Sunday, April 7, 2013
Getting Honest About Midwifery and the Flaws of the Natural Birthing Community
Thoughts have been bouncing around in my head for some time now. Thoughts about midwifery and home birth and legality and skill. So many thoughts I don't know quite what to make of them.
As time has gone on and I have delved deeper into the natural birth community it I have noticed a few things. Sometimes we are full of contradictions and hatred, just like everybody else. Sometimes it seems that we hold the same strange reverence for midwifery as the rest of society holds for the trained medical doctor.
I hear people talk about Ina May as though she were a goddess who can do no wrong. I hear people talk about Ricki Lake as though she is the beginning and the end of birth knowledge. I hear people say things like, "Just have a home birth, then everything will be fine." Over and over again I have heard people talk about birth being safe and painless if only we are without fear. "Trust Birth" is the motto and all complications are a result of failing to do this.
Don't get me wrong, I respect Ina May and what she has done for women and midwifery in this country. I respect Ricki Lake and am grateful for the difference that her movie has made in the world. I loved my home births and value the beauty and yes, the safety of out-of-hospital birth. And I do think fear can have a very negative impact on the birth environment.
Oh, but I think we need to be careful too.
I wish I could find a clever way to say this. A way to be funny about the flaws of the natural birth community. I have tried in the past and it always kind of falls short. I wish there was a perfect answer and I wish I knew what to say in just the right way.
So here it is, the best I can say it without sounding too high and mighty.
I think it is time we STOPPED acting like midwifery is always the answer. I think it is time we stopped talking about birth as though it should always be trusted. I think it is time we stopped acting like if something goes wrong it means mom did something wrong or it could have always been prevented.
I think it is time we held midwives up to the same scrutiny in the natural birth community as we hold OB's. It is time we realized that there are good and bad midwives. Some are ethical, some not. Some are skilled, some are not. Some are smart and yes, some are idiots.
I would love to see us stop talking about empowering women. It drives me absolutely batty for natural birth supporters to act as though they have the ability to give a woman her own power. OY! What's next- we let her eat food in labor!? Go us!
I would love to see women making their own informed choices and not getting their information just from blogs - yes- EVEN THIS ONE! (Sometimes people send me questions- MEDICAL QUESTIONS! And I have to say, it scares the living HELL out of me that somebody would ask me medical advice. It does not stroke my ego. It scares me. I am not a doctor. And if I WERE a doctor I am not your doctor! But I AM NOT A DOCTOR!) You should not trust me or any online personality with your health care.
I love natural birth. I think it goes right so often that it absolutely blows my mind. I have read memoirs from midwives and it is shocking to me that more people didn't DIE considering the horrid conditions they were birthing in and the complete lack of care, nutrition, sanitation and support. The female body is amazing. The birthing process is well designed. But please, please, please, we MUST recognize that it is not fail-proof. We have GOT to see that birth doesn't always work. There is very little in life that always works, our bodies included.
I had an unassisted birth. (It doesn't count towards my crunchy holy grail because it was accidental.) It was an amazing experience and I am so grateful for it. I believe that (for a few reasons that are too sacred for me to share), it was the right birth for our family at that time. But I have to say that I was so very deeply grateful that everything was fine and healthy and beautiful. I had experienced minor little bumps in all my other births. A postpartum hemorrhage. A baby that didn't breathe right away. A wrapped cord. All little things that were nothing because I was always surrounded by knowledgeable midwives who were quick and smart and respected the process but also knew when to step in, even in a small way.
I have heard people in the natural birth community dismiss these little "needs" for intervention. "You won't hemorrhage if you are birthing naturally and the baby nurses right away." "The cord keeps pulsing so it is OK if the baby doesn't breathe right away." "A baby can be born fine with a wrapped cord." I must admit that I and stories I have shared have perpetuated these phrases. And they are true- sometimes. But not always. Sometimes women do bleed out even when things are normal and they nurse. Sometimes the baby doesn't breathe right away and needs resuscitation despite an intact cord. And sometimes a wrapped cord necessitates an intervention.
Not always - but sometimes.
So, lets be honest. Let's apply the same scrutiny and demand for evidence based care to OURSELVES as we apply to the traditional medical community. It is kind of scary to look in the mirror and acknowledge our flaws as people and as a community- but it is so necessary. Doing so will make us stronger. Being honest about the down sides of the natural birthing community will make us better and more approachable. We shouldn't be dogmatic. We should be willing to re-asses and re-think and reconsider what we are saying. We should realize that we are wrong sometimes. That doesn't make us weak- It makes us HONEST.
I sincerely believe that more women want natural births than are getting them. I think that part of the problem is us as a natural birthing community. I think we can be scary. I think we can be mean. I think we can be so "out there" that "regular" women think we are freaks and want nothing to do with us.
There is so much good we can do for birth. I believe it must start with us. Lowering the c-section rate will start with women and it will start with DEMAND. But demand begins with education. And people don't want to learn about natural birth if we make it look like an (scary) exclusive club that is just as fear mongering as their "let's schedule your c-section at 38 weeks" OB.
We can do better.