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Posts Tagged ‘childbirth’

How did we go from what was once Woman-Centered Birth to Protocol-Centered Delivery?

I have my own rather cynical view.

Once there were women who learned to support women during birth. They witnessed the power as women brought their babies into the world. Midwives offered skilled hands, in addition to a reminder of the power already present in each woman.

But in a patriarchal society, women had a rightful and dutiful (and humble) place to fill. And removing power from women, via birth, would help this cause. But how?

We’ll tell you we’ve got a way to save your life. Birth is dangerous – fact is women often die from infection after birth (because there were no antibiotics at the time). And if we tell women we can make it safer, that will definitely get them thinking. And if we can convince the men, their husbands will insist we take charge.

If we’re going to make an impact, we have to change how birth is viewed- starting with how we talk about it. We’re going to call it a delivery. There. That’s better. Now it doesn’t really even involve women, except that they’re present.

“We’ll deliver your baby.” There’s action in that phrase. We are doing this delivery!

And it sounds a bit like a rescue doesn’t it?

Oooh, what a great idea! We’ll make every delivery seem like a rescue! Then women will believe that everything that we do is important. Really, really important, and necessary to rescue them from themselves. After all they got themselves into this mess…

Moving into more modern times with some women actually asking for choice, a patriarchal view continues.

You may think you want to avoid certain procedures or protocols, but really, we know what’s best for you. We’re the experts. You can’t possibly know what we know. You’re not a doctor (and even if you are, you’re too emotional to think clearly.)

And as long as you understand what we do is for your own good, we get to have it our way. (Wait that’s a different ad…)

We do lots of things that work well for us, but may not work as well for you. Most of us aren’t doing those things because we want to make you uncomfortable. We’re not really thinking specifically about you at all. We’re focused on the outcome- keeping you and your baby safe.

We believe that our place is to rescue you. We’ve been taught that birth is dangerous. It’s a crisis waiting to happen. And we’re here to avert that crisis. We have learned the best way to keep you safe is to protect you from yourself.

This is important enough to repeat: We’re the experts here. You’ve been here once, twice, three times? We’re here every day. We know what goes on. The stories we could tell if HIPPA regulations were not in place. (Well, we tell a little bit, but not enough to identify people. We don’t want you talking to those patients anyway- we’re using the story to prove our point, not as a reference for our services.)

We know the best way for you to deliver is on your back, so we can see. I mean really, how are we supposed to see anything if you’re squatting? Ok, the bed does allow for that. But that’s a selling point the marketers wanted. We don’t actually use that stuff. We use the stirrups. We can see; a light can be positioned to shine directly on the baby as it comes out; and who doesn’t like lying down?

I don’t think doctors (or men in general) are malicious. Men are goal-oriented thinkers. Attention to the life-process of birth may not even make sense to them.

But I know managed delivery and I know powerful birth. And as a life-process, powerful birth (the opportunity to be supported in whatever choices you make for your body and your baby) has a profound and lasting positive impact, that patriarchal society should fear a little.

I know what I’m capable of now.

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There are people who really believe that having a baby is inherently dangerous. Maybe more dangerous than extreme sports.

Not just people watching A Baby Story on TV, where women are routinely whisked away in a panic for surgery. Not just people regularly watching women on soap operas faint, only to find out they are pregnant. Not just the drama made for television and the movies, teaching us visually that clearly most women just aren’t up to the job of birth- it’s way too hard, too painful, too scary.

According to some medical providers pregnancy and labor (but especially labor) are accidents waiting to happen. And for these practitioners, the idea of a woman giving birth outside of a hospital setting is selfish and extremely dangerous. For all who believe birth is inherently dangerous, I bring you Birth – an Extreme Sport.

Welcome to the Birth Arena.

First in the line-up is Mary Averagemom. A generally low risk pregnancy, Mary’s fundal measurements were on target with her estimated due date throughout her pregnancy. Her practitioner began discussing induction at her 35 week appointment, to prepare her for this eventuality. He also offered to schedule an elective c-section at the same appointment.

