I Say Classy Things About "Natural Birth"
Tuesday, September 29, 2009 at 2:21PM
During “Best of” Week, a discussion was generated over Molly Remer of Talk Birth’s post called “What to Expect When You Go to the Hospital for a Natural Childbirth.” The question that came up was “What is a natural birth?”
Good question.
I don’t know.
I jumped in the discussion and proceeded to have a very, very busy week with minimal internet time. Yesterday I stopped in my tracks and asked myself, “Did I really write ‘blow it out your ass’ on the Facebook Fan Page?”
Indeed I did.
“Natural birth” remains a catch-all phrase but it’s really not the most accurate when talking about working to make sure that a range of options is available to women in the perinatal period and that women are treated respectfully and with honesty. Plus, the term carries with it a few generations of baggage. I sometimes fall back on it, too, just because… I don’t know.
My views on natural/normal are focused more on what would be the best health care decision. I guess it would be looking at what the body would do if uninterrupted. Then add needed interventions that are in the best interest of the laboring mother-baby dyad. Set that as optimal in terms of health. Then factor in patient preferences such as pain relief and anesthesia, noting that sometimes these are included in with the necessary interventions depending on what’s going on.
As with any transition in life and potentially unpredictable event, birth opens itself up to lots of spiritual, philosophical and mystical beliefs. Frankly, I can’t think of events more powerful that sucking in that first breath of air and exhaling the very last. In the last century, we’ve seen the burden of producing a psychologically perfect child heaped on the mother and that belief also worms its way into discussions of birth. I do my best to avoid that when talking about the health benefits of avoiding unnecessary surgery. To me, birth is a beautiful event and it’s really, really amazing when women know their rights, understand what is happening, are treated respectfully, are supported in being as close to their baby as they want to be and letting “nature” unfold under a trusted and watchful eye. If “nature” isn’t going as planned and intervention is needed or wanted, I believe that most women will welcome needed interventions (or wanted interventions) if they are treated respectfully and can trust that they are receiving accurate, honest information.
However, with defensive medicine in action, who can you really trust?
Anyway, I don’t like having spiritual beliefs and judgments dumped on me anymore than the next person. If you’re going to tell me that the fentanyl I took made my birth spiritually flawed or my daughter is less of a child of the universe or whatever, I’ll tell you to blow it out your ass. You can work your spiritual beliefs out for yourself. But if you tell me that fentanyl has some crappy side effects that they don’t tell you about and has the potential to compromise fetal health and could delay bonding if that’s important to me, I’ll listen. Because that’s true. THAT is natural birth advocacy and education to me. But the whole natural! birth! makes! superior! humans! mindset freaks me out on many levels. Know what I mean?
So now I have two questions:
How do you define “natural birth?”
Did Fentanyl actually relieve any pain for anyone? Because THAT WAS THE WORST EXPERIENCE OF MY LIFE. The pain magnified but I was too doped up to do anything but moan, grunt and writhe around. Thankfully it wore off, a kind nurse set up the squat bar and I got active. I didn’t realize until after my second birth that birth doesn’t have to leave you feeling like you got hit by a bus. Except for maybe your tailbone.
Reader Comments (23)
You did write "blow it out your ass" and it ROCKED! As do you ;-) I still want to write about this topic on my blog as well. Not sure when I'll have time, but I did save what I wrote on your FB page just in case I could use it...
Strangely enough we were discussing what "natural childbirth" means today at work. I will be part of a panel in Oct and Nov in my community on natural childbirth. It is being run by midwives and they wanted me there because I experienced a highly medicalized birth/C-section and a VBAC with midwives. I will be there to share my experience and answer questions. I hope to god I don't tell any participants to "blow it out their ass," even though I think it is hilarious that you said that!
more like the vagina (for blowing it out)
You go- unnecesaerean- keep telling people to blow it out their ass. Why is it in child birth there is sometimes a complete departure from reasonable thinking! Choice in childbirth is our perrogative. (no Bobby Brown jokes please) The goal is safe birth for all any way they so choose. Can you please link to this ass blowing out comment? I need a good laugh.
