judge a situation before offering my opinion to any pregnant woman. Sure, I may not agree (for me)...but it is ultimately each of our choice.

Thanks,
Abby


----------



## mamallama (Nov 22, 2001)

I think the part regarding evidence based care & choice is very interesting.

We all talk about the emotional and psychological aspects of birth, and how much influence they have over the physiological aspect of birth.

Some women have a feeling deep in their bones that they are going to need x, y or z; things that would not be indicated by evidence based care. This is where the emotional and psychological aspects of birth come in. Are x, y and z really necessary for a safe and satisfying birth? It's not up to me to say.

I don't understand the negative interpretation either. The fact is that the emotional & psychological aspects of giving birth impact the psysiology. The mother's emotions and her state of mind cannot be _wrong_, therefore her thoughts on what she needs for an optimal birth are of paramount importance.


----------



## mamallama (Nov 22, 2001)

lauraess--baby steps. Ask open-ended questions and _listen_. As some of the moms on this thread have said, pregnant women are overwhelmed by friends, aquaintences and veritable strangers giving well-meaning advice. What women need most is someone to listen to their concerns and give them the space to find their own voices.

If you need to vent about the current state of maternity care in the US, do it somewhere else!


----------



## lauraess (Mar 8, 2002)

Thanks Mamallama!
It seems she's not so mad she couldnt call. we talked. she apologized for not showing me much respect (calling me "her little liberal friend" after i left her a message saying i wish she hadnt gotten an u/s because they are controversial. And I apologized for judging her as not understanding what i was talking about.
so, you're very right. a lot of things were said during this thread discussion that i could learn from.
I must listen and listen and offer gently, no lecturing.
After i get over being such a pushy freind maybe I'll be able to give her some sites to look at.
Laura


----------



## Greaseball (Feb 1, 2002)

Quote:

Isn't Brazil the place where the c-sec rate is 80%?
Actually, the last thing I read was that it was 95% among rich women (those other 5% must be accidents!) and 65% among poor women.


----------



## emmalala (Dec 3, 2001)

Great thread! I'm sorry to be posting so late but I had a thought about why cs moms appear to be defensive and giving a lot of explanation.

From her perspective, she may feel that someone who judges her doesn't know enough about her experience. So *she* wants to educate about what specifically happened and how.

I can well understand how cs moms are feeling attacked - it hurts to see that some posters to this thread have felt the need to explain their birth experience, I don't see that the birth activists have done that...

I'm seeing how that arrogant/ignorant split is arising. Don't know if this post helps anyone, of course...


----------



## Peppermint (Feb 12, 2003)

Quote:

_Originally posted by emmalala_
*Great thread! I'm sorry to be posting so late but I had a thought about why cs moms appear to be defensive and giving a lot of explanation.

From her perspective, she may feel that someone who judges her doesn't know enough about her experience. So *she* wants to educate about what specifically happened and how.

*
I think you hit the nail on the head, thanks!


----------



## eilonwy (Apr 3, 2003)

I realize that this thread is really long, but could someone please answer my questions? I seriously want to know. Thanks.

Quote:

_Originally posted by eilonwy_
*
I have some questions:

1)What does it mean to be a "birth advocate"? I'm really confused about this. What does it mean to be an advocate for babies or laboring mothers? Who/what is it that you're advocating for?

2)What are your motivations for this? Are they altruistic, or do you just like being "better" than other people (this is the impression I get from most self-proclaimed "advocates" of any cause).

3)What is it that you want to change, or see change?

4)Who is responsible for causing these changes to happen?

5)What outcomes are you hoping to see? Natural births, homebirths, unassisted births, what is it that you are looking for?

I think it's unrealistic to expect women to be thrilled when you pick apart their birth story and tell them what they/the doctor/the midwife/etc should have done differently to produce the outcome *you* think is best. I think it's exceptionally rude for women to say "Oh, I've never been through what you have but I know why you were wrong and what I would have done in that situation." I totally disagree. I have been told some very negative things on these boards (and I don't think I'm allowed to quote them) implying that my decisions regarding my son's birth and my upcoming birth are selfish and heartless. What could you possibly be hoping to improve by saying such things? All I can see it doing is boosting your ego.

It's one thing to post "having an epidural increases your risk of a, b, and c". It's another thing entirely to tell lies "If you have an epidural, you won't be able to nurse your baby" or "Your baby will be born drugged if you choose to have an epidural" or "If you love your baby then you can put up with the pain of labor."

I've noticed that people here tend to assume that if you didn't have a homebirth and/or you aren't planning one that you are wholly uneducated about normal childbirth, or that your doctor is. There's also an assumption that if you see an OB instead of a midwife, for whatever reason, then you are automatically going to have problems, that even if you want an intervention-free birth you probably won't get one. These things aren't true. I've done the research, honest. Just because you want to have a homebirth and I want to go to the hospital and get an epidural does not mean that I'm completely unaware of the potential risks. Whatever it is that you're advocating for, please keep in mind that not everyone out there is ignorant just because they made/are making different choices from your own.*


----------



## captain optimism (Jan 2, 2003)

Quote:

_Originally posted by eilonwy_
*I realize that this thread is really long, but could someone please answer my questions? I seriously want to know. Thanks.*
I think I might qualify as a birth advocate, a little bit. i'm not political about it, but I did loan all the good birth books i bought to my friend when she got pregnant, and I'm about to do the same thing again for another friend.

