Where Do the Interventions Start?
I recently shared the story of my Postpartum Depression journey in my September 2007 newsletter. I also spoke about how difficult the recovery has been - particularly my emotional recovery - from my Cesarean section.
Some of my readers wrote back to me and asked how I could compare my C-section to a rape? They thought it was a harsh comparison, and they thought that it would scare moms-to-be.
Scare moms-to-be? If that was the effect, well then... good. Not that I want pregnant women to live in a state of fear... for in an ideal world, birth would be the natural, powerful process that it was meant to be.
But in our day - and particularly in the U.S. - birth has become anything but natural and powerful (at least for the woman giving birth) and unfortunately, women who want to protect their bodies, their lives, and their babies' health SHOULD be scared.
Not scared into paralysis or defeat, but scared into action.
Pregnant women today need to know that the U.S. maternal care system does not have their needs at heart.
Even though it seems like pregnant women have more rights than before (after all, they get to wear their own nightgowns at the hospital, bring their husbands and doulas into the room with them, and write a birth plan), these advances are cleverly hiding the fact that other, more important, rights are being taken away.
The unfortunate fact is that moms-to-be need to be ready to battle for their rights during pregnancy and labor. If they don't understand why this is so - then they need to start reading. The first step for battle preparation is to educated yourself.
Let me tell you - we don't.
For the first time in decades, the number of women dying in childbirth is increasing (this is largely due to the number of Cesareans, especially repeat Cesareans).
27 countries have lower maternal mortality rates than the U.S.
More than 40 countries have lower infant mortality rates than the U.S. The U.S. has the second worst newborn death rate in the modern world. How can this be? Again, I ask... how can this be? With all of our NICUs and our fetal monitoring and our ultrasounds and our fancy surgery rooms... how can we have the SECOND WORST NEWBORN DEATH RATE IN THE MODERN WORLD? Something is wrong there... do you see it?
One out of three women who gives birth is sliced open... which is ludicrous to me. How could women suddenly lose the ability to give birth? It's not like our bodies have changed all that much over the last few decades (or centuries, for that matter). I smell something rotten here, and it's not the mom or the baby.
The fact is - whether you choose to turn a blind eye or not - the birthing system in the U.S. is absolutely, 100% screwed up. It's enough to make me seriously debate whether or not I want to have another child. To push and fight through that system IS like going into battle... all to protect a process that should be MY choice, MY experience, MY baby's right in the first place.
We moms are slowly losing the right to say what happens to our bodies. We are losing respect, we are losing our voice, and we are losing our lives. We are losing babies. C-sections are only piece of the puzzle, but they represent a giant piece... one that is morphing into an ugly, brutal mess.
If you don't believe me, here are two books that you should check out:
Pushed by Jennifer Block
If you haven't read these books, then please rush to your closest bookstore or library and dive into them. Especially if you or anyone you know is thinking about having a baby. These are just two of many, many, many books I've read about birth... but they're two of the best for beginners... for they present a factual, unbiased look at the real story behind birth.
When I got pregnant, I had NO IDEA that birth was screwed up. And if I'd only read "What to Expect When You're Expecting," "A Girlfriend's Guide to Pregnancy," and watched TLC's "A Baby Story" (or any of those god-awful baby shows) I would have no idea just how bad it was. The traditional pregnancy books don't talk about what's going on... and the TV shows? Well, they live for drama... so they highlight all of the problems, and then sit back and relish the high ratings that come from birthing emergencies.
Normal, natural childbirth simply doesn't create good TV.
In another article, I'll list the sources that really got me turned on to the sobering birth reality in this country. But for now, I want to get back to my original thought for this article.
If you’ve had a C-section (or know someone who has had one) you may have been conned into thinking that it was necessary. Now, I want to say that I believe some C-sections are necessary. Some. But most aren’t. Many moms will tell you their C-sections were necessary, and they really truly believe this. They believe it because their doctor told them something like:
"Your baby was too big to be delivered vaginally."
