Sunday, December 19, 2010

The Abnormality Of Our Birth 'Norms'

Recently I posted a status on Facebook, which expressed my concern over what I had just watched on a popular birth show. It was no surprise, that with such an interesting, relevant, applicable to EVERYONE subject (such as birth), there would be much response. I loved the experiences shared and the different views given. Even if they are different views- it ultimately gets our minds thinking and is food for thought. There is so much to be discussed and so much to be shared, just simply from this one Facebook post, that I thought I would post it here, in addition to my subsequent thoughts from the comments left…

“I decided (against my better judgement) to turn on TLC and watch 'A Baby Story.' It's supposed to be a happy, cutesie show, but all it's doing is making me sad. These people don't even realize what they're doing...eager to have their baby, uniformed, and being wrongly led by the Doctor. Induced at 39wks for no medical reason, water artificially broken at 3cm, epidural at 3cm, even before the onset of labor. And they wonder why she's not making progress?”

The goal of my posts have always been to make statements- to bring to attention things which I feel passionate about and which we should discuss, share, and hopefully make better. The goal of this post was just that- to discuss the kinds of things that happen all too often and make up the birth stories of so many women. Uniformed women, MISinformed women, and healthcare providers who leave them uninformed and MISinformed and portray these interventions as being without consequence.

There is a misconception that just because these interventions are now seemingly routine interventions, that it is ok and they are safe. You might think that because your sister or your best friend, or even YOU have had an elective induction, artificial rupture, monitors, early epidural, and the like, and you have had a “healthy” or “good” outcome, that these things are therefore ok. But individual, personal experiences cannot always be used as examples. It might be one’s argument that social, elective inductions happen all the time and often times end in safe, healthy deliveries...or that epidurals happen all the time and often time end in safe, healthy deliveries, seemingly without consequence. But instead of applying it to individual experiences or small scale perceptions, we need to look at the larger picture. For example, my mother smoke and drank during her pregnancy with me…and I was a healthy baby who went on to be a well-adjusted, intelligent, educated woman. Does that mean that smoking and drinking during pregnancy should be considered safe? No, because just looking at smoking- we know that babies born from moms that smoke have a statistically higher chance of being born premature, of having low birth-weight, and having respiratory problems.

This goes beyond hospital birth vs. birth center birth vs. home birth. It goes beyond surgical delivery vs. medicinal pain relief vs. unmedicated birth vs. natural birth. It has nothing to do with a WOMAN’S CHOICE regarding epidurals or social inductions. That IS her choice. But it should be HER choice and it should be her INFORMED and EDUCATED choice. Is an elective induction with artificial rupture with a high baby and an epidural BEFORE labor a good or SAFE idea? Come on. Is it a surprise that after a day of labor that she had made no progress? And my last and hopefully resonating point- Why is this being portrayed as ok and normal?

I have had the privilege of supporting women and families in many births, both Out-Of-Hospital and in the hospital. I very much agree that beautiful, wonderful births happen within the hospital…to include induction and epidural births! My argument is for care providers to never portray these interventions lightly, to fully inform their patients, and to acknowledge that statistically speaking, we have better, safer outcomes the less we intervene (in normal circumstances). And if we are going to socially induce or use epidurals, let’s do so with good timing and therefore more safely, to minimize the risk.

Not as care providers, but as a women and as families, what can we do? Choose your care providers wisely! Word of mouth can be powerful for a Dr. who is a no-go vs. a Dr. who people love and respect. Next, know that it IS ok to interview them! Pick up the phone and schedule a consultation! There is importance in knowledge, bedside manner, compassion, and views and beliefs on birth. What are his or her feelings on interventions, to include inductions? What is their primary c-section rate? WHY is it that? This is just the very beginning of getting a feel for this provider. Once you have met, once these types of questions have been answered, you might have a glimpse into who they are and their style of practice as a care provider...hopefully you will feel as they will be good support to YOU, helping YOU care for yourself and helping YOU to make educated decisions in YOUR care. Lastly, educate yourself. Your Doctor’s input should only be one source of knowledge. Read books, visit respected websites, and question, question, question!

Why is this important? Why does it even matter??? It matters because what that television show showed is not an entirely unrealistic depiction of the majority of other birth stories in our country. I see it happen all too often, I hear testimonies that sound not very far off from it. Women come to us from far away, in seek of having a VBAC (Vaginal Birth After Cesarean), and most of these women look back with 20/20 hindsight and knowledge gained from the first time around, with very similar stories. It matters because to intervene is NOT the normal process and in reality, it should not be our norm to be a culture of uninformed or misinformed women who electively induce, view epidural anesthesia as a needed or required passage of birth, and who have a 30%+ c-section rate.

It is all intertwined.