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[valancystirling]

I would just like to announce that, six months after giving birth to an 8lb 10oz baby, I am wearing my old clothes. No doubt this miraculous transformation was brought to you by the letter G(odiva double chocolate cheesecake).

I'm still reading The Mask of Motherhood here and there in spare moments, and I'm determined to post more from it. The discussion about the idea of what is a "good birth" is particularly interesting to me.

Apparently a lot of what many women have a hard time dealing with is themselves, and their "performance" as it's being called. Honestly, that's not my problem at all. Yes, I did go into the experience with a lot of preconceived notions and expectations that turned out to be wrong, but I still feel proud of myself and the way I dealt with it all. I'm not saying I didn't have my moments of begging to be taken to a hospital and given every drug there was, and I distincly recall saying I just wanted a c-section to have it over with at one point. But that was by far not the majority of the time. Most of the 23 hours I was handling it fine, doing whatever I had to do to stay alive, or so it seemed. I don't feel like I ever "wussed out" or made an exhibition. So yes, I'm proud of my "performance", all said and done. It's the rest I'm not so thrilled about, as we all know.

And it kills me to hear obs/midwives talk about delivering babies and all that crap, because really, in a natural childbirth, what did they really do? *I* delivered my own baby, *I* gave birth, etc. Why do we give that up so easily? Who delivered your baby? I was there, I know how it went. I think too many childbirth professionals have an inflated sense of their own importance in the whole thing. If I ever do decide to become a midwife, I want to be very clear on what my role is in the semi-grand scheme of things. I know what role I wanted MY midwife to play, that's for sure. I think it's really sad that so often the experience is taken away from women.

Of course, from talking to lots of women about this, many of them don't have any strong feeling about their births one way or another and were glad the doctor "took care of everything". So who knows.

I hope I work all this out soon. It's literally taking a huge percentage of my brainpower lately.

Comments

[darkenedminds.livejournal.com]

Wow, 8lbs! And she's only 6 months old? From the pictures I always assumed she was 7-8 or so! Congrats on fitting in the old clothes :)

[millennialhippy.livejournal.com]

I think you hit the nail on the head.

"Of course, from talking to lots of women about this, many of them don't have any strong feeling about their births one way or another and were glad the doctor "took care of everything". So who knows."

As sad as it sounds, this is the true majority. And even those who do have strong feelings about their birth have even stronger feelings about the risks of birth and very real fears about not having access to every possible resource and tool medicine had to offer to save them and their baby. Training in ob/gyn is training to handle those high-risk cases. So, when an ob/gyn says something about delivering a baby, more often than not, they truly earned it.

I look at this in perspective of their medical training. Ob/gyn training focuses on a lot of high-risk situations. The specialty is a surgical specialty for a very good reason... because some women need the medical attention to live and many women need the medical attention to feel secure.

Can women go it alone? Absolutely. I hate to see medical resources wasted, and frankly America goes above and beyond every other country in the world in terms of wasting medical resources, just for the sake of insurance and legal defense. Do I think the system is going to change? Not for a very long time, especially when our culture of birth is built on so much fear. The internet and access to information is certainly a catalyst for medical patient autonomy, but when it comes to life or death (and birth is very much life) the average person will want to depend on someone who knows body pathology the best: the doctor.


I think the main concern of yours has less to do with the semantics of "delivering a baby" and more to do with the service that people in healthcare positions give. I was just talking with some women yesterday about the lack of confidence many women have relating to giving birth without medical intervention (Re: Angelina Jolie). Is confidence something that doctors, midwives, and nurses can restore in the birthing community? What can be changed in a doctor-patient relationship to ensure that every mother feels the most capable of progressing in and through her pregnancy? A lot of the stuff you are poking at midwifes/doctors for is a strong artifact of our own American culture, not a result of their medical training or personal ideals.

[aliyna.livejournal.com]

I agree with both of you entirely.