When Mary made an appointment, at about 5 months along, specifically to discuss her written birth plan, her provider reviewed all the items and agreed to all of the options, as long as there were “no complications during labor” and “assuming hospital policy allows it.” This included intermittent EFM (15 min on, 45 min off), no IV, no induction/Pitocin, no epidural, eating & drinking during labor, husband and doula present, squatting for the pushing phase and baby presented to Mary skin to skin at birth.

Hospital policy did deny food during labor, but Mary was told the other requests listed were the doctor’s prerogative. So begins this Extreme Birth– because shouldn’t these be Mary’s prerogative?

Throughout her time in the hospital, even with the support of her husband and doula, Mary was bombarded with pressure from staff (nurses and OB) to consent to protocols. Mary refused the unnecessary IV line 4 times before being told she could not decline. Although she had discussed intermittent use of the EFM for monitoring well in advance of labor, (and agreed to 15 minutes of monitoring per hour) she was regularly scolded for detaching the belt and getting out of bed to change position. (The staff did not respond to Mary’s call button at the agreed removal time- another example of ignoring her limited consent.) Pitocin was brought up multiple times (at least 4) although Mary was clear she would not consent to Pitocin during early labor.

When it came time to push, Mary was told not to push(!) because the doctor was delivering another baby down the hall. When pushing did not go according to the count, Mary was scolded and told her wasn’t trying hard enough. (This all followed an argument about the use of the squat-bar on the bed -part of the original birth plan, which the doctor had affirmed agreement to at 8:30 am that morning. It’s extreme that a doctor would attempt to argue with a woman in labor, ready to push, and expect a discussion. Words don’t come easily during pushing and I believe he expected Mary would be unable to defend herself at all and simply yield to his preference- which eventually she did.)

Following “delivery”, minor tears were sewn while baby nursed. Nursing staff refused to speak to Mary after she’d been so difficult. (Doctor also left the room without a word.)

This is extreme treatment. Ignoring consent. Condescension. Mary’s discovery that her doctor had no intention of honoring her birth plan- finding this out during labor!Extreme measures that disregard the definition of CARE for women.

Care- to be concerned or attentive; have thought or regard; with the opposite being indifference. But this “care” was indifferent, and the fact that this is the standard of care, means the standard is indifferent to women.

Contestant number 2:

She’s mom to a young toddler, pregnant with baby number 2, and views birth as a physiologic process designed by God. She’d like to birth in an environment where she is respected, her choices are honored, and no one is trying to rush things along. She’d also like the option of having child #1 present to witness the birth of her younger sibling. Meet Hannah Homebirth.

During her first birth in a hospital, she experienced care like Mary’s. She wants to avoid a repeat of that routine treatment and has chosen a homebirth midwife for prenatal care and to attend the birth.

Hannah read several books about birth during this pregnancy: Henci Goer’s The Thinking Woman’s Guide to Better Birth, Pam England’s Birthing from Within, Ina May Gaskin’s Ina May’s Guide to Childbirth.

She discussed with her midwife reasons a transfer to a hospital might be needed. Which hospital, admissions through ER, the potential reception by staff. Hannah and her husband have discussed reasons to birth at home, concerns, risks with each other & their midwife.

The time for labor came on naturally, 40+ weeks. Hannah drank some water & ate a granola bar. Contractions just begun, a walk around the block brought Hannah into active labor. Doula & midwife arrived to find a relaxed, focused beginning labor. Hannah headed to the birth ball and asked her husband to fill the tub.

The water- the heat and buoyancy- relieved a lot of pressure. Contractions became closer, stronger. Hannah requested no vaginal exam & although the midwife legally had to offer and document findings, the exam was presented as an option. She refused each time, feeling no pressure.

Encouraging words spoken through labor- “You’re doing a great job!” “The baby is doing great” (after intermittent Doppler check.)

Pop! Water bag spontaneously broke at 9:15 pm. (Light on.) A quick check revealed no meconium in the fluid. (Lights back out. Candles flicker.) Relief of darkness & relief at clear fluid.

