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Thursday, February 17, 2011

A bitter birth nerd

The other day I posted this question as my FaceBook status: "Do you ever think sometimes that you just need to step back from birth stuff for a moment or you'll explode?"

I was kind of surprised that some wholeheartedly agreed yes - although I'm not sure why I was. Normally I love the writing, the reading, the interacting with others - but sometimes I just get so bummed by the situations of people around me - people I don't even know - and don't know how to put my finger on those feelings.

I lie awake and think, What is wrong with me? I can feel a tension, an undercurrent, and I'm not even sure what it is. I realize that I worry, for other people. Women I don't even know. I can't read "certain blogs" (ahem) before bed because I will stew and seethe fitfully through an entire night's sleep. I lie there and wonder, How am I impacting anyone? Who am I really helping? Why does it seem that so few women agree and that so many women are sucked into the vortex of unnecessarily abnormal birth? How can they not see it? 

Sometimes I think, Will my blog just keep going on forever? What will there be to write about? What kind of advocate will I be in 10, 15 years or will I even be one? I like to consider myself a "birth nerd," not a "junkie," mostly because I know certain people (the same people who write those "certain blogs") consider that statement laughable, perhaps derogatory (even though they themselves live, eat, breathe birth, just a different kind of birth). I never started out on this path intending to be anything other than a mom, and somehow careened into something else. I never dreamed I would come to this point.

Knowing what I know now, and in sharing the experiences of other people, it's hard not to be bitter and hopeless about things sometimes. Especially in the comments I received on my last post, I was disturbed by the responses I got. I feel angry for these women, wondering why some of them aren't angry, too. Thankfully, some of their husbands stood up for them and confronted the doctor. But then what? What did it change? If we keep hearing how this happens, how it's legitimized, what has it really changed?

It's hard not to get defeatist or angry over other people's decisions, knowing that it's a decision I would never make for myself. But then I remember, they're not me. So it doesn't matter what they do. It ultimately doesn't matter what I think.

My niece just gave birth to her first child, and as usual, the end of her pregnancy was miserable. Just like it is for just about every woman. I know many women suffer in physical and emotional ways that are far above the norm, and I don't want to make light of their ailments. My niece was uncomfortable, but said she did not want to induce without a medical reason. I took that as a good start and offered advice, as did many of her friends: avoid Pitocin. I tried to encourage her the best I could, offered tips on how to manage labor and blah blah blah. The usual "Your baby will come when he's ready" stuff that us Birth Nerds like to tell everyone, which sounds crummy and well-meaning to her, but hey - it's the truth.

When she posted pictures of herself on FaceBook after she had the baby, I found myself scrutinizing them closely. A shot of her husband standing next to a sterilized cart of medical instruments, no doubt "just in case." I thought, I am being an idiot, but honestly - I do it all the time. I'm not sure if this is good, bad, normal or what - but I wondered, Did she get a cesarean?! I was so hoping not, that she had gone into labor on her own and just let the baby do his thing.

My mom called the other night and asked me if "I'd heard." Apparently they never told any of our side of the family, until my sister blabbed. Of course, I had a sinking feeling when I saw that picture of her, smiling, hugely pregnant and in her hospital gown. Few women in true, active, unmedicated labor look like that, I thought. And if they're medicated, they don't look like that, either. My mom sounded kind of disgusted, which secretly pleased me: "She got induced."

I knew it. My heart kind of sank.

I told her I had tried to help and knew she was uncomfortable, told her that it could potentially raise her c-section rate, and her group of friends and I told her to avoid the Pit. I kind of thought, Geez, why even ask for advice and sympathy when you're just going to ignore it? She suffered just like the rest of us do, and then later I read status updates on how awful she felt and what a "rough recovery" it was. Yeah, no kidding, honey. I don't want to say, I told you so, but ... well, I told you so. I can even picture a possible scenario (God I hope not): I tore so badly with my last birth, why don't we just schedule a cesarean this time and avoid all that?!

It's hard not to get too caught up in other peoples' decisions. My mom even told me, "Don't take it personally." I try not to, but I still can't help looking at pregnant women in public and wonder, Where are they giving birth? I bet she's had a cesarean. I wonder if she'll get an epidural? It's the most absurd conversation ever, and yet, I bet I'm not the only one who does it.

Sometimes in conversation with strangers we'll start talking about babies, their upcoming birth and whatnot, and something will slip: "Oh, I'm due on July fourth." I immediately picture the woman on the operating table, told her "fluid was low, baby was big!" kind of crap perhaps because her doctor had a Fourth of July picnic to go to that was more important. You can't just open up a can of worms with strange women in public like that. At least not unless you want them looking at you like you've grown a dozen heads and suddenly started talking in Pig Latin. I wish I could tell them. So much to say, so little time. So few people who really want to hear it.

I know my niece, and many like her, made a decision. Was it the right one? I don't know. I don't know if even she knows that. I don't know how much she knows about birth, or why she's feeling like she is, like she got run over by an 18-wheeler. I don't know if she'll make that connection the next time she's in labor, if there is a next time.

