These images you have been exposed to involved women screaming and hating their husbands

September 22, 2011 1:05 PM

YOU are Invited to Watch My Natural Home Birth Live Online... Chiropractor and Natural Birth Coach Nancy Salgueiro announces plans to stream her homebirth live. Some videos of unassisted birth. Controversial anti-home birth blogger The Skeptical OB weighs in: "nothing says love, support and respect like an audience of strangers watching your crotch."
posted by the young rope-rider (160 comments total)

If there are already videos online of unassisted birth, what makes this lady special?
posted by roomthreeseventeen at 1:06 PM on September 22, 2011 [2 favorites]

I love The Skeptical OB. Fight the good fight for science, doc!
posted by ThePinkSuperhero at 1:11 PM on September 22, 2011 [6 favorites]

Wow, the skeptical OB post sounds like trollbait or something.
posted by PhoBWanKenobi at 1:11 PM on September 22, 2011 [4 favorites]

The same thing that makes every parent and child special, of course: the headlong descent into self-absorption and the cosy, hormonally-driven specialness of their very own little "miracle".
posted by Decani at 1:11 PM on September 22, 2011 [50 favorites]

The angriest post-performance Q&A session in the world.
posted by griphus at 1:11 PM on September 22, 2011 [2 favorites]

I looked for one voice in all of this that wasn't totally insufferable.

No dice.
posted by pts at 1:11 PM on September 22, 2011 [12 favorites]

Oops My post was in response to roomthreeseventeen's question. Meant to paste that in. Something must have slipped.
posted by Decani at 1:12 PM on September 22, 2011

The same thing that makes every parent and child special, of course: the headlong descent into self-absorption and the cosy, hormonally-driven specialness of their very own little "miracle".

You don't like kids all that much, do you?
posted by KokuRyu at 1:12 PM on September 22, 2011 [1 favorite]

This is a pretty big step. I can imagine some magical future time when one can see a conception somewhere on the internet.
posted by bondcliff at 1:13 PM on September 22, 2011 [28 favorites]

When my wife gave birth in one of those pool things, they provided a tea-strainer for me to chase poop around the bath with.

There was a good deal of shouting and fear and pain and awe and tears and wonder that Sunday night, but of all the the things that were indelibly etched into my memory of that day, the little tea-strainer stands out the most.

And so, basically, what I'm saying is, I don't want to watch this woman do that.
posted by Jofus at 1:13 PM on September 22, 2011 [70 favorites]

My belief and passion in birth started when I was in Chiropractic College. I attended a seminar on birth trauma and why children need chiropractic care.

So, rather than a birth date pool, how about we go in on how many days (hours?) post-delivery she gives her baby its first (omg horrifying scary baby cracking) adjustment? Chiropractors, amirite?
posted by phunniemee at 1:13 PM on September 22, 2011 [2 favorites]

She says in the video that she's aiming to show all of labor, since videos online are often just the actual birth or only little clips of the labor. Makes sense; it sounds like her motivation is to show people what unmedicated labor and birth are like, and a two-minute clip can only go so far toward that aim.

Is her birth going to be unassisted? I couldn't really tell from her announcement video.
posted by mandanza at 1:13 PM on September 22, 2011 [3 favorites]

When my wife gave birth in one of those pool things, they provided a tea-strainer for me to chase poop around the bath with.

And their continental breakfast sucks. Would not stay here again.
posted by hal9k at 1:15 PM on September 22, 2011 [49 favorites]

Good on her, and also I will absolutely not be watching that.
posted by everichon at 1:15 PM on September 22, 2011 [2 favorites]

There's quite a lot of home birth footage in this biased but interesting documentary. One woman basically wiggle-dances a baby out of herself in a kiddie pool and makes it look like something you could do during your lunch break, and another one screams for hours and begs to be taken to a hospital. What I'm saying is that I hope Nancy knows that this might not turn out to be a Beautiful, Spiritual Thing.
posted by theodolite at 1:15 PM on September 22, 2011

Wow, the skeptical OB post sounds like trollbait or something.

She loves to get people all riled up! Example: A simple question for waterbirth advocates: Would you completely immerse your head (eyes open, of course) in the fecally contaminated bloody water of a birth pool in the aftermath of a birth?
posted by ThePinkSuperhero at 1:17 PM on September 22, 2011 [3 favorites]

Wow skeptical OB has that paternalistic medical doctor shit down cold. I'm not really one to argue that women need less say in their own pregnancies.
posted by mandymanwasregistered at 1:17 PM on September 22, 2011 [25 favorites]

This is like a whole new "special" level of exhibitionism. Can't it just be taped and put up on online somewhere??

Cos, if things get dangerous or scary, and they can actually, I think showing it live is going to fuck up the priorities of birth. Which should be first and foremost, the health of the child and the mom, not to fucking televise it live on the fucking interwebs.
posted by Skygazer at 1:17 PM on September 22, 2011 [1 favorite]

Of course, it's possible to have a natural, unmedicated birth in a hospital, too. You know, just in case some intervention is actually needed.
posted by mollweide at 1:18 PM on September 22, 2011 [16 favorites]

Whatever happened to everyone else pacing in the hall with a hip flask and cigars?
posted by valkyryn at 1:18 PM on September 22, 2011 [11 favorites]

The only thing weird to me about this is that it is unique.

I used to feel like an exhibitionist for ever putting any sort of personal photo on my blog. The word has really changed a lot in 10 years.
posted by MCMikeNamara at 1:20 PM on September 22, 2011 [3 favorites]

Has anyone that has children not seen a birth? Who gives a crap if this woman wants to do it online? If she announced she was going to masturbate online like a hundred thousand others already have, would some angry blogger feel compelled to weigh in?
posted by rusty at 1:20 PM on September 22, 2011 [13 favorites]

I won't be watching the video. I've seen several births, and that's enough for me.

I applaud someone bringing awareness to the concept of home birth, though. I guess if you were considering it, seeing someone actually go through the experience might help you decide whether or not it's for you. Having someone like Dr. Amy Tuteur speaking to you in the manner in which she does in her blog post probably won't help matters, though. She has her opinion, and that's fair enough, but there's no need to be mean.
posted by Solomon at 1:21 PM on September 22, 2011 [3 favorites]

would some angry blogger feel compelled to weigh in?

priorities seem ass backwards to me is the thing. Giving birth is difficult enough without a whole layer of complexity added to it.

My two cents plus tax.
posted by Skygazer at 1:23 PM on September 22, 2011

Hmm...is she the "fancy back massage" kind of chiropractor or the delusional-bordering-on-fraudulent "I can cure diseases by moving your spine" kind? Let's check the website. Yep, she's the second kind, albeit one that knows to hedge her language:

"We do not treat Attention Deficit Hyperactivity Disorder. However, since ADHD appears as a neurological disorder and chiropractic care attempts to reduce nervous system disturbances, many parents who want a natural, non-drug solution for their child have found chiropractic care helpful."

"Chiropractic care doesn’t treat allergies. So, why do so many people with allergies mention that they see improvement by receiving care in our practice?"

"Chiropractic is not a treatment for asthma. However, many who suffer from asthma report improvement by receiving chiropractic care."

Since she's made a profession out of lying about medical care (either to herself or to her patients), I see no reason to listen to her about home birth. Which is not to say that home births are universally terrible or that hospital births are shining beacons of perfection, but Nancy Salgueiro is not somebody that people should listen to about medicine.
posted by jedicus at 1:25 PM on September 22, 2011 [40 favorites]

A simple question for waterbirth advocates: Would you completely immerse your head (eyes open, of course) in the fecally contaminated bloody water of a birth pool in the aftermath of a birth?

If I'd just spent nine months drinking my own pee and floating in my own extrement, this probably wouldn't seem out of order . . .
posted by peep at 1:25 PM on September 22, 2011 [26 favorites]

Has anyone that has children not seen a birth?

Yeah, me. Not live anyway. I was too busy holding my wife's hand and talking her through the emergency c-section surgery.
posted by jimmythefish at 1:25 PM on September 22, 2011 [10 favorites]

We've experienced birth from both ends of the spectrum:

Our eldest was born at a licensed midwife clinic in rural Japan; our youngest was born in a hospital in Canada.

My wife says (leaving out the cultural and linguistic issues entirely) that the experience with the midwife clinic was better. It was a combination of ob-gyn clinic and traditional Japanese "minshuku", kind of like a B&B. The midwife had a masters degree in nursing, and had worked for many years as a school nurse before taking over the clinic from her own mother; many, many people in town had been born at the clinic, including some of our friends. My wife did not choose a hospital birth because C-sections are pretty common in Japan (as they are in Canada).

While the Canadian hospital experience was adequate, it was much more utilitarian. Cervix not dilating on schedule? Administer hormones. If that doesn't work in 24 hours, we'll cut you open. As an added benefit, any and all residents will be invited in to look at your wife's vagina. It was weird, especially the deference seasoned nurses paid to snot-nosed med students on the doctor track.

Home birth? No way no way no way. A friend of ours nearly died during a home birth. Our eldest son himself nearly died a few days after birth. That's taking things way to far.
posted by KokuRyu at 1:25 PM on September 22, 2011 [3 favorites]

the headlong descent into self-absorption and the cosy, hormonally-driven specialness of their very own little "miracle".

Fortunately you're so special you don't even need the child to enable your relentless self-absorbtion.
posted by rodgerd at 1:25 PM on September 22, 2011 [6 favorites]

extrement = excrement, of course.
posted by peep at 1:26 PM on September 22, 2011

As someone who is skeptical of the suitability of home birth in some situations, can I say that Skeptical OB is not helping the discussion any? She's horrible.

I'd rather be trapped in conversation with the most earnest crunchy-granola earth-mother nature-spirits-will-guide-my-sacred-womb-birth home birth advocate than read anything by her again.
posted by feckless at 1:27 PM on September 22, 2011 [22 favorites]

The Skeptical OB is the like the Richard Dawkins of women's birth issues, but even more dismissive of her foes, rude, and sanctimonious. Despite being skeptical of birth woo, I tangled with her awhile back about hospital food and giving birth in non-supine positions. She absolutely insisted that there was no evidence that giving birth in a non-supine position would have any benefit and said I must have not really read the scientific papers I was quoting, assuming I was just some woo person who was trolling abstracts. If you want some interesting, humanistic, and reasonable stuff about women and birth, I suggest the books of Dr. Wenda Trevathan, particularly Ancient Bodies, Modern Lives and Dr. Kate Clancy's blog.
posted by melissam at 1:27 PM on September 22, 2011 [16 favorites]

Put Louis C.K. and the room and I'd watch.
posted by 2bucksplus at 1:28 PM on September 22, 2011 [5 favorites]

...in the room...
posted by 2bucksplus at 1:28 PM on September 22, 2011

A simple question for waterbirth advocates: Would you completely immerse your head (eyes open, of course) in the fecally contaminated bloody water of a birth pool in the aftermath of a birth?

Non-sequitur. My wife was only comfortable in the tub. Everyone is different. If you don't care for one method over the other, be it water birth, home birth, hospital birth, taxi birth, field of wildflowers birth, nightclub birth, then please just shut the fuck up about it and choose what you're comfortable with when you need to get a 7 pound living thing out of you without either of you dying. If you can find any joy or spirituality in it along the way, that's a goddamned bonus.
posted by jimmythefish at 1:29 PM on September 22, 2011 [37 favorites]

priorities seem ass backwards to me is the thing

If we're gonna get upset about everyone whose priorities seem backwards... well, we're gonna be busy, is all I can say.

Yeah, me. Not live anyway. I was too busy holding my wife's hand and talking her through the emergency c-section surgery.

Yes, well, me too, but that was just an opportunity to observe my wife's level of abdominal marbling first-hand. The second time I was right next to the gore canister, where all the blood and stuff from the suction went. My son still asks me sometimes to tell him about the time he was born, and the gore canister.

Every birth is beautiful, or something, is my point I guess.
posted by rusty at 1:30 PM on September 22, 2011 [4 favorites]

KokuRyu, that's the infuriating thing about Skeptical OB. She refuses to acknowledge legitimate issues with hospitals or that there might be a middle way. If I have the opportunity, I'd like to give birth in a country that offers hospitals that provide a more humane experience (separate birthing units, well-made food, hospitable surroundings, try to help you give birth vaginally if possible, allow you to walk around while in labor, etc) , but have modern medical innovations.
posted by melissam at 1:30 PM on September 22, 2011 [5 favorites]

Didn't Doonesbury do a strip about this in the late 80s?
posted by Omon Ra at 1:30 PM on September 22, 2011 [1 favorite]

Two words: Birth. Fetishism.

I guarantee a significant portion of the audience will be guys whacking their wing-wangs as she pushes her kid out.
posted by SansPoint at 1:31 PM on September 22, 2011 [1 favorite]

Rule 34 of the internet.

