Birthing – and living – without fear
Dec. 15th, 2007 07:48 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
mamagotchaI wrote a response to one of the comments from this post, but it was too long. Since it includes some further ruminations along the lines that I was writing about, I'm posting it here as an entry.
(The commenter is a mother who had two surgical deliveries, and explains her circumstances and views in some detail):
You are right. I cannot say "I don't mean you" or your birth because I wasn't there (I did read your birth and breastfeeding stories, but they went down within days of me reading them, because I went back to read them again and they were gone. This was before I started reading your journal, though, and we never had a dialog about them).
Those 30 births I mentioned? They were mostly in-hospital doula births... plenty of things happened at them that I did not choose for my own births, that I needed to support (and loudly... try getting an epidural done quickly in a non-emergency situation). I had to learn how to help parents make really hard decisions in the heat and pain of labor – you go as simple as possible: lay out the paths they may choose from, including doing nothing, with ALL the pros/cons/potential complications or side effects/level of commitment (can we stop doing xx once we start it if we don't like it or it's not working?), answer questions to the best of my knowledge, then accept their decision and do my best to effectively implement it quickly.
The very first birth I attended as a doula was a VBAC. I was left alone in the room with the mom as the new baby was whisked away... Apgar of 0. You know what that means. I started my birth support career having to answer that mom: "What happened? What's wrong?" That baby was resuscitated after 20 minutes, and it took another few years to finally confirm that no lasting damage had occurred. It was one of the scariest events of my life. But that mom and dad never said "I wish we'd done a VBAC" or "I shouldn't have had a midwife" or "We should have induced" (baby was over 2 weeks late). They took full responsibility for their decisions and choices. They truly inspired me, both as a parent and as an advocate. They knew that there just aren't any guarantees... where there is birth, there is potentially death, a horrible and painful truth.
This event definitely helped me move towards a better understanding of personal accountability. A few years later, supporting one of my oldest and dearest friends through the stillbirth of her first child (an attempted homebirth), and then the birth of her next baby, illustrated the other side of the coin... what happens when there isn't a miraculous recovery. She never, ever blamed her midwife or herself, even though there was evidence that, in hindsight, they might have been able to diagnose her baby's problem and deliver her alive surgically (although she possibly would have been profoundly damaged... she had a velamentous insertion of the umbilical cord and had probably been significantly compromised during the entire pregnancy).
I'm so sorry you had such an terrible experience, and I can't magically say if any decision at any point could have changed the outcome... there's still always a chance of an injured, even dead, baby or mother, even with surgery... something that our culture firmly denies.
I'm going to go out on a limb here... and if I piss you off again, I'll edit this part out if you want me to. I think that maybe you might still be wrestling with this birth experience, that you might be feeling anger or pain, blame or frustration at the midwife or yourself or homebirth advocates or God or some other thing.
Finding a way to forgive who or what you are angry at might help you find peace with this awful experience. I know, I know, MUCH easier said than done! As parents, as fallible humans, we have to know... deep down, believe with all our hearts... accept as truth that we did the absolute best we could with whatever information and resources we had in our possession during whatever situation we were in.
When we can refocus our eyes to see from that point of view (a place that is NOT popular in American culture today, I'd like to mention), it brings a sense of confidence, peace, and hope... instead of fear, worry and doubt, the things that fuel so many aspects of our lives. Lawsuits, lack of tolerance for those who don't share our beliefs, second guessing, reliance on drugs, disconnect from our bodies... it's not only the in the arena of birth that we see the fallout of our fear. And, as you point out, romanticizing birth (or anything) is a Pollyanna error, even when well-intentioned. Willfully ignoring potential consequences, positive OR negative, of our choices can cause just as much harm as fearing them.
(I have such a hard time with this myself. I'm still angry at my mother for doing things I think she should have known better than to do. I keep working on forgiving her, on believing that she was doing the best she could with what she knew and what resources she had. Making my heart believe what my head says... not so easy.)
I want to increase those resources for parents. The choices of the consumers influence the actions of the providers. That's why I want to support the consumers... I know that many people aren't even aware of their choices, much less research them (if I had a penny for every parent I talked to, as a homeschooling advocate, who said "What? I can just take him out of school? And nobody will arrest me? It's legal? I can DO that?").
So yes, I do want to point at the actions of care providers. And I think that educating and supporting parents will be the best way to change those actions. Doing that with compassion, wisdom, loving kindness, intelligence and, eventually, positive results... well, it's clear that this is where I could use some improvement.
(The commenter is a mother who had two surgical deliveries, and explains her circumstances and views in some detail):
You are right. I cannot say "I don't mean you" or your birth because I wasn't there (I did read your birth and breastfeeding stories, but they went down within days of me reading them, because I went back to read them again and they were gone. This was before I started reading your journal, though, and we never had a dialog about them).
Those 30 births I mentioned? They were mostly in-hospital doula births... plenty of things happened at them that I did not choose for my own births, that I needed to support (and loudly... try getting an epidural done quickly in a non-emergency situation). I had to learn how to help parents make really hard decisions in the heat and pain of labor – you go as simple as possible: lay out the paths they may choose from, including doing nothing, with ALL the pros/cons/potential complications or side effects/level of commitment (can we stop doing xx once we start it if we don't like it or it's not working?), answer questions to the best of my knowledge, then accept their decision and do my best to effectively implement it quickly.
