Wednesday, December 14, 2011

Obstetric Lie # 85- I Know What Natural Birth Is


I talked to a woman once who believed in natural birth.  In fact she had had her first few babies unmedicated in the hospital.

She delivered on her back (without pain relief), her doctor cut a nice episiotomy and she had horrid recoveries.  They were difficult experiences for both her and her husband.  She got epidurals for her next few babies and had a much more positive experience.

To many people involved in medicine, this is what "natural birth" is- it is a woman suffering through the typical hospital assembly line, supine, Pitocin in your vein, let's pull this baby out, hospital birth- only she does it without the relief of an epidural.

This may be unmedicated but it certainly isn't NATURAL.  In fact, it is nowhere near natural and can be quite traumatic indeed, even suffering of the first order. 


There is a very good chance that your doctor has NEVER seen a natural birth.  Oh, he may have seen a handful of unmedicated births, sure.  Those happen every now and again with a dedicated mother or somebody who just arrived at the hospital too late for any pain relief.  But an actual NATURAL birth- that is another story altogether.

Let's talk about an example of an unmedicated birth.  So as not pick apart the birth experience of another, I will use my own.

When I arrived at the hospital I got a vaginal exam (not natural) that found I was at 8 centimeters dilatation.  I got an hep lock IV (not natural) because there was worry about me needing fluids at some point.  I labored in a tub which was wonderful.  I started feeling pushy and got another vaginal exam (not natural).  They pulled me out of the tub (unnatural) because water births were against hospital policy.  I moved to the bed and pushed for four hours in every position known to man.

At some point I was hooked up to a bag of saline solution (not natural) because my contractions had slowed and my midwife thought I could use some fluids to pick things back up.  After four hours I was offered two choices- vacuum extraction or an episiotomy (neither natural).  I choose an episiotomy.

My son was born just after that.  He was healthy and strong.  I started to bleed out and received a shot of methagrin and some Pitocin in my IV.  Again- those are unnatural interventions.

I had a totally medication free birth, but it was not natural.  There were interventions that were not part of the natural process.

Now before anybody gets the wrong idea I want to be very clear- NATURAL BIRTH ISN'T ALWAYS BETTER.  

That sounds weird from somebody like me, but it is true.  I am deeply GRATEFUL for most of those interventions.  Some of them saved me from a c-section and others probably saved me from a lot of blood loss and maybe even death.  Natural isn't superior just because or all of the time.  (I happen to think that the more natural the birth the less need for some interventions, but that is another post altogether.)  I think I needed that IV and I think I needed those anti-hemorrhage drugs.  I don't really think it is fair or nice to pick apart another persons birth experience and tell them what they needed or didn't. 

I also don't want to give the impression that any of those interventions left a bad taste in my mouth- it was a fabulous birth.  It changed my life, it gave me confidence, and it changed me.  I never felt the need to be angry or sad over a birth experience just because there were a few interventions, necessary or not.  We don't always get what we want- and that is just part of birth- and part of life.  

Just so that's clear.  Now let's move on.  


I talked to a medical doctor who was in my class once.  She had caught hundreds of babies.  We watched a birth video with women squatting and pushing their babies out with zero interference.  Nobody even touched the baby, it simply feel onto a towel just under the mother.


This medical doctor, skilled in delivering babies, didn't know that was possible.  She was trained to pull, traction and "assist" the baby out.  That is what she had been taught was needed.


I submit that when we talk about real natural birth with people in the medical community they often don't even know what it is we are getting at.  The truth is, to go through the normal induced, assembly line birth without pain medication could very possibly be a traumatic and incredibly painful experience without some pharmaceutical relief.  "Why would you want to do that?" is an obvious question when you know that a little needle can make it all go away.


And it is a good question.


We don't just want an unmedicated birth.  We want NATURAL, physiologically normal, women led, instinctive birth that is respected.  We don't want to be mocked, laughed at, forced on our backs, forced to have our babies at somebody else's convenience with an IV, Pitocin, lots of vaginal exams, pressure to dialate according to a textbook, and an episiotomy when we finally make it through all that labor stuff.


At the risk of being offensive, very few births in this country are actually natural.  Even those that are unmedicated almost always have unnatural interventions.  Some of those interventions are prudent, needed, and even LIFESAVING.  But oftentimes, they are none of the above- they are just part of training, part of the routine, part of the policy and the politics of male dominated, epidural heavy, date oriented modern birth.


Sometimes when women try to go unnmedicated within this machine they find it very difficult indeed.


I don't know what the solution to this problem is, though I do think it is a problem.  I would love for all medical doctors and nurses and midwives to see an normal, healthy, natural and woman led birth.  It can happen safely all the time.  I think that could change the way birth is seen and practiced, even if it is practiced by trained surgeons well versed in pathology.


Maybe more doctors should birth at home.....

Well, a girl can dream.  


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