Just sayin'
posted by stormpooper at 1:32 PM on September 22, 2011 [1 favorite]

Watching your own child being born is a wonderful, life-affirming experience. Watching someone else's child being born on the Internet isn't.
posted by tommasz at 1:33 PM on September 22, 2011 [11 favorites]

Whatever else I'd say about those videos, that's the worst set of music I've ever heard in one place.
posted by A Terrible Llama at 1:35 PM on September 22, 2011 [1 favorite]

Oh man, that gore canister. And the little tree where they hang the bloody rags? (presumably to do the "we haven't left any inside" count) What the hell is that thing called, anyway? I want one in my den.
posted by feckless at 1:35 PM on September 22, 2011 [1 favorite]

Let me just turn on the speakers full blast at work and click he--OH GOD I'M FIRED
posted by spamguy at 1:36 PM on September 22, 2011 [5 favorites]

Non-sequitur. My wife was only comfortable in the tub. Everyone is different. If you don't care for one method over the other, be it water birth, home birth, hospital birth, taxi birth, field of wildflowers birth, nightclub birth, then please just shut the fuck up about it and choose what you're comfortable with when you need to get a 7 pound living thing out of you without either of you dying. If you can find any joy or spirituality in it along the way, that's a goddamned bonus.

Actually, this is the one thing my wife said - there was just more choice at the midwife's clinic. Want a waterbirth? Go for it. Standing up? No prob. On all fours? Sure thing. The only annoying part from our perspective was the midwife's habit of taking tons and tons and tons of snapshots during the delivery, and then printing them out so we could "pass them on to our parents."

Come to think of it, our eldest got very very sick about 3 days after birth - viral and bacterial meningitis, it turned out - so he spent a month in the pediatric ward of Obama City hospital. The staff were very kind (typical of the people living in Obama), and I have nothing but good memories (once the scare was over) of that hospital.
posted by KokuRyu at 1:36 PM on September 22, 2011 [1 favorite]

During the last trimester of my wife's pregnancy, we watched a bunch of videos, including National Geographic's In The Womb. I'm not sure if it was the In The Womb: Multiples video or not that showed a variety of childbirth techniques in graphic detail or not, but man, it was not for the timid.

They showed a woman giving birth by cesaerian. Another giving birth to triplets at home with no drub intervention. And another who'd had an epidural. For my job, I watch a lot of surgical procedures, and didn't think it was too bad. My wife was curled up next to me on the couch and didn't say much until the natural birth of the triplets came on. On the screen, the mom started screaming in pain, there was a lot of blood and it just looked excruciating. I glanced at my wife and she was sitting, chalk-white, with a terrified look on her face, huge, bulging eyes and her knuckles jammed into her mouth.

"Would you like me to shut it off?"
*vigorous nodding head*
"Okay."
*click*
"It's okay. Would you like to talk?"
*shakes head no*
"Okay, well, it's okay. You'll be fi-"
"SHE'S INSANE! SHE'S OUT. OF. HER. FUCKING! MIND! NO DRUGS?! YOU MAKE DAMN SURE I GET THOSE FUCKING DRUGS! I WANT THE DRUGS. WHEN THEY WHEEL ME IN TO THE HOSPITAL, DO NOT LET THEM TELL YOU I CAN'T HAVE DRUGS!"
"Uh... Okaaay"
"We are not watching any more of these videos. She's out of her damned mind!"

And of course, it was the fear talking. Once you reach the point of no return in a pregnancy, there's going to be an inevitable conclusion. Childbirth can be a really, really scary prospect.

I have deep, deep respect for anyone who chooses to go through a natural childbirth. Huge respect. But am also convinced certain videos of them could be used to scare people out of ever having children.
posted by zarq at 1:38 PM on September 22, 2011 [16 favorites]

I WOULDN'T EVEN ALLOW MY MOM IN LAW T WATCH...CAN I CUT THE UMBILIAL CORD?
posted by Postroad at 1:40 PM on September 22, 2011

Actually, this is the one thing my wife said - there was just more choice at the midwife's clinic. Want a waterbirth? Go for it. Standing up? No prob. On all fours? Sure thing. The only annoying part from our perspective was the midwife's habit of taking tons and tons and tons of snapshots during the delivery, and then printing them out so we could "pass them on to our parents."

We did the midwife thing in the hospital - it was a compromise that we came up with. I wanted to be in the hospital, but we were in a private room with the midwife. It gave my wife an opportunity to try different things. Unfortunately the kid was coming out in a facial presentation (less than 1% of kids present that way) and we couldn't get her turned around. So, C-section.

I really liked the midwife/hospital combo it but I can see the appeal of a home birth too. Being at home right away would be awesome.
posted by jimmythefish at 1:41 PM on September 22, 2011 [3 favorites]

42 inch tv? Check.

Surround sound with subwoofer? Check.

Ok, I'm ready.
posted by Brandon Blatcher at 1:43 PM on September 22, 2011 [8 favorites]

I was going to go the epidural route, but I learned about hypnobirthing via the web and my very knowledgeable doula. My husband I took the classes and both of us learned way more about the birthing process than the doctor's office class or any medical text book(or health class or that video they show you in 5th grade!). I made it through 17 hours of labor with no drugs in the hospital, but my son's heart rate was going up and down, so I ended up with an emergency c-section. I certainly wouldn't have wanted to post that for all to see(or me to view later), but this anti-natural birth lady is ridiculous!
posted by cherryflute at 1:46 PM on September 22, 2011 [3 favorites]

Yeah, I had a midwife but gave birth in a hospital and it was great. Walking around, no monitors, ate food, all that good stuff. But had the OR right down the hallway in case something went wrong, as well as plenty of nurses around and the midwife was more than happy to do epidural etc if I wanted that. (nothing went wrong, quick birth with no drugs.)
posted by gaspode at 1:48 PM on September 22, 2011 [4 favorites]

My wife had a last minute C-section, after my son refused to come out the standard way, so I missed out on the whole "miracle of birth / Play-doh Fun Factory" thing. I almost didn't look over the sheet until I realized I would probably never again get the chance to look into my wife's open belly. It was... honestly I don't really remember. It was dark in there.

Recently, I was telling my son about his birth.

Me: "Yeah, instead of coming out mommy's vagina, they cut her belly open and took you out."

Him: "Gross! That's so gross!"

Me: "Just wait until we tell you how you got there in the first place."
posted by bondcliff at 1:51 PM on September 22, 2011 [19 favorites]

Ok, I'm ready.

You forgot the garden mister full of warm water, set on "spurt".
posted by fatbird at 1:52 PM on September 22, 2011 [1 favorite]

Watching your own child being born is a wonderful, life-affirming experience.

I thought it was merely okay. I'm glad that I did it, but it was more about meeting my daughter than hearing my wife's mournful wails and gazing upon her distended vagina on a poop-smeared table.

This modern Cult of Maternity is bullshit. Human birth is no more special than any other thing that happens millions of times a day, or any other mammal birth for that matter. The truth of the matter is that overfocus on birth, breastfeeding and childrearing is merely a convenient proxy that narcissists can use to further their craft.

Have a baby in a special tub while Peruvian pan flutes play, breastfeed it with your milk that is purer and more nourishing than anything seen before and buy it Veblen goods and feed it Veblen foods. No one can stop you. But shut up about it. Acting like you've given a gift to a world of want by adding another consumer is revolting. If you feel the need to preach your choices, it's not about parenting; it's about telling the rest of us how awesome you are. We get the message, and the only people buying it are the ones with similar inclinations (and they don't think that you're half the parent that they are.)
posted by Mayor Curley at 1:52 PM on September 22, 2011 [49 favorites]

The truth of the matter is that overfocus on birth...

In hindsight, baby-care classes would have been a hell of a lot more useful than birthing classes. The birth happens once, hopefully with professionals present. The child care afterward happens from then on, with (at first) everyone involved having no clue.
posted by rusty at 1:56 PM on September 22, 2011 [5 favorites]

Recently, I was telling my son about his birth.

Me: "Yeah, instead of coming out mommy's vagina, they cut her belly open and took you out."

Bondcliff, we had a very similar conversation, except my son's response was to say, "ALL RIGHT, WE'RE DONE HERE." Then he turned and walked out of the room.
posted by peep at 1:58 PM on September 22, 2011 [18 favorites]

Watching your own child being born is a wonderful, life-affirming experience.

Um, I never get this. I mean, maybe afterwards, like a day or two later when all the smoke and rubble has cleared and it's you and the healthy ALIVE mom and child recovering, but for me while it was taking place, all I could think was now I knew why men went to war.

And it was so they could say they'd done something tougher than giving birth.
posted by Skygazer at 2:01 PM on September 22, 2011 [9 favorites]

Every frickin' birth is different. There is no way to experience one (or even 5) and say you have a comprehensive knowledge of birthing. Over the course of the months when people knew my wife was pregnant, she had heard enough to come to the conclusion that a hospital could provide enough peace of mind with back-up options. All natural? OK! Heavily sedated? Can do! C-section? The operating room is down the hall.

We were in a hospital with nurses checking in on my wife, and a midwife who helped her (us?) through the serious, insane, pushing part. My wife was medicated when the contractions got worse, because she was in agony. Breathing helped for a while, and maybe she could have learned some other tricks to get her body to ignore the pain it would be going through to get a 7 pound person out of her womb, but I don't wish anyone to endure any birthing experience with any more stress and pain than they already need to go through to get their baby/babies out safely.

In the end, our son was fine, and it was kind of stunning to see his squishy head slip out into this world, and how easily the midwife twisted his body around to untangle the umbilical cord from around his neck, but I felt no more pain than a squeezed hand. My wife was worn, but glowing, after the birth. To be honest, I was surprised about her emotional transformation, but everyone is different. I felt light-headed - I was holding a living thing in my arms, it was so floppy and helpless. The process of his appearance only made it seem more unreal. Miraculous? I'm not sure. But there are no pictures or videos of the process, just some blurry images of a little plum baby (seriously, the little guy was purple all over, adding to the surreal experience) on a sweaty mom's breast, looking beaten but joyous.
posted by filthy light thief at 2:05 PM on September 22, 2011 [6 favorites]

Are there any Dutch people here? They seem to have home-births as the standard, and are still surviving.

Home birth seems like a good idea if you and your child are healthy. We all have to remember that giving birth is natural, and not a medical condition. A lot of the pain women experience comes from lying in ridiculous positions and from (reasonable) fear.

My kids are 18 and 13, and after all these years of deep thought, I have come to the conclusion that fathers aren't absolutely necessary during child-birth. To be honest, I didn't care much, and in retrospect, the experiental trauma was not a good thing.
I acknowledge that some - millions of - men are mature enough to see their wives being cut up or screaming or pooping or whatever. But other millions aren't.
posted by mumimor at 2:05 PM on September 22, 2011 [4 favorites]

My daughter was born in a hospital (11 years ago today! Happy Birthday honeybunny!) but without any interventions. We had a doula and the nurse in charge was gung-ho for unmedicated birth (She also had an intern shadowing her and she as happy to show this intern what unmedicated births were like.) They let me hang out in the tub (which was gross and in a closet) and push in various positions for hours without suggesting a C-section.

One thing that helped me was not thinking that my birth was super special but that nearly half a million other women would be doing the same thing! That was actually pretty empowering. (and that's about as woo-woo I'll get about birth.)
posted by vespabelle at 2:06 PM on September 22, 2011 [5 favorites]

What I'm trying to say is: the birth process is very personal. Hearing and seeing the process experienced by others can help you see what you could expect, which might be nice if you want to know that kind of stuff. But after the experience, it's something you probably want to share. It's new and amazing to you, so people will talk. Everyone else, get over it. If you don't feel excited about this event, tell the story teller so (in kind words, please) and talk about something else. It's a video on the internet? Great, watch if you like, move on if you don't. It's like the parents who are big fans of their kid's sports, dance or music performances, or anyone and the item of the intent interest. If you don't care for it, move on. I don't think there Cult of Maternity is any more ominous or annoying than the Cult of Little League, or the Cult of Major League Sports, Religious Beliefs, Car Care, or Musical Tastes.

Your favorite birthing story sucks.
posted by filthy light thief at 2:13 PM on September 22, 2011 [3 favorites]

Reading this is all giving me a flashback to the year I was fifteen, and somehow ended up in the kitchen after a family Thanksgiving, where my mother and aunts were all cleaning up. Somehow, my mother and two of my aunts ended up trading their Birth War Stories -- about my brother's labor being induced by a bee stinging my mother's belly, my cousin being born breech and coming so close to death that the doctors were openly weeping, yaddda yadda....