1. I'm advocating for women to have good experiences and healthy children, through information about good prenatal care and self-care.

2. I am motivated by caring for the individual women I talk with about this. As you know about me, I had not the greatest birth experience, and there are things I did that I hope to persuade others to avoid! (I think I was under a lot of stress around the birth and I also feel like my labor might have gone better in a place where I was allowed to eat and drink.) I also made some good choices. So I can't really feel superior to other women.

(At least, not about birth.







)

I'm also motivated by feminism. I think there is still a model that's hanging around our culture that what women do in childbirth is for the sake of their doctors, not for their own sakes!

3. I want to see women and their children get appropriate health care during pregnancy and after birth. That means, no unnecessary drugs or surgeries. I think there are some steps women can take while pregnant to make sure they get good care, like reading about pregnancy, like visiting prospective birth places before selecting them, like meeting their pediatricians while still pregnant--that kind of thing.

4. I think if we want birth to change that we have to vote with our feet. the hospital where I gave birth brags about low c/s rates. Why? Because they know women where I live want that.

5. I would like to see more healthy births with good outcomes for mothers and babies. I am not attached to homes, hospitals or birth centers as places where that should happen. Wherever!


----------



## KKmama (Dec 6, 2001)

I wanted to (very sincerely) respond to something Pam said... (I think in response to my asking that birth activists target drs and hospitals instead of/in addition to pg women.)

Quote:

All the positive changes that have been made in hospital care has come from consumer driven desires.
Not necessarily... I have kind of a complicated example... there's a hospital about an hour and a half me that used to have a very low epidural rate (~14%, from what I was told). But then they decided they wanted to have an anaesthesiologist available 24 hrs (I believe so they could do VBAC? that seems to be one of the requirements these days for hospitals to offer them). But then of course in order to justify this staffing, more women need to avail themselves of the service. So the epidural rate has been creeping up. There's good and bad here, and I'm not sure how consumer driven either is. I also think that in order to keep the epidural level low, it might take some pushing from activists to change the way they are "selling" them to patients.


----------



## 2BMamaof3 (Oct 13, 2003)

*1)What does it mean to be a "birth advocate"? I'm really confused about this. What does it mean to be an advocate for babies or laboring mothers? Who/what is it that you're advocating for?*

For me it means educating and lobbying insurance companies and health care providers about evidence based best practices. I am involved in this through my participation in LLL and by signing petitions and writing letters to my legislators. As an advocate for babies or labouring mothers...which I am not in any professional sense, but as a friend to women who have or will give birth...it means to listen to them, to hear their concerns and their excitement. To answer questions honestly and with real facts if they ask my advice. To support whatever decisions they make about giving birth and if care is "forced" upon them, to hear their stories without judgement on them. AND...to support their decisions even if they don't know all the facts (and clearly don't want to know them). SOME women AREN'T educated about the risks of interventions and don't want to be...I must respect that too. Ultimately I am advocating for women to be given the opportunity to own their power...to have their intelligence and self-knowledge respected. Not everyone is there. We are all on a journey...

*2)What are your motivations for this? Are they altruistic, or do you just like being "better" than other people (this is the impression I get from most self-proclaimed "advocates" of any cause).*
I firmly believe that the medical establishment/insurance companies are a HUGE example of patriarchy in action. Because I am a feminist, and want to move toward an egalitarian world...I am motivated to change the current system. Much of the medical practices (or a lot...or SOME....but enough for me to want to effect change) has stripped away women's right to make informed choices...stripped away her right to voice her wants and needs...assumes she knows nothing and "they" (the doctors/nurses...and yes, sometimes midwives) know EVERYTHING. I believe even if women are given the opportunity to be partners in their care, some may not want to...but to give the opportunity is important to me, and THAT is what motivates me. Choice is of the utmost importance in being free (which is really important to me). I also admit that my spirituality is influenced heavily by the belief that follwoing the natural rhythms of nature is a very good way to find freedom...you can't fight nature (and I understand not everyone believes this)...but since it is my belief it is a motivator to effect change as well.

*3)What is it that you want to change, or see change?*
I think I've answered this question above. But again...to give women the opportunity to make choices, to give them access to information, to not have decisions forced upon them...and when women can't or don't want to take on the choices...to have what is done to them and for them based on evidence based best practices.

*4)Who is responsible for causing these changes to happen?*
Everyone...consumers...health care providers...women...men...me...you.

*5)What outcomes are you hoping to see? Natural births, homebirths, unassisted births, what is it that you are looking for?*
My ideal would be to stop the climate of fear surrounding childbirth that is perpetuated by the medical establishment convincing women (and men) that birth is abnormal and a state of "an emergency can go wrong at any given second and unless we are here to help you, you will die or at least be in a lot of pain!!!" I would love to see our society move toward a more spiritual and natural view of birth. However, since not everyone shares the same ideals...I would and will be MORE THAN HAPPY if medical practices surrounding birth are based on evidence based best practice. They ARE in some areas...they are most definately not in others. It really depends on the care provider and the woman's history/filter. YKWIM? On the other hand...if a woman does make a choice for care that is outside of the "best practice" model...so be it...but it will be her choice.