Natural birth is one that starts on it's own and proceeds without intervention. Natural birth is most healthy for mom and baby, and I believe most emotionally fulfilling for mom as well. I don't, however, think that it creates spiritually advanced children. More easily attached, maybe, but that is very different than somehow different spiritually.
So many people define the term in so many different ways! I've heard some women say that a particular birth wasn't "natural" because the midwife suggested a position change or something, rather than the mother doing everything -- and I mean *everything*. Others use the term as any vaginal birth, or at least any vaginal birth w/o forceps or vacuum. When I use it, I mean birth without drugs of any kind, particularly pain meds. But most women who get pitocin will get pain meds anyway, although I always give extra kudos to women who have had Pit w/o an epidural or other pain meds. But I don't get anal about it. To each her own!
Fentanyl - I loved the stuff. I wish I'd stayed with it a little longer instead of getting the epidural. But I also am a freak of nature who responds VERY WELL to medications other people hate. If there is a side effect 1% of people get? I get it. If 50% of people hate something? It rocks my socks.
See also: the lovely lovely epidural that dulled the contractions pain, let me feel when to push, and allowed me to feel my son come into this world, and I was up walking on my own in less than two hours and felt like a million freaking bucks (physically.)
That being said? My son was so stoned when he was born and my overall birth experience was so traumatic I still have nightmares. I will be attempting a drug free birth this time, in a new setting with a new doctor, if I don't just stay home with a midwife.
And I think when my family and friends say "OMG YOU HAD HIM AT HOME ARE YOU INSANE?!" I will tell them to blow it out their asses. ;)
I can't define "natural" birth, but what you said is pretty much how I would define "ideal" birth:
Basic bodily functions that, assuming health, are going to happen even if we don't do anything
+ Loving and knowledgeable support from caregiver(s) / partner(s) of the woman's choice
+ Any interventions that are NECESSARY to ensure the health and safety of both mother and child, with informed consent and without coercion
+ Any reasonable (reasonable meaning no going out to score the mom some coke or anything, LOL) interventions that the woman WANTS, including information about what she's trading for her preferences (ie, side effects, risks) so she won't be surprised or feel cheated later
That sounds so simple, doesn't it? Plenty of room for everyone to choose to birth their own way, no need to feel guilt when actual medical intervention is required, support for all. And yet it seems like a lot of hospital births don't meet ANY of those criteria. Natural functions are preempted by doctor-elected, often coerced, inductions and cesareans. Loving and knowledgeable support is replaced by contempt from doctors and generations of female friends and relatives with extremely limited understanding of birth. (Which is not so much their fault as the fault of generations of doctors passing out half-truths and misinformation.) Mothers are told that anything and everything is necessary, while informed consent and personal preference are trampled under efficient hospital policies. Fun.
I guess I would define natural birth as one in which pain medications were not used. If a mom has pitocin but no epidural or narcotics, I would say she had a natural birth.
I don't know if that is a "pure" natural birth, but I would call it natural. Or maybe I would just call it un-medicated. Though there was medication used, just not pain medication.
Hmm, I agree it is not easy to define. Why must we define birth anyway?
I remember Jennifer Block wrestling with this one in "Pushed" as well. If I recall correctly (I don't have it in front of me), she too concluded that the term "natural" was losing its meaning - though she definitely found it exasperating that, in so many contexts, "natural" is becoming synonymous with "not a c-section". Epidural, Pit, cEFM, IV, purple pushing on her back, as long as it's vaginal, it's natural! AY CARAMBA.
Block suggested using more accurate - and just plain relevant - terminology for what WE (meaning us birthy folk here) generally mean by 'natural': spontaneous, physiological birth supported by expectant management (as opposed to the hospital status quo "active management"). I like this. but it's not going to become the colloquial replacement for natural anytime soon. Not very catchy.
