Friday, April 30, 2010

That Post on Natural Childbirth

Apparently this one has been coming for awhile, so here it is.

I realize some of the things I say here may piss some people off, so I'm going to attempt to tread lightly while speaking some truth. So let's start with some procedural comments and disclaimers.

I am not a fan of extreme positions in general. First of all, I think that extreme positions are often the result of intellectual laziness or kneejerk reactions or a lack of the nuance and subtlety that's required to get a grasp on the complicated, fluid reality of human experience. I think that staking out and defending extreme positions requires us to over generalize and try to tell metanarratives that silence real voices and delegitimize real lived experiences. And finally, insisting that we are always and everywhere required to choose between extreme positions, besides being logically fallacious, often ends up being a silencing technique that stifles constructive dialogue.

So nothing I have to say on the tricky topic of childbirth is going to be coming from any of the extreme positions. This means that nothing I have to say on the topic is some cleverly disguised way to say something like this "natural childbirth is the only good way to give birth and if you don't have natural childbirth then you are lazy/a coward/a tool of the patriarchy/a bad mom." If you suspect that I'm saying something like this, you might go back and carefully reread the section that seemed problematic to you. If it still seems like I'm saying that, then go ahead and send some hatemail.

Second, most of what I have to say about childbirth is not about mothers personally, but about the cultural system in which they are carrying and birthing and mothering their children. It is entirely possible to critique a system without by extension condemning the people who are functioning within that system through no fault of their own. I can note, for example, that a particular company has a very corrupt corporate culture without indicting the moral sensibility or behavior of each and every employee of that company. The same thing is true of a cultural critique. I assume that all of us live and develop within a cultural framework that shapes who we are and how we perceive things and what choices we make in profound and subtle ways. This doesn't mean I think that all women are unthinking automatons who are helplessly blown about by the prevailing cultural winds. But I also reject the opposite notion that a person can be entirely independent and throw off all the influences of the culture in which they are embedded and make choices that are entirely unconstrained by their cultural framework. As usual, I suspect the truth lies somewhere in the middle of these extremes.

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There's a disturbing trend in feminist discourse that goes something like this:

  • x (for example childbirth, breastfeeding, having a career or being a stay at home mom) is drawn to our attention as a locus of patriarchal control
  • advocacy work is done to fight off the patriarchal control and encourage practices that are thought to be better/healthier for women
  • the advocacy groups go a bit too far in their encouragement of the better/healthier practices and women begin to feel that their choices are now being curtailed in the opposite direction
  • a backlash ensues in which we seem to feel that we have to deny the often well-documented and undeniable benefits of this thing the advocacy groups are fighting for.
Hence you see feminists denying that breastmilk is nutritionally better than formula, or that births with fewer medical interventions are, generally speaking, safer for mothers and babies. And this puts us in a really strange and irrational position, because we're having to deny facts that are well-established through mountains of research. So this whole thing is troubling to me, because this version of feminism requires women to behave in an irrational way, which simply confirms one of the most misogynistic assumptions our culture makes about women. Talk about playing into your opponents hands.

Beyond the strategic issue this raises, there's the fact that this pattern of discourse keeps us running on the hamster wheel of finger pointing and in-fighting. And the tragedy is that this prevents us from having the conversations we really should be having about the systemic forces that make it so hard to maintain our physical autonomy and make truly free well-informed choices. The day that a woman choosing natural childbirth receives the same amount of physical, social, and personal support as a woman going the medicalized route is the day when we can start talking about free choices. The day when women are really given the whole truth about the risks involved with various medical interventions and aren't bullied and hurried and eye-rolled into conforming to whatever the medical professionals they're working with want for their birth experience is the day when we can start talking about free choices. And the day when real support and encouragement and birth assistance is available to women of all socioeconomic backgrounds is the day when we can start talking about free choices.

I've been told that by merely noting that natural childbirth was an empowering experience for me I'm oppressing women for whom natural childbirth was not an option. And I'm sorry, but that's bullshit, and that silences me and delegitimizes my experience. I don't have to deny that natural childbirth was the best option for me and my baby in order to make it OK that you couldn't or didn't want to go that route. That's just not how it works.

While I was pregnant I did a ton of research and read piles of scientific studies and books that traced the history of childbirth and documents that argued for and against our current model of hyper-medicalized childbirth. I read the statistics about your chances of having a c-section if you go the epidural-pitocin route. I read about our high c-section rates and the accompanying high rate of maternal mortality and the host of other negative consequences that follow from unnecessary c-sections. I read about the physiological processes that occur naturally within a mother’s body during childbirth that benefit both mother and baby, and how these processes are interrupted or derailed by medical interventions, including epidurals. I also read about how these processes have been denigrated and dismissed by the patriarchal medical establishment that tends to believe that there's nothing that occurs naturally that can't be synthetically duplicated. (Ironically, after reading this I was actually told by a nurse "oh honey, pitocin is just the same as oxytocin." Ha! The timing was deliciously ironic.) I processed all of this and talked it over with friends and my partner and decided that I was going to try to do it naturally.

My decision was based on the fact that, all other things being equal, natural childbirth is healthier for the mother and the baby than any of the other options. This is a non-normative, purely descriptive, well-documented fact. This doesn't mean every single woman who decides to have a baby should be able to do it naturally and is a failure if she doesn't. This doesn't mean that women who decide to have medical interventions are bad moms. It just means that if you are fully informed and willing and able and supported in your choice, it's the best way to go if maximizing the health of you and your baby is your goal.

And for me, personally, taking the natural route was also a defiant act of standing up to the bullying and the smirking and the micromanaging and the distrust of women's bodies that's so prevalent in the medical industry. It was me saying "Fuck you and your patriarchal fucking attitude toward my body and my mental toughness and my instinctive knowledge of how to birth my own fucking baby." And I took on natural childbirth, which was tough and painful and stressful and one of the hardest things I've ever done, and I fucking kicked its ass, and it was an incredibly empowering experience. Because what I learned was not that natural childbirth isn't that hard or painful, but that I was stronger than I had ever had a chance to discover before. I've broken bones and torn ligaments and had concussions and root canals and dislocated joints before. I've played through the pain and run half marathons and climbed mountains and flipped a car at 50 mph. But this was entirely different, and required a different kind of physical strength and mental grit. But if I'm not allowed to say this, because somehow my experience of childbirth means that you have to feel guilty or deficient concerning your childbirth experience, how does that help us as a group?