So...informed choice first, choice second...if no choice...then decisions made by medical professionals based on what has been proven to give the best outcome in the end. I think we would then see a reduction in medication during labour and birth, a reduction in epidurals...more birth position options and encouragement during labour and delivery (specifically in hospitals), yes...ultimately more natural childbirth...more doulas!!! But if a woman decides she NEEDS or WANTS medication...then so be it. But I truly believe if there was less fear induced by the medical establishment (and the insurance companies that are making a SHITLOAD of money by encouraging more interventions...more money paid out...more money paid in) we would see more natural childbirth. You can see these statistics in action by looking at the climate surrounding birth in countries such as Sweden (where a majority of babies are born through natural childbirth and a great deal at home).

I do not believe homebirth or UC is for everyone. I know that not everyone believes in following the natural rhythms of nature. I believe we all come to birth with our own beliefs and history...our own filter of experience if you will. But SOMEWHERE something has to give (and I believe it is within the medical establishment and the insurance companies) and realise that we pregnant women do not suffer from some sort of disease that must be managed (some pregnancies must, of course...but not the majority). But birth is just the start...we also have to start looking at the practices the medical establishment uses surrounding death as well (but that is another can of worms...isn't it?).

Namaste,
Abby


----------



## ladylee (Nov 20, 2001)

I know that not everyone believes in following the natural rhythms of nature.

Hmm. I hope I can express what I'm feeling about this statement.
I believe in following the natural rhythms of existence, life, destiny. Two cesarean births were part of the "natural rhythm" existence intended for me. Therefore I have no problem reconciling my cesarean births with my natural/holistic beliefs.


----------



## 2BMamaof3 (Oct 13, 2003)

I did not mean that those who have a c-section aren't following natures rhythms. I see NO reason why someone who has a c-sec., such as yours lady lee, shouldn't be able to reconcile that with natural/holistic beliefs. I'm certainly not suggesting that just because someone may not be able to have vaginal childbirth that we should just let someone die just to go along with nature!!! NO WAY!!!! Nature has also given us brains and intellect and the ability to figure out ways to survive longer (when medical interventions become medical miracles!!!).

But there are those women out there who believe very strongly that it is silly to feel pain in childbirth and want drugs and epidurals or WANT c-sections even though there is no medical reason to do so. That to me is NOT following nature...but I support the right to choose!!

Abby


----------



## ladylee (Nov 20, 2001)

I understand. What I'm suggesting is that perhaps more of those cesarean births are a part of someone's natural rhythm than one might assume.


----------



## LiamnEmma (Nov 20, 2001)

Lee, I sure do like you and your thoughts.









Quote:

All the positive changes that have been made in hospital care has come from consumer driven desires
I agree that this is generally how change comes about. People insist upon it...for example, right now I'm fighting with the local hospital for a procedure for my daughter. But more than that, I'm fighting for other patients. They've treated my dd (her case, not in real life) terribly, made lots of denials when they shouldn't have, contradicted themselves and even lied, etc. I've gone and gotten her a patient advocate at the hospital (based on a very smart mama's advice on this board) and even thought my first goal is to get her the level of care she deserves, my ultimate goal is to make changes at the departmental level so that other patients who don't have mama bears guarding them and their rights also receive the level of care they deserve...

Back to birthing though. I agree with this pamamidwife, but again, I say that the target audience needs to be more inclusive. Make speeches to larger groups--it takes the personal out of the message and makes it easier to digest and listen to. Go to health clinics and give presentations, go to (ooh, I like this one) health benefits fairs at companies and school districts (I'll tell you when ours is and I bet they'll let you come) and have a table where you can disseminate information. Get to know birthing instructors and give presentations during their birthing classes. I truly believe that you have to plant the seeds and let the people sow them. I think we all have to have faith in the intelligence and motivation of the masses. If we believe no one will ever understand or listen, of course we treat them with less respect and don't listen to them as openly...probably not even consciously.

Leah


----------



## LiamnEmma (Nov 20, 2001)

Quote:

I also don't come into forums I know I will disagree with, such as the vax or family bed forum and tell everyone that they really need to look at both sides of the issue and that what they are saying really doesn't work for everyone
I meant to respond to this too. Greaseball, this is the Birth and Beyond forum. Not the homebirth forum, or the unmedicated birth forum. All babies were birthed, just not necessarily vaginally. So there will likely be more disagreement than in say, the vax forum, where it's known that it's anti-vax, or the Case Against Circumcision--that agenda's pretty clear! :LOL This forum is for all births as far as I can tell, and exclusionary practices won't be helpful for any side of the argument, you know?

