How to be supportive of women’s birthing choices

*Note: throughout I got tired of writing ‘women and their partners and families’, so I just wrote ‘women’. But I do believe wholeheartedly that birth decisions affect the whole family, and so should be a somewhat group decision.

Ah, the Mummy wars. Just as we might be close to reaching some kind of rapprochement over one issue (breastfeeding), we really hammer into a new one: birth. For the unenlightened, a war is indeed brewing. On one extreme, you have the group who think that any intervention is ‘birth rape’ (not kidding…). On the other side, perhaps as a backlash, you have the women claiming that allowing any kind of pain in childbirth is anti-feminist, and women who don’t give birth in a hospital are baby killers. It’s just another incarnation of the nipple waving breastfeeding sluts vs. the poisoning lazy formula feeders debate.

It would be nice if we could just ignore this. Let the extremists be extreme, and live in a happy middle road. But the knock on effect is that women are becoming miserable – people feel judged and found wanting, guilty, denied a right, some even feel violated for a medical professional doing their best. While I support attempts to improve medical care, and thus women’s birthing experiences, this does not seem the right way to go about it. I understand that is hard when people think they are fighting risk to babies, or denial of rights to women – both highly passionate issues – but it seems to me that the path we are going down is not working. Families and caregivers need to unite in support of one and another to enable informed choices and happiness with those. That’s not the same as inaction, nor will it lead to stagnation. I believe that within this modus operandi, there is still room for encouraging change and I also believe it is the way to help women and their partners make better choice.

Here is how I try to be supportive of all birthing choices:

(1) Everyone: Be realistic and scientific.

Don’t lie. Home birthers: admit that the risks to mother and child are higher (but very small) and note openly that scientific evidence shows that epidurals at the right time do not increase C-section rates. Hospital birthers: be open: yes, a C-section is more likely, even when other factors are controlled for. Yes, pitocin increases the likelihood one will want an epidural, and not due to this, also increases the likelihood of a C-section. Be honest: you are more in the doctor’s hands, and you may be pressured to make an alternative choice. Home birthers: women in hospital may also not be pressured to make choices against their will and may work with professionals who are incredibly dedicated to following their birth wishes.

I have seen both done. At my Bradley classes (a natural birth class), our instructor was having a home birth. In the discussion about risks and benefits she noted that the risk were higher, but in absolute terms extremely minimal. She told us to go away, read, and make our own decisions. When my OB told me I needed an induction and I was resistant, she honestly talked through the increase in C-section occurrence. She told me to go away, think and read, and make my own decision.

Only by talking through openly and honestly about the facts and figures can women* make informed choices, and research ways to mitigate unwanted outcomes. When my OB was open about the increase in C-section risk with pitocin, I was able to research how to deal with this, and constructed a careful plan which took 2 days to effect, but resulted in a vaginal birth.

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(2) Anti-home birthers: Accept that you cannot save all of the babies, all of the time.

It can be a very emotive subject, and anti-home birthers usually cite the well-documented and reliable statistics of increased mortality with home birth. It is a tiny increase, but the pleading ‘won’t you please think of the children’, often accompanied by a picture of a stillbirth, can be very compelling. But here is the thing: home birth is not the last bastion of child (or maternal) risk. Children are starving to death, being shot to death in war, being shot to death because of lax safety, dying of vaccine preventable diseases, dying of non preventable diseases, dying because the basic standard of medical care is not uniformly distributed across economic strata in the US. That’s not to say that we should be cavalier about infant mortality, but some perspective helps. If you are not pouring equal amount of vocal outrage into all causes of child suffering (especially given how many more children die from these other causes, than from home birth), I would ask you to reconsider your reasons for championing an anti-home stance.

(3) Home birthers: to use your own words: anyone could do it.

If forced to, then I am pretty sure (but have not checked the empirical evidence) that anyone could deal with the pain of childbirth. Some people choose to have an epidural (or other pain relief) and there is nothing ‘weak’ about it. It’s just a choice, like the one to go to Kroger vs. Fiesta (or Tesco vs. Sainsburys for my dear UK readers), and should not have a value judgement attached to it.

(4) Anti-home birthers: We all take risks with our child.

Accept it, we all take unnecessary risks with our child. To anyone taking a ‘holier than thou’ approach to their child rearing I could point out preventable risks you take. Take your child in a car? Increased risk!! Why not stay at home or within walking distance until the child is 16 ?  You might say: that’s not practical, the benefit outweighs the unrealistic cost.

Sure – to *you*. There are people, I am sure, who follow this (small number though they are).  Ultimately: you don’t know the cost to someone of going into hospital. You don’t know their fears and needs, and how strong they are. You cannot judge for someone else whether the costs outweigh the benefits, because you don’t know them.

(4) Home birthers: We all take risks with our child.

You may tout increased bonding for a drug free childbirth, or a cite the evidence that some aspects of pain relief get to the baby and affect their immediate post-birth presentation. But again, you will do something that is sub optimal for your child’s development (although defining that is tricky), sometimes out of ignorance (and so some education is OK), but sometimes because to you and your family judge the benefit to be greater than the cost, as above. And that’s OK.

I could go on, but it has been (for me) a long post. I will always choose a hospital birth. I will always research and learn, but I will always reach an agreement with my trained medical professional. If I can’t do that, I will seek out a medical professional with whom I can, because this provider is obviously not right for me. For my birth, I agreed to an unwanted induction, but I worked out a fairly long and complicated plan for doing everything I could to ensure a vaginal birth. Indeed, this was necessary, if I had not worked with my OB on devising a 2-day induction, I would have been one of the ‘C-sections after a day on pit’ statistics.

That being said, if I had had a C-section, I hope I would have worked with my provider and still have thought it a wonderful experience. Many aspects of my birth sucked (or at least the aftermath), but I am delighted with the whole experience. Shit happens. But I got this thing out of it:

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My plea: chill, relax, channel your energy / outrage somewhere else [send refugees donations, volunteer at your local hospital, whatever], remember that you are not a bat, and don’t know what it is like to be a bat. Gain some perspective: birth is important, but it is just one aspect of a whole lifetime of wonderful experiences.

Peace. Love. Babies.

 

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