I realize that not all women experience childbirth the way I did, and I realize that not all women approach childbirth with the kind of resources and physical health and support that I had. But my point is that silencing people when they talk about the flaws of our overly-medicalized, patriarchal approach to childbirth or about their personal experience of natural childbirth is not the answer. By merely mentioning that I experienced natural childbirth or that I am aware of the benefits of it, I am not committing myself to a hardline approach in which everyone has to have natural childbirth or they're a bad mom. There is middle ground here, and knee-jerk reactions do nothing to further the dialogue and improve the conditions of real women. And denying the empirical facts concerning childbirth and breastfeeding just makes us seem silly and irrational. Instead, we should acknowledge the facts and do what we can to make systemic changes so that these choices are viable options and women are truly supported in the whole range of choices they might make.

79 comments:

  1. Anonymous4/30/2010

    You are awesome. THis post is awesome. Thank you.

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  2. I never realized that these issues were so divisive wihtin feminism until the big Facebook breastfeeding blowup, and then I was surprised by the bitter debates that took place on some of the blogs. Your analysis of the evolution of debates like this seems accurate to me.

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  3. Anonymous5/01/2010

    I'm just turned off by arguments that claim that experiencing the pain of natural childbirth is some kind of rite of passage or indication of a woman's dedication to her kid or something. But I think your right that arguments in favor of choosing natual childbirth don't have to be like this. Back in the day a rabidly religious old lady told my mom that pain in childbirth was given to us by God to remind us of Eve's sin, so we shouldn't use pain meds to help women in childbirth because that intervenes with God's plan!

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  4. Anonymous5/01/2010

    This is a really great post, but I'm wondering about the use of the word 'natural'. NOT to silence you, but the term is rather imprecise. Do you mean 'non-medicalized' or unmedicated, or midwife attended, without epidural, or out of hospital? I have no idea, and I think this might be why some people might feel defensive when people share 'natural' childbirth experiences, because it means anything else is 'unnatural'.

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  5. I've hung out with the hippy-granola crowd for so long, that it would never have occurred to me that natural childbirth and the views surrounding it were seen as problematic somehow. Of course, since I can't give birth (unfortunately), I've always been on the periphery of these issues, hearing other women speak of their perspectives and experiences.

    You learn something new everyday.

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  6. melbatoast5/02/2010

    The thing that strikes me about this post is the way you describe so accurately the methods medical professionals use to bully women into compliance. It was one of the most vulnerable times in my life for sure, and so all the eyerolling and "we'll just see how things go sweetie" tactics effectively intimidated me into not insisting on my preferences. When I said I wanted to try nursing immediately before they took her away to clean and weigh her, etc they said "well it just doesn't usually work out that way" and even though my daughter was perfectly healthy with no signs of any danger, they did take her away with no explanation and when they finally brought her back she was too sleepy to nurse just like the breastfeeding books say will happen. But nobody felt any need to explain to me why they had to take her away or keep her away for so long and they brought a bottle of formula back with her even though I had told them we were going to breastfeed exclusively. It was like everything I wanted was just a cute silly little suggestion that they didn't even have to explain why they were ignoring. The only way I can describe that feeling is impotence, and for me it was the reason I wanted to leave the hospital and go home ASAP.

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  7. emjaybee5/02/2010

    I run into this in my own family, in which c/sections are the norm for every woman of my generation and the next. Every one. So even talking about it being bad means that several women automatically feel judged and criticized, and yeah, partly because it DOES challenge their rationalizations for their own births.

    When I had a coerced unnecessary c/section after trying so hard for a vaginal birth, it got even weirder, because instead of laughing and saying, "Wow, I was an idiot to try anything else!" I grieved and was angry.

    Still am. I can't help the women in my family or change how they feel about their experiences. I can only refuse to agree with their opinions about mine.

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  8. Well I think I just found a new blog to read! Loved this post. Yea and Amen!

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  9. As someone who believes that for medical reasons a syntocin induction (although perhaps not all of the sequelae) was indicated for her first birth, I absolutely agree and I am proud to support feminist critique of and activism around birthing.

    Frankly, not all natural-childbirth advocacy and medical-childbirth critique is feminist, nor is all breastfeeding advocacy. But this should not detract from feminist birth activism.

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  10. WYmidwife5/03/2010

    Just right. Perfect.

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  11. You read my mind! I've been so frustrated with the flack I have gotten for having unmedicated hospital and homebirths, and supporting breastfeeding. It has been tempting for me to say that I'm entitled to my own fucking feelings about my births without it having anything to do with anyone else's feelings and birth experiences. I am a feminist even if my birth, feeding and parenting choices are different than other women's choices.

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  12. Anonymous5/04/2010

    Thank you for saying this!!!

    -Terri

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  13. FierceMama5/04/2010

    Beautiful. Perfect.

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  14. Thanks for the positive comments, everyone. I really appreciate it.

    @ Anonymous (the one who asked about my def of "natural childbirth")
    I tend to think of natural childbirth as a birth that is not managed medically and where medical interventions are kept to a minimum and only involved when absolutely necessary. And what I mean by managed is "labor and delivery have to progress on our time frame or we'll keep introducing medical interventions in order to keep it on our time frame up to and including a c-section." So I also think of childbirth that involves medical pain management as not in the "natural" category because pain meds inevitably interfere with the natural physiological processes and generally require many other interventions as a result. And I think this is fine as long as the mother is given complete information about it. My issue is that most are not (the brochure I was given that explained epidurals and their risks and possible side effects was laughable) but for some reason we as a culture think that childbirth is an exception to the normal standards governing informed consent. Which is I think an accurate reflection of our view of pregnant/laboring women as non-rational being who are basically incapable of making autonomous decisions. I think this also explains why people are so incredibly inclined to talk babytalk to you (and to casually violate social norms governing physical boundaries) when you're visibly very pregnant and when you're in labor.

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  15. Brandywine5/04/2010

    I love that you could replace the words "natural childbirth" with "breastfeeding" and it still makes perfect sense. Like this:
    The day that a woman choosing [to breastfeed] receives the same amount of physical, social, and personal support as a woman going the [formula] route is the day when we can start talking about free choices.

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  16. This kicks so much ass. Thank you.

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  17. Anonymous5/05/2010

    I generally find myself on the opposite side of the spectrum from the views that you support, however, I felt your post was very articulate and fairly non-judgmental towards mothers like myself.

    Speaking on behalf of many "mainstream" moms, I think many of us get turned off by natural birth advocates when it is assumed that because we chose or ended up having medical interventions that it is because we didn't do enough "research" or we weren't informed enough, or were bullied into those choices by our health care provider. Otherwise, surely we would have chosen natural childbirth.

    This position is terribly insulting and hurtful toward mothers such as myself who (twice) chose induction. I have my reasons, am at complete peace with my choices, and will never feel a need to justify my choices to anyone.