Time to push. On hands and knees, semi-upright, Hannah roars her baby out slowly. No one else present makes a sound. Once her head is out (and midwife checks for cord), 2 pushes bring her fully into the world. To Hannah’s breast, a beautiful baby girl! 9:45 pm.

Perhaps these are the extremes: from indifference to genuine love. But it’s an extreme worth looking into. I don’t want my birth to be part of someone’s routine. I want my birth to be part of someone’s passion.

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Women experience birth. Every life experience leaves an imprint. It’s really that simple.

The experience of birthing a new life (vaginal or c-section) can have a profound impact on the woman. It can be as much of a life-changing event as parenting a new baby. For some, birth results in a new awareness, confidence and purpose. And for some, it can mean insecurity, depression, and fear.

Giving birth- especially the first time- is a pivotal point in a woman’s life. She is transforming from woman to mother. She is often confronted during pregnancy with fears and insecurities about being a good mom, knowing how to respond to her baby’s cues, and wondering how life will change.

And anyone with children knows that life will most certainly change, in many wonderful ways.

The process of giving birth- the birth experience- can impact women positively or negatively based on the woman’s perception of what happened. What many care providers see as routine, women are experiencing for the first time. Because labor and birth is largely hidden from our modern society, women have their own expectations as they approach motherhood. And many expectations are based on individual factors like self-image, education, self-confidence, and the experience of autonomy women enjoy in our contemporary culture.

I have heard first-hand from women who were so traumatized by the birth of their first child that they are purposely preventing pregnancy, even though they once dreamed of many children. I read online the blogs and stories of women coerced into submitting to interventions they initially refused, trying to figure out how to advocate for their children, when they were not able to stand up for themselves.

So what happened?

In a nutshell (and in my opinion, of course) women don’t expect the world to be turned upside down because they are pregnant. If a woman generally makes her own decisions in her life, she expects to continue making her own decisions during pregnancy and labor.

Women expect, and rightly so, that being intelligent, autonomous persons, they will be permitted (and expected) to make their own healthcare decisions, even during labor. They believe that trusting their care provider equates to being cared for. Why would a doctor or midwife attempt to manipulate or rush labor? Certainly these professionals have enough experience to understand labor can occur any time of day (or night) and last as long as it will?

The relationships women form with their providers are often based on assumption, because communication is often difficult during 5 minute appointments. But women have reason to feel confident about asserting their right to informed refusal. They are often educating themselves during pregnancy, reading books that help prepare them, mind and body, for birth. Armed with information about possible complications and procedures, they expect to discuss benefits and risks with their provider if circumstances warrant.

And when situations arise, in the office or in the hospital, where the woman’s voice is ignored, where she is discouraged from asking questions, where she is told she is endangering her baby (selfish, bad mother!), where she is manipulated or coerced in submitting to procedures or tests… then she is upside-down.

The world has suddenly shifted and she’s lost the ground. All her life, she’s been told to speak up, ask questions, try harder, think smarter. Now she’s been told she’s a bad mother for expecting to have a say about her own body.

When women with stories like these speak up, they are often told to get over it; that they are making a big deal over nothing; that they are scare-mongering other women; that they are selfish for wanting to feel whole AND have a healthy baby. (And this time, it’s usually other women/mothers calling her selfish!)

Every pregnant woman wants a healthy baby. And it’s ok to want that.

But when you say a healthy baby is ALL that matters, you disregard the mother. Mothers matter too.

Mothers want to feel cared for during pregnancy AND BIRTH.

Mothers deserve to make their own healthcare decisions- even during labor.  (Are other patients also treated with disrespect when they decline routine, but often unnecessary, tests and procedures?) Mothers deserve clear communication and to be approached with respect, as living, thinking, feeling human beings. Women are trusting midwives and doctors (and L&D nurses too) to provide safe care- to hold this trust, and help us be active participants in our care so we are making informed choices for ourselves (powerful, not powerless!)

