Wednesday, March 09, 2011

Trust Birth?

I've been cogitating on this post for a while now. I have had a couple of experiences lately with women wanting an unassisted birth (UC). I bet this will create a firestorm, so I'm getting out my asbestos panties.

There is this thought among some circles that UC is the ultimate birth experience possible. That it is more "pure", "better" or even "holy/sacred". I don't buy it. Some even call it Purebirthing or Freebirthing. If a woman is having to think and be aware of what's happening is she really free to go to that primal place? What happens if her baby needs resuscitating and she has to do it herself? Certainly that's possible. Some women may prefer that. For myself, I did not want to have to, even though I know HOW.

I understand that this is largely a backlash against the overuse of technology in birth. For some women it's a reaction to a horrible previous experience, either with a midwife or a hospital birth. Here in America, where we have access daily to clean water, plenty of food, adequate shelter, and indoor plumbing (with it's resultant sanitation perk), women are most often healthy enough to give birth to healthy babies with not a lot of issues.

However, birth is not always perfect. Even when the woman is educated and unafraid. Shoulder dystocia is a thing. It happens. And it's not always as simple as "flip the mom over and the baby pops out. Easy peasy". If only that were so! It's not always as simple as "if the mom bleeds, pop a piece of placenta in her mouth or a dropper of Shepherd's Purse and her bleeding will stop before it's dangerous". If only that were so! It's not always so simple as "If mom eats good food when she's hungry, and listens to her body, she'll grow a healthy baby." If only that were so!

The catchphrase is "Trust Birth". Well, I don't trust birth. Birth can be a fickle and capricious mistress. We live in a sinful, fallen world. Our bodies are no longer in the perfected state in which they were created. I trust God, not my body. My body gets sick. My bones can break. My body is not perfect. I trust God, but I still buckle my seatbelt. I trust God, but I still have life insurance. I trust God, but I still bring in an income to help feed my family. I trust God, but I still carry equipment and supplies for resuscitation and to treat hemorrhage.

Some UC birthers end up going to the hospital when it's not necessary simply due to a lack of knowledge or support. Some end up staying home when they should go in because of a lack of knowledge or support.

I've heard several stories lately about UC birth. In one a woman who showed up three times to two different local emergency rooms with questions about her health postpartum. The third time was a day and a half after the birth and she had a perineal tear she wanted evaluated. If she'd had a midwife, she would not have needed to make any of those visits to the ER, using taxpayer resources at the most expensive level possible.

Another situation was a first time mom who had developed every classic sign of pre-eclampsia and was still debating if she should have to go to the hospital. (She did, thank God)

The office of midwife is one ordained by God. It is talked about in Scripture. Midwives are even named in scripture and we are told that God blessed them and their families. Women from the beginning of time have had midwives by their side giving birth, and there's a reason for that.

Even I had the idea that women give birth unassisted "all over the world" with no problem. Until I talked to several midwife friends who had been to third world countries on mission trips and saw the problems that can occur. Until I dealt with my first shoulder dystocia that was NOT because of a big baby, but because of the position of the baby's arms. Changing the mother's position did nothing. Until I dealt with the woman who had a partially separated placenta and had dumped a huge amount of blood and was losing consciousness.

I have seen enough in my short little career as a midwife to convince me that most of the time I am "expensive cleanup", but there have been a few times I have been there that I (and the parents) have been very, very grateful for.

Some women say they are taking the responsibility on themselves, but if they are not conscious, or their baby is stuck, they will not be the ones dealing with it. Their partner or husband will be. Is HE ready to deal with those emergencies?

I am sure this will not be an entirely popular opinion, but there it is. Midwife Judy Mentzer has said, "All the midwives need each other and the women need all the midwives."

11 comments:

Amy said...

I so agree.

One of my good friends is now 43+ weeks pregnant and waiting for her UC. Needless to say, it scares the @#$% out of me.

And if I remember correctly, didn't the president/spokesperson/founder (don't really know what her role is) of the UC movement lose her baby a little while back from heart complications? I don't completely recall the story.

I'm all about giving and getting support.

Mrs. Spit said...

Every time I read of unassisted births, I think of 2 things. I think of my pregnancy, which progressed normally, until my midwife caught the early stages of pre-eclampsia. Suddenly my blood pressure was 210/120. I *still* felt fine. I was moments away from death, but I would have never known.