    Although I don't feel that your post makes this assertion, I do feel like this is a hallmark argument for natural birth advocates. I have often found myself getting defensive when reading the thoughts of an advocate or having a discussion with an advocate and thinking "I don't think about/involve myself with/care about how you chose to give birth to your children, where do you get off thinking about/involving yourself/caring about how I chose to give birth to my children?"

    When advocates for natural birth can focus and articulate their goals as you have, perhaps both sides to this discussion can come closer together and have a thoughtful dialogue without hurt feelings and closed minds. Cheers for helping to bridge the gap...

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  18. Thank you! That was beautiful.

    I'm a birth doula, so I resonate deeply with this post. I live in the birth culture and have had to find a way to have this conversation in a way that speaks truth but keeps people open. It's a line I walk every day, and I get better at it every year I'm in the business, but what I have found that works well for my clients is this: "Although I believe the evidence indicates that GENERALLY natural childbirth is safer for mom and baby, SPECIFICALLY I always stand on the side of what a mother's unique needs and desires are for HER birth experience. I have supported women in natural births in the hospital and at home, and have also fully supported women during inductions, epidurals, and cesareans, whether unplanned or planned. Every woman deserves support for her unique needs in birth, whatever they may be." I think this is pretty close to what you are saying as well, but thought I'd share the verbiage for that middle ground you, and I, are looking for when it comes to how women talk about birth.

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  19. Amen... and amen... and AWOMAN!
    You're Kicking ass feels SO good!
    Wish I had said it!

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  20. Exactly.
    There is SO much more to expound on here.
    But I feel the energetic shift in birth slowly occurring in our culture. It is almost imperceptible; but we feel its waves.
    Let's ride it, mama.
    Natural birth - and homebirth - were inherent decisions for me. It's hard to explain that to some folks who want hard reasons and evidence. But some things, like Love, just can't be explained.
    You know what is truly Feminist? Speaking our Truths. Whatever they are. From a place of raw, deep love.
    Thank you for doing just that.

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  21. Beautifully put - and I'm not even a true feminist! Loved it.

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  22. A truckload of incredibly loaded responses to this, as anticipated, to the point where I almost didn't click through from a friend's facebook link. I've felt alienated by the discourse around natural birth, and by statements that, for instance, insist our entire motherhoods are defined by the birth experience (that's a word-for-word quote). Having a baby who died after a crash c-section that was necessary because of an emergency complication changed everything for me. It made statements like that viscerally intolerable to the point of wanting to put my fist through a wall.

    I'm a proponent of free choice and informed choice and, most important, adaptability and the shedding of guilt. I've seen the discourse around natural birth cripple many women who haven't been able to kick ass for any number of reasons. It's got a prickly flip side, that desire to kick ass, though I'm genuinely happy to see that you kicked it. And so I tend to get my back up at the semantics and the rhetoric, as much as I agree with the intention and the feminism behind it.

    I'm babbling, and it sounds more like a counter than intended. I'm just trying to articulate that I'm generally not comfortable with this line of discussion, and that 90% of the time, I grimace at the expression of something I heartfully agree with - because so often, the expression goes too far in its need for being on an offensive (against the medic al establishment). This was a great, great post. I respect it utterly and it was fresh air in a stale room. Thanks.

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  23. Bravo! Well said! Thank you for a great addition to a much-needed, constructive and respectful dialogue between women.

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  24. Anonymous5/06/2010

    "all other things being equal, natural childbirth is healthier for the mother and the baby than any of the other options. This is a non-normative, purely descriptive, well-documented fact

    cite please.

    Seriously, you just state you read a bunch of studies, then state some fact.

    I am especially curious because that's counter to every study I have read that concludes it's equal or safer then natural child birth. The variable being the mothers health and complication. Good health, no complications, no statistically means difference's.
    SO when you enter a hot bed topic and then just state something as a fact, you do nothing be create confusion and add to the 'balanced sides' confusion.

    The emotional content of just being a mom is so great, and discussion about it must use solid studies and facts. with out them we get Jenny McCarthys of the world thinking just being a mom gives them some magic knowledge.
    It doesn't.

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  25. Anonymous,

    I admit that all the research I did was about 3 years ago now, and as such I can't possibly list all the things I read. Also, I kinda think people should be responsible for educating themselves.

    But I will say this. If you want to access a host of studies and research that has been done by totally reputable institutions, in large, well-structured studies, you can start with Henci Goer's work. Her books (The Thinking Woman's Guide to a Better Birth and Obstetric Myths Versus Research Realities) are a great resource. I combed through the Bibliographies for her books and read the suggested reading she offered at the end of each chapter, and just doing this alone leads you to hundreds of well-respected scientific research on the whole range of medical interventions. You can also do a Google Scholar search for any of the relevant keywords ("C-section rates and maternal mortality," "Medical Inductions and C-section Rates," "Pitocin use and C-section rates" ...) and come up with piles of info. A lot of it is hard to access unless you have institutional access through an academic or research institution, so I admit that I'm privileged in the sense that I had access to lots of info that is not readily available to everyone.

    But this is exactly my point. Women are rarely (or never) informed of this kind of stuff, and are often even intentionally misled by medical professionals. Start by looking at the World Health Organization's recommendations for C-section rates. In America we have a c-section rate three times their recommendation, and our rising maternal mortality rate tracks with our rising c-section rate. Then look at the link that interventions such as epidurals and pitocin and fetal monitoring have with c-section rates. Then look at other obstetric practices that we're so devoutly committed to in the U.S. like clamping/cutting the cord immediately, delaying breastfeeding, giving every baby antibiotic eyedrops that irritate their eyes and prevent them from focusing on the faces of their families for the first 24 hours in every case even when we know the mother tests negative for the STDs that would pose a danger to the baby's eyes, routine episiotomies that generally don't help and usually cause more physical damage than natural tearing would cause, forcing women to labor and deliver in the prone position, not allowing women to eat and drink during labor, etc. etc. Then compare America to western European nations like Switzerland, where most births are homebirths with midwives and very few interventions, and infant and maternal mortality rates are far far lower than U.S. rates. Why is it true that in nations where low-risk mothers routinely give birth at home with no medical interventions mothers and babies emerge from childbirth healthier?

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  26. cont'd
    Reading all these studies and finding all of this info was an eye-opening and disillusioning experience to me. Knowing that the medical industry in the U.S. is so resistant to these realities, and so coercive in the way they handle women, and so willing to not only hide information from women, but intentionally mislead them for the purposes of profit and lower liability and institutional schedules and routines is hard to accept. We've been socialized to idolize doctors and believe anything they tell us. We've also been socialized as women to be pleasant and docile and non-confrontational. All of this puts us at a huge disadvantage when dealing with the medical machinery.

