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Sunday, January 10, 2010

Control Freak!

I'm sure that anyone who's thought about this as much as I have already knows this. Perhaps it's just a rant, an out-loud thought or observation that no one else is here to experience. But when I think of the typical model of birth in this country, especially among women I know (or based on my own experiences) things happen in one of several scenarios:

• You go into labor on your own, you receive an epidural, you have your baby.
• You go into labor on your own, but things don't progress to your doctor's liking (read "I have an important golf game/dinner banquet/my son's birthday party to attend! Hurry up and give birth!") and you're given Pitocin, you have your baby.
• You approach your due date, the due date passes, and nothing happens. Two days after your due date, your doctor gives you Pitocin, "lets you" labor for a few hours, and after nothing happens, does a c-section.
• Your baby is breech either upon the onset of labor or a few days before the due date. Your doctor does a c-section.

It used to be, probably during the days of our grandmothers and great-grandmothers, much different:

• You went into labor on your own, probably even up to two or even three (!) weeks late, had your baby at home, and everything was fine.
• You went into labor with a breech-presenting baby, doctor delivered the baby, and everything was fine.
• You went into the hospital with mild contractions but no other signs of labor, and they told you, "Sorry, honey!" and sent you home until it was really time.

Now, obviously this is an oversimplification, but I think you get the idea. It's important to note, though, that even with the higher infant mortality rates in the days of our grandmothers, that even with all of our medical technology and know-how, we still have extremely high rates of newborn death (in fact, the second worst, according to this article) among other industrialized nations. How on earth did this happen?

Somewhere between our mothers and ourselves, it seems the lines have been blurred. Somewhere along the path of medical school and obstetrical practice, our doctors, by and large, decided they were too busy or important to wait on our babies to be born when they decided to. At this point, they became impatient and wanted to control the one last vestige of life that is, still, largely unpredictable. You can have 100 vaginal exams a week before birth, all of which reveal some cervical dilatation or none at all, and it still won't be a good barometer of when you're going to give birth. You can be tightly closed with no effacement and then, six hours later, be holding your baby. It's the unpredictable nature of babies (both inside and outside the womb) that I think drives most modern-thinking OB's (read control freaks) absolutely nuts, because they just might get interrupted in the middle of something important. Nearly gone are the days of your OB racing to the hospital to catch your baby, like my mom's did - in a tuxedo.

No wonder the stories of women giving birth in elevators, taxi cabs and air planes are so rare and sensational - who gives birth like that anymore? There are some doctors who think every woman should give birth by c-section, no doubt just to avoid the unpredictability of birth and have it done their way. It's important to remember that, while there are interventions that are definitely necessary, those that truly aren't mean there's a price the rest of us have to pay.