And at some point, my lone unmarried aunt looked over into the corner where fifteen-year-old-me was sitting and listening. And I must have looked very uneasy, because she came over, put an arm around me, and said, "So the moral, EC, is that you should do what I did -- get a dog and have puppies instead!"

She was teasing. But every time I hear stuff like this I'm reminded of this and inclined to consider it THE BEST ADVICE I'VE EVER GOTTEN.
posted by EmpressCallipygos at 2:15 PM on September 22, 2011 [26 favorites]

TRUMAN, YOU'RE ON TELEVISION!
posted by roomthreeseventeen at 2:20 PM on September 22, 2011

rusty: If she announced she was going to masturbate online like a hundred thousand others already have, would some angry blogger feel compelled to weigh in?

I'm pretty sure I wouldn't have to google very hard to find thousands of anti-porn bloggers. That any particular person avoids being a specific target of the anti-porn crusaders speaks more to the sheer number of artists than it does to a lack of angry bloggers.
posted by Mitheral at 2:22 PM on September 22, 2011 [1 favorite]

I love, love, love the Skeptical OB, even though I understand that her tone can sometimes be a bit much. I'd compare her to another fave of mine, Orac, in that both seem to be so exasperated by quacks that their tone occasionally crosses the line. Both are particularly incensed by mothering.com, and have directly commented on posts there, as well - Ora on anti-vaxers and Skeptical Ob on dangerous homebirth advocacy.

I really encourage those of you who are citing successful homebirth or midwifery examples from outside the US to read through the rest of the Skeptical Ob blog, in particular her dissection of the difference in the US between (highly qualified) CNMs and (totally unqualified) direct-entry midwives. Her recent posts on the idea of "normal birth' and how that is exploited in the marketing of direct-entry midwifery are priceless.

Mumimor, you might be particularly interested in this post about the Netherlands, which has a far superior homebirth 'system' to the US.

Skeptical Ob is not at all against midwives, btw - both Dr. Amy Tuteur and the most active posters are clear that they are opposed to direct-entry midwifery and midwife-led care in unsafe settings, rather than CNMs operating in birth centers or very near hospitals.
posted by Wylla at 2:26 PM on September 22, 2011 [11 favorites]

Oh my god. I am currently pregnant with my first and terrified out of my flipping mind. Should I watch birth videos? Should I not? I think I might watch this, even though I tend to side with Skeptical OB. I just can't not watch it.
posted by arcticwoman at 2:34 PM on September 22, 2011

Then there are the garden variety narcissists like Gina Crosley-Corcoran, the Feminist Breeder, who apparently misses the attention and fan devotion of her years in an all girl band

Wait, so it's the Skeptical OB vs. the Feminist Breeder?

Come to think of it, our eldest got very very sick about 3 days after birth - viral and bacterial meningitis, it turned out - so he spent a month in the pediatric ward of Obama City hospital. The staff were very kind (typical of the people living in Obama), and I have nothing but good memories (once the scare was over) of that hospital.

See, Obamacare works!
posted by delmoi at 2:34 PM on September 22, 2011 [2 favorites]

42 inch tv? Check.

Surround sound with subwoofer? Check.

Ok, I'm ready.

I'll bring the popcorn and beer.
posted by spinifex23 at 2:35 PM on September 22, 2011 [1 favorite]

arcticwoman, don't watch birth videos. Also, don't be terrified.
posted by doyouknowwhoIam? at 2:37 PM on September 22, 2011 [1 favorite]

arcticwoman: "Oh my god. I am currently pregnant with my first and terrified out of my flipping mind. Should I watch birth videos? Should I not? I think I might watch this, even though I tend to side with Skeptical OB. I just can't not watch it."

Congratulations!!

I suggest skipping anything that says, "National Geographic" on the cover. Or all the videos in general. And you're going to do great! :)
posted by zarq at 2:38 PM on September 22, 2011

Should I watch birth videos? Should I not?

Well, I know it's kind of rhetorical but....No! Anecdotes aren't data!

Nobody's birth is exactly like anyone else's. When you're pregnant, people tend to want to share their birth experiences with you. Frankly, that's burden enough. I mean, I wouldn't go Googling 'c-section' YouTube videos either.
posted by A Terrible Llama at 2:53 PM on September 22, 2011

Wow, the skeptical OB post sounds like trollbait or something.

I read about 4 words into the title and quit. If he or she has a serious argument to make, that's not the way to do it.

I really encourage those of you who are citing successful homebirth or midwifery examples from outside the US to read through the rest of the Skeptical Ob blog

How about some straight-up stats about homebirthing vs. hospital birthing?

As has been shown many times before, and is supported by countries like the UK, it is just as safe for a woman with a normal pregnancy to birth with a qualified midwife at home as it is to birth in a hospital.

What I'm saying is that I hope Nancy knows that this might not turn out to be a Beautiful, Spiritual Thing.

She's a natural birth coach. I think she knows by now. (And as long as mom and baby end up healthy, I'd call it a "Beautiful, Spiritual Thing" no matter what it looks like.)

I absolutely love natural birth videos--definitely my favorite part of childbirth class. There was one where the mom delivered twins on the toilet by herself (the second one foot first presentation), all the while yelling at the dad to keep filming (while holding their other child), and in the background you can hear the tub still filling up and the (late) doula showing up. Awesome!

Of course, it's possible to have a natural, unmedicated birth in a hospital, too. You know, just in case some intervention is actually needed.

Of course you can, but as a partner of someone who did exactly that twice, it seemed harder in the hospital. There is a lot of pressure to "keep things going" with Pitocin, hook up an IV lock, etc. It really depends on where the mom will feel much comfortable. If she's worried about complications, she won't feel comfortable at all. If she's worried unnecessary interventions, possibly vice versa.

Plus (something this performance runs contrary to), childbirth (much like pooping) is facilitated by privacy. As Ina May Gaskin says:

Excretory, cervical, and vaginal sphincters function best in an atmosphere of intimacy and privacy.

... I expect this woman to know enough not to let X eyeballs affect her, but who knows?

Home Birth—Why It's Necessary

In hindsight, baby-care classes would have been a hell of a lot more useful than birthing classes.

Did you have natural birth? I can't imagine even trying without a class. The whole medical industry is working against you. Baby care is best learned in real-life practice. You can't really do that with childbirth. You only get one shot.

I don't wish anyone to endure any birthing experience with any more stress and pain than they already need to go through to get their baby/babies out safely.

One of the big themes of our childbirth class was that pain and stress are not directly related. Pain is natural, and if you accept and manage that pain without stressing or getting scared, you have a huge advantage.

I have come to the conclusion that fathers aren't absolutely necessary during child-birth.

Depends if you're going natural and if you have another partner. Doing a natural birth without a partner seems insane. I took over managing my wife's breathing several times in her second birth.

And while we're pimping our personal experience, the best book for fathers and partners I found BY FAR is The Birth Partner by Penny Simkin. Unless you are already a pro, it is absolutely indispensable.

One thing that helped me was not thinking that my birth was super special but that nearly half a million other women would be doing the same thing!

That was pretty much my wife's mantra. Women did this shit in the fields, yo.

If you don't care for one method over the other, be it water birth, home birth, hospital birth, taxi birth, field of wildflowers birth, nightclub birth, then please just shut the fuck up about it and choose what you're comfortable with when you need to get a 7 pound living thing out of you without either of you dying. If you can find any joy or spirituality in it along the way, that's a goddamned bonus.

I think you win.

Your favorite birthing story sucks.

I actually love birth stories. Keep 'em coming!
posted by mrgrimm at 2:57 PM on September 22, 2011 [14 favorites]

My first child was born in a hospital, with an epidural. It was great. The epidural was the best part of the experience, but I had a lot of choice and freedom in my labor and delivery. It was FAST, 4.5 hours from stem to stern, and I got a beautiful baby girl.

The aftercare? was horrible. I'd just had a baby, but nobody would let me sleep or rest for more than ninety minutes without coming in to take my blood, or my temperature, or my blood pressure, or my daughter's blood, or my daughter's blood temperature, or my husband's temperature, or god only knows what else. She screamed when we put her in the bassinet, but the nurses wouldn't let me sleep while holding her in the bed. My husband tried to hold her while he dozed, but the tiny cot in the recovery room was on wheels so he couldn't even keep it shoved up against the wall. And they made me feel like such unmitigated shit for breastfeeding on demand that it gave me a complex about feeding her that lasted for more than a year.

Enough, I decided. My second kid would be born in a free-standing birth center. I just couldn't take another 24-hour recovery period of being shouted at while they refused to let me sleep, after doing the hardest work of my life. We hired midwives -- yes, the dreaded Direct-Entry midwives listed above. I will say, this quote:

(totally unqualified) direct-entry midwives

is not really accurate. The problem is that there is no standard for non-nurse midwifery, and so you range from the Oregon situation (anyone can hang out a shingle and call themselves a midwife) to the situation in my state, Washington, which has some of the highest requirements for midwives in the country. In Washington, direct-entry midwives are highly trained professionals with a well-regulated and well-regarded scope of practice. They carry drugs like pitocin to stop post-partum hemorrhage, they can start IVs to run antibiotics if the mother is group-B strep positive. They do suturing, they do newborn resuscitation, and they have a lot of ongoing continuing education.

My midwives were in a practice along with a CNM, who oversaw their cases as necessary. And they had both had multiple years' experience practicing in the Phillipines, where they got a lot of experience in all kinds of birth, normal and not. Those two things gave me a lot of confidence that they would be able to recognize a developing situation rapidly and respond appropriately.

We ended up converting to home birth because the freestanding birth center I'd chosen was full when my labor was amping up, and the next closest birth center was 45 minutes away and NOT right near a super-fancy hospital, as my home is. It turned out to be a good decision; the entirety of my active labor was 78 minutes, with 8 minutes of pushing. A home birth with midwives is better than a side-of-the-road birth with paramedics.

I didn't understand what all the fuss was about direct-entry midwives until I learned how uneven the licensing and certification processes are. I'm glad to live in a state where direct-entry midwives are fully licensed and regulated, carry malpractice insurance, and can carry needed medications without being subject to prosecution for practicing medicine without a license. There was a well-designed peer-reviewed study of planned home birth in British Columbia that showed that for the low-risk cohort, neonatal outcomes were equal between the three populations (home birth with midwife, hospital birth with midwife, and hospital birth with physician), but that maternal complications were much lower in the home birth cohort. The home birth cohort included births that were transferred or transported to the hospital.

My hospital birth was wonderful; my home birth was wonderful. The least good part about the home birth was not having an epidural. I'm done having kids, but were I to have another one, I'd do it at home again, given that I wasn't too risky.
posted by KathrynT at 2:58 PM on September 22, 2011 [18 favorites]

arcticwoman: "Oh my god. I am currently pregnant with my first and terrified out of my flipping mind. Should I watch birth videos? Should I not? I think I might watch this, even though I tend to side with Skeptical OB. I just can't not watch it."

Yeah, don't be scared. It's nature at it's absolute finest moment and it's biggest show. The one where all the stops are pulled and it's like the stellar performace. A thousand biological, chemical, and physiological l systems kick in smoothly and flawlessly and leave you wonderous at what an absolutely amazing thing the human body truly truly is.

Not only that, but for the medical field, it is also one of it's finest moments, with amazing training and incredible techniques and medicines to help every single aspect of it. Including the pain aspect via this brilliant thing called an Epidural, which you should keep as an option or decide from the getgo as a definite avenue.

So, really do not worry, just prepare and focus on the preparation and everything else takes care of itself, more or less.
posted by Skygazer at 3:00 PM on September 22, 2011 [2 favorites]

Congratulations, arcticwoman. You will be OK, and you should not watch any type of propaganda videos. Just remember, women have been giving birth for millions of years. It can be done.

Wylla, I was indeed interested by that post. Interested enough to get out of bed and back to my computer. It turns out that the infant mortality rate in the Netherlands is indeed a tiny fraction higher than in most other European countries, but it is still a lot lower than in the US and Canada. I know there is not an direct correlation between the two sets of data here, but I also noted that the data in the study Skeptical OB linked to only compares between European countries, not to the Americas. On preview: I think mrgrimm is right to think the medical industry has too much to say in the US.