    I don't think just being a mom gives me some kind of magic knowledge. I developed the habit of reading about everything, and researching everything in great detail in my years in graduate school. It is not in my nature to take anyone's word for anything when it comes to something that is intensely important to me. This includes the words of "granola-type" natural birth advocates and the medical professionals who laughed at my questions and likened childbirth to having a root canal and lied to me about the risks associated with epidurals and pitocin. So I did my research and read the studies, and concluded that medical interventions aren't bad if they're used in the right way. It's great that we have medical interventions available to us in cases where things really are going wrong in the course of childbirth. But what's fucked up is that this has become the norm even in births where these issues don't exist. You would think that in America every pregnancy is high risk and dangerous based on the multiple interventions that are almost always involved. Rather than using them as tools to help maximize positive outcomes, we've allowed them to take over and become the norm in spite of the damage this does to mothers and babies (colonization of the lifeworld, y'all). I don't need the "mom sense" you find so laughable to see that sacrificing women's bodies and physical autonomy on the alter of ego and profit and paternalistic institutional control is pretty damn fucked up.

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  27. Catlyn5/06/2010

    I don't need the "mom sense" you find so laughable to see that sacrificing women's bodies and physical autonomy on the alter of ego and profit and paternalistic institutional control is pretty damn fucked up.

    This! A thousand times this.

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  28. TheOneHeather5/07/2010

    @Anonymous ("Dr" Amy, perhaps?),

    Why don't you cite any of your sources? We're all waiting with baited breath.

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  29. To me one of the really hard issues about this is this very surface level conception of "educated" and "informed" we have concerning these kinds of choices. I truly believe that if most women really knew the immense risks associated with most obstetric medical interventions they would run away screaming, and yet it's still commonly believed that epidurals are as harmless as getting a novocain shot at the dentist, and that pitocin is just exactly like oxytocin, etc. If basically nobody (except those who have taken a lot of time to educate themselves and happen to be a bit of a contrarian to begin with - no offense Rachel cuz you know I love you) knows this stuff then clearly the med establishment is being more than a bit obstructionist, and we need to start asking ourselves why. Especially in the face of our rising maternal mortality rate. Why be obstructionist? Why distribute so much misinformation and put so many obstacles in place of women who are making their choices? It seems downright criminal to me.

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  30. Anonymous5/07/2010

    Ok, here's where you lose me. Up until now, the conversation has been more than civil, thoughtful and thought-provoking, but a few comments that come close to challenging the core beliefs of the post and now the comments have grown increasingly defensive and extremely generalized and IMHO this is why many moms who do not consider themselves to be natural/home birth advocates tune out.

    I'll tell you why - Rachel, you make comments like "Women are rarely (or never) informed of this kind of stuff, and are often even intentionally misled by medical professionals." and "We've been socialized to idolize doctors and believe anything they tell us." I think these are very loaded statements and ones that are really insulting to every doctor who worked their asses off through 4 years of college, 4 years of medical school and 4-7 years of residency in order to practice. Are there bum doctors out there who are as you describe? I have no doubt, but to categorize an entire industry of professionals in this way is insulting.

    The other thing that I think is important to note is that while many of your assertions are not false, they can be interpreted as not entirely accurate or complete. One example that I've noticed many advocates like to cite is the rise of maternal mortality rates. To link this exclusively to increased medical interventions is just not true. There are a myriad of reasons the maternal mortality rates are increasing in the US, only one of which is increased scheduled C-section rates. Another reason is the vast increase of obesity in the US and underlying undetected health conditions of obese mothers and complications that arise at birth. Another reason is the increased specificity of cause of death coding and reporting on death certificates which has undergone several large modifications in the past 10 years which contributes to the number of deaths which are correlated to maternal issues.

    So while interventions may be one reason there are several others to note - your assertion neglects to note these other possible causes. In fact, medical journals and articles (including one from the Lancet) states that advanced medical practices and obstetrics is what has caused the MMR to plummet in past decades.

    I'm not saying you're all wrong, I'm just saying in over-generalizing to make a point you passionately believe in, you lose people's belief because it is not comprehensive.

    One last point that I feel is getting lost is to give credit to a very large number of women who consciously CHOOSE to have medical interventions. To indirectly assert that women who choose medical interventions aren't educated or haven't done the research is just plain insulting to them too.

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  31. Anonymous5/07/2010

    OK, I have to admit I thought s/he'd play the obesity card first, and s/he actually didn't get to it until a couple paragraphs in, but still. I love how medical professionals or wannabes always appear sooner or later in these kinds of threads and display the exact paternalistic attitudes Rachel is referring to. Nothing like proving your point for you.

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  32. Anonymous5/07/2010

    Ok, here's where you lose me. Up until now, the conversation has been more than civil, thoughtful and thought-provoking, but a few comments that come close to challenging the core beliefs of the post and now the comments have grown increasingly defensive and extremely generalized and IMHO this is why many moms who do not consider themselves to be natural/home birth advocates tune out.

    I'll tell you why - Rachel, you make comments like "Women are rarely (or never) informed of this kind of stuff, and are often even intentionally misled by medical professionals." and "We've been socialized to idolize doctors and believe anything they tell us." I think these are very loaded statements and ones that are really insulting to every doctor who worked their asses off through 4 years of college, 4 years of medical school and 4-7 years of residency in order to practice. Are there bum doctors out there who are as you describe? I have no doubt, but to categorize an entire industry of professionals in this way is insulting.

    The other thing that I think is important to note is that while many of your assertions are not false, they can be interpreted as not entirely accurate or complete. One example that I've noticed many advocates like to cite is the rise of maternal mortality rates. To link this exclusively to increased medical interventions is just not true. There are a myriad of reasons the maternal mortality rates are increasing in the US, only one of which is increased scheduled C-section rates. Another reason is the vast increase of obesity in the US and underlying undetected health conditions of obese mothers and complications that arise at birth. Another reason is the increased specificity of cause of death coding and reporting on death certificates which has undergone several large modifications in the past 10 years which contributes to the number of deaths which are correlated to maternal issues.

    So while interventions may be one reason there are several others to note - your assertion neglects to note these other possible causes. In fact, medical journals and articles (including one from the Lancet) states that advanced medical practices and obstetrics is what has caused the MMR to plummet in past decades.

    I'm not saying you're all wrong, I'm just saying in over-generalizing to make a point you passionately believe in, you lose people's belief because it is not comprehensive.

    One last point that I feel is getting lost is to give credit to a very large number of women who consciously CHOOSE to have medical interventions. To indirectly assert that women who choose medical interventions aren't educated or haven't done the research is just plain insulting to them too.

