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Wednesday
Mar032010

Too Polite to Fight

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Courtroom Mama is a lyrical genius.

I’m not sure if she remembers writing “maternal request or doctor behest” in an e-mail a year and a half ago, which I totally hoisted once or twice without due credit, but she’s identified a cousin of the “Too Posh to Push” archetype.

Her cousin, “Too Polite to Fight.”

Ms. Too Polite to Fight is a stereotypical manifestation of gender subordination. When faced with a recommendation of a cesarean, she feels uncomfortable questioning the doctor or midwife and sheepishly schedules the surgery.

On the Internet, Ms. Too Polite to Fight gets her share of shit from anonymous mobs of men and women who yell, “IF YOU HAD JUST EDUCATED YOURSELF, YOU WOULDN’T BE IN THIS PREDICAMENT!” and “WOMEN JUST NEED TO STAND UP FOR THEMSELVES AND SAY NO!”

Ms. Too Polite to Fight, it was your fault.

After all, it has nothing to do with institutionalized sexism or violence, the doctor/patient imbalance of power or the societal doubts about whether a pregnant women really is an autonomous individual and subsequent dehumanization of her. Or medicolegal factors or physician preferences and biases or hospital policy. Or the woman’s personal history of emotional abuse or her religious beliefs.

She was just too polite to fight.

And next time she can go to the same hospital and see the same doctor and everything will be different because this time she’s going to educate herself and fight for her rights.

 

Right?

 

Right?

 

Yeah, right. It’s just one piece of the puzzle.

 

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Reader Comments (24)

And if you're not TPTF, you are "pushy" a "troublemaker" a "crazy hippie-granola type" or ultimately "a selfish mother who doesn't care if she KILLS HER BABY OMG !!11!!"

MotherBlaming: the sport of..well..everyone, pretty much.

March 3, 2010 | Unregistered Commenteremjaybee

Yep. It's all my fault. Everything.

Just ask my kids.

March 3, 2010 | Unregistered CommenterMichelle

So, I'm a student nurse. And over the past two weeks I had the honor of doing my labor & delivery rotation in a local hospital - the one where the freestanding birth center does their transfers when needed. I had a hospital birth with my twins, who had TTTS, and the folks in my practice were so kind and totally humored our, 'what, are we interrupting your GOLF SCHEDULE?' (in february) attitude when they recommended early induction and worked very hard to ensure a good experience overall. In a teaching hospital, especially, I thought that was the bees' knees. I had a birth center birth with my oldest and my youngest was attended by a midwife in a hospital. So you can see that I haven't had a whole lot of direct experience with your basic, routine hospital baby birthin' - and quite frankly, I was scared shitless.

So my patient last night was so sweet. She had complications with her first pregnancy and after 3 hours of pushing endured both forceps and a vacuum extraction. That was over a decade ago, and here she was, sad to be overdue but okay with her induction that was already taking 2 days - cervadil in, cervadil out, cytotec orally, then pit/AROM all at once yesterday AM and she asked for an epi (and got it) at 2cm. I arrived at about 3 and she was 6cm and 75% effaced. She was uncomfortable but cheerful and she warmed up to me really quickly. I'm primarily a massage therapist, so I checked out her contractions on the monitor and I taught her mom how to squeeze and massage her ankles (so conveniently lined up with the uterus reflex) and pretty soon she was contracting regularly. She went into transition and became fully dilated before 6PM, which was when her favorite doctor was scheduled to leave - but the nurse assured us that he promised to see it through. We were all in high spirits, her boyfriend had gotten involved and was rubbing her belly and joking. I'm going to gloss over how many times fingers entered her vagina and how the 15-minute interval btw temperature checks...just...you know.

Although I guess I technically had the same kind of pushing experience with my twins, it seemed much more focused and emergent. (It was, I guess - my babies were in danger and hers was shouldering the pitocin beautifully.) I wasn't prepared for a nurse looking at a monitor and telling us when to grab her legs, and the counting to 10 while she held her breath and pushed. I felt for her between contractions because she kept asking if it didn't just make sense for her to get up as much as possible so gravity could help out. She was working so hard and the nurse checked a few times and said the baby was starting to descend. We could see changes in her belly. She was excited and scared.

You know where this is going, I'm sure. Why else would I be sharing it here?