Personally, I had both children in a hospital, and I am not a home-birth advocate, if home-birth is as described in the post. But I also feel maybe the fronts are drawn up too sharply. It makes sense to me that women are able to do this at home or at least naturally, because that has been the norm across the globe until recently, and it still is for most women.
posted by mumimor at 3:03 PM on September 22, 2011

I am reminded of a home birthing video I saw maybe 20 years ago on public access cable TV. After several graphic birth videos, the narrator shows poorly shot amateur video of her own home birth. She proclaimed that "children even as young as 2 or 3 years old enjoy seeing their siblings being born, and it's not scary at all!" And then the camera cuts to her 3 year old son, who has his back against the wall, and a look on his face of absolute terror.
posted by charlie don't surf at 3:06 PM on September 22, 2011 [4 favorites]

I think Victorian fathers had the right idea. You'd wait out the birthing process over a couple of brandies at your club in St James, and hear news of its successful conclusion via a discrete note from one of the waiters. First encounter with the child would come only after nanny had wiped the goop off and had it properly sedated.
posted by Paul Slade at 3:10 PM on September 22, 2011 [3 favorites]

mumimor: It turns out that the infant mortality rate in the Netherlands is indeed a tiny fraction higher than in most other European countries, but it is still a lot lower than in the US and Canada.

The Skeptical OB addresses this:

1. The US does very poorly on infant mortality.

Infant mortality is the WRONG statistic. It is a measure of pediatric care. That's because infant mortality is deaths from birth to one year of age. It includes accidents, sudden infant death syndrome, and childhood diseases.

The correct statistic for measuring obstetric care (according to the World Health Organization) is perinatal mortality. Perinatal mortality is death from 28 weeks of pregnancy to 28 days of life. Therefore it includes late stillbirths and deaths during labor.

The US has one of the lowest rates of perinatal mortality in the world.

2. The Netherlands, which places the greatest reliance on midwives, has low mortality rates.

No, the Netherlands has, and has had for some years, the HIGHEST perinatal mortality rate in Western Europe. It also has a high and rising rate of maternal mortality. The Dutch government is deeply concerned about these high mortality rates and a variety of studies are underway to investigate.

The most recent study published in the BMJ is early November 2010 revealed and astounding finding. The perinatal mortality rate for low risk women cared for by midwives is higher than the perinatal mortality rate for high risk women care for by obstetricians!
posted by purpleclover at 3:15 PM on September 22, 2011 [7 favorites]

KathrynT, Skeptical Ob discusses that Canadian study - possible methodology issues and how it is/isn't applicable to the situation in the US - here.
posted by Wylla at 3:18 PM on September 22, 2011

I will also note that the Skeptical OB has never, ever, EVER to my knowledge discussed or even acknowledged the existence of the CMAJ study I linked to above. I appreciate her dedication to science, but science isn't about cherry-picking data.
posted by KathrynT at 3:20 PM on September 22, 2011 [3 favorites]

Shoulda previewed. Lemme go read that.
posted by KathrynT at 3:20 PM on September 22, 2011

For people who are turned off by the Skeptical OB's "tone," how can you read something like this and not feel outraged? My tone is getting shriller by the minute.

One of the big themes of our childbirth class was that pain and stress are not directly related. Pain is natural, and if you accept and manage that pain without stressing or getting scared, you have a huge advantage.

This is so nonsensical I can barely parse it. What do you think pain is? What do you think stress is?
posted by purpleclover at 3:26 PM on September 22, 2011 [6 favorites]

arcticwoman, don't watch birth videos. Also, don't be terrified.

It's easy to say "don't be terrified" but when our popular culture re-enforces (over and over again) how unbearably awful and painful childbirth is, it's pretty hard to remove that (fallacy, imo) from our subconscious.

One of the biggest problems my wife had was dealing with her fear. It is a real thing, but ... (it's really up to you and your comfort level of course) I would recommend watching as many *good* birth videos as you can find. You can have your partner screen them first to eliminate anything you might find traumatic.

Among the "good" birth videos, there is a very wide range of experiences. Knowledge is almost always a good thing, imo. It was comforting for my wife to see all the different ways that women managed their labor.

you should not watch any type of propaganda videos

Propaganda which way: pro natural birth or pro drugs?

By the way, here's a pretty thorough analysis of recent research on epidural anesthesia.

Including the pain aspect via this brilliant thing called an Epidural, which you should keep as an option or decide from the getgo as a definite avenue.

Epidural anesthesia is a good thing for pain, but (some) research says that it will increase your chance of cesarean section, i.e the "cascade of intervention"

In a review of 15 available studies, 12 suggested a significant association between epidural and c-section. Risk of c-section generally found to be 2-3 times more likely with epidural.
An influence on this is what point in labor the epidural was administered. One study found that cesarean rates were 11% if epidural was given at 5 or more cm dilation, 16% at 4 cm, and 28% at 3 cm. Another study was even more striking, finding that cesarean rates increased to 26% when epidural was given at 4 cm, dilation, 33% at 3 cm, and 50% when the epidural was given at 2 cm dilation.

posted by mrgrimm at 3:28 PM on September 22, 2011 [2 favorites]

OK, well, I have to say, I'm not particularly impressed with her rebuttal. The 3x mortality increase she ascribes to "American" homebirth midwives is based on a lone study done in Colorado, and the results of that have never been replicated anywhere. The statement that "American homebirth midwives are grossly undereducated and undertrained" is not accurate, because there is no "American" standard for homebirth midwifery. Some American DEMs are undereducated and undertrained; others are not.

Check out the curriculum overview for the Seattle Midwifery School; there's a single 1-credit course about complementary treatment, a far cry from saying that "most of the courses are in gem energy and flower essences."

I am sympathetic to Amy's concerns about uneven training and licensing requirements, but she doesn't exactly do her cause any good when she selectively chooses which data to support and which to ignore. Her entire rebuttal of the Canadian study appears to be "It doesn't matter because it doesn't."

Purpleclover: I did a course in hypnosis for labor management, which I found very helpful during my unmedicated labor. The idea is that the more scared and the more freaked out you are, the tenser you will be, and the more it will hurt. That seems utterly reasonable to me, and was really borne out by my experiences during labor.
posted by KathrynT at 3:34 PM on September 22, 2011 [4 favorites]

mrgrimm, I really encourage you to read deeper into the Skeptical Ob, 10 Centimeters, etc - a lot of the ideas you are citing (and their originators, like Ina May Gaskin and Penny Simkin) are discussed there from a different perspective you might find interesting/useful.
posted by Wylla at 3:42 PM on September 22, 2011

Tuteur is notorious on the various blogs addressing issues like home birth, legal rights, the rights of pregnant women, or anything that has to to do with birth.

Full disclosure: I write for one of those blogs, so I won't self-link, but Tuteur shows up there, a lot. The blog owner (not me) has gone out of her way to use US-based stats, have fact-based arguments and present a case for women's autonomy, and every single time Tuteur pulls the dead baby card, to whit: question your OB in any way, for any reason, and babies die.

To explain why this is inaccurate would require what I can't do here, which is go through the whole history of obstetrics and the ways it has often treated women abusively or nonsensically (if you are curious, then read up on the lithotomy position, routine episiotomies, and the statistical ineffectiveness of electronic monitoring vs hands-on nursing care). Nor will I go over the ethical and political reasons to respect women's autonomy in labor and birth, because other places have done that and you all know how to Google.

Within this diverse group of adovcates, here is definitely a spectrum from woo to scientific, conservative religious to feminist. It is not monolithic, and only a minority are in any way opposed to good science and good healthcare. There are many who are at this moment seeking standardization of midwifery licenses, usually against very strong opposition by the American Congress of Gynecologists and Obstetricians, who, probably rightly, see midwives as a financial threat.

There is a very strong strain of paternalistic thought that Tuteur embodies, and she has made herself the de facto spokesperson for that position. But she has also repeatedly shown herself to argue in bad faith, ignore research or facts she does not like, deliberately mis-state other people's statements, and if all else fails, accuse her opponents of wanting to kill babies for spirtual enlightenment.

There is a reason she was asked to leave the Science -Based Medicine blog, definitely not a crunchy-granola place. While she claims to speak for the cause of skepticism, over and over she has proven herself to speak for the cause of professional obstetrics and its right and/or duty to control the medical decisions of pregnant and laboring women by denying them agency and dismissing their legitimate concerns about the quality of the care available to them.
posted by emjaybee at 3:43 PM on September 22, 2011 [19 favorites]

Skeptical OB is grossly overstating her claims, because most western countries have perinatal mortality rates equal to or lower than the US - and quite a few non-western countries have too. It doesn't count if you are better than Libya at this. Also, a difference of 1-2 percentage points is barely statistically significant.
The thing is, we need to get out of the trenches. Maybe they are overdoing it in the Netherlands, I don't know. But there are countries less hell-bent on the full hospital treatment than the US that are doing very well.
This is also about health-care costs -it's like 'death panels' at the opposite end of life. Something that is both more humane and cheaper somehow gets called out as freaky and irresponsible.
posted by mumimor at 3:47 PM on September 22, 2011 [1 favorite]

There are locations where hospital birth is taken seriously and full of empathy. My daughter was born in a hospital where I had a private room, and there was a nurse who took care of only two women in labor. There was a bath (which I hated) and lots of other things to facilitate a natural birth (I ended up going with some pain management through medication, which didn't help a whole lot-- no epidural).

I agree that Dr. Amy can be a bit crazy but her distinction between accredited nurse-midwives and those untrained or minimally trained is crucial, in my view.
posted by miss tea at 3:49 PM on September 22, 2011 [2 favorites]

What do you think pain is? What do you think stress is?

Well, semantics are semantics, but what should we use as authority: Wikipedia?

"Pain is an unpleasant sensation often associated with damage to the body."

"Stress refers to the consequence of the failure of an organism to respond adequately to mental, emotional, or physical demands, whether actual or imagined."

Or Merriam-Webster?

"Pain: 2a : usu. localized physical suffering associated with bodily disorder (as a disease or an injury); also : a basic bodily sensation induced by a noxious stimulus, received by naked nerve endings, characterized by physical discomfort (as pricking, throbbing, or aching), and typically leading to evasive action"

"Stress: 1c: a physical, chemical, or emotional factor that causes bodily or mental tension and may be a factor in disease causation"

I honestly cannot see your point. You are the nonsensical one! ;)

I recently was hit by a car and shattered my acetabulum. Trust me, I know what pain and stress are. When I was in pain and stressed in the hospital (e.g. whenever I thought of my 4 m.o. daughter, or where we would live after the accident, etc.), my heart would start racing, my entire body would shake, and my hands would contort, and I couldn't move my fingers.

When I was in pain and not stressed, I just felt pain. And took pharmaceutical pain relief, of course.

Pain can certainly cause stress and stress can cause pain, but they are not the same thing, by (almost) anyone's definitions.

mrgrimm, I really encourage you to read deeper into the Skeptical Ob, 10 Centimeters, etc - a lot of the ideas you are citing (and their originators, like Ina May Gaskin and Penny Simkin) are discussed there from a different perspective you might find interesting/useful.

I read the Penny Simkin article and found it incredibly biased. I've read Birth Partner 3 times front to back, and nowhere does she advocate "ignoring" pain. A huge chunk of the book is devoted to managing pain. Nowhere does this person provide direct evidence that Simkin advocates "ignoring pain" (or please show me where she does.)

Again, I'm sure there could be some good information in what these skeptics have to say, but I'm inclined to side with KathrynT. It seems like they are trying to win an argument rather than present the unvarnished truth. It also seems like they are completely misreading (or intentionally misrepresenting) the opinions of natural child birth supporters. justmy2c.

Something that is both more humane and cheaper somehow gets called out as freaky and irresponsible.

And everyone (intelligent) is pro-choice when it comes to abortion, but when it comes to delivering your child how you see fit, oh no no no!
posted by mrgrimm at 3:51 PM on September 22, 2011 [1 favorite]

I do not like the crappy information about epidurals presented by mrgrimm being taken as fact. Here's a review by a physician that suggests that the "cascade of interventions" does not necessarily follow en epidural.

Of note, from that blog post: Another confounder is that patients with problematic labors are more likely to ask for pain relief, so some of the complications previously attributed to epidurals might well have been due to other factors.

KathrynT, I'm glad you had a good birthing experience, and I know a lot of people who have enjoyed their Hypnobirthing experiences. In fact, my father is a mental heath professional who thinks that hypnosis in general is underused to ease both mental and physical pain and problems. It sounds like you were really responsible and sensible in your choices, and I applaud you.

NB: I'm, like, 9 months pregnant, and I'm fed up at all the well-meaning people who assume that to have a "good" birth I'm going to reject painkillers and medical advancements. Painful and dangerous does not sound like a good birth to me! These are people who would never, as Harriet Hall writes in her Science-Based Medicine blog, suggest that I have a root canal without pain management, but somehow to prove my womanly bona fides, I need to suffer a lot and (as I see it) put my baby at risk.

I am troubled that only women are encouraged to eschew painkillers and call upon our "inner strength" when relatively low risk painkilling options are available. I hate the idea that prudent care for me and my baby—which will be performed by my female OB and female L&D nurses—is somehow my bowing down to the patriarchy. I have done my homework on this! I have decided that this is what I want! I am a woman! Stop telling me that I'm being cowed by the Big Manly Medical Establishment.
posted by purpleclover at 3:53 PM on September 22, 2011 [11 favorites]

Stop telling me that I'm being cowed by the Big Manly Medical Establishment.