Warmly, Leah


----------



## candiland (Jan 27, 2002)

Eilonwy, I think all of your questions can be summed up to one thing: evidence-based medicine.
Most of the obstetrical practices we see today are *not* evidence-based. They are based partly on tradition, partly on distrust of womens' bodies, and partly on the $$$$ made from interventitive births.
If you truly want to learn about this, pick up Henci Goer's "The Thinking Woman's Guide to a Better Birth" and "Obstetric Myths Vs. Research Realities". They are all research-based; she has chapters of medical references that you could look up for yourself, if you are so inclined.
That is what birth advocacy is about, for me: to push for evidence-based medicine. Most hospitals have to rush women in and out to make room for the next group; the things they tell women they need to do and need to have done are rarely in the best interest for mom or baby. Women need to KNOW this, whether they choose to act on it or not.
I suggest you look up the birth statistics from Sweden, as well as any and all research done by the World Health Organization. The WHO clearly states that in first world countries, there is a direct link between the amount of unnecessary intervention used on laboring women and infant and maternal morbidity. We rank 23rd; Sweden ranks first. Guess which uses evidence-based medicine, and guess which does not? In Sweden, you cannot get an o.b. to attend a low-risk birth without paying out of pocket! And a third of all babies are born at home.
Most birth advocates clearly understand that some women may not want to hear these things; that has to be respected. Others would like to know these things, but never, ever will because they take a hospital Lamaze class, get *told* what is best by their doctor, and never see the other side of birth (read: trustworthiness and normalcy.) And others may learn about evidence-based medicine, choose a hospital birth and want an epidural, or need a cesarean.......... and that MUST be respected, as well.
Do you get what I'm saying? Sure, there are birth extremists out there. Ones that say "homebirth is the only way to go!" and other such nonsense. But for most of us, it is about having access to the true risks and benefits of all interventions and deciding for ourselves what will work best for us....


----------



## pamamidwife (May 7, 2003)

Leah, I'm working on it. However, in every large group, there will be defensiveness about anything that I have to say. Once again, I cannot control how any one person will react and I will not dilute my passion to meet these varying needs. (Nobody should!)

I am thinking about doing more public speaking with junior high and high school aged groups. It seems like getting it in the early years might plant some seeds of trust.


----------



## Peppermint (Feb 12, 2003)

Quote:

_Originally posted by LiamnEmma_
*I meant to respond to this too. Greaseball, this is the Birth and Beyond forum. Not the homebirth forum, or the unmedicated birth forum. All babies were birthed, just not necessarily vaginally. So there will likely be more disagreement than in say, the vax forum, where it's known that it's anti-vax, or the Case Against Circumcision--that agenda's pretty clear! :LOL This forum is for all births as far as I can tell, and exclusionary practices won't be helpful for any side of the argument, you know?

Warmly, Leah*
Leah- thank you for addressing that, I wanted to address it myself, but I couldn't think of how to say it, you said it very well, I wish all could see that my babies were birthed, and therefore, I have something to add to the discussions here. Also- the tremendous support I have gotten on the cesarean support thread has been so great







Also- threads like IOF and Meg'sMom working on their c-birth plans were very valuable to anyone who read them.


----------



## Hannah's Mom (Jan 5, 2003)

I read this whole thread and thought everyone had some excellent points. My first birth was a c-section after induction for PIH, perhaps unnecessary, and I feel that I wasn't enough of an advocate for myself. I'm planning a VBAC for my baby due in August and using a CNM who's very supportive of that. I wanted to let you know what has been effective to get me to question the traditional ob advice. I knew all about the risks of epidurals and other interventions on paper prior to my dd's birth, but it was on an intellectual level. I didn't know anyone IRL who had an unmedicated birth. I didn't really know midwives were an option. And I didn't really trust my body or my ability to get through the pain of child birth (my mom is a big weanie about pain and not so confident about the amazing things our bodies can do and I definitely absorbed that from her).

How did all this change (and I'm still working on gathering the confidence for my hopefully unmedicated VBAC)? I heard birth stories from women who had wonderful, natural childbirths and realized that most of the ones I knew from around here chose particular care providers (CNMs or OBs). After that, I KNEW that it was possible, that these women were very similar to myself and THEY were able to do it, why couldn't I be successful? Not one of these women was combative or had an apparent agenda, they just shared their birth experience with me and answered my questions. I also noticed that most of the women I knew (IRL and from MBs) who had more natural births (meaning fewer interventions - some in birth centers, some in hospitals, one at home) generally had MUCH easier recoveries than those who had intervention-filled vaginal births or c-sections (whether necessary interventions or not). With a toddler afoot, it began to make sense to me that my life would be easier if I had the chance of an easier recovery.

I guess I'm trying to say that getting the word out there is the best possible thing. And do it with the intent to share your story, not necessarily to convince EVERYONE in the room that you are right and the medical model is wrong. And yes, maybe you need disclaimers that you understand that sometimes interventions and c-sections are necessary, is that such a bad thing? I think it's wonderful that so many women are so passionate about this subject, but I agree with the women who talked about what made THEM defensive about their interventions. I've always had the suspicion that my induction could have been avoided, even as I checked into the hospital after leaving my ob's office. What I didn't know was what I could have done in that situation. That's why getting the message out there is so important. I haven't ever felt defensive, but I didn't really put my story out there to birth activists until I was ready for feedback and acknowledged what I said above. I can see how if I was educated and realized MY c/b was necessary and shared the story only to be questioned by activists that I would be VERY defensive. I guess the point of that comment is to say, don't assume that just bc someone submitted to interventions or had a c/b that they were uneducated about the alternatives. Some are.