I think a lot of the 'glad the doctor took care of it' mentality comes from absolute ignorance of our bodies and the way nature works. We've had this knowlege stolen right out from under us by the booming birth industry (and what an industry it is) and women are not only clueless, but so deluded that they're unwilling to believe that there could feasably be another way. We are so alarmingly, ashamingly, hideously high in our C-Section rates, and Maternal and Perinatal death rates, that you would THINK someone would notice that something was wrong, but instead we just turn right around and go back to those that are causing the problems for help, so it becomes self-fulfilling. We're building a society where we are teaching women that there is NO other way.

Just look at the way birth is portrayed on TV, for an excellent example.

[millennialhippy.livejournal.com]

"absolute ignorance of our bodies and the way nature works"

And the scariest thing is, even the most intelligent people aren't immune to this hapless and self-destructive ignorance. I think, though, many people are just happier that way -- hence people still smoke. :X

[valancystirling.livejournal.com]

I think what bothers me the most is how medicalized birth is in general. I have read studies all over the place relating to the incredible c-section rate vs the actual medical need of such. There's a huge chasm between the two.

I personally believe that fear is something perpetuated by the medical industry--and yes, I do mean industry--to ensure that the majority of women will have hospital births with all the bells and whistles that put someone else in control of birth, and that probably have a higher payoff. I think it's a tragedy that most women have so little confidence in what their bodies can do, unassisted.

For anyone determined to be "low-risk", I don't see the point of a hospital, or an ob/gyn, frankly. For the higher-risk women, I can see it, but I think the term high-risk is so variable and loaded that again, it's all about fear, and instilling it to gain and maintain control. Turns out in my case, for example, my mom had two c-sections, no vaginal births. I grew up thinking that was normal. I heard the harrowing tale of my own birth, which consisted of an "emergency" c-section after 10 hours of labor. Oh my! Such tales of drama! All because apparently my head was at a funny angle and labor wasn't accomplishing much. I was determined to be different. And what do you know--same thing happened with Topaz. There is no question that had I been in a hospital, I would have followed my mother's footsteps. Fortunately, I was convinced that even a complication such as this was manageable without such drastic intervention as surgery. And with a little work and knowledge, it all turned out fine. And it's stories like these that I hear all the time, which make me feel like so many of those "emergency" c-sections could be avoided with a little old-fashioned know-how.

I'm sorry, I get upset about this topic. I should probably shut up about it.

I understand that ob/gyn training is vastly different from midwifery training in that the ob approaches birth from the perspective of SOMETHING IS GOING TO GO WRONG AND I CAN FIX IT! As opposed to the midwife's perspective of, Birth is a natural process that most women can accomplish with little interference, and I'll be here to help if something does go wrong. It's different worlds. I suppose for the pregnant woman, choosing doctor vs midwife is a decision to be made based on which of those perspectives they best agree with. However, again, I don't think the medical model should be the norm, rather the exception.

I like to think I'm concerned with far more than semantics. An ob/gyn is, as you said, trained to handle complications of pregnancy. Not normal basic problem-free pregnancy and childbirth. How are they supposed to do their job when it's just a normal boring birth? It's more "doing their job" to step in and DO things, as opposed to stand back. I wouldn't feel like I was earning my money if I wasn't DOING something. Letting something happen--why would I need to be there?

I guess I wouldn't undergo brain surgery for a headache.

Okay, enough for now. I hope I haven't offended you inadvertently. I'm not poking at YOU.

[millennialhippy.livejournal.com]

It's reasonable you get upset -- it's something very personal to you. And everyone deserves their passions. I really hope all the energy and motivation you get from this will help you build something wonderful out of your dreams and ideals.

That said, I think your specific passion is coloring the general issue quite a bit. Western medicine, period, whatever the field, is ripe with over-intervention and over-reliance on drugs. In the case of which came first, the fear or the medicine industry, I would definitely say the fear. Medicine is the way it is because people asked for it that way and people continue to ask for it that way. I'm not interjecting my own opinions here, simply reflecting on the history of medicine.

