Thursday, December 11, 2008

Pushing

The decidedly female act of pushing a baby out of her body and into the world may be the most amazing instance of female power that exists.

Pushing, also know as second stage is the part of the birth where the baby is pushed out of the mothers body. Well, you probably already knew that but, it is an interesting topic on many levels. Many women enjoy this part of the birth because now, instead of relaxing through a possibly painful contraction they get to work with their uterus as they together try to expel the baby. It can be painful or painless. It is often hard work for the mother. Women often hold their breath and bear down. It can be a noisy time too. The sounds emerging can be very primal, some even call it a roar as a mother does what seems to be impossible to bring her baby into the world.

Motherhood

How does pushing relate to being a mother? There are many lessons inherent in pushing. It is hard work with a tremendous reward. Learning to do this will give a mom a belief in her ability to mother and overcome physical challenges. I had never been athletic in any way before having children. After the birth of my first child, in which I pushed for 4 hours, I felt more physically capable than I had ever before. I ran my first 5k a few months later and it was difficult but I knew I could do it because, it was way shorter and easier than childbirth. It gave me a tremendous confidence in myself that I never had before, that I didn't even know was there.

What are we so afraid of?

When you look at the recent history of birth in America it is striking that this is the part of labor that often women have taken away from them.

(For a brief history and books with more check out: http://www.naturalchildbirth.org/natural/resources/history/history01.htm )

During the days of twilight sleep women were often totally unconscious for this part of their birth. A large surgical opening was made between the vagina and the rectum (called an episiotomy) and the baby was pulled out with forceps by a male physician. When I first started learning about birth I assumed this model of care was far, far outdated. But, if you start talking to women, even our mothers, women in their 60's and even 50's, this is how they gave birth. I remember talking to a coworker while pregnant. The last thing she remembered about the birth of her first son was telling the doctor that she didn't want them to give her anything to make her baby sleepy. She woke up hours later and a baby she did not even remember giving birth to was brought to her. The days when women were delivered this way are not that far past.

Today, women are almost always conscious during the birth of their babies, but we are missing out on pushing for a different reason: the rising c-section. http://www.childbirthconnection.org/article.asp?ck=10285 There are varied reasons for the cesarean section, many of them valid. But I think we can agree that a rate around 31% is ridiculous. There are numerous risks to the c-section that I won't get into here. What I want to talk about is why this is happening and what it does to women on an emotional level.

Power

A trained natural birth mother, comfortable in her abilities and her body is often quiet or peacefully moaning during labor. She may lose control briefly and scream or get louder, but labor in general is an incredibly peaceful event. A well supported women will be surrounded by loved ones and care providers who respect her in this miracle. This may change when she starts to push. Pushing requires great physical exertion and with it are often physical noises. Have you ever watched an athlete of any sort? They use their breath and their body to make noises to increase their physical power. Laboring women often do this too -purely based on instinct. A natural birth mom roars her baby into the world. This moment is magnificent and it is powerful. And- it scares the hell out of a lot of people, including women themselves.

I want to make clear that when a woman pushes her baby out, of her own free will and under her own power she is demonstrating the great power of femininity in a glorious way. She is noisy and she is amazing. She is literally pushing a 6 to 10 pound baby out of a very small part of her body. I don't care what male sport you can think of, there is nothing that even compares to this. There is inherent power in the pushing and birth of a baby.

This is why, I believe, this part of birth is so often silenced and taken away from women. An unconscious woman does not birth her own baby. It is surgically removed from her vagina by a male 'expert' in delivery. She doesn't help at all. Her power is gone. Fast forward to today, a woman who has her baby cut from her lower abdomen is not an active participant in the birth of her baby. She is having the help of a trained surgical team. If this procedure is unnecessary or coerced then she has lost her power. We instead have a silent woman with a surgically removed baby. Who has the power in this relationship? The obstetrician, not the woman. This is why a woman who feels like her c-section was unnecessary is often so dissatisfied with the experience. A mother medicated with an epidural or something similar is also often quiet during her pushing stage. She must be instructed on how to push her baby out if she can not feel to do it herself. She must be told when and how long to push by "experts" who are closely watching a fetal monitor. This whole process is backwards. An unmedicated mother does not wait to be told when to push. She knows! She tells other people when it is time. If she is in a supportive environment, people are paying attention to her, not a beeping machine attached to her. She moves how her body tells her, not how the obstetric surgeon instructs her. If she is in tune with her body she positions herself in a way that is ideal for her and the baby, but possibly inconvenient for the person catching.
I had an OB nurse tell me that many of the mothers delivering at her hospital were so medicated that they would stop pushing when instructed, even with the babies head sitting right on the perineum. They would wait until the doctor entered the room, even for 10 or more minutes. They could feel nothing! This is ridiculous! The woman should be pushing when she wants and when she feels is convenient.

To Close-

I have to admit that pushing scares me too. It was the part of my second birth that I feared the most. It is the time that I lost control and my body took over. It is also a beautiful and powerful time for a woman. It is often noisy and intimidating for all who witness it. We fear female power in this country. If women become powerful we expect them to do so in the way that a man does, by making money or obtaining high office. We never embrace the ways that women are powerful on their terms. It is grudgingly OK if women go about getting power in the male approved avenues. But we seem to think that it is too disruptive and loud if a woman shows her power in a female way that can never be duplicated by man. This is the reason we silence women in the moment and the height of their glorious and howling power. This is also the reason we must stop this practice and embrace what we as women can only do.


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