And if you're speaking to large groups of people, as suggested by a couple of posters (and which I think is a great idea, BTW), be aware you AREN'T going to reach EVERYONE. But you might reach a few, who will go on to have good birth experiences and share them with possibly other receptive people, and so on.

I hope I made some sense in this rambling post.


----------



## Defenestrator (Oct 10, 2002)

I have been following this thread all of the way through and intended to reply long before now, but have been thinking pretty deeply about what it is that I really want.

(Warning, super long)

I started out working as a doula with teen moms and high risk moms in a local volunteer program. I had been a childbirth educator and a birth activist for about 4 years previous to that, but when I started working with real births, I did so in a hospital environment with moms who were really not well served by my attempts to impose my ideal vision of birth upon them. The teenagers were often very easily led, so that they didn't follow their own instincts, but just listened to me as a trusted leader. The high-risk moms had multiple issues that affected their health and often needed the interventive care that they were getting. So, since I have been working as a doula, my experience has really reinforced the idea that I need to step back and listen to women's stories and try to serve them within the parameters of their own ideals, and also meet them halfway a lot of the time. One of my worst failures occured when I was starting out as a doula and my second client was a young mom who was homeless and pregnant with boys who had severe twin to twin transfusion syndrome. She was pretty heavily mourning the loss of her vision of an ideal birth and I thought I would try and help advocate for her with her doctor for whatever little scraps of it she could keep. What ended up happening, though, is that we had a total break and she stopped returning my calls. I can only guess what happened, but I believe that above and beyond the mourning was a fear for the life of her babies, and that my message that her life and health and wishes were somehow just as important as their well-being set up lots of internal conflict that stressed her out.

I still work with the perinatologists a lot, and have been to too many complicated births to feel like I can hear the short version of a birth story and really know what happened there or what went wrong when a less than desirable result happened. I have also seen some instances (amongst the caregiver population as a whole) of truly incompetent, insensitive, inappropriate and impatient care. The worst of the worst are infrequent, but within the hospital system there are structural flaws that make providing the best care very difficult.

When I talk to mamas about their previous, current and future choices and about their experiences within the hospital system, I will sometimes point out when I think that the standard of care at the hospital or within the medical practice they are with influenced their bad outcomes. I think that it is important for women to know when the practices that they have been told are necessary are not universally practiced and have been discredited elsewhere. I know that when I am talking to someone outside of my own area that the wealth of choices that might be available to me and my clients locally are not available everywhere. I also know just how difficult it can be to walk into a medical practice and judge whether or not it is going to be compatible with your values. My current favorite group of hospital midwives in my area is a group practice of 12. I HATE large practices, but my experience with them has consistently been better than with anyone else. The OB group at my local teaching hospital consists of 14 doctors, some of which are very, very good and who provide good, sensitive prenatal care. I can imagine being a patient in their practice and feeling like I had a very strong bond with my doctor. But I have met clients in that practice in their 3rd trimester who were not told that their doctor was only on call 12 hours per week, that there were 13 other doctors, and that the 13 other doctors varied widely in philosophy (and IMO some of them are EVIL) and that residents were likely to provide all but about 15 minutes of their labor and delivery care. Other small group practices I like in my area practice at archaic, poorly staffed, poorly equipped hospitals. The doctors and midwives are wonderful, but the nurses who care for you, the facility you stay at, the pediatric staff who decides about the care for your baby, the hospital policies you have to abide by and the nursery that might or will take your baby all suck. What kind of average, normal consumer has the time to find all of this out ahead of time? Who can blame the mama if something in this giant machine doesn't work right? So, I do try to balance the info that I give with an understanding that sorting all of this out on your own as a consumer is nigh impossible.

What I want to see as a birth advocate, activist, etc., is more evidence-based practice, better continuing education -- including periodic examinations, reform to the resident training system and a near-universal use of informed consent. I believe that the ultimate power to decide what is appropriate for a patient should lie with the patient herself, even if that means allowing her choices that I don't personally agree with. Evidence-based medicine has to be coupled with a solid right for informed refusal, or women will just be dictated to based on the evidence (like, c-sections produce statistically better outcomes for breech birth, so no vaginal breeches). We all know that studies can be twisted to say just about anything, anyway.

Well, enough for now


----------



## bloobug (Nov 21, 2001)

The OP states that a presedential candidate supports c-sections, and I'm just wondering who that is and if there are any articles that I could read.

Thanx
Megan


----------



## Greaseball (Feb 1, 2002)

What might this mean if he is elected president?


----------



## Evergreen (Nov 6, 2002)

John Edwards is the candidate. Pamelamidwife posted a thread with the link in Activism (I think) it is probably burried by now, but the title was "John Edwards, he's my man" or something like that.


----------



## lollaleeloo (Jan 29, 2003)

Quote:

The OP states that a presedential candidate supports c-sections, and I'm just wondering who that is and if there are any articles that I could read.
It's Sen. Edwards. He was a trial attorney specializing in "defective baby" malpractice suits.

Quote:

What might this mean if he is elected president?
Oh, I think we're safe.


