Wednesday, November 21, 2007

Moms, give yourself a break

I love Shannon Hayes recent post, "Homespun Mom Comes Unraveled." Shannon's story was featured recently in the New York Times. Reading these articles got me thinking about the discussion I witnessed last weekend at a screening of The Business of Being Born. Moms are so hard on themselves and each other.

The Business of Being Born is the brainchild of Ricki Lake. Apparently Lake wasn't satisfied with the birth of her first child in the hospital and sought out midwives and home birth for her second. She became somewhat obsessed with the topic, attending conferences and reading all she could. Rather than become a midwife, she decided to enlist the help of a friend, who happened to be a filmmaker. During the filming her friend gets pregnant and has to decide whether to go with a home birth or not.

I enjoyed the movie itself. Some of the statistics and historical footage of hospitals from the early twentieth century were shocking. I didn't realize what the standard procedures in most American hospitals were. The movie is definitely pro-midwife, but I thought did a fair job of being open minded.

On the other hand, the post film panel turned fairly quickly towards accusations and judgment. I don't know if the phenomenon is exaggerated in this time and place, but the pressure to be a perfect mom is on. For whatever reason it was amazingly easy for the discussion on the pros and cons of home birth to turn nasty. Home birth advocates are often highly judgmental of anyone advocating painkilling drugs. One the other hand, doctors are often dismissive of the risks of caesarean sections. According to the documentary approximately 1/3 of the births in the US are caesareans, a much higher rate than an other industrialized nation. The US also has extremely high rates of death and injury to both mother and baby in comparison to most industrialized nations. What's not clear, is whether one factor causes the other, or whether they are both simply the result of a substandard health care system. The movie also implies that in most European countries normal births are supervised by midwives and the outcomes for mother and baby are better. Again, the two things aren't necessarily causal, but it's certainly something to consider.

I haven't had a baby (yet) but the wisest advise I heard during this discussion was for women to share their birth stories with each other. Women have wildly different experiences of labor. Some women have massive orgasms while giving birth, most don't find it so pleasant. When I asked a friend about her experience of having her first baby at home she said, "It was the hardest thing I have ever done. It was like climbing a mountain." I can sympathize, having done some mountain climbing. I'm familiar with the feeling of just putting one foot in front of the other, taking it one step at a time, the entire time thinking to yourself, "I can't do it, there is no way I can do this, I have to stop." Only with a baby you can't just stop and turn back around. The funniest part of the movie was the film a New York midwife giving birth, the entire time whining and whimpering that she couldn't do it.

Many home birth advocates love the book Spiritual Midwifery, a classic from the heart of the counterculture. While I'm fascinated with the birth stories and the gumption of the midwives, I'm not sure the tone of the book is entirely helpful. Denying the fact that labor hurts isn't going to reassure expectant mothers that they can deal with labor. Passing judgment on anyone who decides to get an epidural isn't going to improve things for mothers and babies. On the other hand, the movie pointed out that most labor room doctors have never seen a birth without drugs. Many new moms don't seem to understand that having a
caesarean section is major surgery. It's risky. The second or third caesarean is all the more risky.

Useful information about the risks and benefits of various choices is helpful. Declaring one way of giving birth is the only "right" way, no so much.


Leslie M-B said...

Amen. There's so much political about giving birth, when really it comes down to this: each birth is going to be different, and most women can't predict what they're going to want or need when labor comes upon them. It's good to understand one's choices and options well before going into labor, but my understanding is that "birth plans" frequently get changed during labor.

wil said...

Our family doctor is a midwife and experienced with home births, so if/when we have a child, we want a home birth. Pregnancy and birth are not pathologies!

Breena Ronan said...

That was one point in the movie, it can be really difficult to get doctors and nurses to pay attention to your birth plan. Apparently it's common for interventions to just get started and sort of domino. It's difficult for laboring moms to say no because the doctors and nurses will say its for the health of the baby, even if it's actually for the convenience of the doctors and hospital. On the other hand moms in NYC are scheduling their elective C-Sections, combined with tummy tucks. It's a strange world.

Anonymous said...

I agree with trillwing. I had a birth plan with the first but I had no way of knowing that I have prolonged labors and my water breaks early--before any contractions--which is immensely more painful and difficult.

and while I think sharing birth stories is a good thing in general, it can actually be a little frustrating sometimes, esp if you didn't have a "perfect birth." and here we go again but sometimes, I'd rather just keep it to myself.

Breena Ronan said...

After witnessing that discussion I can understand why most women don't share their stories. You never know who is going to judge you for the choices you made and it's something so personal. I just with more women knew the wide range of experiences people have. As someone who hasn't been through it, hearing different experiences and viewpoints is so helpful. But it's not just birthing that is vulnerable to judgmental attitudes, so many elements of motherhood seem to be that way.

wil said...

You're right. It is a strange world.