Ideas?
Great Post!
The time you spend preparing for birth is vital. I've had four wonderful natural births. It drives me crazy when people say "you're just good at having babies." Thank you so much for posting this article.
This is why now, when I talk to people, I usually use the term "normal childbirth." People haven't heard it before, so they are curious and ask what it means. They don't have a knee-jerk reaction (crazy hippie natural-childbirth martyr!) that causes them to shut down. I can tell them about "spontaneous, physiological" birth (I agree Dou-la-la, Jennifer Block is awesome!) with interventions limited to true medical need - and all the benefits this has to mother-baby outcomes. Sometimes folks are willing to explore options related to normal birth, even if - having seen too many television birth scenes - they have closed themselves off to the idea of "going natural." Of course I do think in most cases skipping the drugs gives you the best chance of having a normal birth!! But you can get to that part later, once the mind is open...
Hey Jill!
I like Megan's comment on "normal birth" ~ good thinking!
I typically think in terms of natural v. vaginal...for example, natural would not be induced/augmented/helped with any *drugs* (pit, pain relievers, etc.) v. vaginal is anything that comes out vaginally, no matter what interventions are used. Now, I do consider my HBAC natural, in spite of the fact that I used herbs and castor oil to help bring on contractions (although really they didn't do much...); I made the decision to try these as my waters had been broken > 24 hours and we had concerns about baby sitting too high, or I probably would not have. Some people may not consider this natural... So natural is definitely a matter of personal interpretation. I guess I figure I tried *natural* (nature/God-provided) means of augmenting so I that's where I drew *my* line for natural.
Is natural better? Of course, I believe that when it's possible it's safest for mother and baby. Is it more spiritual? Maybe for some, but I wouldn't say that across the board. Frankly, a c/section birth is the ultimate trust and spiritual birth for me, because I HAVE to trust, I have no control there, and I absolutely am a total baby when it comes to hospitals/surgery/medical procedures/ etc. Natural birth was actually the *easiest* option for me. So is it more spiritual to take the *easy* way out? Well, depends on your definition of spiritual I guess, but I certainly wouldn't impose my definition of easiest or better on someone else :-) Might be more spiritual to do what's best for baby regardless of how you feel about it (not saying it is, but saying it could be seen that way).
I like what you said Jill. Tell me the facts, but let me determine my own spirituality. Don't attach a spiritual judgment to decisions I made based on the best info I had at the time...decisions that I may or may not change if I had to do it over again.
Frankly, although I hated my c/sec, I feel that in the long run I had it for a reason and it has made me a much more spiritual person. So there! ;-)
Great post! (Especially the blow it out your ass part).
I am teaching a class at a midwifery school right now, and one of the students went on a long rambling story about how kids' auras or chakras are permanently damaged by some birth intervention, I forget which one.
I think it is abominable the way some practitioners (I'm looking at you, harried labor nurses) push fentanyl and stadol as "just taking the edge off" or "will let you rest a little" as their only informed consent. What's even more ridiculous is people considering any vaginal delivery a "natural birth".
I saw the comments that got your blood pumping too. And they stirred me up to post about it. My thoughts are here: http://intentionalbirth.wordpress.com/2009/09/24/a-right-way-and-a-wrong-way/
Anyway, I enjoyed your thoughts. I don't think there is an "ideal birth scenario" where the details match for everyone. Each woman has the right to decide for herself.
My definition of natural birth: Birth fully in line with the most intimate, loving, internal vision of the birthing woman.
Maybe this will come up when we talk on Monday: http://www.blogtalkradio.com/expectationsradio/2009/10/05/Informed-Consent-and-Informed-Refusal
:-)
I think we need different categories. Instead of Natural vs. Unnatural, whatever those mean, what about our goal being Respectful Birth?
As in respectful of the mother's rights to bodily autonomy, her wishes, her body's processes, and good medical evidence and practice. As in, first do no harm.