The very first birth I attended as a doula was a VBAC. I was left alone in the room with the mom as the new baby was whisked away... Apgar of 0. You know what that means. I started my birth support career having to answer that mom: "What happened? What's wrong?" That baby was resuscitated after 20 minutes, and it took another few years to finally confirm that no lasting damage had occurred. It was one of the scariest events of my life. But that mom and dad never said "I wish we'd done a VBAC" or "I shouldn't have had a midwife" or "We should have induced" (baby was over 2 weeks late). They took full responsibility for their decisions and choices. They truly inspired me, both as a parent and as an advocate. They knew that there just aren't any guarantees... where there is birth, there is potentially death, a horrible and painful truth.
This event definitely helped me move towards a better understanding of personal accountability. A few years later, supporting one of my oldest and dearest friends through the stillbirth of her first child (an attempted homebirth), and then the birth of her next baby, illustrated the other side of the coin... what happens when there isn't a miraculous recovery. She never, ever blamed her midwife or herself, even though there was evidence that, in hindsight, they might have been able to diagnose her baby's problem and deliver her alive surgically (although she possibly would have been profoundly damaged... she had a velamentous insertion of the umbilical cord and had probably been significantly compromised during the entire pregnancy).
I'm so sorry you had such an terrible experience, and I can't magically say if any decision at any point could have changed the outcome... there's still always a chance of an injured, even dead, baby or mother, even with surgery... something that our culture firmly denies.
I'm going to go out on a limb here... and if I piss you off again, I'll edit this part out if you want me to. I think that maybe you might still be wrestling with this birth experience, that you might be feeling anger or pain, blame or frustration at the midwife or yourself or homebirth advocates or God or some other thing.
Finding a way to forgive who or what you are angry at might help you find peace with this awful experience. I know, I know, MUCH easier said than done! As parents, as fallible humans, we have to know... deep down, believe with all our hearts... accept as truth that we did the absolute best we could with whatever information and resources we had in our possession during whatever situation we were in.
When we can refocus our eyes to see from that point of view (a place that is NOT popular in American culture today, I'd like to mention), it brings a sense of confidence, peace, and hope... instead of fear, worry and doubt, the things that fuel so many aspects of our lives. Lawsuits, lack of tolerance for those who don't share our beliefs, second guessing, reliance on drugs, disconnect from our bodies... it's not only the in the arena of birth that we see the fallout of our fear. And, as you point out, romanticizing birth (or anything) is a Pollyanna error, even when well-intentioned. Willfully ignoring potential consequences, positive OR negative, of our choices can cause just as much harm as fearing them.
(I have such a hard time with this myself. I'm still angry at my mother for doing things I think she should have known better than to do. I keep working on forgiving her, on believing that she was doing the best she could with what she knew and what resources she had. Making my heart believe what my head says... not so easy.)
I want to increase those resources for parents. The choices of the consumers influence the actions of the providers. That's why I want to support the consumers... I know that many people aren't even aware of their choices, much less research them (if I had a penny for every parent I talked to, as a homeschooling advocate, who said "What? I can just take him out of school? And nobody will arrest me? It's legal? I can DO that?").
So yes, I do want to point at the actions of care providers. And I think that educating and supporting parents will be the best way to change those actions. Doing that with compassion, wisdom, loving kindness, intelligence and, eventually, positive results... well, it's clear that this is where I could use some improvement.
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gotta start it somewhere
Date: 2007-12-16 03:37 am (UTC)as a soon-to-be dad, who's partner is an activist [unsure of timing because we're probably over-thinking this a bit] i want to thank you for these links, both of them. i hope that the worst-case scenarios stay just that, scenarios, and not anybodies' reality, ever.
Re: gotta start it somewhere
Date: 2007-12-16 03:54 am (UTC)Fear only robs you of the joy you can have. I have spoken with mothers who have lost their babies to SIDS and horrible birth defects, who say that they were finally able to come to terms and find peace and yes, even joy, from their experiences... that they were glad to have had brief contact, even just during the pregnancy, with their babies. The thing that stays with me: they often say they wish they hadn't known ahead of time that there was something "wrong" with their babies, because it stole those few precious days or hours of joy.
This is why I am so conflicted about prenatal testing... I see moms being hesitant, tentative about embracing their babies with joy, instead living with fear and apprehension until a doctor or some test gives them the all-clear. No test can promise a perfect baby... and no test can predict every potential problem. And there's always the dilemma that you can change a system merely by observing the system... that by administering the test, you can inadvertently cause damage (for instance, CVS can cause damage to digits or even miscarriage).
I wish you a wonderful journey towards parenting!
(no subject)
Date: 2007-12-16 05:08 am (UTC)So I posted it at my journal. It's public. :)
(no subject)
Date: 2007-12-16 09:39 am (UTC)(See, I CAN make a short post when I want to!)
