Tuesday, April 28, 2009

Bottom Line About Birth

I haave been trying to come up with a short statement that describes my beliefs about birth. I've been thinking of it kind of a guiding statement that can inform my efforts. This is what I've come up with so far but I know that it will evolve. Originally this was posted in an online discussion board. At the end of the statement, I discussed the implication of my belief statement.

Birth is a normal process in a woman's life much like the menstrual cycle. Typically, in the majority of cases, it is a process that women can handle on their own without medical assistance. Sometimes the process goes outside the normal range so its a very good thing that traditional and medical knowledge and intervention is available for consultation and judicious use. Menstruation, like birth, can be a painful (intensely painful) experience for some, even most experience pain in relation to that womanly process. Therefore it is perfectly reasonable for women to seek out ways to minimize that pain (unfortunately a tylenol isn't so effective in labor as Morphine!).

What are some of the implications of this belief?:
1) Drs, hospitals and midwives are not necessary in most cases for birth. It would be like going to a hospital when menstruation starts and staying for the duration of the bleeding cycle while efforts are made to speed the shedding of the uterine lining, reduce pain and discomfort and prevent excessive bleeding.

2) Sometimes consultation is needed when something is varying widely from normal and its a good thing that those experts and facilities exist.

3) Those facilities and trained experts need to exist, know the role they are intended to play and use practices that are based in logic, evidence, safety and effectiveness with minimum intervention. I cannot say that I believe that current obstetric and even midwifery practices support this.

4) I'm not going to begrudge anyone who seeks to find pain relief for either womanly process, but I will point out that the big guns of anesthesia are not typically warranted for pain associated with such a normal event (and I'm going to say it) everyday event.

5) Birth is not treated like an everyday event in our world, but in many ways it is. Its a normal part of life that is filled with significance and symbolism, but its just birth like defecating is just taking a poop and menstruating is just the shedding of the uterine lining.

6) There needs to be levels of involvement based on need when something is going wrong. The first response to derivations from normal is the individual relying on knowledge sought and shared by peers and women who have taught her about the process. Self-comfort measures, then possibly herbs, then possibly stronger pain relievers, then consultation with an outside trained consultant who offers the minimum of support for a normal process. As more is needed, those services can escalate to meet the need presented before them. But prophylaxis is not really warranted. Treatment of symptoms and finding the root cause while supporting the overall process ought to be maintained as the standard of care. What this implies is that midwives need to be able to consult freely and make referrals to obstetricians without fear or reprisal. OBs need to remember their place in the process not as the director but as consultant. Women need to accept and act on the belief that help and assistance is not needed and its something that they, their bodies and their babies do as an everyday fact of life.

7) Where does trauma fall into this? When things goes serious wrong with any health related concern, the emotional trauma can be profound. Women in childbirth aren't the only ones who are traumatized by a major health crisis: cancer, injury, surgery, hemorrage all are scary because there is a threat to our sense of safety within our own bodies. Those crises are scary and its no wonder that people have long term emotional effects from those experiences. For birth, there's also another cause for trauma besides the pain, besides the fear of when things go wrong. There is what happens when people who shouldn't be meddling in a normal process get involved and screw things up. Providers don't realize the physical and emotional damage they are doing when they push for unecessary and not evidence based practices to control and process that they are afraid of. Its not something to be afraid of in most cases. Yes, sometimes it can be scary but that doesn't mean that every poop needs to be closely monitored and controlled. Doing things that don't need to be done will just make things worse.

Why I am a UCer

One of my online groups asked each member to explain their personal reasons for UCing. This was my response:

I came to UC through a traumatic hospital birth, but I feel I can truly say that
it is not why I choose to UC. Before my son's birth, I didn't know that UC was
an option, and not one that I would have considered. I thought that babies were
born in hospitals for good reason, not knowing (or taking the time to find out)
the history behind hospital birthing.

After becoming a mother, I started really learning about birth: to make sense of
what happened in the hospital and to prepare myself for something different and
better for the next birth (which I'm about a month away from now!--so be warned
that the following is all theory at this point. We'll see if and how the
following changes after the new baby is born).

Being LDS, knowing that I am meant to have more than one child and having a
strong sense of justice, I knew I had to find a better way to birth. I likely
would have been comfortable with a birth center with a midwife but I felt drawn
to UC when I heard about it for a few different reasons.