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  33. Anonymous5/07/2010

    Sorry - not a medical professional or a wannabe - I'm just a mom. Why do you get so defensive when someone challenges the tenets of the natural or home birth argument? You don't just believe anything that's told to you, why should I?

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  34. So, you're "just a mom," but you don't believe/won't pursue the wealth of scientifically-based info out there that confirms that there are huge issues with the way we practice medicine in the US, and yet you still think you're qualified to contradict the conclusions I reached after months of research. And I'm supposed to take you seriously why? You still haven't cited your sources, or refuted any of mine. You can start be explaining to me why Henci Goer is wrong in each conclusion she's reached in Obstectric Myths. Let's go chapter by chapter, and I expect complete citations for your sources as well as an explanation of how each study you cite refutes Goer's claims. Then we can move on to a basic Google Scholar search, and for any study I cite supporting my claims, you need to cite a study or studies refuting them. I'll make available to you any results that come up that require institutional access.

    And please don't yammer on to me about choices women make. I've already covered this in great detail here and elsewhere. In an environment of coercion and misinformation it makes little sense to talk about choices. I'm not interested in coerced, misled choices. If we really respect women then we'll give them all the information and let them make truly informed decisions. That's how you respect someone's autonomy, and that's what feminism is all about.

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  35. GirlFriday5/07/2010

    Anonymous,

    You're the one that came in here kinda hostile and demanding proof. What is it you expected?

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  36. Anonymous5/07/2010

    Um, Rachel is the one who said she doesn't just take anyone's word for things that are this important, not me. All I did was conjecture that you work in the medical field, as you clearly have a lot at stake in maintaining the status quo. The WHO has criticizes American medical practices, and many medical professionals admit that there are some huge issues that need addressed as well, so it's odd that you would be so defensive of an obviously flawed status quo. But of course, wherever there's money to be made...

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  37. "But I choose my choice!" ...whine, whine, snivel, snivel...

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  38. Ahem, Jamie. Please take it down a notch. I'm no fan of the "I choose my choice" meme within feminism either, but your tone is a little less than respectful or constructive.

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  39. Anonymous5/07/2010

    Rachel, I don't expect you to take me seriously or exchange your belief system or opinions for mine, but I just ask that you respect that people reach conclusions on important personal decisions differently. You don't trust the medical industry - I get that. You chose to do your research yourself. You are probably in the very slim minority who knows where to access truly legitimate information (not just any-old-page-or-blog-you-might-find-on-Google), cull through complex jargon and interpret statistics and their implications without any kind of translation assistance. Most people can't.

    I also never said that you didn't have valid points about flaws within the medical community. I agree that there are many many documented instances of where they system isn't working. I just don't buy the assertion that all medical professionals lie and purposely mislead their patients for profit. We're just going to have to agree to disagree on that.

    Instead of relying on my own research regarding my pregnancy and birth, I sought an obstetrician I trusted and then entered into a relationship with them filled with discussion and questions.

    I just have a hard time taking your conclusions as gospel when you seem unwilling to admit that there might be another side other than yours that isn't broken for many women.

    Not to be inflammatory, but advocates might make more headway if they didn't beat up other women for not taking the same path they did. It may not be an intentional aim, but it's off-putting and counterproductive to the valid points that you so eloquently made in your orignal post.

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  40. I'm really not getting where you get the idea that I'm beating up on other women for their choices. Please provide quotes. I'm not sure you read the post very carefully.

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  41. Seeley5/07/2010

    "Just a mom" might start her re-reading of the post with this:
    Second, most of what I have to say about childbirth is not about mothers personally, but about the cultural system in which they are carrying and birthing and mothering their children. It is entirely possible to critique a system without by extension condemning the people who are functioning within that system through no fault of their own.

    Also, awesome post, Rachel.

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  42. voiceofreason5/07/2010

    Anonymous,

    That's exactly her point. It shouldn't be so terribly hard to get good information, balanced information, accurate information on this stuff. How are women supposed to make good decisions concerning their bodies if this info is so hard to acquire and they are frequently fed half-truths and straight up inaccurate info via a coercive and powerful medical industry? That's the whole point here. If I feed you a line of bull and pressure you strongly to do what I want you to do, and society has given me a certain amount of authority that you lack, how good is that choice you're going to make? That's the entire point here.

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  43. Anonymous5/08/2010

    OK. Love this post. It expresses a lot of the joys and frustrations which I have encountered after my own NCB, which was pretty darn natural considering that the baby arrived well before the midwife. (Not cool when you are counting on having medical attendance, and we didn't even get a portion of the fee back. Thank goodness that it turns out that I'm quite able to catch babies, which IS cool.)

    Anyhow, this post makes me think of diamonds. I heart diamonds when they are "good" diamonds. Those of you who are in the know know what I'm talking about. And I'd never tell anyone that the SI-H she's waving in my face, which she loves, is an SI-H. She's happy and glowing. End of story.

    Now give me that same woman before she says yes, and give her an information intervention. She can now choose to pass on that info. to her significant other in order to let him know what she wants. It's her choice to wait and see what's in the box, or do all she can to make sure that what's in the box is what she wants.

    Let me come back to birth. If a woman is happy with her birth we should all celebrate with her, even if what we're hearing is an I-J birth story. She's happy. End of story. (And if she is unhappy we can also hold her hand, and our tongues if necessary.)

    Now give me that same woman, or any woman, while pregnant, and give her an information intervention, and that's a whole other ballgame.

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  44. And I think the whole "don't attack women who were happy with their medicalized births" thing is a red herring.

    When I was doing my psych rotations in Michigan I worked with a local group that did art therapy for women who had had traumatic birth experiences. And believe me, if you start advertising a service for women who were traumatized by the CB experience, they come out of the woodwork. It's staggering to see the number of women who say "until I heard it described as a traumatic birth experience, I didn't even think of my experience that way. I explained it away as postpartum depression or something, but once I heard that term I was like 'YES!'" And the art they produce is so sad and disturbing. It's full of imagery like prison bars and skulls.

    So obviously the number of women who did feel violated by their medical birth experience and experienced a loss of autonomy is much bigger than we're willing to admit in our culture, and this is exactly why this kind of discussion needs to occur. So just going on about how we shouldn't attack women who were happy with their birth experiences is beside the point and portrays natural birth advocacy as doing something that it's really not usually doing.

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  45. Anonymous5/09/2010

    Dr. Amy just compared NCB to white supremacy in the comments section of her website (SkepticalOB).

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  46. Yes, It's a cute little strawman she's fighting. I teach my students in the first week of Critical Thinking how to take a few quotes from an article and build them into an easily demolished strawman. And it is fun. I'll give her that. But it tends to make people stop taking you seriously. It's almost...cute in it's naivete and total lack of sophistication.