And when women are offered a relationship of trust and care, when they are afforded the respect to make choices, when they are encouraged to trust themselves during birth, often they learn they are capable of amazing things- including mothering.

Mothering relies heavily on following your instincts. Babies don’t come with instructions and we all worry about knowing what to do. Having a birth experience where you trust yourself can give you confidence to trust yourself to meet your baby’s needs when s/he is born.

If you have experienced birth trauma, you are welcome to comment here about your experience. Also be sure to check out today’s episode of A Labor of Love for more information.

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If you heard my recent interview with Henci Goer, you know I’m really interested in women having the information they need to make decisions for their care, especially during pregnancy. I also think women have the right to choose the care they feel most comfortable with, no matter how certain data is interpreted, or by whom, or if there is no data at all. For example, choosing midwifery vs OB care can be based on statistical data of outcomes for certain providers, or it can be based solely on how a woman feels about a particular individual.

When it comes to risks and benefits, it’s up to individual women to discern their own comfort levels, especially about safety, weighing the benefits and the risks based on her individual perspective.

Similar decisions are made by individuals all the time. For example- the option to drive or walk to the store:

I live less than 2 miles from my local grocery store. A sidewalk exists on one of the 3 roads that I need to travel. The speed limit on the roads without sidewalk is 30 mph, but enforcement is nil and generally cars travel about 40 mph. Because I live in Florida, the weather is generally nice enough to walk 90% (or more) of the time.

Benefits to Walking:

  • Walking is great cardio exercise.
  • Carrying my groceries will help me save money b/c I may not be able to carry “extras”
  • Ecological benefit- less pollution
  • Save money on gas
  • Fewer miles on car/less maintenance needed
  • Safer than driving

Risks to Walking:

  • Possibility of getting hit by car where there is no sidewalk
  • I could trip/fall
  • May take time away from other necessary activities

Benefits to Driving:

  • Faster
  • Can carry as much as I want/need to buy
  • Safer than walking

Risks to Driving:

  • Possibility of car accident (3 left turns to get to store)
  • Danger of navigating the cars backing out of parking spots
  • May spend too much money due to no limits on carry weight

If you read closely, you’ll notice each option is “safer” than the other, as listed under benefits. That’s because there is a risk of injury in both cases, and ways to be safer in both cases. I could walk on the grass shoulder; wear a seat belt; wear reflectors; drive defensively. I’m sure somewhere I could find statistics that define the probability of accidents for walking vs. driving this distance under various conditions and make a statistical comparison.

But even with a thorough review of the statistics, I get to choose which feels safer to me. Even if the data “clearly show” a greater chance of injury for one option, the benefit of speed (or a smaller carbon footprint) might outweigh the risk.

Choices should be offered to women for childbirth with the full understanding that women are ultimately responsible to choose, and that women have the right to choose for themselves, no matter how others interpret the benefits and risks involved.

After all, risks and benefits cannot always be measured and statistically defined. In birth, it’s more personal than that.

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I’m going to get a bit political today. If you’re not into that, skip this post. There is so much going on about healthcare reform in the media and I can’t help but notice there isn’t much mention of improving the sorry state of pregnancy-related care and maternal/fetal outcomes. No one is talking about the continued restriction of valid childbirth options for women with a history of c-section. Yes, I’m talking about VBAC.

VBAC, short for vaginal birth after cesarean, is a valid healthcare option for pregnant women in low risk categories. According to Childbirth Connection.org:

If you do not have a clear and compelling need for a cesarean in the present pregnancy, having a VBAC rather than a repeat c-section is likely to be:

  • safer for you in this pregnancy
  • far safer for you and your babies in any future pregnancies”

Most OB’s and hospitals that refuse to support VBAC do so citing concerns about uterine rupture. And while this is a possibility, educating women about risks and benefits is vital to informed consent of patients. To be vital, informed consent requires patients (in this case women) the option of informed refusal. It is the right of every person to make healthcare decisions personally. Each pregnant woman, therefore, should also have the same right to choose what she will and will not accept as part of her individualized care. She can choose to accept or refuse induction, epidural, ultrasound, fetal monitoring, IV. She has the right to change her mind, even during labor.

