Wednesday, June 30, 2010

A Call to Labor

Meet my daughter - the big baby.  The one that would surely clock in at over 10 lbs.  She was called "fat," "macrosomic" and "chubby" before she ever graced this world with her adorable presence.  Unfortunately for the doctor, the big baby card didn't fly with me, so I started getting told about cord prolapse, dystocia, stillbirth until my confidence in my own instinct was worn down and I agreed to go in for induction, which resulted in two, yep two, inductions, and a repeat cesarean.  I was told the cards were stacked against me, but the biggest card was losing my faith in myself.

Connected Daughter arrived after several bags of I.V. fluid and who knows how much pitocin, weighing 8 lbs, 11 oz on her due date.  By the next day, her weight was down to 8 lbs 4 oz, which I believe would have been her birth weight (Henci Goer discusses how intravenous fluids artificially inflate birth weight.)  So much for that big baby I was sure I could birth vaginally if I was just left well enough alone.

Despite education, my birth didn't go as planned, and I will be the first to admit there were risk factors, but three months later there is one thing that haunts me.  My decision to allow them to induce me.  In that moment I gave over control.  Something I regret.  Control is something so many caregivers believe they need.  Even caring, informed caregivers fall victim to this need for control.  And the easiest way to ensure control over birth is to induce labor.

I'm still kicking myself for giving up control over what may be the most important aspect of birth - the start of labor.  Because that decision instantly removed all hopes for normal birth. Normal birth cannot begin with induction.

I should pause for a moment and say that there is a place for induction.  There are truly situations that develop that require this intervention, and I do believe women should try for that before electing for a cesarean.  However,  truly necessary inductions are about as rare as truly emergency c-sections.  No one ever needed to be induced for a big baby, or discomfort, or getting too close to their due date.

We're being sold on induction in this country by physicians who want to control the spontaneous process of birth.  Take a moment and ask yourself how many times you remember hearing of a woman going into labor recently.  Now how many times have you heard of a woman being induced?

The desire to induce isn't part of some maniacal ill will toward women by doctors.  I think that somewhere we've started to believe that women's bodies have forgotten how to birth babies.  Instead of laboring in birth, we're laboring under the false assumption that fetal monitors, pitocin, I.V.s, hospital beds, and sterile rooms are necessary for birth.  The reality is that doctors have forgotten how to attend birth.  Many of them never even learned how.  Because a birth attendant needs to know one thing: what normal birth looks like.  When we were interviewing midwives, we met with CPM Anita Woods, former President of ICAN, and she said something that has always stuck with me.  The FBI doesn't learn how to spot counterfeit money by studying counterfeit money.  They learn by studying the real thing.  They can spot counterfeit money because they know, really know, what the real thing looks like.  A good birth attendant works the same way.  They are so well-versed in normal birth that they can spot a problem days, weeks, sometimes months in advance.  By becoming so quick to induce, doctors no longer have that knowledge.  Instead of treating birth as a normal, natural event, it's a crisis from the get go.  The most important thing we can do to change birth practice in America is to stop inducing pregnant women.  We must get back to the normal process of childbirth.  Doctors need to see normal birth and women need to experience it.

Recently I posted a piece on Coping with Birth Disappointment.  It's been by far the most read piece on my site.  What a bittersweet accomplishment.  I'm so glad I could offer encouragement to women struggling with birth disappointment, but so sad to see how many women it affects.  In America, we so often treat the symptoms without curing the cause of a problem.  I hope my thoughts on birth disappointment touched women dealing with it, but it is my duty as a birth advocate to take this issue a step further.

What I'm proposing is radical, because not only do I believe that we must stop inducing women, I believe me must stop patronizing physicians who actively use unnecessary interventions.  It's a simple economic principle.  If you want to see results, hurt them in the pocketbook.  Obstetricians need to realize that lip service to changing ideology is not enough and that we will hold them accountable for their decisions if we hope to teach them the patience necessary to stand back and observe birth.  We have to get birth back to normal if they are ever going to learn what truly normal birth is, only then will they be able to differentiate between high-risk, emergency situations and the process of birth.

Now I realize this is all such a lovely, impractical idea.  After all, am I asking you to fire your OB and hope everything goes a-okay?  Not at all.  I'm suggesting you find a provider who has seen normal birth, whose studied it, who attends and promotes it.  Find a midwife.  And if you're an OB reading this, I'm asking that you consider how important this truly is.  I'm asking for the humility in a profession of arrogance to recognize how you are failing your patients and then I ask you to go find a midwife and do a real internship.  Learn how to let birth happen. 

