The author, Henci Goer, has gone through most of the options available where birth is concerned, e.g. labor induction, O.B.s and midwives, birth centers, C-sections, epidurals and other drugs during labor, episiotomies, electronic fetal monitoring, IVs, etc. She has read the medical literature and presents the pros and cons for each option along with the possible consequences. I am one of those people who wants to see the research, and here it is! Actual studies are cited, making this book fact-based and opinion-free.
Reading The Thinking Woman's Guide to a Better Birth may or may not convince you that less intervention is best, but at the very least, you will be informed about your options and the possible consequences. There will be no surprises like an epidural not working, an unexpected C-section, a presumably healthy baby that ends up with respiratory distress, a postpartum backache, a baby that doesn't nurse well, etc. There will be no surprises because you will know the possible consequences of any choices you make for your birth. Knowledge is power!
Meet Fei. Fei is a thinking woman. When she was pregnant with her first, she had some preferences for her upcoming birth based on things her mother and sister had told her. So she talked with her O.B. about them. Her O.B. went through her list and said, "No... no... no... I will not acommodate your wishes." (Fei was not asking for anything EXTRA--she was actually asking for less-than-the-norm: no labor induction, no epidural, etc.) And so, in the middle of her third trimester, Fei fired her O.B. She later told me she had no idea where to go. She sent an email out to the Relief Society, asking if anyone could recommend somebody. She got a recommendation for a midwife group from a girl she didn't know very well. Fei had never considered going to a midwife, but as a thinking woman, she decided to check it out. Fei ended up with a wonderful water birth in a birth center, attended by caring midwives who were aware and respectful of the fact that birth is a normal body process. Her little girl was born naturally nine days after her "due date" at about six and a half pounds and absolutely perfect.
Fei and PipI didn't meet Fei until months later, but it was her story and that of my sister-in-law, both of whom switched to a different care provider late in pregnancy, that prompted me to make the last-minute switch to Ellen when I was almost 40 weeks pregnant with Pip. A switch that most likely saved me from getting an unnecessary C-section and instead gave me a fabulous birth memory that will bring a smile to my face and tears of joy and gratitude to my eyes for the rest of my life.
Fei is now pregnant with her second. She and her husband have chosen to pay out of pocket for a birth center birth rather than let insurance cover the intervention hospital birth that everyone else they know is getting. A thinking woman married to a thinking man. Awesome!
3 comments:
Hey TL it's Ann but I'm logged in as Brian. I needed to email you this. Can I leave a comment that is super long?
Birth Centers in Utah are under attack (see http://www.womenandbirthcare.com/politicalaction.html) . No matter how a woman chooses to bring a child into the world, I feel that the preservation of choice is a very important issue. In short, when old birth center regulations were recently brought up for review (in hopes that obsolete and ineffective 20 year old rules might be updated), the Utah Hospital Association and other opponents of natural out-of-hospital birth jumped on the opportunity to submit their own proposal which would in effect shut down the 2 licensed birth centers in Utah within a year. These opponents have relied on groundless claims and scare tactics to influence a public largely uneducated about the realities of out-of-hospital birth. Our baby daughter was delivered at Birth and Family Place in Salt Lake last June, and the difference between her birth and my son’s hospital birth is indescribable. The Utah Hospital Association and other ‘health’ committees would like to take away choices in birth by exploiting our culture’s unhealthy fear of birth. It is tragic that we are taught by our culture to fear birth and to mistrust our bodies when the vast majority of births could be conducted without medical intervention. Yes, birth is unpredictable and at times warrants intervention to save lives. But studies have demonstrated time and time again that with common sense precautions, outcome statistics at Birth centers regularly exceed those of hospitals. As outlined in the link, there is an meeting there is a meeting at the Health Department (Cannon Building, 288 N. 1460 W, SLC ) at 9am on March 25th . The most critical thing needed is NUMBERS. The governing bodies need to see that there is a large population in support of choices in childbirth.
I have some strong opinions about childbirth since it is a field I have been active in, even years before my own child bearing. I trained as a labor and postpartum doula six years before I had my first baby. During graduate school I presented a paper at a Medical Anthropology conference in London about teen mother's mental health as it relates to their childbirth experiences. I have always been amazed with birth. I feel it is a miraculous and spiritual process where the power of God moves through a woman’s body to bring new life. In America there is a current crisis in maternity care as discussed in the film “The Business of Being Born”. Suffice it to say that Cuba and Poland have better infant mortality rates than the USA . The film obviously has a very pro natural birth stance and explains some of the choices and options available. I read another article recently that stated “the maternal death rate in the USA is four times higher than it should be and why is no one talking about this?”* . There are many very alarming trends that hurt women and children, many of which come from cultural/medical perceptions which treat birth as a pathology and not a normal, healthy process. I am very grateful for the medical advances that are available and that save women and children everyday. However, for the majority of women, birth is a normal process and more problems can arise when medical interventions are introduced. I am not judging people who choose a medical birth, but I believe that with proper preparation, a belief in the birth process, and confronting the fear of childbirth instead of giving into it, women could have more options in the process of birth. If women really looked at some of the trends in maternal/child health and knew what questions to ask then some different choices may be made. Here is a local example from Utah . Utah has around an 80% induction rate, which directly corresponds to a nearly 40% cesarean rate (at some hospitals) as induction greatly increases the probability of a surgical outcome. In normal circumstances, about 15% of pregnancies will have a medical reason to end in a cesarean, which again, is wonderful and saves lives (Only 3% of the births at our birth center transfer and result in C section). But C- sections are major surgery and carry all the attending risks of major surgery. When they are happening almost 3 times more often than necessary, it is time to ask some questions.