Let’s look at the risks associated with uterine rupture during VBAC (from this article at ChildbirthConnection.org):

“What is the added likelihood that the scar will give way (uterine rupture) during a VBAC labor?
Best research suggests that an extra 27 women experience a ruptured uterus in every 10,000 VBAC labors, compared with planned c-section deliveries. Thus, nearly 400 women would need to experience surgical birth to prevent one instance of uterine rupture during VBAC labors. While the scar giving way usually requires an urgent cesarean, loss of the baby is much less common (see next paragraph).
Added likelihood for a woman with a known low-transverse (horizontal) scar: MODERATE for scar rupture compared with planned repeat c-section.”

“What is the added likelihood that the baby will die as a result of the scar giving way (uterine rupture) during a VBAC labor?

Best research suggests that about 1.4 extra babies die due to problems with the scar in every 10,000 VBAC labors, compared with planned c-section deliveries. Thus, over 7,000 women would need to experience risks of surgical birth to prevent the death of 1 baby from scar problems during VBAC.
Added likelihood for a woman with a known low-transverse (horizontal) scar: LOW for death of the baby around the time of birth compared with repeat c-section.”

To fully understand the risks associated with VBAC and make an informed decision women must also comprehend the risks to mother and baby for repeat cesarean birth. (From this article at ChildbirthConnection.org)

“Extra risks associated with cesarean section: Current research suggests that cesarean section has the following disadvantages in comparison with vaginal birth:

Physical problems in mothers: Compared with vaginal birth, cesarean section increases a woman’s risk for a number of physical problems. These range from less common but potentially life-threatening problems, including hemorrhage (severe bleeding), blood clots, and bowel obstruction, to much more common concerns such as longer-lasting and more severe pain and infection. Even after recovery from surgery, scarring and adhesion tissue increase risk for ongoing pelvic pain and for twisted bowel.

Hospitalization of mothers: If a woman has a cesarean, she is more likely to stay in the hospital longer and is at greater risk of being re-hospitalized.

Emotional well-being of mothers: A woman who has a cesarean section may be at greater risk for poorer overall mental health and some emotional problems. She is also more likely to rate her birth experience poorer than a woman who has had a vaginal birth. {Note: This risk is reduced somewhat for planned cesarean birth.}

Early contact with, feelings toward babies: A woman who has a cesarean usually has less early contact with her baby and is more likely to have initial negative feelings about her baby.

Breastfeeding: Recovery from surgery poses challenges for getting breastfeeding under way, and a baby who was born by cesarean is less likely to be breastfed and get the benefits of breastfeeding.

Health of babies: Babies born by cesarean are more likely to:

  • be cut during the surgery (usually minor)
  • have breathing difficulties around the time of birth
  • experience asthma in childhood and in adulthood.

Future reproductive problems for mothers: A cesarean section in this pregnancy puts a woman at risk for future reproductive problems in comparison with a woman who has a vaginal birth. These problems may involve serious complications and medical emergencies. The likelihood of experiencing some of these conditions goes up sharply as the number of previous cesareans increases. These problems include:

  • ectopic pregnancy: pregnancies that develop outside her uterus or within the scar
  • reduced fertility, due to either less ability to become pregnant again or less desire to do so
  • placenta previa: the placenta attaches near or over the opening to her cervix
  • placenta accreta: the placenta grows through the lining of the uterus and into or through the muscle of the uterus
  • placental abruption: the placenta detaches from the uterus before the baby is born
  • rupture of the uterus: the uterine scar gives way during pregnancy or labor.

Concerns about babies in future pregnancies: A cesarean section in this pregnancy can affect the babies of future pregnancies. Studies have found that they are more likely to:

  • be born too early (preterm)
  • weigh less than they should (low birthweight)
  • have a physical abnormality or injury to their brain or spinal cord
  • die before or shortly after the birth”

When women are fully informed of the risks associated with repeat cesarean and VBAC, they should each have the opportunity to choose which risks they are willing to take. When a doctor refuses to “allow” his patients to attempt VBAC, s/he is taking away a fundamental right of women to determine the direction of their healthcare.