At 7 was the changing of the nurse guard. We'd gotten out the baby warmer and all the equipment for delivery. We'd started to set everything up. The nurse who was leaving was optimistic, too. She mentioned in passing to the oncoming nurse that the patient had pushed for 3 hours with her first baby who was a 6lb. preemie @ 34 weeks, induced. The nurse paused and said, "oh." She took a couple more notes and left the room.

The doctor came back, looking pissed. At this point, it was close to 7:30. He checked her roughly and asked her how big her first baby was. "Six pounds, and you couldn't push her out? How do you think you're going to be able to push this one out? She's at least 8." The patient floundered, saying that the u/s the week before had said a little over 7. "You think all THIS is only seven pounds of baby?" he said as he jabbed her at the fundus. She started crying and said, "But I only gained 15 pounds! I did such a good job!" He said something about how she hadn't been working hard enough, hadn't been pushing hard enough, and then he snapped off his glove and left. By this point it was 7:30 and time for me to leave, so I squeezed the grandmother's hands and told the mom that I knew she was going to have such a wonderful time with her baby and then I walked past the room right across the hall where they were already setting up for her c-section.

I'm still horrified. I mean - I read about this stuff all the time. I hear it from people I know. I'd actually put out a little prayer to Baby Jesus in his hairy baby Jesus shirt not necessarily to help me figure out where I'm headed with all this back to school as a grownup nonsense, but more to just show me the things I needed to see. My facebook status last night was "Be careful what you ask for." I want to go find that doctor and follow him to the grocery store and kick him in the shins! And I just know...this was one mom, in one hospital, on one night. Ugh.

March 3, 2010 | Unregistered Commenterfoxy.kate

Hm. That was real long. Sorry about that. I sure needed to get it out, didn't I?

March 3, 2010 | Unregistered Commenterfoxy.kate

I think the trouble is that there is so much information out there designed to instill fear in the parents. Look at all the "reality" birth shows... is there one birth that doesn't have some cliffhanger emergency that needs rescuing? Look at the roughly 1/3 of all birthing mothers having cesarean births... presumably to save the baby in most cases, creating the impression that something must be dangerous about birth if 1 out of 3 birthing mothers have to have surgery to give birth. Look at movies and TV shows that turn birth into this horrendous and/or comical event.

I'm not saying that art doesn't reflect culture. I definitely think it does in this case, but it also reinforces the harmful and false idea that birth is inherently dangerous and women need to be "saved" from it.

And then there is the dead baby card that is played at some point in almost every hospital birth I've attended. "You don't want this pitocin to get things moving? Your baby could get an infection if your water is broken too long...", "You've pushed long enough, we need to use the vacuum or your baby won't be breathing when he comes out...", "I don't know what your endgame is, but I want a healthy baby..." I could go on and on and on... No matter how educated one is *before* the birth, once they are faced with the threat of death for their baby, they are no different than the parents who never stepped foot into a lamaze class or didn't open a childbirth book.

Education must be paired with empowerment in order to improve the birth experience. The system that I am a part of often does everything it can to take power away. I see how little education can matter in the end.

March 3, 2010 | Unregistered CommenterVanessa Manz

Yo, my science is tight.

Love the graphic. I'd love to make graphics representing all the mother-blaming tropes that get trotted out in discussions about birth -- I'd spit a couple more but I can't top "Too Polite to Fight"

March 3, 2010 | Unregistered CommenterCourtroom Mama

You won the internet this week, CM.

March 3, 2010 | Registered CommenterJill

foxy.kate - thanks for sharing that story. i can see why you needed to tell it. that mama was lucky to have you there.

March 3, 2010 | Unregistered CommenterMegan

I commented on the original post, but here it is again:

I wasn't trying to say that EVERY woman down here who has a c-section does so because she's a mint-julep-sipping-rich-white woman. However, there is a tendancy in the South, where I've had ALL 5 of my babies, including my last hospital VBA3C, to not make waves and not question authority. I'm not blaming women for their c-sections. I've just giving a guess as to ONE influencing aspect in what has become a horrible trend in medicine.

March 3, 2010 | Unregistered CommenterBethany B

I just wanted to say thank you because thanks to the recent and ongoing discussion here and on the sister blogs (I don't know what to call them) I literally fired questions at my OB yesterday trying to bridge the gap and not put up that wall of silence between he and I when it comes to my care. I was definitely becoming TPTF. I want to feel like we are a team involved in my care. Keep up the great work women.

March 3, 2010 | Unregistered CommenterSaanenMother
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