As a doula, I was taught that when considering medical procedures we should consider the risks, benefits, and alternatives available. Women are typically not taught to think like this about childbirth and the medical establishment is certainly not forthcoming with any options other then those which fit their model. Many first time moms I have spoken to did not even know they had other options in childbirth outside of the typical interventions. And even if a woman is aware of other options, the power disparity that typically exists between a laboring woman and her OB/GYN makes choice illusory.
* from “Masking Maternal Mortality” by Ina May Gaskin in the March/April 2008 issue of the magazine “Mothering”.
More interesting reading about the cultural fear of birth:
http://www.davis-floyd.com/userfiles/Culture%20and%20Birth.pdf
Robbie Davis-Floyd is a Cultural Anthropologist and has many interesting articles about childbirth here: http://www.davis-floyd.com/ShowPage.asp?id=158
Feel free to stop reading here.
On a personal note:
Before I was trained as a doula and assisted other women through childbirth, I assumed I would deliver my future children the way most American women do: in a hospital, with an OB and medical interventions. Instead I have taken another route. My first son was born in a hospital, and the birth itself was a wonderful and empowering experience. I had my husband laboring with me and could not have done it without him. He has become a great advocate for natural childbirth as he is among a minority of people who have witnessed how labor can proceed naturally (only about 14% of American women give birth naturally). We also had a great nurse, midwife, and two very supportive friends who came to welcome our son into the world. The hospital never pressured me to receive pain medication or unnecessary interventions, and I was very, very happy to not have an IV, continuous fetal monitoring (Doppler yes but I was not strapped to the bed). However, I had a very quick labor (8 hours total, about 5 hours in the hospital) and things may have been different if I had been hanging out there for 24+ hours. I trusted my body. I trusted the birth process, and visualized every contraction bringing me closer to holding my baby. I was able to totally relax, not fight against the process but completely give into it. The only time I felt uncomfortable in the whole process was when the nurse made me stay still or in a position I did not want to be in to take my blood pressure. I was free to move around and naturally and innately found ways to be comfortable. We had a situation with our son after he was born where we felt that hospital policy took precedence over what would have been best for our situation, and this is why we chose to give birth in a birth center instead of a hospital with our second child. The birth center is amazingly peaceful and lovely, and has a 3% cesarean rate (which is partially due to the fact that higher risk pregnancies are referred out to OBs and hospitals, as they should be.) All other outcome statistics are also better than average at the birth center. I do understand that if there is anything had threatened my life or the life of my baby, we would have gone to a hospital, and I completely trusted my midwife to make that judgment call. We enjoyed a very peaceful, but intense water birth to welcome our new daughter into the world and I am so grateful that I had this choice in childbirth. Please help support birth centers and support choices in childbirth!
I think our medical system is so messed up. I am, however, at the same time SO grateful for it especially because of Talmage and how his life was saved.
Every time I hear someone like you talk about a more natural birth it sounds so great, but I think I am a wimp because I don't think I could ever do it or want to. I guess it's possible that what I exprienced with Sydney was more painful than a natural birth...I was induced to begin with and then didn't get my epidural until after I went through transition.
I always think I am going to die even knowing I am getting an epidural. I guess I wish that the two "sides" were more united so that women didn't have to "choose sides" so to speak, but could learn, experience and choose what felt right at the right time without any outside forces trying to influence but only educate and support.
I think the perfect scenario for me would to go into a birthing situation with a doula and prepared and ok with and for either situation.
And I wish that there were more doctors like my grandpa. Doctors who looked at the whole person and not just appendage by appendage.
Wow. Who knew I had such an opinion! Well I guess we both do now:) Maybe Dave can be that kind of a doctor:)
How many kids did Henci Goer have?
Tomorrow I start my hypnobirthing classes. I finished the book today. As I told my husband (who is not at all convinced about the value of this), I believe the basic premise has merit, but there is also a lot of opinion in there.
I had my first two wonderful experiences in a hospital, but see no problem at all with birthing centers. I wouldn't do it myself I think. I know someone who had to have such a quick emergency C-section that the baby would never have survived the transfer from the birth center to the hospital. (Although in fairness, I think she was trying for a VBAC so wouldn't have been in a birthing center in the first place.)
Another friend had a baby who had some condition where the umbilical cord was not attached right (veins and arteries were right, but it basically pulled out during labor), which no one knew until she was far along in labor and the baby's heartrate stopped - he had almost bled to death in her uterus. As it he's a 6-year-old miracle with only some kidney damage after his liver and kidneys had failed. The mom tells me that part of the miracle is that they had a Level 3 NICU in that hospital, and the state laws in Kentucky mandate a Neonatalogist on the premises. It's actually a really cool story. But my point is that she had every indication going into labor that she was low-risk, but her baby would have died in a birthing center.
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