I don't know how much of her choice was really hers, in the end. I'm not sure if she's knows that either. She may have read some books, asked some friends, but in the end, did it matter? Maybe she thought, That's not what my doctor is telling me, or That's not what the pregnancy book I read said. Just some crazy relative talking out of her ass, that's all.

I know I can't make decisions for other people, and that every birth is unique. I'm not feeling their emotional pain from having weaned themselves off their antidepressants and rounding the corner into a possibly monumental bout of postpartum depression. I'm not feeling the physical pain of SPD. But I have felt the physical pain of cesarean, the emotional pain that everyone tells you to get over because you should "just be happy you have a healthy baby!", the psychological stress of wondering how much I'll have to fight for the birth I desire, should I ever get pregnant again. And I can see what might lie ahead for my niece and others like her, because I've already been down that road and don't want someone else to go down that path, either. At least if they don't have to.

Some thoughts that sum up what I wish I could tell people, that I wish they could understand:
When we treat high risk women with all that we have to offer, we lower their risk. When we treat normal women as high risk, we make them sick. - Michael Klein, MD
Any decision that is made without research and education, is NOT a fully informed decision. It is a decision based on fear and/or one that relies on dumb luck. - Health, Home and Happiness


Sarah--Well Rounded Birth Prep said...

Yes! All of it! That's me! (The birth nerd, not the type like your niece.) I'm trying to find a balance so I can be effective as a CBE without carrying other people's baggage for them.

The Deranged Housewife said...

Exactly. While our personal experiences matter and can offer perspective, it shouldn't taint our view of our advocacy, either. It's a fine balance!

Anonymous said...

You know, I struggle with what you have said here, but not because I disagree with you. The problem is that so many women are uninformed, and society teaches us to trust those in authority. We are taught that Drs. are a kind of authority - when it comes to our health and wellbeing.

That said, I was induced with my son at 42 weeks. I was nowhere near ready to go into labor, but my Dr. insisted on it. I had other issues going on, such as high blood pressure and intense migraines throughout most of my pregnancy. This was not pre-eclampsia, as I was tested for it a number of times. I even had a migraine when I was induced into labor, so I wound up asking for an epidural bc I couldn't handle both types of pain. Like your cousin, I had a very challenging recovery. I tore some, but not a whole lot. However I could very well have wound up w/ a C sec. as well, because I pushed for 3 hours - he was at zero station when I was 'ready' to push, and I couldn't feel anything. It bothers me to think about how it happened, but I felt helpless to do anything differently. I didn't know a whole lot better at the time, but I did know that, where I'm from if the Dr. says you have to induce you can lose your Dr. if you don't consent. Then you are left to the devices of whoever is the Dr. on call at the hospital if/when you go into the ER to give birth. That scares the crap out of me, because there are some wacky Drs. around here. One is literally nicknamed 'Dr Cleaver.'

What suggestions would you give to someone in the same situation as mine?

Diana J. said...

All of it. Apparently we are operating on the same channel!

I saw you comment on Kathy's FB and eventually found your blog - love it! Can't wait to read more!

Here's one I absolutely loathe that I hear a lot: "I'm due on [day X] and I'll be delivering on [day X minus 1 week]." In other words, (1) a scheduled cesarean without even attempting to THINK about VBAC, (2) delivering at 39 weeks, when baby is NOT READY to come (instead of waiting for labor, which is SO inconvenient). Oh, don't get me started.

Nice to meet you!

mella said...

YES, yes, yes. Omg. I can't even begin to tell you how much I can relate with you on this. It extends into breastfeeding as well. The worst part is when women ask you for advice on birth and what they should do because they know that you know, and then they deliberately go and have x,y,z done, despite ALL the things that you told them about what was going to happen. Then, repeatedly post on FB about how horrible everything was and the circle of pain, fear, and how "the doctor saved my life! The doctor saved my baby's life!" crap can start all over again. UGH.

The Deranged Housewife said...

Hi Diana! Nice to meet you as well. :)

To the 42-weeker: that is such a hard call. I think if I had it to do all over again, one thing I would have done was labor down - if you couldn't feel anything, maybe you were like me: you had no urge to push and were just doing so because they told you to. Turn the epi down so you can feel something; I hear so many people say how they can do that, and yet wonder, do they really? Cause I'm also hearing a lot of "I couldn't feel a thing to push," which is wrong! I can't even imagine who you would be able to know what you were doing if you were numbed. It's like when I had the spinal for my last cesarean - you can try and 'will' yourself to move, but you just can't make it happen. And at 42 weeks, there are risks to being overdue, even though plenty of women do it and do just fine. it's an individual decision and one that you as a mother should feel comfortable with, taking into account the level of risk and realizing that your doctor might not be on board with it. That I can understand. But "getting in there" at 38, 39 weeks like some do is crazy.