Here they are:
Faith and trust in Heavenly Father and His creation (my body and baby)
Intimacy with husband
Freedom to follow instinct
Privacy/ not being hindered by observation
Being fully responsible

As I studied and reflected upon the scriptures after my first birth, I
frequently came back to "leaning on the arm of flesh." I felt that is exactly
what I did during my first birth and pregnancy. Rather than trusting in HF and
turning to him for guidance and support, I turned to the omniscient cult of
medicine and put my trust there. I was burned big time and I feel I needed that
experience to teach me to truly turn to God and put my faith there with Him.
This desire to trust Heavenly Father also ties into my respect for His creation.
Life on earth amazes me as I learn more about it. Birth and the woman's
capability to grow and birth a baby is another example of how his creation works
most of the time. And I believe that its works best when the organism is
trusting in Him as it strives to fill the measure of its creation. The measure
of my creation is being able to birth my babies and to give Him the glory I feel
it deserves, I want those births to be the purest they can be so the credit is
given to Him and his ability to create a body that can grow and birth a baby
without a bunch of meddling. When I learned about UC, I saw that the practice
could be a pinnacle of faith in that process because the outcome would be the
ideal: a healthy mother and baby united by peace and love. Since then, I've
learned that, for me, the pinnacle of faith would know be to trust in man in a
case of an emergency birth. I would have to receive VERY strong promptings from
the Spirit to turn to the hospital for assistance in birth. I'm that terrified
and distrusting of the whole medicalized system of birth care. And then my
decision to UC plays into my faith in the abilities of babies. HF has engineered
them to be so capable of so many things that many adults don't give them credit
for. Because babies aren't believed to be capable of those things, the
opportunity is taken away from them. The breast crawl is an example of this. I'm
just amazed at the active role that babies play in the birth process and I want
to respect that innate ability and once again glory God in His creations of
babies that most of the time come out healthy and perfect just like He intended.

I have to say that I was swayed by Lynn Greisemer's theory of husband
involvement in birth. I like the romantic notion that the person who put the
baby in my body during an intimate, sacred act of creation would be the one to
witness the coming forth of that fruit in another intimate, sacred setting. I
have this sense that birth is supposed to be spiritual and intimate with a
deepening of the husband/wife connection. I also know that during my first
birth, labor was started by engaging in intercourse. So I learned that being
intimate with my husband was one way to call a baby forth from my body. Then
later I learned that it might have been advantageous to be intimate again during
early labor and maintain that cuddling, kissing connection throughout the whole
process. I found having birth attendants there just interfered with that ability
to connect with my husband to the point that he was a peripheral character that
was just present and pushed to the side. I don't want that to happen to him
again. I want the birth of our babies to be something that we do together since
it was coming together than created that baby in the first place.

Just like I felt that the typical birthing settings interfered with the
husband/wife connection, I also felt like it interfered with my own ability to
listen to what my body was telling me. I was so in the mindset that I was going
to be guided by more knowledgeable people that I didn't take the opportunity to
follow my instincts, which I trust and believe were ingrained in me by Heavenly
Father. So being able to follow my instincts ties into being able to have the
trust in God and his processes.

In order to have that freedom to follow my instinct, my faith and the connection
with my husband, I feel that privacy is very important. I don't think that I
could experience those things with strangers present. Especially strangers that
are "paid to be paranoid" (<---borrowing from Jeanine Parvati Baker). I learned
that I could not trust them because invariably their own sense of
comfort/perservation/convenience is going to interfere in some way. And even if
the attendant is the best they can be in not interfering, just having their
presence there would be intrusive to me. Even them knowing that I'm in labor
would be intrusive to me...which is likely why I don't plan on informing the
midwifery practice I have as back-up when I go into labor. I anticipate that I'd
be able to feel their thoughts and concerns and I'd just ruminate on what they
were thinking, feeling, etc.

The last reason is likely my strongest bit of rebellion. I feel that it is
deeply ingrained in our culture to give away our responsibility to others in
order to share the blame in case something bad or wrong happens. Outsourcing or
hiring out for help in something, to me, is an indication of seeking to not be
responsible in case it is done wrong and to have some one else to hold
responsible. I don't want to give away my responsible and stewardship as a
parent starting with birth. I want to be the one to make decisions for myself
and my children, according to my conscience and the guidance I receive in my
decisions. As a preschool teacher, I saw so many parents abdicate their roles as
parents to someone else and it saddened me to see that rift occurring at such
young ages. I was surprised to learn that it started during pregnancy and birth.
Since I had never witnessed it before, it took experiencing it to know that
there are entire systems out there that (inadvertently) undermine parents'
autonomy. In my understanding of the gospel, that's not how it is supposed to
work. Self-reliance and trust in God are important values to me and I see how I
can apply those principles to birthing and hopefully that will be a lesson to my
children in taking responsibility for their own actions so they will make
prayerful, well thought out decisions without going along with the pack.

I really am interested to see how my perspective changes after this baby is
born. Like I said this is all in theory now, not having given birth UC at this
point. I'm looking forward to it though! I'm 34 weeks now. I have to admit that
there is some fear in me that says that I'm going to sour on the idea of UC when
I attempt it and fail. We'll see how the process unfolds. I'm believing that all
will be well and I'll have a lovely private, intimate homebirth. And maybe if
someday I have to turn to the maternity care system for assistance that I'll be
humble enough to do it...and in the meantime I'll hope that I never have to.

Inspiring Monolouge