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Monday, January 24, 2011

What birth stories can tell us (if we listen)

Every birth story is important, and we need to listen
carefully: What does it tell us about ourselves? And
of our past and present birth culture?
Photo credit: Jennifer Lasseter
Every so often, I talk to women who's birth story - or in this case, lack thereof - stick with me and really have an impact, whether for their joy or their profound sadness. I think of these women and wonder, if in a different time and place, things would have turned out much differently for some of them.

Mary, an elderly lady with whom I used to attend church, told me a fascinating if not altogether creepy story of how her doctor intentionally turned her first child breech in the womb, resulting in a breech vaginal birth. I wondered how poor Mary fared and if she ever questioned the "expertise" of her seemingly odd doctor, considering that probably nearly all the women Mary knew had babies who came out head-first. It's a wonder that she went on to have two more children after that.

Later at one of my OB visits while pregnant, I mentioned Mary's doctor to my OB, who dismissively said, "Yeah, that sounds like Old Dr. So and So." No word on what his crazy theory was supposed to mean or what results it was supposed to yield, other than making for an unnecessarily painful, most likely difficult and probably traumatic birth.

Another friend, Andrea, didn't have a birth story so much as she had one taken away from her: she confided in me that she had been diagnosed with bipolar disorder and depression. She was married for fourteen years and has struggled off and on in relationships. Her doctor told her that because of her bipolar disorder, she should never become pregnant. She reluctantly followed her doctor's advice.

Maybe Andrea's doctor was right; maybe not. I do know some perfectly competent mothers who are bipolar and manage with proper medications, monitoring and support. I can't help but wonder what Andrea's doctor's goal was: to keep her from "breeding" and passing on her "defective" genes? To somehow "spare her" the trials of motherhood?

Sandy, the mother of two grown sons, gave birth to her second son - on the heels of his older brother almost exactly a year later - and didn't want or feel she needed any pain medication. Sandy got into the delivery room just in time for the baby to crown, yet the nurse was adamant on giving her pain medicine.

I've had this post mostly finished in draft mode for months, and something sparked in me when I read a recent blog post from Birth Without Fear, who recounts the story of Zelda from Peggy Vincent's book Baby Catcher that unfolds much like Sandy's. Zelda was a black woman laboring on her own terms, vocalizing and doing great - until she is forced onto a bed and given pain medicine that she neither wanted nor needed. What is the real point here? Were doctors teaching us a lesson? Saving us from ourselves, that surely birth must be painful for everyone (because either I say it's so, or I make it so) and you're no exception?

Judith, who had just delivered her first baby and was determined to breastfeed, was given hormone medication to take after her birth - which was actually quite common then. Later she realized the nurse had given her pills to dry up her milk, even though she had made it quite clear her plans to breastfeed. How is it that someone makes that decision for you, without even asking your permission? Sorry, but this still happens today - "Take this pill," without so much as an explanation. Hang a bag of Pitocin after birth in order to shrink the uterus, even though mom is successfully breastfeeding, no questions asked, no reason given. Before you know it or can even object, it's done.

Even in the not-so-great birth stories, they're still important - in helping us understand the rocky history of "modern obstetrics," as well as putting things into perspective. While straps were often used to tie down a patient to force them to comply, those straps have turned into IV lines and lead strips for EFM today. The tethers that were once present at birth to quiet a patient have now been replaced with epidurals. A quiet patient is a compliant patient, and when mom isn't hollering, yelling or vocalizing through the pain, hospital staff doesn't have to hear her or deal with her.

Our culture's tenacious hold on birth ignorance is stronger than any leather strap or dose of narcotics, and it's these people that need to hear these birth stories the most. We need to read between the lines, and educate ourselves: why was grandma's birth story so much different than mom's, or mine? How was it the same, and what needs to change? As we see in Zelda's story, the endless empty excuses and outdated ideas blend with modern medicine. The shackles are still there; they just look a lot different.

More reading:
Pushed: The Painful Truth about Childbirth and Modern Maternity Care, by Jennifer Block
Born in the USA: How a Broken Maternity System Must be Fixed to Put Women and Children First, by Marsden Wagner
Birth: The Surprising History of How We Are Born, by Tina Cassidy