Knowing our rights - not just our choices - is important as well. Abandonment of a patient is illegal, I believe, and they have to give you notice before they drop you. They can't just leave you hanging, but I'm sure it varies from state to state. having a strong advocate with you, whether it's a husband, doula or both helps tremendously. A doula can also be helpful when the husband isn't quite on board with the idea, but it is very difficult when he doesn't fully support you in your decision, whatever it may be.

It's hard to say, because every situation is different. *sigh*

SusanAlexander said...

I am right there. Seriously. I find myself shutting myself up when talking to pregnant women. I try hard to find a balance that doesn't come across as pushy but yet allows me to satisfy the "I must tell you" feelings I have.

A friend of mine was nearing the end of her pregnancy and kept talking about how "baby will be here soon" and so forth (mind you she's something like 35 weeks at this point). At around 36 weeks she starts having more regular BHs/prodromal labor and they decide "it's time" because "the fluid is low" or something along those lines (I honestly can't remember). Meanwhile I'm saying "Please, consider getting a second opinion. Please talk about the possibility of waiting until 37 weeks to induce, etc, etc, etc"

But I knew before I started - my pleas fell on deaf ears. Off she went for her induction because "she was already in labor." Several days later she posts a few things about the experience - long, hard labor, feeling really rough after that fact. I'm still wondering "was it vaginal or a c-section?" and "was there an epidural?" and so forth, but I don't dare ask. :( :(

And this happens over and over... Anyway, my hope is to train as a homebirth midwife someday so I can at least help SOME women help themselves. Sigh...

Anonymous said...

I have the same internal conversations with myself when i see pregnant women. And as a previous poster said, it extends to breastfeeding, but even more for me circumcision. I give the pregnancy advice when i think it will be heard, and at this point I know of 5 women who have had or are planning to have homebirths because of conversations we have had. It makes it a little better.Its hard though when i hear of the inductions and the women having repeat sections because they are told their hips DO NOT spread and never will, or that they are too small to birth. I wish i could step back from it because so many women like the way they birth with technology and I feel like its a losing battle but then i remember those women i influenced.

sara r. said...

This is so me, also. I've been having conversations with a fellow doula-in-training about our philosophies in taking clients- would we support a client who we felt wasn't committed to a natural birth? I'm If something medical came up, then yes, definitely. But someone who goes in for an unindicated induction...if I put myself in that position repeatedly I would get burned out as a doula.

It's really frustrating to talk to pregnant women for me, since I feel that most of what I say will be falling on deaf ears.

Kimberly said...

I feel like you were taking the words from my mind, heart and mouth. I try to "save" as many women as I can but sometimes I feel like they think I'm nuts and maybe overstepping my bounds. I didn't have a c-section partly because I INSISTED on NO PITOCIN, NO PAIN MEDS!! However, I was in preterm labor on and off for 4 weeks before my water broke at 34 weeks. From the time my water broke it only took 4 hrs for him to be delivered. So I would think I really did not need pitocin anyway. I still feel the same way you described though for all those other mothers and babies. Sometimes I feel like if I could get a job teaching women how to avoid interventions during pregnancy, labor and delivery that I would have found my calling and become a work-a-holic.

worms in children said...

I am impressed by your work. We should do more good work. As with out peace this world is like hell. Thanks a lot!

Natali said...

Keep doing what you're doing, whatever you do. I would give almost anything to know what I know now, back when I had my son. My birth experience was horrid and included an induction, 24 hours of labor, and an unnecessary c-section (we were not high risk in any way)as well as an epidural block that did not work during surgery. Our bonding experience was nothing like I'd hoped either (of course, under the circumstances!). Keep fighting the fight. You will help some more than you'll ever know. I now can't have any more children- what I'd give to go back in time and have a do-over...

Ruth said...

Cognitive Dissonance.

Understanding this theory about human nature will help ease your mind to understand why humans behave the way they do. Sometimes even when they know better they don’t do what is best for themselves~!

"Those women" you are talking about are in the majority and part of the popular culture in the USA, not us. They are having culturally normal birth experiences, statically we are not, and we are the ones who choose the unmanaged unmedicalized birth.

As an alternative birth worker I always remind myself “IT’S NOT MY BIRTH”.

Sarah Atondo said...

Amen!!! It's soooo insanely difficult to keep my mouth shut about birth, breast feeding etc. it's so hard to know that you hold this information that could potentially change someone's life. The problem is that 98% of women DO NOT want to hear about what us wacky hippies have to say about what we believe. They have decided to trust their doc to take care of them. I could write forever on this. Just are not alone.

ruth said...

Why make it about bashing other women or feeling bad for the choices they make and how they give birth.

Most women are unsuspecting of how difficult it is to give birth normally in a hospital. If they have not hired you as a their professional to help them navigate or education them why should they listen to you?

I think it's time to stop blaming women for their birth and breastfeeding outcomes in this current culture that does not support physiologically normal birth or breastfeeding.