Mostly, I just think about the woman who got in touch with me 2 years ago. Her baby died. After the police and the authorities finished investigating, the coroner concluded that the unassisted birth directly affected this babies death, she still had to live with the consequences of her baby's death.

She still had to live with the idea that things can sometimes go terribly wrong, and a lay person is simply not trained to cope.

We hire electricians to wire our houses, we hire accountants to do our taxes. Why on earth would we not hire a professional (be that midwife or doctor) to deliver our children?

mommymichael said...

Janet Fraser yes, she did. It's heartbreaking.

Thank you for this post. I completely agree. I once entertained the thought of doing UC. After a month or so of deliberation and google research, I changed my mind. I liked having my midwives around me. They were in no way intrusive, but in every way my life guards.

Mrs. Sara said...

Interesting! I'm glad to see someone talking about the risks of UC. My husband and I are contemplating a HBAC for our third in October (after a successful but traumatic hospital VBAC with our second) and I'm glad to get all the information I can.

infanticipating.blogspot.com said...

I would love to discuss the idea of trusting birth and how it relates to women's rights to choose a uc if that is what they want, or how the average woman can monitor her own pregnancy if she chooses, and what the real causes of pre e are, and other topics.
I do have one question, what does the loss of Janet's baby have to do with UC or the safety of UC?
Sincerely, Carla Hartley
Founder of The Trust Birth Initiative
Founder and Director of Ancient Art Midwifery Institute
www.trustbirth.com
www.ancientartmidwifery.com

Bettie said...

We can point out all sorts of scenarios where midwives are useful. I am one and like to be of use...however, I stand by the rights of the parents to choose to birth unassisted. Even if I do not personally agree with that choice.

A common misconception about Trust Birth is that it promotes unassisted birth, there is not promotion. The truth is that Trust Birth supports the premise that parents are capable of choosing to have an attendant or not, or to have a UC or UA, or to have a midwife who is unlicensed...it is acknowledging that women birth best without interference, NOT that intervention is NEVER necessary.

It is possible to be a midwife who supports Trust Birth and who still practices midwifery. I know because I am one. I believe in the rights of families and seek to serve them.

Cheeky Chums 4 Premature Babies said...

my daughter didnt opt for a non assited birth it just happened just go with the flow my daughter was sent home twice even at 8pm not in labour go home we stayed at a relatives home closer to hospital this time just in case then exactly 1.15am she didt even get chance to get in an ambulance out popped baby on living room carpet in just one push and no pain relief all of a sudden.all went well too.girl 6lb 6 full term.from sheila at http://cheekychumsonline.co.uk

Jane Doe Does It said...

Re: U/C women going to the ER "using taxpayer money"

First off, how do we assume all u/c mothers are using taxpayer money in the ER?
I am a UC mother, and taxpayers don't fund my healthcare.

What about the cost of birthing women, using licensed midwives, who are driving up the cost of midiwfery by the very existence of licensing? Should we criticize them for choosing a midwife? Some women use taxpayer funds for midwives. I am betting that is pricier than a uc'er going to the ER a few times.

Just because you don't "trust birth", doesn't mean that someone else doesn't. Women choosing UC should have the support of women, not the criticism of them. If it concerns you so much, be proactive in making good, true information available to all women, u/c or not. Not information based on isolated occurance, fear and misinformation. Life has risks, including in birth. I believe my risks in birth are LESS with an unobserved, instinctive birth, than with a birth managed by a midiwife.

One Hot Mama said...

Dear Jane:

You said "First off, how do we assume all u/c mothers are using taxpayer money in the ER?
I am a UC mother, and taxpayers don't fund my healthcare. "

If you go back and read carefully in my post, you'll see that the taxpayer resources was referring to one specific UC mother, who was on military health insurance -- i.e. taxpayer resources. I did not say or assume that all UC mothers were using taxpayer resources. As for your other comments, I do give good information. Shoulder dystocia and hemorrhage and babies needing resus are not "isolated events" used for fear mongering.

I unconditionally support women's right to make their own choices, but I am not required to believe all choices to be equal. I DO provide good and true information to women to help them make their choices. Hiding your head in the sand about potential risk does not make it go away.