"Your labor wasn't progressing fast enough."
"Your baby's heart rate was dropping."
"Your baby was too small."
"Your baby had its cord wrapped around its neck."
"You're too overweight to give birth vaginally."
"Your blood pressure was too high."
"You were simply taking too long, and the baby was in distress."
"Wouldn't you rather be able to schedule your birth and get it done with quickly?"
"If you give birth vaginally,then you'll suffer from incontinence."
"If you give birth vaginally, then your husband will never think of you in a sexual way again."
"Your baby is breech."
"You can't have twins vaginally."
The excuses and lies go on and on and on... anything to justify the trauma that happens in Labor & Delivery wards on a daily basis. And it's not just C-sections that happen. It's epidurals, episiotomies, inductions... these are all part of the game.
Before you start throwing stones, let me say this:
Sometimes, intervention is necessary. I believe that some interventions are necessary. Some. Some C-sections are necessary. Yes, I believe that and recognize that. I'm not saying we shouldn't be grateful for our technology and doctors. However, when it comes to birth, technology and doctors simply aren't as necessary as they'd like us to believe.
But these days, it's tough to tell where necessity and unnecessity begin and end. That's because the line between normal and intervention-based birth is becoming blurrier and blurrier by the second.
When you intervene in the birth process as much as we do in the U.S., you screw it up - and once that screwed up process becomes "normal" - well, then it's hard to remember what the original normal looked like.
So, when interventions become the new "normal"... "normal" becomes scary... and scary requires more interventions...
And so the cycle continues.
I'm very curious about how this cycle of intervention started in the first place?
Does intervention begin way back during puberty... when women are told to go on birth control or other medication at the first sign of menstrual cramps or a darn inconvenient period that comes (gasp!) while they're on vacation or lasts (gasp!) for more than 2 days? This small intervention from an OB-Gyn has long-lasting repercussions. It tells women that any twinge or pain from their reproductive parts is unacceptable... that it can all be taken care of with a prescription... that a women shouldn't be in tune with her uterus, that it's just too inconvenient to suffer through in this day and age. A simple prescription for birth control pills can take away a woman's connection to her body, and with that, goes her intuition and confidence in herself to know what's going on under the surface. Why is it that we don't teach women what's going on with their bodies during their menstrual cycles? I took Family Life in 5th grade folks, and I can tell you, I didn't learn shit about my reproductive system. It wasn't until I was 27 years old that I learned what actually goes on during my menstrual cycle. That's way too late, in my book. If only I'd known, I would never have gone on birth control pills for nine years...
Does intervention start with the fact that women in labor are sequestered in the hospital, kept away from everyone else? I am 32 years old, and I've never seen anyone give birth (I don't consider my son's entrance into the world a birth... I still consider myself a birth virgin). Why is it that we never see a birth until it's our own time to deliver a baby? Is it any surprise that we women are a bit scared of birth... that we doubt our own abilities to handle labor? Most of us have never seen birth... we've never been around it, smelled it, seen it, watched it, heard its sounds, been with it, or held a woman through labor pains. Instead we've been taught (through terribly dramatic and disempowering shows like TLC's "A Baby Story" and dramatic books like "A Girlfriend's Guide to Pregnancy") that birth is always an emergency... that only a doctor can birth your baby for you... that you will be lucky to be knocked out so you can avoid the pain. If we women actually participated in births before it was our turn, perhaps we wouldn't be nervous... perhaps we would have faith in our ability to do what our bodies are designed to do. If men participated as well, then they would be in a much better position to support us when our time has come.
Does intervention start with that first prenatal visit, where we are told about the barrage of tests, ultrasounds, amniocentesis, etc. that we will have to endure to make sure our babies are healthy? Excuse me, but while those tests may be helpful in some cases, in the majority of situations, they only serve to create problems that don't really exist. How in the world did babies survive before these tests? What if we just let the baby grow inside of us, in peace? That's a novel thought.