Since her wishes presumably include necessary interventions, then we wouldn't have to debate what kinds of interventions are "allowed" or anything like that. Is an intervention necessary, respectful of her rights and is it good practice? Then it's fine. Put the burden on the medical profession to prove an intervention's necessity, not make the mother feel like she's choosing between two ideologies.
I LOVE all of these comments. I want to reply to them all RIGHT NOW. I think I'll throw a quick post up later so this discussion can continue. My muse, emjaybee, showed up and I am so thrilled.
The gnomes are grabbing at me and right now I appear to be the only person around here interested in wearing pants and not peeing on the floor-- see, I AM classy (compared to small children).
I think there's some reframing or rebranding or something that has to happen to make it known what a lot of us are doing spending all of these hours on the internet, usually in the wee hours of the night (I cannot hang with all of the insomniac birth work women on Facebook, btw-- those coffee drinking midwives, docs, nurses and doulas are hardcore). I keep half-laughing, half-getting annoyed with some of the misinterpretation of birth activism. Maybe it's time for Second Wave Birth Activism.
I'm pretty sure someone is peeing in some corner right now. Deep thoughts to be continued...
First of all: 10 points for the image. You stay classy!
Second: I think I agree with other people when I say that I try to go with other words than "natural". I try to say "unmedicated" when we're talking about a mom not getting pain medications (obviously there are other medications but unmedicated for pain is what I'm referring to). Usually when I say "natural" I'm either using it because it's accepted by the person I'm talking to, or because I'm thinking generically of natural as in no pain medications and no one screwing around with the labor using Pitocin or other induction/augmentation methods. What I prefer to use for that second category is "physiologic", but I think that's a little too medical-wordy for a lot of people. I like the suggestion to use 'normal" birth.
(This is leading me into a post on my own website about physiologic/normal birth vs. not. I just went to a very normal physiologic birth on Sunday and I've been wanting to write about the contrast between all the medicated babies I see, and the few unmedicated ones.)
Third: On the topic of whether anyone's "better" for having a particular kind of birth: I posted recently noting that I don't think having a baby in any certain way, or having a baby at all, makes anyone a better mother, person, or woman, just because I was so concerned some people might start thinking that I was one of those crazy hippies. (A friend of a friend was told recently that she had hemorrhoids postpartum because she "didn't use a midwife". Right. Obviously.) It's about being better off.
Fourth: I question whether Fentanyl really does much for people - my observation from the outside is that it's much as you describe. Women react to contractions very similarly, they just sleep more in between. Maybe much earlier in labor it actually does dull the pain. To me, the best use for it is when someone is totally exhausted and/or juuust about ready to get an epidural, because it can help them rest and/or give them a tiny break so they can pull it together and forge on. But again, that's my outside perception...
I've heard this debate too, and we need to stop making women feel small for their choices. "Natural" doesn't bother me, though I know it does some. I suppose I prefer unmedicated or physiologic for the kind of birth I had.
Normal gives me a knee jerk reaction, because it reminds me of the way that we as health care providers (I'm not a labor nurse but I am a nurse) refer to textbook presentations of things as "normal" and others as not. Nothing about my contraction pattern or labor lengths was "normal" based on anything I had ever read, but it was definitely physiologic. And it got the baby out fine in under 12 hours. For what it's worth, my midwives at home gave no indication that my labor was not "normal" but any doctors I talked to later looked shocked some of what I reported (such as the 7 minute pushing phase for a primip). Now I realize I am not talking about a labor with any problems, but I worry about normal being interpreted as, say, adhering to the friedman curve or whatever.
They don't have a knee-jerk reaction (crazy hippie natural-childbirth martyr!) that causes them to shut down. I can tell them about "spontaneous, physiological" birth (I agree Dou-la-la, Jennifer Block is awesome!) with interventions limited to true medical need - and all the benefits this has to mother-baby outcomes. Sometimes folks are willing to explore options related to normal birth, even if - having seen too many television birth scenes - they have closed themselves off to the idea of "going natural."