Who said that? I'm just trying to present science-based medical information.
posted by mrgrimm at 3:59 PM on September 22, 2011

You know the puppies are sounding better by the minute.
posted by Flitcraft at 4:05 PM on September 22, 2011 [7 favorites]

I had two good birthing experiences! I am absolutely satisfied with my choices both ways; like I said, I loved my hospital birth, and I loved my epidural. I have nothing against epidurals at all; I only went drug-free in my second birth because I didn't want to do it at the hospital, and that's where they keep all the drugs. I had no investment in being some sort of superwoman, in triumphing over pain, in having an orgasmic pain-free birth (which, for the record? It wasn't. It really, really wasn't.) I am right there with you on the idea that we have to Suffer to be Female, because that is bullshit.

Also bullshit is the people who are all about choices, choices, choices! Until you choose differently than they did! At which point you're some sort of Gender Traitor! I counted my epidural to be worth every penny I'd spent on it, even if I'd had to earn the money selling limericks at the bus station for a nickel a line. I've seen many, many nurses and midwives say that a solid epidural can help minimize perineal trauma by allowing women to "labor down" their babies, letting the baby make a slow, gradual descent through the vagina until it's time to be born. I will say, the endorphin rush at the end of my unmedicated birth was a whole hell of a lot better than the itching and catheterization at the end of my medicated one, but all other things being equal? I'm not sure I'd make the trade.

I love hospitals, I love C-sections, because they save lots and lots of lives. I just also think that midwifery and out-of-hospital birth is within the spectrum of responsible and appropriate reproductive care.
posted by KathrynT at 4:07 PM on September 22, 2011 [6 favorites]

If one more of my Whole Foods friends tells me that I have to have a home birth, I am going to punch all the soy on the planet. I am so sick of these-- "man, hey, dude. Listen, Patton, I know that you're probably going to go to a hospital, but you got to think it through, man. You gotta do it at home naturally. That's the only way. That's the way the pioneers and the settlers did it, man."

Yeah, the pioneers and the settlers. That's who I'm going to emulate. I'm sure they-- you know what--the pioneer women having their babies out in a little cabin that they built out of bison poop and then whatever wood was left over from when the stagecoach; you know what they were dreaming about when they were having their babies out there? Hospitals. They dreamed about hospitals. Weird, fantastical future buildings full of clean white sheets and doctors with needles full of magic liquid that made the pain not happen ever. Home birth. Jesus, god in heaven.

And by the way, having a home BIRTH IS BULLSHIT. It's not the way the settlers did it, because the settlers, they didn't have a clock radio next to the bed. They didn't have a flat-screen TV on the wall. To have a home birth, you should go all the way. Build a little hut in the backyard. Dig a little birthing trench. Have the baby during a hailstorm, and, hey, when it's all done, a wolverine can sneak in and steal the afterbirth, and then, by the way, if you're going to do a home birth, make sure to have, like, nine kids, because five of them are going to die from the rickets, just like the pioneer kids. Two of them are going to get stole by the Apaches. Oh, no. Opal's learning Tomahawk throwing skills. She's going to kill me when she passes the test of the laughing fire. I'M FUCKED. Yeah, that's life on the prairie.
posted by Brocktoon at 4:09 PM on September 22, 2011 [15 favorites]

Purpleclover, I wish you the best of luck. Happily, you are free to do as you want, and soon you will have a lovely baby.

I don't think anyone in this thread is trying to push any sort of child-birth on you, or judge you. There is not a right way. For my first baby, I agreed to participate in an experiment (long story), and there were 7 doctors, 3 nurses and a midwife in the room, and I had all the painkillers I wanted. It was magical, and my baby was beautiful. (But it hurt like hell for 4 hours).
Second time round it was all natural with two midwives, no doctors and no sedation. That was also an all-good experience, and the pain was about ten minutes.
As I see it, you need to be intelligent to be scared. I couldn't really imagine what it would be like, so I wasn't scared, and then it was over. At the end of the day, the important thing is the baby. You have the baby for the rest of your life. This is just about one day.
posted by mumimor at 4:10 PM on September 22, 2011 [1 favorite]

My wife just had our first kid, the whole thing was wonderful, and everyone is super stoked and healthy.
I'm not going to tell you what flavor the birth was, but I can sure tell you that the crazies on both sides of the spectrum are just that, crazy.
posted by Stonestock Relentless at 4:12 PM on September 22, 2011 [2 favorites]

I want to hear about the experiment, mumimor!
posted by ThePinkSuperhero at 4:15 PM on September 22, 2011

Metafilter: I am going to punch all the soy on the planet.



Whole Foods brings that out in me too. And I love Soy Milk!
posted by Skygazer at 4:17 PM on September 22, 2011 [3 favorites]

I can't think of better birth control.
posted by Ideefixe at 4:21 PM on September 22, 2011

I came out blue and had to be incubated. I would never in a million years attempt to give birth at home. Maybe it's less natural, but it isn't altogether natural that I'm alive, either.
posted by Adventurer at 4:22 PM on September 22, 2011 [2 favorites]

And everyone (intelligent) is pro-choice when it comes to abortion, but when it comes to delivering your child how you see fit, oh no no no!

Not going to address your other points because I am really crabby right now but I will say that no one is trying to legislate anyone's right to birth wherever the hell they please, whereas about a million people are trying to ban abortion and in many areas they have succeeded in reducing access such that there is a de facto ban.

I really, really hate when people compare people criticizing their birthing choices with anti-choice activism.
posted by the young rope-rider at 4:28 PM on September 22, 2011 [5 favorites]

Did you have natural birth? I can't imagine even trying without a class. The whole medical industry is working against you.

Yes, yes, yes ... and a million times yes. Education and preparation is essential - if for no other reason to be able to make good medical choices!

I attended the births of three of my grandchildren (on natural in the hospital and two home births -- the last one a water birth) and I watched both my daughters go through the whole preparation process. They chose the Bradley method -- HUSBAND coached childbirth. (This method, btw, required 12 weeks of intense training and education and at no time states that it must only be a home birth. It educated the parents on all possible medical concerns, procedures, anatomy, alternative choices, etc.).

The most significant thing for me -- watching these miraculous birth processes -- was the participation of the fathers, my son-in-laws -- they were not just 'observers'. They were attentive and comforting, but also active in managing anything or anyone that might distract the mother during the birth. She was free to do what she had to do.

Both of my son-in-laws really impressed me ... and to this day I see that the home birth (father-assisted) experience affected these marriages in ways that probably could not have been imagined. Both fathers are far more involved in parenting than most I've known. Both marriages have deep trust and clear communication.

So, yes, home birth has my respect, and, no, I would not want to see a stranger's home birth (televised or not).

Giving birth is such a painful thing to go through with anyone. I remember almost laughing at how I, the midwife, the doula and the father were wet with sweat, exhausted, still shaking and almost limp ... as the baby was placed in my daughter's arms. My daughter then sat up brightly with a grin and those magical hormones kicked in. Two minutes before she looked like she was going to die (I was still left with that picture) ... now she was laughing and cooing.

Ain't mother nature a kick!



My daughter once transcribed my story of my experiences giving birth for a class she was taking ... my story goes back to 'the dark ages'. She cried. I don't share that anymore.
posted by Surfurrus at 4:29 PM on September 22, 2011 [3 favorites]

I am troubled that only women are encouraged to eschew painkillers
posted by purpleclover

I agree. When men give birth, they too should be encouraged to eschew painkillers.
posted by George Clooney at 4:29 PM on September 22, 2011 [2 favorites]

Thepinksuperhero: Oh, I was just really young and stupid. She was in a breech position, and the hospital hadn't tried a natural delivery for a breech position for 24 years, so they wanted to try it out and asked me if I would agree to a planned and monitored experiment. I said yes because I was too dumb to imagine the consequences. So I had a fastdial for the ambulance, and they invited guests to come and see. And naturally there was a surgeon and and a anesthetist and a pediatrician there just in case. They had found an old midwife who had tried it back in the day to manage the whole process, and the doctors just stepped back and tried to learn (and drug me down whenever I asked for it). As far as I know, they tried a couple of times more, and then decided to give up and go back to ceasarians.
It was painful, but actually I didn't realize just how bad it was until the next one came out the normal way, and it was no big deal.
One amazing thing about the first one was, because she came out the wrong way, she looked so strangely perfect - her face was untouched. The midwife was very proud of her, and came to visit on her day off.
posted by mumimor at 4:30 PM on September 22, 2011 [1 favorite]

I just want to say that I watched LOTS of videos, and I loved it, all of them, even the cesarians, but I simply could not reas Skeptical OB while I was pregnant.

It's really cool to watch someone pull a person out of another person.
posted by bq at 4:55 PM on September 22, 2011 [1 favorite]

I think there are two types of pregnant people; some of us seem to obsessively seek out information about everything that could possibly go wrong (me!) and some of us prefer to focus on the positive.

How many mefites are 9 months pregnant around here? It seems like ALL OF US. Was metafilter really that boring last holiday season?
posted by the young rope-rider at 4:57 PM on September 22, 2011 [2 favorites]

Big blizzard! :)
posted by ThePinkSuperhero at 4:58 PM on September 22, 2011 [3 favorites]

Given that it is the pre-eminent sex act, it has surprised me that no real birth pornography has developed to this point.
posted by jamjam at 5:00 PM on September 22, 2011

Thanks for the congrats everyone! People who've followed me over the years know what a struggle it's been.

Anyway, the problem with educating oneself is (as other posters have suggested) that it all seems like propaganda. Every book, every film, unless you swim in the scientiffic literature it is extremely hard to separate the sound advice from the unsound. I mean, I'm comfortable drinking some wine now and then, but what resources do I have to determine how dangerous brie cheese really is, or if the demands that I stop eating it are pseudoscience or alarmism? I'm comfortable with a hospital birth, but I don't know about pain relief options and I have a hard time finding information that seems neutral about pain relief options. I'm overstating my difficulty a bit, because I am reasonably scientifically literate and skeptical, but I'm not overstating by much.

I'm still undecided on watching birth videos. I think having my partner vet them is a really good idea.
posted by arcticwoman at 5:14 PM on September 22, 2011

My friend runs a cult film night, and one year it fell on my birthday. They were showing Werewolves on Wheels, so that was fun. Before the show she showed the usual run of educational films, including one that showed a live birth. It was meant to be campy, but it was so gross I almost threw up.

My parents tried to educate me about this before my younger brother was born. Again, it was very gross and I mostly avoided it.
posted by Lovecraft In Brooklyn at 5:38 PM on September 22, 2011

I had planned for an unmedicated birth, and my Obs were completely supportive. Then my labor dragged on and on, and at about 30 hours, and I was just too worn out. So I got the epidural so I could sleep, and 6 hours later, I had a gorgeous little girl. And it didn't matter at all that I didn't tough it out.

If you're obsessing over the birth itself instead of the baby, you're doing it wrong.
posted by snickerdoodle at 6:12 PM on September 22, 2011 [2 favorites]

There are many who are at this moment seeking standardization of midwifery licenses, usually against very strong opposition by the American Congress of Gynecologists and Obstetricians, who, probably rightly, see midwives as a financial threat.

Do OBs really see CPMs as a financial threat? Homebirths are only about 1% of all births.
posted by the young rope-rider at 6:48 PM on September 22, 2011

Skeptical OB is grossly overstating her claims, because most western countries have perinatal mortality rates equal to or lower than the US - and quite a few non-western countries have too. It doesn't count if you are better than Libya at this. Also, a difference of 1-2 percentage points is barely statistically significant.

According to your own link, there were 4.1 million births in the United States in 2000. A difference of 1-2 percentage points, at that scale, is 40,000-80,000 dead babies. It is the difference of more than the entire number of home births that take place in this country each year.
posted by kafziel at 7:06 PM on September 22, 2011

Homebirths are only about 1% of all births.

I thought I heard it was closer to 3-4%, but either way, I think it's more conspiracy theory than anything else to suggest obstetricians oppose licensing midwives because they are in any way threatened by them.
posted by ThePinkSuperhero at 7:09 PM on September 22, 2011 [1 favorite]

Oh, that's random - check out the article that I'm indexing for PubMed at the moment:

Posttraumatic stress following childbirth in homelike- and hospital settings. (Stramrood et al, 2001. J Psychosom Obst Gyn 32:88-97).

Netherlands study (impt to note!). Found that after controlling for complications (i.e. stuff like emergency c-sections are inherently more stressful) there was no difference in posttraumatic stress symptoms between home and hospital birth. (wow, they say PTSD -DSM-diagnosed- prevalence in women who have given birth is 1%. Seems high but what do I know).