Does intervention start with the "due date" designation? I mean, c'mon... no woman has ever stayed pregnant her entire life. That baby will come out... when it's ready. Whether we have a due date or not. A baby doesn't care about a due date... and I don't think we should care as much as we do. A due date is an arbitrary number based on arbitrary calculations... and all it does it create a very easy way for the doctor to give you a reason why you should be induced when it's convenient for him/her. And due dates work... women start getting really antsy when their due date has come and gone. They also feel like it's OK to induce a week or two early, since it's "so close." What they aren't told is that the due date can be off by several weeks... especially if you don't have 28-day menstrual cycles. So oftentimes, babies are forced into the world before they're fully cooked. I'm always curious what would happen if women weren't given a due date, if they were just allowed to go into labor when their baby and body deemed it time? That would certainly reduce the number of "Have you had the baby yet?" phone calls that make women so self-conscious and antsy in the last weeks of pregnancy.
Does intervention start with our society's fast pace? After all, most moms work up until the baby's head starts to crown. Moms who work outside the home often try to work as close to their due date as possible, so they can have the maximum time at home after the baby is born. Restricted maternity leave creates stress, which prevents moms from slowing down and getting ready for birth. Moms who work at home are so stressed out from running their businesses or managing their household and kids that they go into labor feeling tired and stressed as well. Where is our societal support system for pregnant women? The one designed to honor and respect a mom who's about to bring another human being on to the earth? We can't just give the mom-to-be a nice fuzzy blanket from Pottery Barn Kids and consider our job done. We have more responsibilities than that. We have to take care of her, help her get sleep, rub her feet, cook her meals, help her prepare emotionally. Other cultures understand this... why don't we?
I must admit, the way we birth in the U.S. makes total sense to me. I look at the way people prefer to eat in our country. Fast. We want food. We want it now. We gulp it down while watching TV or working. Why wouldn't labor be the same way? We want the baby now... we want it fast... we don't want to have to think about labor, feel it, or experience it. God forbid we lose control.
Perhaps if we could just slow down for a second, we might see that labor - as it's been designed by Mother Nature - is the perfect last preparation for motherhood. But no, once we become moms the fast pace starts again... we don't know anything but overscheduled, overstressed, overworked lives... so why would labor be any different?
Does intervention start with the doctor's need for convenience and control? For example, if you are "due" the week of Christmas, you can bet that your doctor is going to find a really good reason to induce you and start labor before Christmas Eve rolls around. Same thing applies if you go in for a regular prenatal appointment on a Friday morning, and your body shows signs of going into labor over the weekend. I bet money the doc will get you in for an induction on Friday morning... that way, his weekend won't be "ruined" by an unpredictable birth. It's funny how most births tend to take place between 9 a.m. and 5 p.m. Monday through Friday - who's setting this schedule? It certainly isn't the babies.
Does intervention start with the legal system in the U.S.? Most doctors are scared to death of being sued, and for good reason. Malpractice insurance is expensive as heck... and one false move, and you're out. So docs now do anything they need to in order to avoid a lawsuit. This means: get the baby out alive. If the mom is injured or dies, well, that's not so bad. The baby is the important thing. But not just that. The baby has to be delivered by C-section... because if a baby is damaged in a vaginal birth, then the doctor will get ripped a new one for not doing a C-section. If a baby is damaged during a C-section (or a mom, for that matter) then the doctor's butt is covered... because they were the heroes of the day (insert SARCASTIC TONE HERE) and did everything they could.
So, if a doctor has to choose between doing a risky surgery that would save her butt and trying to help a mom through a normal, vaginal birth... which would she pick? Well, the doctor's going to protect her butt. And can we blame her? On second thought, I won't answer that question. If we dig deep into the layers, the real person who's being kept alive during a C-section is the doctor, not the mom or the baby. Funny, I thought maternity care was about the mom and baby. Perhaps we should start calling it OB Care instead of Maternity Care.