According to ACOG’s Committee Opinion #321 from November 2005, respecting patient’s autonomous decision making is a fundamental ethical obligation:

“Requiring informed consent is an expression of respect for the patient as a person; it particularly respects a patient’s moral right to bodily integrity, to self-determination regarding sexuality and reproductive capacities, and to the support of the patient’s freedom within caring relationships.”

“The ethical requirement for informed consent need not conflict with physicians’ overall ethical obligation to a principle of beneficence; that is, every effort should be made to incorporate a commitment to informed consent within a commitment to provide medical benefit to patients and thus respect them as whole and embodied persons.”

“[Even if] a woman’s autonomous decision [seems] not to promote beneficence-based obligations (of the woman or the physician) to the fetus, … the obstetrician must respect the patient’s autonomy, continue to care for the pregnant woman, and not intervene against the atient’s wishes, regardless of the consequences.“(emphasis mine)

“The obstetrician must keep in mind that medical knowledge has limitations and medical judgment is fallible” and should therefore take great care “to present a balanced evaluation of the expected outcomes for both [the woman and the fetus].”

So how can it be true that women have the right to make autonomous choices regarding their healthcare, including care during pregnancy and childbirth, yet doctors choose to ignore and even ban valid healthcare options for these same women?

This is about women’s rights. A woman doesn’t stop having the right to bodily integrity because she is pregnant. She maintains the right to independent thinking, personal preference, and choice throughout the 40+ weeks gestation. Choosing to bring a child into the world doesn’t limit my right to individualized care or informed consent. In fact, choosing to bring a life through my body has made me more focused on what is appropriate and acceptable risk to me and my baby- and this is a very personal choice.

I should always have the final say about what is ok and not ok for my body, and any baby residing within it. And that’s what I teach my girls.

Who does your body belong to?

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I’ll admit it- I have a thing for shoes. The man at the store may not know me by name, but he does clear off a bit of counter space as I wander through, occasionally bringing boxes forward, wearing anything except the shoes I wore in. Within each aisle, finding different styles- flats, mules, pumps, casual sandals, sport sandals. I try not to buy more than one of each shoe type on any given visit.

This morning was no different. I found a cute, dressy sandal in navy blue that matched so well with my outfit, I wore them out of the store. I also found several other shoes that looked absolutely adorable. But when I tried them on (in various sizes -just to be sure) I just couldn’t get the right fit. No matter how good they may look on the wall or on my foot, I can’t justify a choice that doesn’t fit my foot.

It’s a lesson long in the making for me, with too many shoes collecting dust in the closet because I won’t wear them if they don’t feel right. Birth choices can be like that too. Women can walk through information, testing this and that, researching, but when it comes down to it: what is a good fit for one woman’s birth, may not fit another.

Opinions and definitions of “natural” vary depending on the individual or entity providing information. When it comes to childbirth, opinions on what is natural can range from medication-free vaginal hospital birth (with or without hospital interventions) to unassisted homebirth. Where does the true definition fall?

It falls within the heart and soul of each expectant mother. Defining what is natural is about defining what belongs to each individual woman: how she views her ideal childbirth experience; where she will feel most safe; how and by whom she will be best supported in her choices. Natural, then, must be based on the innate internal desire of each woman.

The key to this premise is undoubtedly reliant on the ability, opportunity and desire of each woman to search within herself to find the answers to some challenging questions about her beliefs, about her body, about fear. This is part of the process of finding the right fit.

It may seem difficult, trying on so many ideas to find the best match- already it may look easier to just let someone else with “experience” manage the whole thing. The only dilemma: no one else can possibly have experience with your individual expected birth- because it hasn’t happened yet. No one else can possibly know what is right for you in your heart. It cannot be considered “natural” to simply follow someone else’s “rules” for pregnancy and birth, without considering how they correspond into your own desire.