Compelled to mention it for the coincidence.
posted by gaspode at 7:50 PM on September 22, 2011

-I just also think that midwifery and out-of-hospital birth is within the spectrum of responsible and appropriate reproductive care.-

I really don't disagree with the sentiment, but I also imagine there's graph out there that will show that the rate of perinatal deaths and complications tracks an arc in which there is more danger the further one is from modern hospital operating suites and ICU beds. Everything is fine and dandy. Until it is not. Have the kid at home by all means, but also be aware that it involves risk that can't be conclusively predetermined. Everything else is about tofu and self righteousness.
posted by peacay at 8:29 PM on September 22, 2011 [3 favorites]

there's graph out there that will show that the rate of perinatal deaths and complications tracks an arc in which there is more danger the further one is from modern hospital operating suites and ICU beds.

That's true. It's also true of hospital birth, though. My house is six minutes from a fancy hospital with a level III+ NICU, but there are rural hospitals that only have one anesthetist on call at any given time. If that guy is working the gas on a MVA, how long is it going to take to get another person up for your crash section? For people who live 2+ hours from a hospital, is it really always better to have to drive that distance by yourself than to have a midwife who might be only 10 minutes away come to you?

Homebirth absolutely does involve risk that can't be conclusively predetermined. But so does a c-section, particularly as it affects future pregnancies. The number of providers who will do VBAC at all is steadily dwindling despite evidence that it's safe, and multiple C-sections adds up to a lot of maternal and fetal risk pretty quickly. Given that well-trained, well-educated midwifery care in a non-hospital setting shows comparable fetal outcomes in a low risk cohort but with 1/3 the risk of a C-section, I don't think the decision to birth outside of the hospital is always, as you say, "about tofu and self-righteousness."
posted by KathrynT at 9:14 PM on September 22, 2011 [5 favorites]

I think all the second-guessing of women's birth choices is silly -- but then, that is what people do about everything.

I gave birth to my second child completely unattended, all by myself. It was unexpected. Suboptimal. But the baby was fine and I was fine -- and my husband and my mother eventually recovered.
posted by pH Indicating Socks at 9:18 PM on September 22, 2011 [5 favorites]

KathrynT, I was using the pullquote from your comment as a jump-off point rather than trying to engage you specificially. I'm sorry if I gave a different impression. I should also clarify further: I believe that choosing a homebirth is choosing unnecessary risk in a discrete sense and not by comparison to some (probably regionally slanted and certainly arguable in some senses) hospital practices or statistics or outcomes that might give pause for thought.

But, generally speaking, choosing homebirth is choosing unnecessary risk, save as to those in rural settings. I love and have worked with many midwives but if the shit hits the fan, they can only do so much. It's risk, full stop. The tofu and self righteousness was meant simply to imply that any argument for homebirthing is pushing a barrow up hill against logic outside of the acceptance of risk.

I think the move these days is to have birthing centres as parts of hospitals which, to my mind, is the best of all possible worlds. It's much more casual and less controlled by medical orders and the somesuch but, of course, benefits by being within the cooee of all the emergency and specialist practitioners one could need if things go awry.
posted by peacay at 10:31 PM on September 22, 2011 [1 favorite]

If I ever get pregnant, I'm giving birth on the front lawn.
posted by spinifex23 at 10:44 PM on September 22, 2011 [2 favorites]

The day I gave up all my views on childbirth: My friend's daughter, a teenager, was giving birth. She was so naive that she had asked if going swimming while she was pregnant would drown the baby. She refused to educate herself in any way on the process. She did the equivalent of covering her ears and going "LALALALALA" when we'd try to tell her anything.

She ended up with pre-eclampsia (the doctor didn't bother to tell her this, just said "your blood pressure is high and there is protein in your urine, we should get the baby out soon.")

He admitted her to the hospital for the night, put in the sticks to dilate her, at 7am gave her an epidural and started her on pitocin, and 7 hours later she had the baby pretty much pain-free with 7 or 8 pushes, from what I understand.

The two friends I'd coached through birth, I'd made sure they were educated on every possible option and outcome. They had good but somewhat painful, hard-work births, at 14 and 10 hours of labor, one with 2:45 of pushing, the other with 5 minutes. Some of my friends who were super prepared had labors lasting over 36 hours.

The girl who refused to educate herself? Had a relatively painless, easy birth.

It was at that point when I said fuck it all, do whatever the hell you want, just have a healthy baby.
posted by IndigoRain at 11:43 PM on September 22, 2011 [5 favorites]

It was at that point when I said fuck it all, do whatever the hell you want, just have a healthy baby.

That's exactly the attitude that the Skeptical Ob and other alternative-medicine skeptics promote...except that they're against the promotion of "options" (like DEM-supervised home births for high-risk women, or totally unattended 'freebirth') that make a healthy baby much less likely, and furious at people who try to make it sound like if you just 'trust birth' and do the unproven and dangerous things they recommend, a healthy baby is somehow what you get as a prize for your faith.
posted by Wylla at 12:35 AM on September 23, 2011 [1 favorite]

I am too old to have any more babies. Had two, they are grown and one has two children. I had an emergency C-section with the first and I had a not exactly planned fir VBAC on the second. I had back labor with her. I am not at all against home birth, but I might be dead if I had done that, and perhaps at least one kid would be.
Both births were at high altitude as well. That is a risk factor.
I personally am glad my doctors and nurses knew what they were doing and I am also glad that there is such improvement these days in the maternity care available in my part of the country. Nothing like a high-drama birthing or two to make you appreciate that. My daughter had two high -drama birthings and decided that it just doesn't go with living way out in the country.
My mom had four of us, one at home. She was a just say no to drugs person. The drugs they had then were not wonderful. She had pre-eclamsia with me. She had killer morning sickness with all of us.
My grandmother had such a tough time having my mother that she refused to ever have more children. She was widowed soon after my mother was born. So arranging to not have more children was doable.
I am not a fan of fathers in the delivery room. Let them bring the mother something like a whole roast chicken or a big fat steak. After even a short labor I was hungry! After a C-section, wait until she can actually eat. I guess I am old-fashioned. I won't be wartching this live-stream. Even cats mostly know to keep private things private.
posted by Katjusa Roquette at 1:10 AM on September 23, 2011 [1 favorite]

Wow, the Skeptical OB.

Are we sure this isn't viral marketing for some new TV pilot, a la "House"?

She's Dr. Amy; she's an Ob. Gyn., and she's Very, Very Angry.

and ew, I prefer my doctors to just not ever use the word "crotch." Talking about some pregnant woman's "crotch"... er, no. Also could do without an Ob Gyn throwing around the word "whore" – call me sensitive, but yuck.
posted by taz at 1:10 AM on September 23, 2011 [8 favorites]

If adults want to engage in the woo of chiropractic "medicine", then that's their choice, but this Dr. Nancy is a pediatric chiropractor who advocates X-raying and adjusting the spines of infants regularly. That plus her seeking out a PR firm willing to promote her live birth coverage just makes me "meh" on this whole thing. Is this about educating women or inking a deal for a future reality TV series? (I remember back in the early 1980s, before camcorders, a proud co-worker brought in a huge handful of Polaroids of his wife giving birth. Everyone in our department was treated to full-on crotch shots of her with legs splayed both before, during and after the birth. Funny, when similar photos are in magazines like Hustler they're called "pornography." But when the baby's head is moments away from crowning it's somehow no longer a naked woman's crotchal region but a mystical portal of life..
posted by Oriole Adams at 2:25 AM on September 23, 2011 [2 favorites]

Truth #1: The image you have in your head about what natural childbirth looks like has come from main stream media like sitcoms and movies. These images you have been exposed to involved women screaming and hating their husbands, women hooked up to machines being told what interventions are going to be done to them.

Actually I have this image in my head from the birth of my son. The marks on my arm from the (now ex-) wife's nails are faded, but not the memory of the cursing and the pain.
posted by Splunge at 5:48 AM on September 23, 2011

They chose the Bradley method -- HUSBAND coached childbirth.

I can't endorse Bradley enough. It really provides a great foundation for the whole process. There's the complaint that some of it can come off too 'hippy-dippy', ( I suspect that's a function of your teacher, though ), but the trick is to not discount everything else because you can't let go during breathing exercises...

One thing we discovered, in a hospital, the nursing staff has their own flow. Going against it can cause a lot of grief -- UNLESS your OB tells them to do what you want. ( e.g.: Strapping you to a monitor and not letting you out of bed. )

So the take-away is -- Make sure you and your OB are on the same page. Keep your birth-plan in perspective. Listing "I want a pony" on it can help.

Oh, and hospital births++. It's nice to know there's a dedicated OR suite down the hall IF YOU NEED IT, and it's REALLY REALLY COOL to have someone else mop up the floor after you're done.
posted by mikelieman at 8:02 AM on September 23, 2011

I think the move these days is to have birthing centres as parts of hospitals which, to my mind, is the best of all possible worlds.

My horrible aftercare experience took place in a hospital-attached birth center. It's a great hospital! I have 2 other friends who gave birth there; one went all-natural with both births (although given that her labors were 90 minutes and 42 minutes respectively it's not hard to see why), and the other had a very high-risk induction that resulted in the vaginal delivery of a healthy baby. But the way I, personally, was treated in the recovery room gave me rising panic whenever I think about it, even now. "Rising Panic" is not a good emotional environment in which to have a baby.

My experience with hospital-based birth centers is that they are hospitals more than they are birth centers. PARTICULARLY the recovery section. If I hadn't been so exhausted (I went into labor at 1 AM and gave birth at 5 AM), I'd have signed out AMA, it was so horrible. And it was so preventable! All that I wanted was a way to safely sleep while holding my baby, and for more than an hour and a half to go by without having someone stroll into the room without knocking and flipping on the lights. So no, hospital-based birth centers are NOT the best of all possible worlds.

PS: it's REALLY REALLY COOL to have someone else mop up the floor after you're done.

My midwives cleaned up after my homebirth. I don't even remember them doing it, except for one of them asking where the peroxide was.
posted by KathrynT at 8:12 AM on September 23, 2011

ew, I prefer my doctors to just not ever use the word "crotch."

I'm OK with "crotch." (I actually kind of like the word, but not as much as "crotchety.")

I'm not as OK with "whore."

Given that it is the pre-eminent sex act, it has surprised me that no real birth pornography has developed to this point.

...

Two words: Birth. Fetishism.

I guarantee a significant portion of the audience will be guys whacking their wing-wangs as she pushes her kid out.

Not to go into too much detail, but I found my sex drive to be remarkably different before and after the birth of my youngest child. Sex was pretty nonexistent during the 3rd trimester, and I didn't even think about it too much. But a few days after the birth, my testosterone kicked in or something and my libido blasted off. I guess it was time to make another baby. :D (No, thank you.)

It's seems logical to me that there would be some evolutionary deficit to being attracted to women at or near childbirth, i.e. the zero chance of procreation. I mean, the folks that find ways to avoid having kids don't pass down their genes ...

Plus, really, have you ever seen a vagina after a child has come through it? It's not for the squeamish.

From my (very limited) searching it seems like pregnancy fetishes are pretty rare, and childbirth fetishes extremely rare. The few personal childbirth-fetish sites I found were mostly from women (similar to Orgasmic Birth), though here is one guy (possibly nfsw).

Even with a pregnancy fetish, it has to be the first or second trimester, right? Is anyone really attracted to women late in pregnancy, all bloated and huge? I suppose there's always someone ... I'm pretty easy, so I was OK having sex with my wife 10 days past her due date (for the prostaglandins, of course), but the situation was very far from being a natural turn on.

So, my bet is that very few people will be whacking it to Ms. Salgueiro's delivery, and that the few who are masturbating will be women.
posted by mrgrimm at 8:43 AM on September 23, 2011

Is anyone really attracted to...

Yes, and there are more websites, newsgroups and forums devoted to it than you can possible imagine. And by "it" I mean every bodily function and permutation imaginable. Every.
posted by griphus at 8:54 AM on September 23, 2011

The two above stories, Mikelieman and Kathryn T, are both examples of how hospitals can overrun the autonomy of the parents. That is tragic. It is completely unreasonable to expect a woman in labor to be in any shape to argue with determined medical people.

I think the 'turning point' for me was watching my first grandchild's birth in the "birthing center". My son-in-law confronted a medical person who insisted that the baby needed a 'monitor' inserted before birth (a wire attached to the descending head?) I knew nothing of this procedure and I probably would have acceded to the seemingly reasonable speech being given. But my daughter and son-in-law had a birth plan and this was not on it. He was instantly on the phone getting advice from someone he trusted (the Bradley teacher? Another medical person?). He turned to his wife, explained the choices and then held the medical people to her wishes. There was no wire inserted - the baby was fine.

