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Friday
Jul162010

Comment of the Week: Erin Becomes an Informed Consumer

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By Jill—Unnecesarean

We get a lot of interesting comments around here, so I thought maybe we could start giving them a thumbs-up.

This week, Erin’s comment on becoming an informed consumer caught my eye.

 

I know what you guys mean - sometimes it seems like a miracle that there are any hospital vaginal births at all! I think it’s testimony to *how well women’s bodies work* that they can take so much unnecessary stress and inference and still function. I had a cascade of interventions in my first birth, but I have to say in my case that while I think they were avoidable, they were not the fault of intrusive practices, only some “bad” decision making. The epidural I finally agreed to was one of the few that we might call medically indicated - one where the benefits outweighed the risks and permitted me a vaginal birth, though of course because of exhaustion and the epidural, my pushing stage resulted in a vacuum-assist delivery. I like the idea of “trying on choices”.

When I was pregnant the first time I wanted a water birth and was so intent on my midwife-birth center natural birth that I only read natural childbirthing books. Then I was confronted with a situation in which I probably needed an epidural, and then the vacuum, and I didn’t know anything about these choices (except that they were “bad’). I was angry with myself, so the next time I bought “The Big Book of Birth” which is a great choice for looking at all options. The author favors normal birth, but provides neutral information on pain relief and interventions. Not educating yourself about interventions won’t protect you from them! I thought, in the very rare event I might need a C-section, I want to know what’s going to happen, and what it will mean, and what I can do to make it the most positive experience.

Luckily, the second time I had the unmedicated birth of my dreams (in a hospital! but with an awesome midwife, and in a mother-baby friendly hospital - they do exist! You can tell because they have a snack room full of food and drink for laboring moms). It was a really beautiful and peaceful experience, in spite of another long pushing phase (an occiput posterior baby - the L&D nurse later said in her nearly 3 years there she’d never seen a posterior baby delivered vaginally; she was really moved by the whole thing, by knowing it’s possible). But anyway, my point is that I learned from my first birth not to be afraid of interventions per se, that I needed to know when they could really help or were necessary and when they weren’t, so then I any decision I made I could be proud of later, no matter how it went down.

 

This also exemplifies a pattern that I’ve observed, which I’m sure has been researched in various contexts and named in a scholarly fashion at some point in time. 

1. Fear and anticipation of major event or stressful life change

2. Latch on rigidly to an ideology for a sense of safety

3. Learn from event

4. Alter world view

 

Thanks for sharing, Erin!

 

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Reader Comments (9)

that is the great thing about bradley classes --- they review all the interventions and how to know when you truly need them

July 16, 2010 | Unregistered Commenterterry

Bravo, Erin!

This is interesting in the context of an article I read recently about how sometimes even facts won't change people's minds, and can, in fact, make people's erroneous beliefs become more entrenched. I wonder how these things gel - like maybe only experiencing it firsthand will actually teach people... I'm also thinking about the belief in a just world and how it influences people's ideas about poverty and social welfare, and how the economic crisis has had a (seemingly temporary) effect on that.

Then again, I guess you have the "MY intervention was Completely Necessary" effect...

July 16, 2010 | Registered CommenterCourtroom Mama

CM, did you get to read Rachel_in_WY's "Priveleged perspectives and the gorilla in the room" yet? Similar vein...

July 16, 2010 | Registered CommenterJill

I just saw this. Thanks, Jill! I really felt like the only way to move past my disappointment in the first birth was to be more prepared the second time. I felt so happy & confident & proud of myself during labor #2.

July 18, 2010 | Unregistered CommenterErin

@ Courtroom Mama - it's interesting how I was able to see my interventions as *both* necessary and unnecessary. I think a lot of labors resulting in interventions are like that. At the time when I agreed to the epidural I think it was the right thing to do, but that doesn't mean it wasn't avoidable. In my case I had an intense early labor (contractions 5 min apart from the beginning, and intense, but very slow progress), coupled with vomiting, which led to severe dehydration & a compromised labor pattern; there were some other factors as well. The second time I took anti-nausea meds right away & got a hep lock at the hospital even though my midwife doesn't do IVs. She knew my history though and thought it was a good idea. I suffer from hyperemesis, so I had the zofran on hand. Second time no vomiting, no need for an IV, no problems. I was thrilled to discover the feeling of labor hormones working, the endorphins and these amazing rushes of love & joy during labor, and of course the power of really pushing. . . Anyway I don't know how we can encourage women to see their interventions this way, so they don't feel ashamed if a birth doesn't go the way they thought, or harden like CM points out into a set "MY emergency was a real emergency" attitude.

July 18, 2010 | Unregistered CommenterErin

One of the best things that happened at my admittedly great hospital birth was that my mother came to me as I was nursing my daughter, 15 minutes or so after she'd been born, and said "I am glad you got the epidural you wanted, and I am glad it worked so well for you. It certainly made it easier for me to support you in your labor. But I want you to know that if it hadn't been available, or if it hadn't been effective, YOU COULD HAVE DONE THIS WITHOUT IT." She spoke very lovingly, with a lot of eye contact, and her manner made it very clear that she was genuine in her appreciation for the epidural and what it had done for me. But it also helped me to contextualize my decision to choose pain medication as exactly that -- a choice.

It WAS a choice. I had a plan for when I would choose the epidural, a plan which changed substantially from my initial feelings ("around 28 weeks" :-)) after I learned, in our hospital-sponsored childbirth classes, about the negative effects of an epidural. My new plan was that I would get the epidural when labor progressed to the point where I felt I was no longer capable of working with my body's process of labor, whenever that occurred. That's the plan I followed, that's the choice I made, and I felt and continue to feel good about that choice.

But the most important part about seeing it as a choice? is that when I decided that there were other parts of the hospital birth experience that I didn't want to repeat with my second birth, I was able to recognize that I would have to make different choices re: labor sensation management if I wanted to birth outside a hospital. And I am; I'm hiring a doula, I'm taking Hypnobirthing classes, etc. Ironically, the recognition of a medical, epiduralized birth as a valid choice is EXACTLY what's freed me up to make different choices for my second birth without having to deal with defensiveness and fear.

July 18, 2010 | Unregistered CommenterKathryn T.

@Terry: We have an ongoing joke in our ICAN group about Bradley classes because most of us took Bradley the first time around.

Just sayin'.

July 19, 2010 | Unregistered CommenterMonkey Mama

Kathryn, that's cool that you got to a place where you could weigh risks/drawbacks and benefits/positives without judging yourself.

What's your mom's story? She sounds interesting.

July 19, 2010 | Registered CommenterJill

My mother gave birth twice, both times in a hospital, both times without any medication. She had to fight REALLY HARD for her unmedicated births, alone, in labor, the first time (with me) in a foreign country. (OK, in the UK, so it's not like there was a language barrier.) She later went on to become a La Leche League leader, which she continued for 17 years. She's an amazing advocate for women's autonomy in labor, and for the idea that women make their own choices for their own reasons. She's the one who taught me to criticize the system that makes some choices so much harder than others, not the women who make their choices in an unsupportive or even downright toxic environment.

She's a hell of a lady.

July 20, 2010 | Unregistered CommenterKathryn T.
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