A doctor is trained in two parts -- one, they learn how a healthy body works. Second, they learn how an unhealthy body works, and this is where the art of medicine arises: how do we get from the unhealthy to the healthy? The role of an OB is unique because most of its patients are predominantly healthy. Therefore, the basic role is that of a facilitator and educator, overseeing the process of birth and guiding the woman through various key checks on the health of the mother and fetus. For that reason, I disagree with your generalization (in all caps). They differ from midwifery because they are trained not only to recognize highrisk situations but the most efficient and careful ways to proceed -- which often include surgery. Although I'm definitely not an OB nor do I ever intend to be, I would be very, very, very surprised to hear most OBs call a normal birth "boring." The field grows increasingly smaller with each given year because of insurance restrictions, long hours, intense diverse residency training, and constant high risk situations. It truly does attract only people who are extremely interested in and inspired by the art of birth.

I think this common criticism of medicine is a sensitive issue for both of us. I personally can't stand most doctors, and a lot of the problems with the system and the culture are some of the strongest reasons why I eventually decided to pursue medicine. I hesitate to make the same general criticisms that you are making, though, precisely because of that decision. Cornering and rejecting doctors or midwives as a whole is an entirely unproductive way to instantiate change. Joining them, on the other hand, can make a world of difference-- something I'm positive you realize, given your desire to be a midwife.

But through everything, keep in mind there is a balance -- and that even healthy, strong women will sometimes choose to get relief from drugs or to get a c-section, and that is a choice worth respecting, because, according to medical ethics, every person deserves every opportunity to be healthy. It is very, very difficult to refuse the wishes of a patient when it is medically and financially possible. This is the strongest reason why I keep pushing this discussion to focus less on the doctor and more on the patient. No matter what a doctor suggests or how they suggest it, the bottom line is -always- the patient (and always should be the patient).

Change how a patient sees him- or herself, and you change medicine. =) Which is exactly why *eastern* medicine is so different!

[valancystirling.livejournal.com]

I'm sorry. I realised later that I was pretty much saying that I hate what you're devoting your life to, and that was obnoxious and unnecessary.

Probably a lot of our disagreement is in the different literature we've read, which is necessarily from different perspectives, coming from people with different value systems and priorities. I have certain opinions, so I go looking for books that back them up, and I assume other people do the same.

It seems like it's all a crazy cycle, in which the cause and effect are indistinguishable, and it's impossible to know which came fear: the fear or the cause of fear or the fear, etc, etc.

Ultimately, we're all working in our own best interests, whatever we determine them to be.

[millennialhippy.livejournal.com]

Well, it's a bit of a misnomer. *grin* The only reason I'm training to be an ob/gyn is because that is the best path to being certified to research and practice in the field of reproductive endocrinology. I really have no personal interest in the art of birth except where it relates to patient rights and doctor responsibilities (aka medical ethics). I also have minimal interest in STD and female pathology except where it relates to public health. I'm pursuing medicine solely to have the flexibility to switch between research and clinical work at my heart's content.

Fear feeds bad healthcare, and the system caters to it. I'm more than content with the work i've been doing advising and educating young women on hormones, behavior, and sexual health. I wouldn't be pursuing a training in medicine if I weren't absolutely positive the years of experience wouldn't make me more able to help and support even more young women. =)

I haven't interjected many of my personal beliefs here, so I'm not at all insulted by your strong opinions, though I do appreciate your apology. I think with time you'll find we're very much on the same page.

[fi.livejournal.com]

You should feel proud of yourself.

For doing so exceptionally well at the birth, in the face of Jeanette adversity.

And for a truly awe inspiring shedding of weight. I salute you!

[valancystirling.livejournal.com]

Thanks :)