Wednesday, January 27, 2010

What does birth mean to me?

We are celebrating the birthday of my first child. It was three years ago today that I became a mother. Three years ago, I fought for an unmedicated, vaginal birth. Three years ago, that I breastfed for the first time. Why then am I still writing and talking about birth?

There is something profoundly special about birth and in recent months there has been alot of talk about what that something is. Rixa clued me this discussion with her post "Thinking No Conclusions Yet". I was also inspired by this post by Keyboard Revolutionary and how she describes how birth impacted her as a maturing, developing individual and mother.

I originally wrote the following statement about birth in April of 2009 when I was 8 months pregnant with my little girl. The top paragraph is a statement of what I believe about birth followed by the logical implications I could think of as well as explanation for why I believe my statements to be true. This post is an exercise for me to see if my thoughts have changed in anyway now that I've given birth a second time and grown in my logic, knowledge and though processes regarding the life event.
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.
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.

Since experiencing Belle's birth, I have to say that the similes between birth, menstruation, and defecation hold true for me. Her birth was such a normal and as I experienced, pedestrian process that it was in some ways boring for me. It certainly doesn't make for an exciting story, there was little drama. Just an emergence and a completion for a normal bodily process.

I did fail to state in my original writing however to emphasize that birth is altogether a more physically demanding bodily process and it is a very special life event for a mother. I do not believe that it the most important events of a mother's life like Jan Tritten states, as I believe that it is overstating a simple transition from one state to another. As a mother who as been traumatized by events relating to childbirth, I know too well the long-lasting emotional effects that a mismanaged, "pushed" birth produces in a woman.

For the baby, the birth (and the manner thereof) is important bio-chemically and throughout development. This is reflected in the research suggesting that babies exposed to pain relief drugs in childbirth are more likely to become drug addicts when they become adults, as well as the research linking birth practices to autism and maladaptive attachment between parents and child. But to say that the events of childbirth are a strong predictor of child's health, well-being and capability as an adult ignores the functional adults (often the mothers who are now fighting for natural births themselves) who experienced less than ideal births when they were babies. It is safe to say that most of the adults up to at least age 70 were brought into this world not in the way that research shows as optimal for development and bonding. How one was born does not often make that child less capable of facing their life's challenges.

So if I just stated the ways that birth is not special, why is it special and what does it mean to me?

Birth is special because it was the moment I got to meet my children. The emotions, environment, thoughts and feelings of my body are still strong in my consciousness as I remember what it was like to bring them into the world and hold them in my arms for the first time. With Willem, I was frustrated with the people around me that is caused my focus to not be solely on my child and I still resent that he was born into a moment of bitterness and frustration. With Belle, the laughter and excitement of the final moments of her birth and the joy of having my husband and child look on still cause me to relive those feelings. With Willem's birth, when I relived his birth. It was in the form of flashbacks and PTSD. With Belle, I relive her birthday and I know joy.

Birth is a woman's battleground where the inherent and supremely unique strength of womanhood is exerted in its fullest. A woman each time she gives birth "walks through the valley of the shadow of death" because there is the possibility that she will die bringing life into the world. So in a sense, a woman faces death and walks away conquerer bearing new life in her arms. Its amazing! No wonder, Goddess worship is common throughout history! She faces fear and pain, discouragement, exhausted and comes out experiencing the highest high of her life (granted she's not facing the commonly disturbed birth environments of today). With both of my children, I fought to bring them into the world without experiencing things that I felt could be damaging to their health. One the fight took place while I was laboring. The other I fought and prepared and schemed before labor so the actual event of her birth could be peaceful and private.

Its because I had to fight, and that all women who are seeking a normal birth the way nature is intended are having to fight for it, that is why birth is so important to me. That its become a cause that I feel like I have something I can do to keep other women from experiencing the emotional suffering and stress that I experienced. Its a matter of right and wrong for me too. Its simply wrong for a woman to be told by authority figures that she is not capable of making decisions for herself. Its wrong that an entire system is structured in a way that many women and babies suffer unnecessary risk, damage, ill-health and distress in the name of what is culturally acceptable. Its these issues that I'm taking on and that I want to work to correct for my daughter and my sister-women so they can give birth undisturbed, in joy and have access to the help they need when it is appropriate.

What does birth mean to you?
How is it special?
In the course of life, how important is it?
How important is mode of entry (vaginal, cesarean, medicated or not)?

7 comments:

Rixa said...

Agreed. Would you be willing to let us use parts of this essay for the book project I'm working on for LDS women? Send me an email if you're interested.

Jennifer said...

What does birth mean to you?

Intense overwhelming pain, panic, abuse, and the subsequent years of trauma and guilt. Maybe in a few months I'll have a different picture - I hope.

How is it special?

No matter how it happens, it is a life changing moment in time. A moment that every woman will always remember (even when they had twilight sleep, they can recall all the events before and after perfectly). It leads to a transition in life that can spark major changes and make you a better person. It is as if the mother is reborn as her child is born.

In the course of life, how important is it?