Does intervention start with Pitocin, which jumpstarts labor before the baby or the moms' body are ready, and causes contractions that are so painful that it's almost impossible to have a drug-free birth? One out of every five women polled in the "Listening to Mothers II" survey said that they were pressured to have their labor induced.
Does intervention start with stripping of the membranes or breaking of the water, which basically starts labor prematurely, and can release the cushion that protects the mom from really bad labor pains... again almost guaranteeing that drugs are necessary?
Does intervention start with electronic fetal monitoring (EFM) which forces a mom on her back (the worst position to labor in)... redirects everyone's attention to a computer monitor... and makes the computer more important than the woman who's actually CONNECTED to the child? Even though EFM hasn't been shown to improve birth rates or cerebral palsy rates, hospitals continue to use them. Why is this? It's another way to save the doc's butt. EFM provides great "proof" in malpractice court.
Does intervention start with some out-dated "You must deliver within 12 hours" birth model developed by a doctor many generations ago? OK, so I'm waiting for the day when some male doctor tells us that we should be able to have sexual intercourse in 14 minutes, and if we last longer than that, then we'll need to have a doctor's intervention. I mean, that sounds ridiculous, right? So, why don't we think a 12-hour restriction on labor is ridiculous? Have we been brainwashed that much? Labor takes as long as labor takes... sometimes a few hours... sometimes a few days. If we give labor a deadline, that mucks up the process and simply makes mom nervous and stressed.
Does intervention start with epidurals? Epidurals, which basically take away the mom's connection to her baby and make it harder for her to know when to push? Epidurals, which make it more likely that a mom's blood pressure will sky rocket and a C-section will be done? Epidurals, which make it harder for a woman to push, which lead to longer second stages during labor, which lead to C-sections? Among many other things...
Does intervention start with the hospital setting itself? Because, in reality, a hospital setting is designed for sick people. Pregnant women are NOT SICK. They are not sick. They are not sick. Let me repeat that again: pregnant women are not sick. They are strong, radiant women... and if you'd just believe in them for one second instead of stuffing them in a gown, tying them to machines, and forcing them to deliver within a 12 hour limit, then they might just amaze you with their strength and health. If they were allowed to labor alone... in darkness... instead of having people barging in the room constantly... and being subjected to exam after exam... then perhaps they wouldn't feel so threatened... and labor wouldn't take so long. If we allowed women to act like momma dogs or pigs or wolves behave when they birth their babies... then we'd probably have a lot more healthy babies and moms. Hospitals are designed for sick people. They're designed to solve problems, to give drugs and medication, to monitor people. Well, birth isn't a problem, drugs aren't a solution, and constant monitoring isn't usually necessary. Hospitals have turned birth into a disease. Is it any wonder why we're all scared of it now?
Does intervention start with the hospital staff? The staff who come in and try to push meds on a mom, even though she's told them she wants to go natural? Some hospital staff have a running joke about the moms who walk through the doors of Labor & Delivery. I've heard jokes about the "well educated, Volvo-driving women with birth plans" who will ultimately end up with C-sections, no matter what they've hoped and planned for. I've heard stories about nurses who set up betting pools based on who will get a C-section. What a cruel way to determine a woman's fate, for these nurses have a huge impact on how the woman feels during labor. If they're betting she goes down, then you can bet there's a high likelihood that she'll go down.
I know that there are great nurses and docs out there, and I personally know some of them. But I've also heard lots of horror stories. I know L&D nurses who can count on one hand the number of natural, drug-free births they've seen. Excuse me, but if nurses and doctors aren't used to attending natural births... then how would they know what their role is in such an event? (hint, they should have LITTLE role in a natural birth). Ah, and therein lies the problems. Doctors and nurses have been trained to solve problem, take action, and react to emergencies. When a laboring woman comes along, there's usually no emergency... so the docs may feel a bit useless. Who can blame them for creating emergencies so they can feel useful?