One of the thing about hospitals is that there is no margin for 'chance' -- a long labor, a procedure overlooked, a hesitant decision could just end up in a lawsuit. The rights, comfort and long term concerns of the patients are not always the only concern. (During a later birth my daughter told me that her two day labor at home would never have been allowed in a hospital - they would have induced the birth with drugs). Having said that, I have seen more and more medical people moving toward more enlightened care - probably because of the demands of more enlightened parents.

Most importantly, medical people do have to honor the patient's demands (birth plan) - especially if it is written down and signed. Articulating, repeating and defending those demands should never be the burden of a woman in labor.

'Men in the delivery room' (at the birth) should be far more than spectators (i.e., man = chosen partner/advocate/protector).
posted by Surfurrus at 9:00 AM on September 23, 2011 [1 favorite]

Even with a pregnancy fetish, it has to be the first or second trimester, right? Is anyone really attracted to women late in pregnancy, all bloated and huge?

....Yes. And I speak from personal experience.

(It is important for me to clarify what that "Personal experience" is: my best friend came to visit in the mid-90's, and her boyfriend asked her to bring back, as a souvenir, "the most twisted video you can find from one of those 42nd Street porn shops". We found something that was about pregnant women who were also morbidly obese at the same time. So -- yeah.)
posted by EmpressCallipygos at 9:02 AM on September 23, 2011

arcticwoman: Anyway, the problem with educating oneself is (as other posters have suggested) that it all seems like propaganda. Every book, every film, unless you swim in the scientiffic literature it is extremely hard to separate the sound advice from the unsound. I mean, I'm comfortable drinking some wine now and then, but what resources do I have to determine how dangerous brie cheese really is, or if the demands that I stop eating it are pseudoscience or alarmism? I'm comfortable with a hospital birth, but I don't know about pain relief options and I have a hard time finding information that seems neutral about pain relief options. I'm overstating my difficulty a bit, because I am reasonably scientifically literate and skeptical, but I'm not overstating by much.

Either childbirth has changed a lot since I had my Monsters (who are 19 and 15 now), or my doc was just the most sensible dude to walk the Earth. The only thing I was restricted on when I was pregnant with either of them was caffeine, because I have high blood pressure as it is. Soft, stinky French cheese? Eat it! Sushi? Eat it! A beer with pizza or half a glass of wine with steak? Go ahead. He called everything people were telling me about not eating this or that "nonsense", and told me that I hadn't suddenly become a delicate and fragile flower, so I could go ahead and keep having my life, just have it in moderation. Take your damned vitamins and limit your beer and wine to 2 or 3 a week, he told me, and for the love of Pete, drink your water.

Hospital births, both. 4.5 hours of labor with Elder Monster, 4 with Younger Monster 4 years later. No drugs, no complications. Went home the very next day.

I would personally not watch the video. No need to get yourself all fretful. I hope your labor and delivery is swift and uncomplicated and you feel like Superwoman when it's all over - no matter what birthing choices you make!
posted by MissySedai at 9:23 AM on September 23, 2011

The tofu and self righteousness was meant simply to imply that any argument for homebirthing is pushing a barrow up hill against logic outside of the acceptance of risk.

What does tofu have to do with anything? Or are you trying to (further) "otherize" moms who home birth?

Most importantly, medical people do have to honor the patient's demands (birth plan) - especially if it is written down and signed. Articulating, repeating and defending those demands should never be the burden of a woman in labor.

I'm curious about this, because of a (to me) small issue that came up during my wife's labor. We specifically said that we didn't want a heplock/IV attached, but then (right in the middle of active labor), the nurses said that the doctor "ordered it" in case my wife needed blood after delivery, when it is apparently harder to put in an IV ...? not sure if I totally believe that, but I went along.

I didn't think it was a big deal, so I didn't fight against it, but my wife was really annoyed by getting stuck with a needle (repeatedly) while massive contractions were coming one after the other or 20 seconds apart at most.

Luckily, the nurses failed to find a good vein, transition was progressing, so we were able to beg off and get in the tub ... which then kicked off the pushing and then it was all over but the crying.

So, if I was a hardass and said "No, absolutely no heplock/IV," what happens? We've been lucky enough in both deliveries to have good nurses who honored our choices (one nurse woke us up at 5am to "take Pitocin or walk" which was kinda shitty ... but walking certainly progressed things). What happens when you have nurses/doctors who are opposed to aspects of your birth plan and refuse to negotiate ... go somewhere else?

I mean, you absolutely cannot say "i don't want any monitors" and deliver in a hospital, at least not where I live. You can ask for wireless monitors (if they have them), but *every* person I know who delivered in a hospital here had to be monitored.

So which birth-plan demands do hospitals have to honor (e.g. low lighting, our own music/sounds, etc.), and which demands do they not have to honor (e.g. no monitors, birth underwater, etc.)? Or is it a hospital-by-hospital thing?
posted by mrgrimm at 9:24 AM on September 23, 2011

I think Victorian fathers had the right idea.

I know what you mean. I was brought up to believe you could choose between walking back and forth for hours chain-smoking or going to a nearby bar to get paralytically drunk with total strangers, but apparently not. Nobody respects tradition any more.
posted by Grangousier at 9:26 AM on September 23, 2011

Is anyone really attracted to...

When I was very, very pregnant with my second baby, frustrated by the fact that we had managed to arrest some late pre-term labor but now that I was TERM nothing was happening, and doubly frustrated by the fact that my husband refused to help me out in the best possible way (sex) because I was already so dilated and effaced that the midwife could touch the baby's head, I wrote a fake Craigslist ad. Yes it was wrong, I plead temporary insanity.

I posted to the Casual Encounters section of a city I live far away from, posing as a woman ten days past her due date who was looking for someone to have barrier-free sex with her to induce labor, because the baby's father wasn't in the picture. I was very blunt; I forget exactly what I said, but it included phrases like "I didn't look like Heidi Klum before I got pregnant, and I sure as hell don't look like a pregnant Heidi Klum now" and "This is not about you, this is about me. If my water breaks before you're finished, I will leave. There will not be any romantic overtures. This will not be like a porn movie. I will not kiss you or exclaim over any part of your anatomy."

I had 27 replies in 10 minutes. About a third of them were people saying "Aw honey that sucks, I know it's rough, hang in there! Best wishes for a healthy baby!" The other two-thirds, though, were READY TO GO.
posted by KathrynT at 9:30 AM on September 23, 2011 [5 favorites]

We found something that was about pregnant women who were also morbidly obese at the same time. So -- yeah.)

I don't really want to take the tangent any further, but there really is a difference between obese pregnant women and women 40-41 weeks pregnant and/or in the act of delivery.

I have plenty of experience with pornography. I've seen plenty of pregnancy porn around. I have never seen childbirth porn in any of the fetish/gonzo sections of stores or online catalogs. I'm sure that there is a market--my guess is that it is very, very small. That's all I'm saying, and I'll seacrest out.

I was brought up to believe you could choose between walking back and forth for hours chain-smoking or going to a nearby bar to get paralytically drunk with total strangers, but apparently not. Nobody respects tradition any more.

Men still do this, and they're not even that rich. They hire doulas. It's not the easiest task in the world, even just once.

When I was very, very pregnant with my second baby, frustrated by the fact that we had managed to arrest some late pre-term labor but now that I was TERM nothing was happening, and doubly frustrated by the fact that my husband refused to help me out in the best possible way (sex) because I was already so dilated and effaced that the midwife could touch the baby's head, I wrote a fake Craigslist ad. Yes it was wrong, I plead temporary insanity.

Lol. For what it's worth, sex (several times) did nothing to induce pregnancy. I tried my best, but I don't think my wife enjoyed it very much. At all.

Also, I think orgasms alone (sans prostaglandins) can help kick off labor too, so masturbation might be a better option than stranger on craigslist. ;)
posted by mrgrimm at 9:36 AM on September 23, 2011

I don't really want to take the tangent any further, but there really is a difference between obese pregnant women and women 40-41 weeks pregnant and/or in the act of delivery.

No, I know. But the video in question wasn't equating the two, it was combining the two. As in, "she's already 400 pounds, but now she's ten months pregnant ON TOP of THAT! Homina homina!"
posted by EmpressCallipygos at 9:39 AM on September 23, 2011

Given that it is the pre-eminent sex act, it has surprised me that no real birth pornography has developed to this point.
posted by jamjam at 8:00 PM on September 22 [+] [!]

Oh I'm certain it's out there, but I imagine a big part is that pornography that suddenly becomes child porn/exploitation halfway through is hard to market openly.
posted by Uther Bentrazor at 9:57 AM on September 23, 2011

It disturbs me greatly how pregnant women appear to be often considered women with questionable agency who need paternalistic care. I feel strongly that this is on the same spectrum of individuals who'd deny women abortions-- they don't know any better, it's for their own good, we're just protecting babies, etc. I find this to be paternalism at its height.

This bothers me on both sides, and I say this as a student nurse-midwife. Whether you consider the woman who chooses an epidural to be a misinformed dupe of the medical establishment, or a woman who chooses a homebirth to be tantamount to a child abuser putting their baby in harm's way, I want to respect women and support their choices and help them make an educated choice. Sometimes this means choices that I really don't agree with, that I think are highly misinformed or just plain ridiculous, but I don't want to abandon a patient or drop them from my care because I think what they're doing is ... less than awesome.
There was a commentary in one of the Obstetrics & Gynecology journals from a doctor pointing out (in the context of home birth) that we have a commitment to be with our patients and not abandon them.
I did some work in substance abuse, I think I understand bad choices and the frustration involved. Sometimes it really sucks to try and help people, them's the breaks of choosing to be in a helping profession.

Don't get me wrong. I definitely understand the anxiety of healthcare providers, the OB field has some serious malpractice insurance.

I want to be mindful of the power dynamics that I have simply by being a person's healthcare provider, and I wish from observing other providers that they also felt this way. I've seen a lot of bullying, poor presentation of options and facts, some real negativity (again from both extremes). Pregnancy and birth is a highly charged, sometimes overwhelming and scary, potentially transformative experience, and I want to be really mindful of how I'm treating people (emotionally and physically).

Admittedly, I'm up to my eyeballs in UpToDate and PubMed these days to try and make sure I can present what has evidence behind it. It's my job to be on top of the information, and I find it sometimes overwhelming, I imagine as expecting parents it must be 10 times as much.

anyway, now I'm just procrastinating studying and writing too much. check out the National Advocates for Pregnant Women. they focus on marginalized women and a lot of the laws coming out that penalize women for things like being in recovery, attempting to commit suicide, criminalizing pregnant women smoking, etc. also issues such as how Washington State is having their Medicaid not consider threatened miscarriage or miscarriage-in-process (i can't think of words today) not an emergency situation, and will not pay out for it. ugh.

get back to me after i get certified and maybe my opinions will have changed .. we'll see.
posted by circle_b at 10:57 AM on September 23, 2011 [5 favorites]

Thanks, circle_b. I meant to response to this, but forgot:

And everyone (intelligent) is pro-choice when it comes to abortion, but when it comes to delivering your child how you see fit, oh no no no!

Not going to address your other points because I am really crabby right now but I will say that no one is trying to legislate anyone's right to birth wherever the hell they please, whereas about a million people are trying to ban abortion and in many areas they have succeeded in reducing access such that there is a de facto ban.

I really, really hate when people compare people criticizing their birthing choices with anti-choice activism.

It's more than just criticism. There is a general sense of wanting to remove agency from pregnant women and tell them what they can and can't do with their bodies. I think there's a real comparison there with the pro-life camp.
posted by mrgrimm at 11:04 AM on September 23, 2011

mrgrimm, my guess is that the nurses wanted the IV in before the birth because it's probably easier to put an IV in before a hemorrhage happens and you start to really, really need the IV right away to prevent blood loss from becoming dangerous. Depending on your definition, post-partum hemorrhage is relatively common. The fact that they were having trouble putting an IV in even before the birth is a good indicator that they were telling the truth about the potential difficulty of getting an IV later on, when fluid volume was even lower.

(A medical type could probably correct me here, this is just based on the research I have done pre-birth)

A birth plan is fine, but it's not really a substitute for the judgment of medical professionals and I would be peeved if any of my docs/nurses blindly followed my wishes in a situation where my health could be compromised.
posted by the young rope-rider at 11:08 AM on September 23, 2011 [1 favorite]

There is no serious comparison to pro-life activism to be made here.
posted by the young rope-rider at 11:11 AM on September 23, 2011 [2 favorites]

mrgrimm: " It's more than just criticism. There is a general sense of wanting to remove agency from pregnant women and tell them what they can and can't do with their bodies. I think there's a real comparison there with the pro-life camp."