----------



## IdentityCrisisMama (May 12, 2003)

Quote:

_Originally posted by pamamidwife_
*That, before posting, you think about WHY you are posting. What is it that you want to convey? What are your intentions? To tell someone they are wrong - or to offer another viewpoint on the subject? To publicly "one-up" another person or to offer some facts?
*
I think this is a good idea that could be used on many threads here at MDC, especially by myself...


----------



## lollaleeloo (Jan 29, 2003)

1.I don't actually get the term "birth advocate" as a general concept. Seems to me there's birth, then there's kinds of births. I'm assuming we're not talking about advocating for birth vs non-birth, but advocating for one type of birth over another type.

2.I don't have any particular 'motivations' for feeling the way I feel, or holding the opinions that I do; I've simply come to some conclusions based on my personal experiences and observations. To be honest, I hadn't actually considered myself a childbirth advocate of any persuasion (before this thread), but I guess by showing a willingness to voice the views I hold about natural childbirth (i.e., that it is generally a good thing), that qualifies as advocacy.

3.What I would like to see change is the cultural mindset that maintains, against overwhelming evidence to the contrary, that birth in general is a dangerous process, and safest when handled within a medical framework. Ultimately, I would like to see the idea of a "safe and normal" birth removed from a medical setting altogether.

4.We as individuals are responsible for effecting changes in our own lives.

5.Since you asked, as a matter of fact I would like to see more natural births, homebirths and unassisted births for healthy women. Leave the medical institutions and their staff to tend to injuries, sickness and disease, not healthy pregnancies. For a healthy well-fed woman, one thing the statistical models do show is that childbirth is as safe (or as dangerous) in your living room surrounded by friends and family as it is surrounded by skilled surgeons and an arsenal of drugs. Even that big ACOG study that showed twice the infant mortality in out-of-hospital births only came down to a tiny fraction of 1% verses an even tinier fraction of 1% (0.36% vs 0.17% )

Really, it's no skin off my nose where or how any woman but me has her baby. I'm at the point where I can finally read a birth story depicting a medicalized birth without having it eat my brain. But it took me 5 yrs to get here, to a place where I realize that everything said around me isn't necessarily about me. I'm bringing that up because I'm a long time lurker, and I've never seen anyone get slammed for choosing to schedule a section instead of a vbac. And the only time I've ever seen a birth story picked apart is when the OP explicitly requests it for her own purposes. I have seen, however, a lot of reading between the lines and not giving fellow posters the benefit of the doubt. I have seen multiple conversations get crossed somehow and end with a rant by a mom who feels under attack.

The first time I ever heard of an HBAC was on a VBAC thread. It was also the first time I witnessed one of these seemingly random c-sect survivor detonations (like the kind I used to have). The OP was an intended HB, transferred to the hospital with an eventual c-sect for FTP, and was mourning the loss of her homebirth:

OP: ...so I guess I have to resign myself to high-intervention hospital births from now on.

P2: Gee, that's too bad.

P3: I agree, that sucks.

P4: They told me the same thing, but I just had my 2nd ten pounder at home. If I had stayed with my original practice, I'd be on my 3rd section by now. CPD my ass. You know what the cure for CPD is? A midwife who knows wtf she's doing, that's what! LOL

OP: Well as a matter of fact, my doctor does know what she's doing and I have faith in her expertise. WE decided a section was the way to go because I had been on a pitocin drip for 2 days with no progress.

Lolla: Wow P4, you had a VBAC at home? Isn't that illegal? Weren't you scared?

P5: Pitocin labor for 2 days! How did you stand it? I only got 2 hrs of it and I thought I'd go insane. By the time I was screaming for my epidural, it was already time to push, so I ended up feeling everything -- including the giant episiotomy I specifically said I didn't want. If they would have let me squat like I wanted, I bet probably wouldn't have needed it at all.

OP: Squatting wasn't an option with me because of the internal monitor, which I have no regrets about at all because it showed decels that weren't showing up on the external monitor. I hate to think of what might have happened if it had continued.

P4: No, Lolla, HBAC is not illegal per se, but it was a challenge finding a midwife to take me. The only thing I was scared of was being transferred to the hospital, but I knew that it would only happen if my midwife saw that I was in real danger. Some midwives will transfer at the drop of a hat, so you have to be careful when you interview.

Lolla: Interview midwives? I know for a fact that there are no CNM's who do homebirths around here. 2 hospitals in my area don't allow VBACs at all any more, even if you've already had one. Who's having all these homebirths? Where are all these midwives doing homebirths?

P4: They're out there. Go to LLL or find a Bradley class and make discreet inquiries. And who says you have to have a CNM? There are lay midwives out there with a broader range of experience than some CNMs. Just don't get discouraged and give up. You still have options if you really have your heart set on a homebirth.

P5: Squatting was the main reason I held off on getting the epidural so long. Fat lot of good that did. I was pushing away and the next thing I knew I was getting cut. No one ever told me the baby was stuck or in danger. They didn't even give me a chance to change positions or anything. Funny enough, the labor wasn't as bad as recovering from at episiotomy. Definitely homebirth next time.