I think it is an important event, one that will always be remembered and retold. I don't think it is a "defining" event though. It doesn't define me as a mother or as a person, and it certainly doesn't define what kind of person my child will be. I do think it is important though to the extent that it should be given attention and one should learn about and prepare for it.

How important is mode of entry (vaginal, cesarean, medicated or not)?

I think ideally an unmedicated vaginal birth is the healthiest mode of entry for all concerned. As a mother who could not achieve that though, it is really upsetting to read about my future drug addict, or that the mode of his birth may have caused my sons neurological issues (not autism - but similar enough...). I think it's pretty questionable research anyway, because between birth and adulthood, or between birth and an autism diagnosis, there could be tons of other things that child was exposed to that could have influenced those things. I think autism is a huge mystery and the rates have increased a lot in just the last few years (one recent study says the last four years!), but women have been having these types of births for decades, so I fail to see how that even correlates to autism. And the research you linked to was a long blog post that I skimmed but could not find the research you were talking about?

My theory on the subject is that a lot of people, probably most in our society, had a traumatic birth and were exposed to some kind of drug in the process. I think that if that baby/child/adult is continually treated in ways that reinforce their trauma and abandonment issues from birth, then yeah, they will certainly suffer effects from a life long pattern of trauma and abandonment. I think though that if a baby is held most of the time, breastfed or attentively fed with skin to skin contact, is not left in their crib to cry it out, sleeps close to their parents and is attended to whenever they wake, and this type of attachment is continued throughout childhood. I think this counteracts the mode of birth, the exposure to drugs, and the possible isolation of the newborn. So basically, I think attachment parenting can erase the momentary trauma of birth. I think we see birth trauma in infants extending into adulthood in our culture because of the way our culture traditionally treats infants reinforces the birth trauma and they never have an opportunity to heal from it.

Jenne said...

Jennifer, I love what you say here:

"I think that if that baby/child/adult is continually treated in ways that reinforce their trauma and abandonment issues from birth, then yeah, they will certainly suffer effects from a life long pattern of trauma and abandonment. I think though that if a baby is held most of the time, breastfed or attentively fed with skin to skin contact, is not left in their crib to cry it out, sleeps close to their parents and is attended to whenever they wake, and this type of attachment is continued throughout childhood. I think this counteracts the mode of birth, the exposure to drugs, and the possible isolation of the newborn. So basically, I think attachment parenting can erase the momentary trauma of birth. I think we see birth trauma in infants extending into adulthood in our culture because of the way our culture traditionally treats infants reinforces the birth trauma and they never have an opportunity to heal from it."

You may very well be right, and I love to have research support this. Of course, I'd love to do the research on this too.

I've had similar thoughts about the drugs during labor/drug addict in later life correlation. It makes sense to me that families who are more embracing of drugs during birth are going to be more likely to embrace painkillers in other life contexts too, effectively teaching children that drugs can ease or erase pain of all kinds. Its not accurate to state that because babies were exposed to drugs during birth will be drug addicts, unless attitudes towards painkillers and actual usage (both observed and experienced) are controlled for. l

Here's the quote from Rixa's post citing Michel Odent about connecting induction of labor to autism:

"Odent is concerned with the long-term implications of any practice that disturbs these vital love hormones, because certain birth practices have been linked to higher rates of autism (induction of labor), suicide (surgical birth, asphyxiation at birth), and anorexia nervosa (presence of a cephalohematoma at birth). (A collection of studies documenting these associations are available through the Primal Health database.)" She links to the Primal Health database in the blog post.


She also posted this too which is what introduced me to this idea that some drugs in labor (specifically pitocin) can impact developmental functioning. http://rixarixa.blogspot.com/2008/08/long-term-effects-of-pitocin.htm

Jenne said...

Rixa, I have been thinking on how to write something for that project, so its great to be given some more specific directions to go with. I would like to adapt this and this other post http://descentintomotherhood.blogspot.com/2009/04/why-i-am-ucer.html for that project. Between to two of them, its pretty much a comprehensive look at my views both intellectually and spiritually on birth and my choices. So, give me a chance please to synthesize these two posts and I'll get back to you. Which parts specifically do you want to include most?

Jennifer said...

The thing that doesn't make sense to me about pitocin or birth practices causing autism is that there are kids who have autism who had drug free births. If pitocin is the cause, or induction is the cause, then one would think that kids not exposed to this stuff would not get autism (or related neurological disorders)? But the rates of autism continue to climb, and they seemingly continue to climb across all groups - those exposed to some of these things and those not exposed.

Jenne said...

This is an example of the difference between causation and correlation. This research I cited, first off, offers more theory than fact at this point and are included as possible explanations and theorized impacts of birth practices. Next, there is much that is not understood about autism and one explanation is not going to be enough to explain all cases of the disorder. There are likely many explanations and pitocin/induction may be one factor that contributes to it possibly occurring or it may make in more likely across a number of cases.

Just like epidurals do not cause death in each example of use. They are however a risk factor.

Does that make sense?

Jennifer said...

Yes, that makes sense. It just seems to be all theory at this point, but these are definitely things worth looking into more.