Above all else, if you are expecting or trying to conceive, get to know your body.  Listen to it.  Nourish it.  Marvel at its complexity.  Revel in your cycles, your fluids, your twinges and feelings.  Rediscover your own awesome, natural power.  So that when the moment comes you know your body as well as an old friend who's sentences you finish, and you know the right decision, because truly you are the person most qualified then to make it.


ambivalence said... [Reply to comment]

My heart aches for you regarding this. I've shared your Birth Disappointment post with friends, and I will share this one as well, because if it strikes a chord with someone who has never given birth or conceived, I imagine it will strike a deeper chord with those who have. The last paragraph is amazingly powerful, and if you don't mind, I'm going to post that. Every woman, even if she is not trying to conceive, should know her body as you describe it. We live in a society that is constantly telling us NOT to listen to our bodies, but to shape them to a given mold. But your words are empowering and I thank you for them.

Stephanie @ Confessions of a Trophy Wife said... [Reply to comment]


I LOVE this post. I was nodding my head along with everything you said. There wasn't a point made that I disagree with. I too experienced birth diappointment, something that I feel happens all too often with women nowadays.

Thank you for posting this. Kudos.

Jess said... [Reply to comment]

I also heartily agree with you, Jenn. I like what the CPM told you about studying the real thing. I was so lucky/blessed to have the experience I did inside a hospital. It was all because of the OB, who supported natural birth and was experienced in attending it. She was very laid back about labor and birth, because she did not regard any of it as emergency-material. I could rest easy that if my birth had ended in c-section, it would have only been because it was truly necessary.
Thanks so much for your words on this topic, you're wise and sensitive and inspiring to read.

Ronda said... [Reply to comment]

I know how you feel. With my first daughter I had alot of problems and ended having hyper tension of pregnansy so instead of letting me go on my own they indused me two days before my due date of July 29th. It took 3 hours for me to even start to dialate. By 4 oclock the next morning they had to take me in and do a emergancy C-section because I started to run a high fever and the baby's heart rate jumed really high. At 5:52 a.m. My daughter was born. They thought she would be 10 pounds and she ended up weighing 7lbs 2oz. I wanted to breast feed and tried but something wasn't right. I told the hospital and they said everything was fine and she was getting food. All she wanted to do was be held and the day she was reliesed which was 2 days later she was down to weighing only 6lbs. I ended up having to start bottle feeding her but she threw it up. Come to find out at 5 days old she was congested and had a sinus infection. I think it was all do to the poor care I got while inlabor. T%hen last year I went in labor with my son and was almost in full blown labor but they don't believe in VBAC's so I had to have another Emergancy C-Section. I so wish they would have let me try a VBAC

Heidi J said... [Reply to comment]

Having a care giver, be they an OB or a midwife, who believes in you and your ability to give birth naturally is vital. I had midwives and I had so many things stacked against me that if I had had care like most women, I would have ended up with a C-section many times over. My son was breech, large (supposed to be over 10lbs, but was 9lbs 3 oz) and I had high blood pressure that turned into pre-eclampsia the day I went into labor. My son was born in a hospital with forceps not in the birth center completely naturally as I had originally hoped, but I have no regrets as I know I had as natural a birth as was possible under the circumstances. My midwives were awesome and I wouldn't hesitate for moment to use them again.

Pocket.Buddha said... [Reply to comment]

All I can say is thank you. I know I already thanked you on twitter, but I wanted to comment too. Thank you SO MUCH for writing this!

Tara said... [Reply to comment]

Thank you for writing this! Even though I breastfed, babywear, cloth diaper, eat organic and natural, I sometimes feel like I don't quite fit in with the 'natural parenting' community because I had an induced labor and all the drugs and medical interventions that came along with it. I developed gestational diabetes while pregnant that I completely controlled through diet. I actually gained less than the recommended amount, but the ultrasound tech and my dr both thought I would have a large, over 10 pound baby. So, I was induced a few days before my due date and after 13 hours of intense contractions and 2 hours of pushing, my 7 lb 9oz baby boy was born! They were actually getting ready to prep me for a c-section when he was finally born. He had pretty bad jaundice and a few other health issues the first couple months that I'm sure were caused by the induction and being born too early.
I've been considering becoming a doula, but my induction experience has been holding me back for fear of not having enough 'natural' experience.

Jenn said... [Reply to comment]

Tara, I'm studying to become a doula and I haven't even birthed vaginally. I thought for a long time that once I VBACed I would do it, because then I would have proven myself. Well, it could be a long time if I wait for that credential! I am passionate and educated about birth and I truly believe that is the most important thing.

And I certainly feel like an outsider in the birth community sometimes!

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