I agree that LIFE is risk. I tell families all the time that there is no risk free place to have a baby. But we must agree to disagree that the safest birth is one without an attendant present.

And, FWIW, I don't "manage" anyone's birth. Have a blessed day.

Jane Doe Does It said...

One Hot Mama said:
You said "First off, how do we assume all u/c mothers are using taxpayer money in the ER?
I am a UC mother, and taxpayers don't fund my healthcare. "

If you go back and read carefully in my post, you'll see that the taxpayer resources was referring to one specific UC mother, who was on military health insurance -- i.e. taxpayer resources. I did not say or assume that all UC mothers were using taxpayer resources."


So, again, what is wrong with "taxpayer" resources being used for ER as opposed to midwife... A few hundred dollars for ER as opposed to thousands for a midiwfe? A military mom. They or spouse, work for their healthcare insurance. They should be able to use it. She had a problem and she addressed it without a midwife. (The specifics of military were not in the post that I was reading.)

One Hot Mama says:
As for your other comments, I do give good information. Shoulder dystocia and hemorrhage and babies needing resus are not "isolated events" used for fear mongering."

But they ARE uncommon events. If this is witnessed at many births, something is wrong with the situation, not the women and the births. Interference in birth creates problems. Being observed changes birth.

One Hot Mama said:
I unconditionally support women's right to make their own choices, but I am not required to believe all choices to be equal. I DO provide good and true information to women to help them make their choices. Hiding your head in the sand about potential risk does not make it go away."


It is not hiding a head in the sand. You really should look more into these topics and do further research. There are very experienced midwives who only rarely see bad things happen. Learn from them! We all can.


OHM Said:
"I agree that LIFE is risk. I tell families all the time that there is no risk free place to have a baby. But we must agree to disagree that the safest birth is one without an attendant present."

We can disagree. However, painting women as not having the "God ordained" midwife at her birth being wasteful and irresponsible (because, that is what this post implies...about birth sometimes being a "fickle and capricious mistress" and women knowing what is wrong WITHOUT a midwife, going to ER/hospital, being a bad move) is far fetched. They took care of themselves...there is really nothing scary about that, except if you think birth is only safe with a professional present.


OHM said:
And, FWIW, I don't "manage" anyone's birth.

I never said that you did

I don't think I will change your mind, but honestly, for the sake of women, do more studying about these things. Don't depend on your short experience as a good representation of what birth is. I am not saying this disrespectfully...We cannot think that the office of midwife, as you put it, is superior and more trustworthy than a woman's body and the ability God created to birth. Because this is what this comes down to...which works better? The finite wisdom of a person, or the infinite wisdom of God (based on what you said about birth being marred by a sinful world, but midwives are less subject to this sin in the area of their perception of birth?)? There ARE bad things that happen at birth that are identifiable and can be dealt with sometimes. But there is so much more that we don't understand and we need to recognize that messing with things we don't understand cannot reliably lead to good outcomes.

RobynHeud said...

The sad thing is that some people who are choosing UC do so because they feel like they have no other options. I wanted a midwife for my 2nd, but because my first birth ended in pre-e, etc, tho he was born vaginally, no midwife would take me. My GP was treating me like I was a ticking time bomb for the same reasons and wanted to do all kinds of early testing and extra exams. Doctors stress me out in general (as do midwives) and I didn't want to go through even more stress trying to find a reasonable doctor. So my husband and I prepared everything we could, keeping track of things like my BP and checking my urine for protein on a weekly basis. I have the advantage of a husband who is trained as a combat medic and we constantly reviewed all of the situations where we would call for help. There were no complications, for which we were grateful, but we didn't turn a blind eye to that possibility. For me, UC was less about trusting birth and more about taking responsibility for my own health and the health of my baby. It was about raising my "birth grade" from an F to a C average, so I could have a natural birth with an attendant the next time. I mostly just didn't want to be treated as high risk with every pregnancy for the rest of my childbearing years and also to show myself and my future care providers that my body is capable of this incredible feat without intervention.

I don't know that the next baby will be a UC. For the very reasons you mentioned, I wanted a midwife, but for some of us, the only choice is between a highly interventive hospital birth or a UC. What is needed more than anything, as with all aspects of reproductive rights, is the right to choose, and not be forced into a decision because something falls outside the medical establishments concept of normal.