Does intervention start with an episiotomy? An episiotomy, which slices a woman's vagina and basically scars her for life. It makes some women fearful of another vaginal birth and more inclined to have a C-section than risk having someone cut their private parts again. 82% of women who were subjected to an episiotomy said that they were not consulted first. Would we ever do this to men... slice their private parts without asking their permission? Oh wait, we do it... but not to adult men (oh no, that wouldn't go over well) but we do it to helpless little boys when we circumcise them. We mutilate their bodies when they can't fight back. Interesting. This is exactly how we mutilate women's private parts... when they're at their most vulnerable, legs spread, unable to move or defend themselves. How cruel is this?
Does intervention start with a C-section? Well, the C-section is thought of as the "ultimate" intervention during labor. It basically bypasses the birth process completely. It stops the momentum of labor from down-and-out-mom-is-birthing-her-baby... and redirects it into "pull-and-lift-mom-is-disconnected." The mom's power is basically bypassed in a C-section.
This intervention creates a mom who can't lift her child for weeks... a mom who has three times the chance of dying during childbirth... a mom who has a large chance of getting an infection, having a miscarriage later... or having to undergo yet another surgery if she ever wants to have another child?
The C-section intervention has far-reaching effects... because it impacts not just this birth, but the moms' birth choices down the line. This intervention makes many women feel helpless... which means that they often doubt whether their bodies can give birth vaginally the next time around. A mom who's had a C-section can be denied a vaginal birth simply because of her scar. In fact, 56% of the women surveyed by "Listening to Mothers II" who wanted a vaginal birth after Cesarean (VBAC) were denied this option. The doctor who slices into a mom can go home and sleep at night, but the mom may never sleep during her next pregnancy, wondering if she'll escape this fate the second time around.
You may say... well, moms WANT C-sections! That's simply not true, despite what the celebrity magazines lead us to believe. In the "Listening to Mothers II" survey, one out of every four women who had a C-section said they felt pressured into it. Only 1 mom surveyed (representing less than 1% of responses) said that she asked for a C-section - that, to me, doesn't indicate a high level of maternal demand.
For the record, I am not saying that these comments apply to all hospitals, all docs, all nurses, all births... but they happen much more often than not. And it's time for it to stop.
The birth situation in this country is absolute madness. And if you think I'm exaggerating, then you need to start reading, talking with moms, listening to docs, and opening your eyes. Because if you remain in the dark about this, it will never change. Things are only getting worse.
THIS IS NOT NORMAL BIRTH, FOLKS. If you think this is normal, then you've been brain-washed, too.
I am so mad about this, I could spit. But spitting isn't productive. So instead, I choose to write about my experience... in the hope that moms and dads and doctors and grandparents and government workers will start to wake up and see that we are going down a very, very dangerous and deadly path with our maternal "care" in this country. And where the U.S. goes, the rest of the world is sure to follow.
I'm not sure we can stop the madness without going to the source and stopping the interventions where they start. That would require starting to teach our girls from a young age that their bodies are miraculous beings... that they have innate wisdom and intuition that they can trust... that they should learn everything they can about their bodies because they - not doctors - are the best experts about their own reproductive systems.
That would require boys and girls to see a birth (better yet, several births, and preferably homebirths) before it's time for their own child to be born... to learn from parents who help them see how aches and pains in their bodies are really signals that their bodies need them to change the way they eat - or slow down - or talk about their feelings... rather than pop another pill or self-medicate with food or video games.
It would require us to slow down enough to really truly listen to our bodies... to set an example... to talk with pregnant women and see how they're truly feeling instead of spending money for baby showers and registries... to take the time to help a mom-to-be out so that she doesn't have to be superwoman during the last few months of her pregnancy. To turn off the emergency-based shows like "A Baby Story" and censor books that make moms feel disempowered.
It would require us to provide a doula for every mom... and legalize midwifery in every state... make homebirth an appealing (not law-breaking) option for moms... make midwifery the standard of care for every woman who's not high risk... and redefine our "high-risk" definition so that it doesn't apply to half the mothers giving birth.
I could go on and on and on, but I'll stop here.
What other ideas do you have? Email them to me, please.