So “natural” is really the connection of your internal truth to your desired birth experience. You do not have to accept another person’s view of what is acceptable, what is ideal, or even what they consider safe. You can choose to follow your own truth. You can take time to explore answers to the questions birth holds for you. You can explore fears and insecurity, question your beliefs, and discover, for yourself, the true definition of natural childbirth: a birth experience fully in line with your most intimate, loving, internal vision.

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I love books about babies and pregnancy and childbirth. I love reading what others have to say. I love it when my mind opens to new information and I stand back and think to myself- Well, that’s a new way to look at it.

I spent so much of my first pregnancy devouring as much as I could and still feeling like I was missing out on something important. I felt talked down to at times. I felt pressured to “do the right thing” which amounted to whatever that author thought was best for me- for everyone, I guess.

I was already a stressed out, type-A personality, perfectionist, trying to do everything right. So why didn’t it feel right to be told what to do? I didn’t even like it much when it was my doctor. And it wasn’t the authority thing- I was a rule follower. Totally inside the box, I thought…

I recently came across a new book on homebirth. I had a hospital birth and a homebirth, so I like books that talk about differences, that give different sides to the whole birth story. I definitely preferred homebirth- but it turns out I’m a bit more “outside the box” than I thought 5 years ago.

When I went to Amazon to read some more and check the reviews, I was surprised by the number of negative comments about this particular book. The readers talked about the level of judgment in the author’s tone: that instead of being a positive “why homebirth is great” it was a judgmental “why hospitals stink” kind of book. I was disappointed and moved on to something else.

Then a bit later in the day, I saw a comment on Facebook where a woman said “there’s no such thing as a natural hospital birth.” Her opinion was that hospitals don’t do anything naturally, so there’s nothing natural about hospital birth- period. And it sounded like she might think there is a “right way” to birth, too.

Does it do any good to bash women over the head with opinions and judgment, when they make different choices?

I consider myself a homebirth advocate. I think it’s great. But it might not be for everyone. For example, if you want an epidural, you generally can’t get one of those at your house. To me, birthing naturally means going with the flow of your heart and soul and body. And if you feel safest in a hospital, you probably won’t find homebirth peaceful, because you’ll be all worried about the “what if’s.”

And if being in a hospital doesn’t bring you comfort, it’s time to consider alternatives like homebirth or an independent birth center. And just like the judgment of “hospitals are not natural” it doesn’t do any good to hear judgments like “you’re putting your baby’s life at stake” by choosing homebirth if that is what fits you best.

Truly, the most recent data shows homebirth to be as safe as hospital birth for low-risk mothers and babies under midwifery care. So I’m going to say that the other way too- hospital birth is as safe as homebirth for low-risk mothers and babies, especially under midwifery care.

And although the same study shows hospitals are likely to perform various interventions more frequently, I don’t think that was really ever questioned. It’s one of the criteria women use to make the choice of where to birth. Some women may actually want an intervention (like epidurals).

Here is my point: women who advocate choice in birth ought to applaud all women who consciously choose their birth place. Yes, it is often a default- not choosing, but for some women, hospital is their actual choice.

This whole argument about the “right way” got me thinking about how women are consistently told what to think when they’re pregnant. Like somehow people think that our brains are no longer capable of choosing for ourselves; we somehow lack the capacity for sound decision-making because of what? Hormones?

And educating women about fully informed consent, informed refusal, and consciously choosing options for birth can only happen when women can hear it. Judgment closes minds, creates defensive posture internally and shuts us down.

But helping a woman open to her own voice, validating the truth inside her- no matter what that looks like, respecting her as a wise and powerful woman, empowers her to be everything she is here to be; to choose the best way for her as an individual.

Most simply, I think of it like this: Although my experience giving birth at a hospital was a very negative experience, it gave me so much strength later on. I learned so much about myself because of that one choice. Who am I to assume that the opportunity for your personal growth in pregnancy and childbirth lies only in one specific direction?

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