Tuesday, October 06, 2009

Learning to Shut My Mouth

One of the hardest lessons of being passionate about something is learning when to shut your mouth about that very subject.

I recently went to the home visit for one of Faerylady's clients. This mom was 38+ weeks and her baby had turned frank breech the week before. I was very anxious to share with this mom all the things I know about giving birth vaginally to a breech baby. I talked with her about acupuncture (she wasn't interested), version, chiropractic (which she was doing), doctors I knew who would do a breech vaginal birth, and the possibility that I would monitor for her and get her to the hospital pushing since her doctor had told her if she came in complete, he would do a vaginal breech.

Evidently, though he said nothing, the dad was extremely offended. He told the mom after we left that he didn't like "my attitude" and that no matter what, I was not coming to their birth.

I feel really bad that I offended this couple. I was so full of zeal, and passion, and trying to help her avoid an unecessary cesarean that it didn't even occur to me that she might be totally cool with an elective c-section for a breech baby (which she was). This is so foreign to me, so far from my own deeply held beliefs, that it is hard for me to fathom. Yet there it is.

I need to learn to back off a little, to follow Preacherman's advice that I don't have to "download everything I know into everyone I meet".

If you've ever quit smoking, discovered natural birth, had a sudden huge paradigm shift in anything, you know the zeal that I feel. It is so hard to just sit by, especially when I ASSumed that since this woman wanted a homebirth, she would be just as interested as I was in avoiding a c-section. It was impossible for me not to put myself in her place, on that cold table, in that cold room, being operated on. It was impossible for me to gasp "NO! Don't do that!" When she told me the c-section was already scheduled for 39 weeks.

Please understand, family that I offended, this was not intended to offend. I feel so deeply and passionately about avoiding unecessareans that I spoke without thinking. Please forgive.


Mrs. Spit said...

One of the things that my son's birth taught me is to let go of the competition of birth. I was holier than thou about natural birth. Very much so. (And I should have been smacked). Then they told my husband I was going to die, and my son did die, and I realized that as much as I love the midwifery model of care, the medical model has some places, and not every situation has to be handled in the same way.

I realized at the end, the goal of birth is a healthy baby, and a healthy mum. Nothing more. And I mean NOTHING. Birth isn't a self-actualizing experience for women, it’s not designed to make us better humans or fulfill our every needs. Birth is about giving birth to a baby.

Obviously we want the best experience we can have, but that looks different for different people. Just because I would choose (if I could, and I can't) for a birth at home, with a midwife and no drugs, other women make other choices, and they are just that, choices. They aren’t life ending choices, they are just choices.

An elective c-section (And I have to confess, as a mother of a dead child, looking at risks, I'm not sure that using the term elective in this case isn't quite pejorative) is one choice. It’s a good choice for this woman. It’s a choice that reflects her needs and wants, and how she has assessed the risks. I think it’s very important that we acknowledge the right of others to be listened to, to be heard.

It seems to me we would all do better for women, and women’s health if we gave information, and let women make their choice, and then supported that choice, or at least kept silent. I don't think we help women when birth becomes a value laden/judgment laden experience, based on our own preferences.

For me, after my experience, childbirth comes down to this: is the baby out and breathing? Not in NICU? Not dead? Good. Is mum still breathing? Can she have more children if she wishes? Ok, good.

One Hot Mama said...

Mrs. Spit,
most certainly, without a shadow of a doubt, we are all the sum of our own experiences. Absolutely, without a shadow of a doubt, there is a time and a place for c-sections, hospitals and interventions.

However, I disagree with you that birth is merely about getting through with a live baby. Birth is an important right of passage that can deeply impact a woman in many ways -- physically, emotionally, spiritually.

For you, the peace of mind of choosing a cesarean may be such a huge benefit, that it would outweigh the risks of such major surgery. Sometimes, choices for intervention are life-ending choices (see Ina May's Safe Motherhood quilt and all the squares of women who died after cytotec inductions), just as sometimes choices to refuse interventions can be life-ending.

It is important that when women are making these choices that they understand all the risks and potential benefits. I agree with you that this information needs to be given in as compassionate and objective way as possible. This was my biggest mistake. I had no compassion or objectivity. Just vomited my opinions and passion all over this couple.

For me, for my upcoming birth, the experience is very important to me. It is important that I not suffer, although I know I can endure pain. A normal, regular, progressive and productive labor would go a long way towards preventing the PTSD I had after my last traumatic birth, and the ensuing severe depression thinking that something in me was defective.

tie-dyed doula said...

I feel ya mama. this is one lesson that is hard to learn, especially for me. I have such a passion, probably stemming from my own personal experiences, that I seem to "vomit" all over people (as you said so well!lol), as well. I can move people to tears, plant seeds or really make people hate talking to me with my passion. Most times the many people are attracted to me because of my passions but some times, I fail at having simply thinking about what I am saying before I say it. Dont beat yourself up too badly, we are all human and learn from all of our mistakes (if you can call it that) and keep moving on. You never know, you may have just planted the seed of knowledge into someone. Keep up the passion sista! Shine on!!

TracyKM said...

I don't think trying to pass on information about something you're passionate about is 'birth competition'.
I've learned, through almost the exact same situation (though I'm not a midwife; I was just reading someone's blog who's baby was breech and missed the line where she asked that no one discuss it or the c-section), to ask first if the person with a 'problem' is 1)concerned with the 'problem' and 2)wants some more info and 3)wants my opinion.
If you had asked first, and she expressed her lack of concern and the scheduled c-section, you could then alter your visit to discuss the benefits of going into labour vs scheduling a c-section.

Majanne said...

I know exactly what you mean, greetings from a Dutch Midwife Majanne