Wednesday, September 15, 2010

Someone To Watch Over You

I have been pondering often lately on the idea of people, particularly strangers, at birth.  I feel very deeply that the presence of others who we do not know or trust can be disruptive, even disastrous for a birth.

I have said before that one of the unspoken cruelties of modern maternity care is the crap shoot that is your birth attendant.  First, most doctors or midwives in hospitals work rotating shift work.  Chances are good that you will be birthing with somebody who you do not know well.  On top of that you will be attended by a nurse who you will almost definitely NOT know.

How does this change birth?  Do we even know WHAT it does to the process of birth?

I am surprised that this is so seldom talked about.  First, because it is a subject that strikes fear into the hearts of most laboring women, and second, because the presence of strangers, particularly un-supportive ones, must be so DAMAGING to the birth experience.

I am not a scientist or a doctor, so I can't approach this subject from that level.  I am a birthing mother, so that is how I will think about this- with common sense and sensitivity.

Birth (despite the possible pain) is very much like the sexual act.  It is intense.  It requires the same body parts.  It involves the same hormones (only at MUCH higher levels).  Women in labor who sound out their contractions often sound as if they are making love.  Birth is in fact the crescendo, the end product, and the sacred culmination of the sexual act.  You begin it with one person you love and intimately make a baby.  It ends with the birth. 

You could have sex with strangers around monitoring you.  Maybe you could even climax.  It is however probably safe to say that it would be much more difficult to do so, and probably a little embarrassing.

It makes zero sense to me that we end this journey of fertility and joy in a sterile, foreign room, with lots of machines strapped to us SURROUNDED by people instructing us on how to do it properly!  And, on top of all of that, most of these people we have just met.

I was blessed with a wonderful midwife and nurse for my hospital birth.  Even though I had never met them they were important in their support of me during that time.  BUT- and this is a big but- I got lucky.

In addition, despite the fact that those attending me were supportive, kind, and knowledgeable, is it possible their mere presence altered the birth negatively?

Studies show that a good supportive doula, or woman labor support, can have a dramatic positive effect on labor.  Is it also possible, even probable, that a person unknown to mom, even opposed to her, not to mention male, can have a dramatic effect in the negative?

It only stands to reason that this is in fact the case.

In fact, a well known Obstetrician, Michel Odent claims that even the presence of the father can be distracting and negative.  Here are some of his thoughts: (you can read the entire article here).


"But my youngest son was born in 1985, at home.
As it happens, at the exact moment our son arrived in the world, the midwife was on her way down the street and I, having made my excuses realising he was about to be born, was fiddling with the thermostat on the central heating boiler downstairs.
My partner did not know it, but I had given her the exceptionally rare, but ideal situation in which to give birth: she felt secure, she knew the midwife was minutes away and I was downstairs, yet she had complete privacy and no one was watching her."

I  of course cannot agree publicly with Dr Odent (being a Bradley teacher and all I happen to think that the well trained and educated father can be a huge asset to the birthing mother) about fathers being excluded, but I think he has a very interesting point- women birth best when left alone and when they feel safe.  He points out that this mom felt safe because she know that the midwife was near, but she was able to tune into her primal birthing self, because of the absence of others.

I am over and over again seeing women who are often prepared and certainly know more than most birthing mothers out there, end up with long difficult labors and the famed "failure to progress".  I can not help but wonder if this "unexplainable" difficulty in birth stems simply from the presence of others (particularly negative others) watching over mama.

I wonder if this "need" to be surrounded by foreign others is based in fear.  Yet ironically, is it possible that the presence of these expert strangers is part of the PROBLEM of birth today?

How many "necessary interventions" are simply caused by the mother and baby reacting with stress to the presence of others?  How many women fail to progress because they lack privacy?  How many births are painful because they are being watched and monitored?

I am not advocating unassisted childbirth, but I will openly condemn the common practice of fear filled strangers at birth.  

We must be realistic about birth.  Things can go right OR wrong no matter where we birth.  We must choose carefully where and with whom we will birth, despite this.

We must recognize the importance of the primal birthing mother who is able to transcend her thinking self and birth without fear or stage fright.  We must have only those with us who reverence the birth process.

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