OP: OK, I've had just about enough of this. First of all, I ended up transferring, not because of my ignorant, twitchy midwife but because I felt in my GUT that there was a REASON labor had stalled, and she supported my decision 100%. Yes, I took the epidural because if anyone knows about pitocin, they know the contractions are ten times worse, so I don't think it was particularly selfish to seek a little relief after 2 days without sleep or food. Would I have been able to squat or change positions without the epi? Maybe. Maybe it wouldn't have done any good. Maybe I just would have stayed in labor 2 more hours while my baby suffered irreversable brain damage. And I still would have had to have the c-section anyway. So help me see the point of all this second-guessing. I made the best choice for me and my child under the circumstances and I'm sick of justifying it to people who think they know better than me what's best for me and my child. Sorry if I'm not some superwoman squatting out babies in a wading pool in her kitchen like there's no such thing as uterine rupture, or prolapse, or abruption. Excuse my ignorance for actually believing that it shouldn't take 3 days to have a baby. Maybe I am being naive thinking my ob/midwife team actually knows something about childbirth. Or just MAYBE I'm NOT a moron for believing that a team of medical professionals just might come in handy during a medical emergency. Look, I believe in natural childbirth as much as the next person, but things happen, and c-sections save lives and it doesn't do anybody any good to forget that.

P6: Whooah -- nobody's judging you, OP. But you can't ignore the data that says that most c-sections are unnecessary yadda yadda yadda

P2: OP, I'm with you. There's such an air of superiority on these boards blah blah blah

P4: No need to get defensive just because I, etc, etc, etc

-----------
I'm paraphrasing the exchange of course, but I'm sure we can agree that we've all seen it in one form or another. My own detonation happened when a woman with herpes posted about how she went with a c-section because she believed that it would be selfish of her to attempt a vaginal delivery with the stakes so high. I responded with my impression of Godzilla on the rag, and let her know in a scorching, bug-eyed rant how the facts say this and the studies prove that and fyi plenty of women, who love their babies just as much as you do, f-you very much, decide against the surgery because because they don't confuse ignorance with selflessness...and, well, you get the idea. What's complicated is, I myself had a c-section for a diagnosis of herpes, that I believe was completely unnecessary for many reasons (not the least of which was I didn't even have herpes, but that's another thread). At the time, I saw my fiery indignation as totally justified in the cause of correcting misinformation and debunking myths. In actuality though, I was working through my own feelings of victimization and powerlessness, and it was jarring to hear another woman describing essentially the same situation, and yet be so serenely at peace with her decision. Add to that the knife thrust of the word "Selfish" (a term wielded with great skill and precision by the medwives to gain my consent to surgery), et voila.

I don't have much to add here except a plea for understanding and patience. I totally get where Anothermama is coming from. To be honest, I'm there myself. As bad as it was to be dismissed on other boards as another natural childbirth "wacko", I think I prefer it to being dismissed as a "judgmental childbirth advocate", ironically, by people who largely share my views. This is an amazing forum here, and it feels like an oasis for many of us still smarting from experiences on other boards. I don't think it's pessimistic or cynical to say that these flare-ups and attendant hurt feelings can't be helped, but to me, that just illustrates how we could all stand to cut each other a little more slack. Pamamidwife, thank you for starting this awesome thread. It's a daunting task, balancing passionate advocacy with compassionate advocacy, but it's worth the effort.

"Be kind, for everyone you meet is fighting a hard battle." -- Plato.

eta:







: I cannot BELIEVE how long this turned out to be. I swear it didn't look that long in the reply box. Sorry 'bout that.


----------



## captain optimism (Jan 2, 2003)

Quote:

_Originally posted by lollaleeloo_
*As bad as it was to be dismissed on other boards as another natural childbirth "wacko", I think I prefer it to being dismissed as a "judgmental childbirth advocate", ironically, by people who largely share my views. This is an amazing forum here, and it feels like an oasis for many of us still smarting from experiences on other boards. [/SIZE]*
Bingo!(I added the italics.)

I love the way you summarized the discussion of HBAC. To me it sounds like you really know where all these different folks are coming from.

I don't know if I will be blessed enough to be able to get pregnant again. But I am collecting everything everyone says.


----------



## eilonwy (Apr 3, 2003)

Okay, I'm going to add one last thought here. On several threads (including this one, I believe) people have likened unnecessary medical interventions to violence against women. I want to quote a fabulous paragraph from "Protecting the Gift" by Gavin De Becker (a book which has nothing to do with childbirth, but which every parent should read nonetheless) which made me think of this thread:

"Over the years, many people have related their stories of vicimization to me, often incorrectly anticipating my response: 'You're probably going to say what I did was very stupid,' or 'I'm sure it was the worst think I could do, but...' I make it a practice to praise people for their management of saftey challenges. Clearly, whatever they did, they survived adequately to be able to relate the story; they were not killed, they were not destroyed by the experience. Since the belief that she failed to protect herself is one of the greatest harms a victim might suffer, _when a victim tells her story and people respond with You-should-have-this or You-should-never-have-that, they are often adding to the victimization._ (Italics mine) Never be concerned that a victim of violence or domination didn't learn a lesson--she did. What victims need to recover is the belief that they are competent to protect themselves."

Good stuff.