    Also, ironically, she refers to journals such as JAMA and NEJM as propaganda.. I wonder what "Dr" Amy thinks of as actual respectable sources?

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  47. Anonymous5/09/2010

    The thing is, I don't know if she's really an MD or not. It could be, and that would make sense that she's motivated by economic concerns. After all, the more women who choose midwives and fewer interventions, the less money OBs make. But she has sooooo much time to troll Jill's blog that I kinda doubt she's employed (or employable) at all.

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  48. Lorraine5/09/2010

    Of course that's her motive. I was a NICU nurse for 17 years and it was well known that the docs made more $$ and had shorter shifts when they did c-sections. Why wouldn't you push more interventions and resort to c-section more often whether or not it's required? The unspoken truth we all accepted around there was that if you wanted a vaginal birth you damn well better get it done with within a 7 hour window or you were probably headed for surgery. Of course it's fucked up, but personal schedules and insurance billing basically dictate chilbirth culture in the U.S., so I don't think any amount of scientific research will change that. The idea that it will is based on a fundamental misunderstanding of how the medical industry works.

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  49. Anonymous5/09/2010

    And someone like "Dr" Amy's response really highlights the patriarchal nature of the industry. There is nothing that strikes fear into their hearts and makes them fight back the harder than the idea of a well-informed, independent woman making her own choices. The idea of educating women and supporting them in their choices is obviously terrifying to someone like "Dr" Amy, based on her responses to this kind of thing. This is why she cannot actually read your post and get what you're saying and that you're not advocating for NCB in every case or that you're in favor of informed decisions that take all the info into account. And your position against harassing women for their choices seems pretty clear to me but is lost on her. Cuz she's such an "advocate" for women, ya know.

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  50. theotherRachel5/09/2010

    Although I notice that "Dr" Amy's not quite brave enough to come here and discuss this with you face to face. Perhaps she's afraid of all the "propaganda" you might cite.

    On a more serious note, it's very sad that this kind of battle is being fought on the ground of women's bodies. Working at the reproductive health clinic I've met some pretty obnoxious natural birth and breastfeeding advocates, but this is no ground for anyone claiming to represent the mainstream medical establishment to dismiss the very real damage that has been routinely done to women in the name of progress or whatever. Western medicine has a history of abusing women, and because of this should take these kinds of issues very seriously.

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  51. Anonymous5/09/2010

    Someone asked so here it is. "Dr." Amy went to BU medical school then trained at BID graduating in the late 80s. She left medicine soon after (more than 15 years) ago and is not currently licensed.

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  52. While I'm not sure about this "Dr. Amy" person (just reading a bit of her blog just now made me cringe) but I believe that most OBs/mainstream medical types are NOT knowingly lying to women. I think that they in their heart of hearts think they are helping women and doing the best thing possible for them with all the medical interventions. One of the previous commenters said that doctors go to school for years and years right? Well, they are being indoctrinated at a pretty intense level while they are doing that. They spend a whole ton of time learning about all the stuff that can go wrong with birth, so they are in a constant state of “OMG, horrible things can happen at any moment…must do everything I can to stop it!” whereas midwives are experts on how things go right, so they don’t get freaked out by normal things during birth, and can more clearly see the wrong and have it dealt with.

    When you have a hammer, everything looks like a nail.

    I had an unnecessary and very traumatic c-section with my first. When the doctor told me that I was going to “need” a c-s towards the end, I cried. And she said (all surprised) “What? What’s wrong?” because she believed she was helping me out, saving me from the horror of birth. I told her “because you are going to cut me open like a fish.” That shut her up. Then I had a crazy botched c-s and a horrible recovery.

    I had my second at home. It was fabulous.

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  53. OMG! You're Hitler! Hitler! And a Nazi! Or you're just exactly like them for daring to question the Medical Establishment. Or something like that.

    It's like she's gotten ahold of a Critical Thinking textbook and is going down the list of Logical Fallacies and checking them off one at a time. Strawman. Check. Ad Hominem. Check. Call your opponent a Nazi. Check.

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  54. Dear "Dr" Amy.

    Your reading skills seem to be terribly deficient, so let me restate that I never cited Henci Goer as my source. I suggested you begin with the bibliography of any of Goer's books, since you seemed at a loss for material. Goer's bibs are filled with references to research done in reputable institutions, with well-constructed studies and large sample sizes. They provide a handy place to start, because Goer has already done all the legwork and brought a lot of great resources together in one place. After that, I suggested we do a Google scholar search and read studies from medical journals and universities. I realize you're not really a doctor and don't have institutional access, so you probably can't access most of these. But I can, and would be happy to save these as PDFs and post them here. Then we can discuss the finer points. I'm wondering why you haven't responded here since I suggested this, and instead made some snarky remark about Henci Goer on your blog? I assume you're too scared to take on a real discussion of the facts. And that's fine. Strawmen and Ad Hominems are much more fun and far less demanding, so I can see why you would go that route.

    And for the record, I'm not a Natural Birth Advocate. I believe that there's a time and a place for medical interventions, and we're lucky to have them when they're necessary. The thing is, so much of the time they're used they really aren't necessary and tend to fuck things up. But whatever. Since that title seems to be the worse thing you can think of to call a person (oh, except Nazi, maybe) feel free to call me that. You're already clearly in the habit of saying all kinds of laughable and untrue things, and if that's what gets your rocks off, more power to you. I just thought I might point out that there are many people in the world who think it's far worse to be a c-section advocate than a natural birth advocate, but it's your choice, sweetie. I myself am neither. I'm an Informed Consent advocate. I'm a Women's Autonomy advocate. I'm wondering why that's so scary to you?

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  55. Anonymous5/09/2010

    Whew. It's good to know she's not actually an OB. Yikes, can you imagine? She'd be the one coming at your ladybits with a knife against your will for sure. Cut now and ask questions later! *Shudder*

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  56. Anonymous5/10/2010

    "When you have a hammer, everything looks like a nail."

    Exactly. I couldn't have said it better myself.

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  57. Anonymous5/10/2010

    I hate posting as Anon, but I can't help it b/c I don't know which other type to choose. My name is Sarah. Anyway, I loved this post. Kudos to you for having a natural childbirth! I applaud women who go the whole gamut without medication and I find it beyond offensive when people patronize women who make that choice (Oh, OKAY, we'll see what happens when you're in labor. Snicker. Eye roll.) Um. Women have been having pain medication free labors since the dawn of time and lots of babies were born to healthy moms. This is something that MANY women CAN do and I think (know) that pushing them towards medicalized birth (rather than letting them make their own decision) denies them the opportunity to have the empowering experience of natural childbirth. All the women I know that have had natural childbirths (and yes, I am calling it natural..because it is) have felt incredibly great about it afterwards. During, maybe not so much, but they overcame and that is just awesome.