(no subject)
Date: 2007-12-16 05:13 am (UTC)This is profoundly true and really resonates with me.
My experiences with pre-natal testing with my first two births caused a lot of stress and fear. I tested high on the glucose tolerance test, had to wait weeks, then took the 3 hour test and was fine. Ultrasound showed a low placenta in the first half of the pregnancy, which lead to many more ultrasounds and a lot of fear. The Dr. was worried about the baby being big, both times, so that was the catalyst for a lot of ultrasounds as well and fear on my part that the baby would be too big to deliver vaginally. They were big, but I pushed 3 times with the first and twice with the second, so all the worry was for nothing.
It was very freeing for me to go from an OB to a midwife (Tosi), especially since I would be over 35 when I delivered and there was the whole advanced maternal age thing. To go from being pressured to being empowered was really life changing for me.
(no subject)
Date: 2007-12-16 09:17 am (UTC)Tosi opened a lot of doors for me, too, and I'll be forever grateful to her for it.
(no subject)
Date: 2007-12-16 05:37 am (UTC)So my personal perspective on the issue is that I felt very fortunate to be able to have a labor and delivery that went entirely according to my wishes, research, and plans -- and that when things turned sour as no one expected they would, I was in a place and with people who knew exactly what to do and had all of the tools required to do it.
I admire you for your doula work, for being the voice of a mother who has plenty to worry about and do during labor. I believe educating women about their options is important. I just fear for women who do not get all of the information on all sides and from all perspectives. It is no better for a woman not to know what the risks of homebirth or VBAC are than it is for her not to know she might be able to do those things successfully. And I think it's imperative not to frame advocacy in a way that implies a woman is somehow not doing right by her child when she is not doing something that endangers that child, and when it is clear she is motivated by love.
(no subject)
Date: 2007-12-16 09:37 am (UTC)It is no better for a woman not to know what the risks of homebirth or VBAC are than it is for her not to know she might be able to do those things successfully.
Maybe I'm just tired, but I'm having a hard time parsing this sentence... I think I might see what you're saying, but I'm not entirely certain I can agree with it. Would it be a PITA to ask you to rephrase it?
Your final sentence, though, I understand and appreciate (check out the stories of moms being snubbed over at
(no subject)
Date: 2007-12-16 02:47 pm (UTC)It's irresponsible to gloss over the risks of homebirth and VBAC for the purpose of getting more women on board with homebirth and VBAC. It's just as irresponsible as it is not to tell women they might be able to have a successful homebirth or VBAC.
(no subject)
Date: 2007-12-16 04:45 pm (UTC)Yes, I agree with this statement.
(no subject)
Date: 2007-12-16 07:23 am (UTC)However, I chose what was comfortable for my family. I feel as though we were entirely well enough educated, and part of our no regrets is that i think we made each choice thoughtfully and with information.
I am a well educated consumer partly because of who i am, though, not all because of my circumstances. And i don't know how you can make that available to all patients.
(no subject)
Date: 2007-12-16 09:15 am (UTC)It's one thing if people consciously choose something different than I (or you, or whomever) would because they researched the options and weighed the benefits vs. the costs. That, I have learned, I can live with and support as a hired doula (mostly... for example, I probably wouldn't agree to serve as a birth attendant for someone who is planning to do something I think is potentially really dangerous, such as a homebirth for a woman who is staring pre-eclampsia in the face. Would I support her right to do it, even if I would not endorse or participate? Erm... let's tackle that one another day, 'k?).
But it's another thing entirely if people are forced into making a certain decision, even if I (or you, or whomever) think it's a good one, without adequate access to information regarding the other potential options.
If there's one thing I've learned at the small number of births I've been fortunate enough to be invited to, it's that there are no "good" or "bad" decisions. There are only the parents' decisions. My job, as a doula, is to help them have as many resources possible to make those decisions, and then to implement them.
What drives me crazy is when the parents don't get the opportunity to make a decision... when the doctor (or the insurance company or the hospital's legal department or – IME, rarely, because mostly they seem to be down with the whole informed-consent thing – midwives) dictates from on high what is Going To Happen. When that occurs, I do my level best to (quietly) inform the parents of what their true options are, even if (heck, ESPECIALLY if!) they are counter to what has been dictated.
Sometimes the parents are willing to challenge the authority (in which case I get to help them do that as diplomatically as possible or else I get kicked out of the room while they are treated like dirt for the rest of their birth experience, something I've been threatened with and heard about from other doulas, but luckily haven't had happen to me... yet), and sometimes they aren't (and then I get lots of practice in tongue-biting and polite smiling and silent hex-casting).
It makes me furious, though, that anyone even HAS to raise a challenge for what should be a basic right: access to complete and clear information regarding their options in a birth setting. I can help, most of the time, as a doula, on a one-to-one basis... but how can I best use my talents, such as they are, to widen that field? Therein, I suspect, lies my own challenge.
And I want to say that I'm really glad to hear that you are happy with your birth experience. I wish I'd been able to be of more help, both before and after your birth... not because I think you needed it, but because it would have been awesome to witness your transformation into the mama you are now!