And very applicable, I think.


----------



## lauraess (Mar 8, 2002)

Quote:

_Originally posted by LiamnEmma_
*
, I say that the target audience needs to be more inclusive. Make speeches to larger groups--it takes the personal out of the message and makes it easier to digest and listen to. Go to health clinics and give presentations, go to (ooh, I like this one) health benefits fairs at companies and school districts (I'll tell you when ours is and I bet they'll let you come) and have a table where you can disseminate information. Get to know birthing instructors and give presentations during their birthing classes. I truly believe that you have to plant the seeds and let the people sow them. I think we all have to have faith in the intelligence and motivation of the masses. If we believe no one will ever understand or listen, of course we treat them with less respect and don't listen to them as openly...probably not even consciously.

Leah*
I think this is great! When can I help someone in this manner? I'll tell my story! We really do have to have faith that thing can change and offer the respect with our words of wisdom!


----------



## LiamnEmma (Nov 20, 2001)

Our health fair is in late August.







For school districts, they'll be held in the last few days before school starts. Other companies have open enrollment periods...you'd have to call them up to find out. But lots of large companies (including my school district) have various health days all the time...my district conducts free screenings all the time for the employees.


----------



## 3_opihi (Jan 10, 2003)

Quote:

Since the belief that she failed to protect herself is one of the greatest harms a victim might suffer, when a victim tells her story and people respond with You-should-have-this or You-should-never-have-that, they are often adding to the victimization. (Italics mine) Never be concerned that a victim of violence or domination didn't learn a lesson--she did. What victims need to recover is the belief that they are competent to protect themselves."Since the belief that she failed to protect herself is one of the greatest harms a victim might suffer, when a victim tells her story and people respond with You-should-have-this or You-should-never-have-that, they are often adding to the victimization. (Italics mine) Never be concerned that a victim of violence or domination didn't learn a lesson--she did. What victims need to recover is the belief that they are competent to protect themselves."
Yes. Thanks elionwy. That about sums up what I was trying to say in my post. I think another thing that kind of irks me is the whole feeling that mothers who didn't have a natural birth needed to be 'educated'. But thats already been said.

Try to look at it from this point of view. What if someone who had had five c/s, or epidurals, or whatever, jumped into every homebirth thread with a bunch of info about what its like to give birth at home, and a bunch of info and statistics about homebirth, natural birth, etc... (And I'm sure its been done, but thats not the point) The point is, it would ruffle your feathers because there would be this person giving you a bunch of advice about something *they* had never experienced, but you had.

I believe we should ALL be advocating to the system. Even moms who want c/s or epidurals can be advocating. For instance, like allowing a third person to be in the delivery rooms with mom, so that she's not alone while Dad goes to the delivery room with the baby. There is always something that can be improved. In fact, I would go so far as to say that these are the things that need to be advocated for most of all. Better treatment of women forgoing non-natural labors.

Sometimes it seems to me that labor is viewed as some sort of challenge or something. Its not about whether or not you have an epidural, or a c/s, or how many interventions you had. Its about whether or not the family is supported, physically and emotionally. And whether they feel strong and secure in their birth choices. Yes, that includes education. And it also includes support.

That's what we need to be advocating for. And it needs to happen on *all* ends. Families, physicians, doulas, and yes advocates. Right now, I don't see this happening, and it makes me sad.

I agree with the idea of large groups. Health fairs, companies, even college campuses. Heck what better of a place to make a change than with nursing students. Of course, your not going to convince everybody. If that were the case, nothing would ever get done---anywhere.

Ok, gotta go--- kids pulling each other's hair!!!!


----------



## IdentityCrisisMama (May 12, 2003)

I have one thing to add concerning speaking to groups about intervention rates. I took a class from an excellent childhood development professor and she covered from preconception up to parenting adults including birth. Her lecture on interventions was very inclusive (IMO) and included the message that birth ideally should have as few interventions as possible. She opened my mind about "interventions" by including common practices such as having a care provider or fetal monitor and that he vast majority of women (including us homebirthers - or, in my case attempted homebirthers) have some form of intervention during pregnancy, labor and birth.

My child development prof. educated about all the interventions available to women in birth with limited bias. Following this she discussed the risks and complications of interventions but she ALSO included a wise statement, which added to her being perceived by me as rather unbiased and inclusive, that nearly ALL interventions (when used well) are wonderful medical technology that contribute to birth and can even save lives of women and babies.

This small statement was important to me to have included in a discussion mostly "against" interventions because I think it helped include women who either choose interventions and/or women who end up having unplanned interventions.

My thought is that you may want to include the benefits of interventions in a discussion about all the other stats about them, kwim? It may also be helpful to broaden what you refer to as interventions to help women see how very common they are, which I think might take some of the pressure off of women for having chosen to have some.

I have some more thoughts about what people have already said but I feel like most of what I think has been said by wise women.


----------



## member234098 (Aug 3, 2002)

I have not read all eight pages of this thread, but I just wanted to say that as a veteran homebirther, I have felt a coward when I have read about unassisted childbirth experiences.

I felt as if since I had to have a midwife help me, I am a coward.

However, I am just glad my children are healthy and I am whole.


----------