    That said, I had about as medicalized a pregnancy and birth experience as possible. I had a five pound fibroid, was diagnosed with placenta previa (which cleared up by the end, how I am not so sure--they told me that couldnt' happen) and was on bedrest for much of the pregnancy. I was never given an option of birthing naturally. In fact, the high risk doctor tried to get me to test my son's lung quality and have a C-section at 35 weeks! My doctor said NO WAY and pushed it to 37 weeks. But my C-section was massive. A six inch vertical scar on the outside, a myomectomy and T-shaped incision on the inside. I had to get two pints of blood and I have been told I will never be able to labor, they will have to give me an early C-section to prevent any contractions. I'm not sure if this is information I should trust...b/c I was told by my doctor shortly after the C that it was a "good cut" and horizontal. It wasn't until my son was over a year before she told me it was a T incision! I was furious!! Why didn't they share that info??!

    As far as breastfeeding, at the hospital I was able to breastfeed in the recovery room rigth away. My son latched right on and breastfed really well. On the third day, my milk still hadn't come in (small wonder...I was only 37 weeks at the time!!) and my doctor forced me to allow my son to be fed formula from a bottle. He said if I said no he would keep in the hospital b/c he was losing weight (he hadn't lost that much weight, he was over 6 pounds and was urinating at least 8 times a day!). The nurse literally FORCED the bottle in my son's mouth when he protested and he screamed and spit out the formula all over her! Then he pursed his lips and refused to drink another drop. I wanted to cheer! I felt so irrationally proud of him! HA! That was the end of that! That very day my milk came in full force and I breastfed my son for 13 months. It was an amazing experience and you had better believe I will fight tooth and nail to have it next time.

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  58. Anonymous5/10/2010

    This is awesome. You navigate the issues so well and, therefore represent all women with this post.

    I have given birth twice - the first was unnecessarily medicalized, and I grieved for the loss of control. For the second, I stuck to my guns, and fought for the right to give birth naturally. It was no easier than the first, but at least I felt that I was making the choices. It is hard, though, when even your partner is advocating the medicalized route out a loving sense of wanting to "protect" you from the pain.

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  59. Hi, I'm going all natural at the end of June for all the reasons you did. I will play your words in my head...

    "And I took on natural childbirth, which was tough and painful and stressful and one of the hardest things I've ever done, and I fucking kicked its ass, and it was an incredibly empowering experience."

    I want to say that.

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  60. Merica5/10/2010

    Also, in case you're interested, the faux-doc is claiming you said you kicked the medical industry's ass. Her whole post is such a deliberate misreading and straigh-up lies about what you've said that it's downright comical! But I wouldn't hold my breath that she's gonna grow a pair already and actually have a direct conversation with you regarding the reasearch. Her style is sniping and character assasination. She couldn't produce anything with real substance if she tried.

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  61. This is interesting stuff:
    http://postpartum-health.suite101.com/article.cfm/post-traumatic-stress-disorder-after-childbirth

    A quote:
    Childbirth may not seem like a likely situation to cause trauma to a mother. However, the level of technology used in many birth settings today can have the effect of "de-personalizing" the birth experience. We also know from research that how the mother is treated by the medical team and other support people is one of the biggest factors in whether she remembers her birth experience as a positive or negative one. Here are some other factors that can influence a mother's experience of giving birth:

    1) satisfaction level with care received during labor
    2) amount of medical interventions used
    3) level of support received during labor

    In essence, the circumstances of the mother's labor and how she is treated have a significant correlation to whether or not the mother has a traumatic birth or develops PTSD.

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  62. Also, by the way, according to the faux-doctor's blog, you're a high school drop out. Which first of all shows that she's willing to say absolutely anything no matter how untrue it is (and how the fuck could she know that anyway?) and second of all shows that she's a total and complete snob. I happen to think that a high school drop out could educate themsevels, given access to the right resources, and make informed decisions concerning their own bodies. Clearly, the pretend lady doctor doesn't.

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  63. This has become a confusing thread. Too many anonymous commenters and the whole referencing another blog where someone is getting off on insulting someone is useless. You have probably given her orgasm after orgasm by letting her know how shocking she is by making up things about people.

    Everything here has proved your original assertions, Rachel. You are not allowed to say what giving birth meant to YOU. Rather than acknowledge your personal truth and let it be, someone has to be right and someone wrong because there’s only one way that women should feel, right?

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  64. I think it's hard for a lot of people to understand what you mean by "patriarchal." I was told by my family that my first OB couldn't be operating in a patriarchal way because she was a woman. But I think anyone with a "shut up, lay down, and spread your legs" attitude is being patriarchal regardless of the equipment they've got between their legs. So I switched to an OB who would answer my questions and listen to my concerns. But I think the thing so many feminists and natural birth activists are fighting against is this exact attitude. And as long as that's the dominant approach in the medical industry, the accusation of "patriarchal" is accurate.

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  65. Saundra5/11/2010

    KLM, I think people have reacted this way because "Dr" Amy has a habit of going around the internet bullying people and saying truly cruel and hurtful things. She's an internet bully if ever there was one. And sadly it really hurts the cause. I tend to think that the extreme natural birth advocates that Rachel references here ("the advocacy groups go a bit too far in their encouragement of the better/healthier practices and women begin to feel that their choices are now being curtailed in the opposite direction ") do a lot of damage as well. But the dogmatic stance taken by many doctors that denies much of the valid research out there that doesn't align with their agenda do just as much damage or more (they have the weight of cultural approval and authority, after all), so I think both sides are problematic. I read this post as being an attempt to sidestep both extremes, but clearly that's not something "Dr" Amy and her drones are willing to do.

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  66. theoldlady5/11/2010

    Oh this is all so sad. I really liked your post, Rachel, but the firestorm it set off has made me so sad and discouraged. Women's bodies continue to be the battleground, and all the dogma on both sides is counterproductive. Sad, sad, sad.

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  67. Adrianna Joanna5/11/2010

    If you get off on experiencing pain, then why don't you just go get a tattoo or something. Leave discussion of the important issues to people who are competent to handle them.

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  68. Anonymous5/11/2010

    Who said anything about getting off on pain? WTF??

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  69. I think the issue that would be more helpful to discuss is how we approach childbirth. Rather than pitting the two extremes against each other (which obviously accomplishes nothing) it would be more productive to lay out all the goals we approach childbirth situations with and negotiate some kind of compromise between them. In med schools the "healthy baby, healthy mom" thing is really pushed hard, and this causes concerns about the mother's experience of it all (is she fearful, in pain, being spoken-down to and excluded from the decision-making process?) to be overlooked entirely. So what if you were traumatized by your birth experience, right? You have a healthy baby, so grow up and get over it already. Which is akin to telling soldiers that they should grow up and get over their PTSD already since they survived combat and we won the war. I think if the goal of maximizing the mother's mental health was also factored in you would see a real shift in birthing culture. But in my experience and based on the testimony of mothers I've worked with, "healthy baby, healthy mom" is cited as the only goal. And I think we need to drop the assumption that healthy physical and mental outcomes are incompatible - that it's an either-or kind of thing. But this would be a very comprehensive shift, and I would expect it to take many years.

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  70. Oh, I think I get it. I've been having a hard time understanding why the "mainstreamers" are so emotionally invested in condemning women who choose natural births, because it doesn't make much sense. So I went over and read some of the comment thread on "Dr" Amy's blog. Apparently they've got it in their heads that you have two options: either a completely unassisted birth (at home, I guess?) or a fully medicalized birth in the hospital. So for them natural birth = unassisted birth. Get it? This makes more sense, because I can see how you could say that in unassisted births there's an unnecessary risk of harm to the baby if anything goes wrong. But it's puzzling why people who seem to be acquainted with the medical industry are unaware of the option of natural births in hospitals or birthing centers. Odd.

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  71. Anonymous5/14/2010

    Thank you. This explains perfectly how I feel but couldn't ever seem to find the words to explain.

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  72. Claire6/14/2010

    I have just come across this. I am in the UK, 2nd year midwifery student. Your words are bang on! Well done for such brilliant articulation. And well done for kicking arse against the machine so to speak.

    Indoctrination is a funny thing and I am glad pages like this are speaking out against it. Time and time again it turns into circular arguments which turn personal and women just bitch at each others choices. My rage is towards the 'machine'; the patriarchal system that denys autonomy on a daily basis.

    And like someone earlier said many of the Dr's don't set out to be like this, but it happens through a long period of indoctrination, fear, misunderstanding about the physiology of labour, lack of experience in normal birth-obs/gynaes here only have to witness a handful of NVB in their training.

    It even happens to the midwifery students. Which I personally find even harder to deal with.

    However much I hate the machine, the only people that will be able to change it, is us women. And I am sorry to see such apathy amongst the women I see. I find this incredibly frustrating, so thank you for your writing. It is inspiring and motivating!

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  73. Your post was a breath of fresh air.

    The comments are often disheartening.

    I applaud you for the original post, and for continuing to defend your completely calm, rational post from, well, you know who.

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  74. Anonymous9/23/2010

    I really wish that so many of us didn't feel the need to "choose sides," and I wish that "natural" and "medical" weren't so at odds here in the US. I wish that there wasn't so much propaganda on *both* sides in the guise of statistics and such (after all, as Mark Twain said, there are "liars, damn liars, and statisticians"). We forget that in bygone days (and indeed in modern days in 3rd world countries) a LOT more women and babies died during or shortly after childbirth. There have been great advancements in understanding of the physiology of birth, making it safer overall when we have equal access to good care (whether it be from midwives or doctors-- I had both in the end, b/c my planned home birth became impossible when my labor passed 50-hours, water broke w/ meconium, so I needed to transfer to hospital... I suffered catastrophic injury to the nether-regions and nearly fatal blood loss, my baby was in the NICU for a month... thank God there was modern medicine to put both us humpty dumpties back together again... but that's a whole other talk show). I think that women who have a traumatic experience like mine need to seek help to ease their suffering, and women who feel proud and ass-kicking about their beautiful experiences need to be sensitive to the fact that a lot of women don't come away with good memories. It's sad that many women who experienced joy in their births feel dismissed by those who had different experiences. It's sad that many women who had traumatic experiences feel judged by those who "kicked ass." Not until we're all supportive of each others' experiences will we be able to come together to change the divisive nature of birth culture and have the kind of constructive dialogue necessary to cut through the crap and make a truly mother-friendly system a reality in this country.

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  75. Jennifer4/14/2011

    I agree with you all the way except for one thing: how can childbirth be empowering?
    When a woman is raped and tortured at Evin prison in Tehran but refuses to give in to the mullahs, or when a woman manages to succeed in her career despite all the sexism in the system, then that would be an example of an empowering experience.
    But in childbirth, you're going to go through a lot of pain and nothing that you do can stop that. At the end, you are either going to die or survive. And you will have no control over it either way. So if you survive, it's not because of your mental efforts, it's the way your physiology has worked. So I don't see how that is something to be proud of.
    Sorry I didn't mean to offend, I am actually not disagreeing with you. I just didn't get this part about empowerment through childbirth.

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  76. Jennifer,

    In this situation, what's empowering is the ability to stand up to the paternalistic medical professionals who are trying to control you, and to take on this difficult thing and make your way through it without giving in to all the voices that are telling you that you can't do it. In our culture we're told that childbirth is a dangerous and diseased process, and that women are too weak to do it on their own. Defying that widespread cultural belief and being the active, driving force in the process rather than a passive and docile body that lies on the bed while the doctors and nurses deliver the baby is a way of reclaiming power that has been taken from women for a long time Does that make sense?

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  77. chatte noire6/24/2013

    Honestly, I'm sick unto the death of being told that I should be "one with my pain" (I have endometriosis that results in three+ weeks of extreme pain a month, including back-labor-like cramps, vomiting, and fainting spells). I'm tired of being told that the only way to give birth as a feminist is to do so without pain meds, without *any* meds, preferably at home, and that birth is super safe because it's natural. The women in my family have a history of nearly dying during birth. I have severe chronic health conditions that could kill me (it's natural, evidently, for my heart to beat 200+ times a minute, and for my lungs to function only when they feel like it).

    It's great that natural is awesome for you, but please tone down the judging of those of us whose lives are at risk... or just those of us who don't *want* all the pain.

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    Replies
    1. I'm sorry if you got the impression that I was taking that position in this post. Clearly that's not my view.

      However, I also don't think that an "everyone has to make their own choices, and every choice is as good as every other choice" approach gets to the heart of the issue here. Mostly because I think in this context, we're not likely to be making informed decisions without really working hard at it - and in some cases fighting for it. When you're functioning within a hierarchical and coercive system, it's not that simple. When institutional interests and preferences trump the needs and preferences of individuals, then it becomes crucial that we ask the tough questions and dig our heels in to make the decisions that are right for us as best as we can tell.

      For you that decision most likely involves more medical intervention than for me. That's OK. It's good that those interventions are available to you. I never once said it's wrong or unfeminist to utilize medical interventions in childbirth. My position is that I wish to be free to politely decline unnecessary and potentially harmful medical interventions for me and my child. That's a feminist stance.

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