Perhaps in spirit, but not in actuality. The disconnect here is that voiced criticism ≠ imposed legislation. If I rant against people who get drunk, that's not the same thing as me lobbying Congress for a return to Prohibition.
posted by zarq at 11:25 AM on September 23, 2011

I've been very open about my birth experience with Toddler Zizzle here. I selected what was reputed to be a hospital even more awesome than the local birth center. I had met with midwives and OBs and selected an OB with a midwifery approach.

Everything was great. Until I went into labor. I had little support. My OB didn't labor watch as she had said she would do, and she pressured me into a c-section I didn't want and more than likely didn't need if anyone would have bothered to suggest some different positions.

Then the anesthesia failed, and I just didn't care any more there was a baby involved. I challenge anyone here to having abdominal surgery under those circumstances and coming out the other side without a screwed up mind.

Then there was the part where they didn't even show him to me until my doula yelled at the entire OR. And the part where the next day the OB asked how I was doing emotionally that I could only stare at her with my mouth agape.

And then the part where the LCs wouldn't show up until hours after called. And the nursesmy husband had to hound so I could get some pain meds. And then the nurse who kept getting my chart mixed up with the woman across the hall who had a vaginal birth and had circumcised her son.

And I wasn't allowed a shower until Wednesday. I was admitted late late Saturday evening.

When I went home, I was in a complete fog, had hardly slept for for a full week, and had absolutely no idea what to think or do with the experience. Breastfeeding wasn't going well, and each time I called the OB's office for assistance regarding the extraordinary amounts of pain I was in, it was made clear that I kinda wasn't a patient any more. Baby was out, what more could they have to do with me until two weeks and six weeks?

Then at two and six weeks I was given a quick once over and then left to my own faculties and recognizance, both of which were completely falling apart so fast that I didn't even notice. The next ten months yielded complete failing at breastfeeding, post partum depression, post traumatic stress syndrome, and continued abdominal pain that took seeking a second and then a third opinion (third opinion more specialized than the second) to resolve, several months of therapy that didn't really work, a lot of trying to emotionally run away, and that OB? Totally washed her hands of any responsibility for her failures in the post partum period and follow ups.

I had a discussion with the chief of anesthesiology with regarding the failure of, well, the anesthesia and he said someone should have come by while I was still in the hospital to talk with me. Umm, no, that didn't happen. Then he said, and I will never forget this, "Next time we'll be able to try something different so that doesn't happen."

I couldn't even speak. Next time? Next time meaning another kid? Next time meaning another surgery? Next time meaning another surgery to have a kid? I wasn't having any more children. I wasn't going to put myself through that again.

And the things I will never forget the OB saying to me. "Some women can't give birth vaginally." 'You have a 50% chance of a successful VBAC." "Some women can't make enough milk." None of which were particularly helpful or reassuring. Or well thought out to say to someone who had gone through what I had gone through.

And I carried all that with me. I had nightmares where I could feel myself being cut open and my organs removed. I'd wake up believing I was dying and my husband had no idea what was going on except his wife was screaming in her sleep.

And the hospital became an incredibly dangerous place.

Then kapow! Birth control failure. Seriously. Rosalie was a complete and utter shock. I just went through the motions. I got some prenatal vitamins. I spent nearly a month wondering what the hell happened and saying things that necessitated looking at Toddler Zizzle and saying, "Mommy didn't say that." I even had a brief debate with myself about having an abortion, but ultimately decided that wasn't what I wanted.

So I did my research. I found a CPM who had trained at Maternidad La Luz and who did volunteer work in Haiti where she, oddly enough, advocated for increased use of c-sections to save lives there, a CPM who is now at a well-known university for an MPH focusing on women's health and birth specifically. And who has a particular passion for VBACs.

As soon as I met her, I knew I didn't need to interview anyone else. She was practical, straight forward, doesn't believe homebirth is necessarily for everyone, and who responsibly turns away clients who are too high risk. And my regular nurse practitioner, knowing what I had been through and after speaking with my midwife, was more than happy to order the labs and testing that my midwife would have difficulty ordering given the lack of licensure in Mass for her specialty --- an advocacy effort she is also involved in.

My prenatal care with the OB was great. I will never ever dispute that. But my experience with my midwife was out of this world. I felt as though I had traveled to the moon. She was diligent about all the same things my OB was, except when I called, I got to speak with her directly and didn't have to first go through a nurse. When I e-mailed, I got a response quickly. And she had such compassion for my previous situation without promising I wouldn't have a c-section. The only thing she could promise was that I was starting in a better place and if anything required going to the hospital, she'd be an advocate for me there.

Last Saturday, I was a week past my due date. Due to the political climate of VBACs and post-dates, she took it upon herself to contact a CNM at our hospital for transfer. We began to make back up plans in case I didn't go to labor. She had some concerns because Toddler Zizzle was born punctually and this was a somewhat unusual situation. We still had a few days, but we needed to have this conversation. It wasn't one I wanted to have, but it was necessary. So we had it.

Then Sunday I started having braxton-hicks contractions lower down than before. Then that night they were lasting long but not terribly strong. Then they started to get stronger. KathrynT and I were chatting on gmail when my water broke in gushes. My midwives arrived two hours later. Rosalie was born at home on my living room sofa bed about six hours later. She was bigger than Toddler Zizzle. She had her right arm across her chest and against her left shoulder, and her umbilical cord wrapped loosely around her body twice (a variation of normal and not a cause for concern). She was immediately placed on my chest, under a blanket and with a little hat on her head. The midwives did the APGAR assessment and then let me cry and hold her and waited until I was ready to do the full newborn exam and to cut the cord. I think it was maybe an hour before any of that happened and only after I said I was ready for it to.

Then after all that, they hung around for a little bit, talked and laughed with us, made sure I had some food to eat, and started a load of laundry. Rosalie was born around 9 am. They didn't leave until close to 1 in the afternoon.

And then Rosalie and I slept without anyone coming in to disturb us. I wasn't in a fog. I hadn't been through anything traumatizing. And I did what that damn OB said I'd never be able to do. And for sure, I'd never have been able to do it in a hospital.

A lot of people talk about the risks of homebirth. But the hospital held far more risks for me this time after what I had gone through with Toddler Zizzle. I was more than willing to listen to my midwife if she ever said it was time to transfer (see last Saturday's conversation). But that was because I trusted her professionalism, her training, and her ability to assess an emergency before it became an emergency. I wouldn't ever have been able to trust an OB that way.

And birth centers? Birth centers are great. There are two in Massachusetts.

And I can't use either.

Because I had a c-section.

So my choices were the hospital or home. And there wasn't much contest as to which would win out.
posted by zizzle at 11:35 AM on September 23, 2011 [25 favorites]

my guess is that the nurses wanted the IV in before the birth because it's probably easier to put an IV in before a hemorrhage happens and you start to really, really need the IV right away to prevent blood loss from becoming dangerous.

You mean the way they do it down in the ambulance and ER every day?

A needless IV is a convenience for the nurses.

Remember: Mothers Comfort > Nurses Convenience.
posted by mikelieman at 11:54 AM on September 23, 2011

Zizzle, your story brought tears to my eyes. I'm so glad for you that everything has ended well. Hugs to little Rosalie
posted by mumimor at 12:20 PM on September 23, 2011 [2 favorites]

You mean the way they do it down in the ambulance and ER every day?

ER doctors have procedures for getting blood/fluids into patients when they're not able to get an IV, because sometimes they're not able to get an IV. Those methods are much more invasive and dangerous than an IV.

Additionally, post-partum hemorrhage can be turned around with quick and appropriate management resulting in a much better outcome overall. Immediate IV access helps tremendously when a few minutes make a big difference.

Of course IVs are uncomfortable, and if the risk of not having an IV is worth that comfort, then fine.

Saying that there is no reasoning behind it and acting like there is no risk at all and it's just for kicks or because nurses are lazy is not accurate.
posted by the young rope-rider at 1:09 PM on September 23, 2011 [1 favorite]

To be clear, I am not judging individual women who don't want IVs. That is completely your right and the vast majority of the time it will probably be fine. I'm definitely picking and choosing my medical care based on my personal risk/benefit analysis.

However, I've actually experienced an attempted (and failed) emergency IV in an ambulance and then ten more minutes of trying for an IV in the ER before they finally got one in. That wtould be about 20 minutes total without an IV. 20 minutes without an IV in a PPH situation would be really, really bad. Difficulty placing IVs is not a myth that nurses made up because they're lazy.
posted by the young rope-rider at 1:15 PM on September 23, 2011

Zizzle. Wow. That was hard to read - I was so glad to get to the second story. (I said I would not share my stories of "the dark ages" -- but they are nothing compared to yours!)
posted by Surfurrus at 1:24 PM on September 23, 2011

I want to respect women and support their choices and help them make an educated choice.

A beautiful promise, circle_b, thank you for being out there.

This should be the first thing anyone asks of their birth care providers: Can you support my choices? If medical providers can respect a "do not resuscitate" order, they can damn well respect the choice of no IV and/or no monitors. They are not GODS.
posted by Surfurrus at 1:25 PM on September 23, 2011

Difficulty placing IVs is not a myth that nurses made up because they're lazy.

I won't say there isn't a benefit to being ready to pump in fluids without delay, but we had decided the overall cost in discomfort and limited mobility wasn't worth it... Our Family Doctor/OB agreed, in fact the rejoinder "They put 'em in in the ER all the time" came from her. Again, the key to a positive experience ( given that it's a normal -- No, not 'normal', because each one is different. Let's say UNEVENTFUL -- labor and delivery ) is for you and your OB to be on the same page.

Personally, I think the major benefit of our 'Birth Plan' was ensuring we brought the right CD's and fresh batteries and the little computer speakers so we had some good things to listen to during the hours. (e.g.: Widespread Panic and the Dirty Dozen Brass Band's "Another Joyous Occasion" )
posted by mikelieman at 3:18 PM on September 23, 2011

You know, I don't like 'uneventful' either. The whole event is an Event. You know what I mean, though...
posted by mikelieman at 3:28 PM on September 23, 2011

And the nurses my husband had to hound so I could get some pain meds.

I particularly remember my wife being offered paracetamol rather than morphine during labour.

There was some medical reason for it, but I remember a fair bit of hounding was needed then some lame psychoanalysing by the nurse " have you had a bad experience with hospitals before ?" - apparently she hadnt noticed my wife screaming in pain and being offered 2 bloody paracetamol may have been some sort of trigger.

I find that soft soap fobbing off tone they indulge in doesnt help much either, if they just said flat out they didnt want to give my wife meds I would have accepted it.
posted by sgt.serenity at 4:55 PM on September 23, 2011 [1 favorite]

Wylla: "That's exactly the attitude that the Skeptical Ob and other alternative-medicine skeptics promote..."

I don't promote anything. I am not anti-hospital, I am not anti-home-birth. I wanted to be a doula and doulas are supposed to advocate for whatever the MOTHER wants, not her own point of view. But the group of doulas I found around here were of the die-hard "hospitals are EVIL!" sort and minimized my own gynecologist saving my life with emergency surgery (not at all pregnancy related). So yeah, I kind of gave up on that.
posted by IndigoRain at 6:08 PM on September 23, 2011 [1 favorite]

IndigoRain, don't give up on it. I have thoughts of becoming a high-risk doula, a labor support and patient advocate for someone whose birth will be hospital-based and high-intervention. I was a lay doula (no training, no education) for my best friend when she had her 38 week induction for pre-eclampsia, with a rotten Bishop score and a desperate desire to avoid a C-section. (Plus she was 39 and GBS+.) The induction took 3 days, 4 prostaglandin gels, almost 5 hours of walking, 22 hours of pitocin -- with 14 of those hours being before she was dilated enough for an epidural -- and resulted, as I said above, in the vaginal delivery of a healthy baby. (Healthy by the time he was 5 minutes old, anyway. His initial apgar was 4, he was grey and grunting and not super vigorous, but some stiff massage and heat and a little oxygen and he pinked right up to a 9.)

I had no specialized childbirth knowledge; I was pregnant with my first child and had never seen a birth. What I did was to stay with her during her labor, and when the medical team would suggest a next step, I would say "What are our alternatives?" And when they would come in and tell me about how her bloodwork was getting less and less encouraging in terms of liver enzymes and platelet levels, I would ask "Does this affect the way we proceed for the next four hours?" I figured four hours was a good solid chunk of time, if they ever said "yes" it would be enough time to talk over the risks and benefits of moving to a surgical birth without it being a crash situation. They never said yes.

There are many, many births that really need to take place in a hospital. Births where a C-section is on the table from the word go, births that need IVs and internal fetal monitors and pitocin augmentation. Those women deserve an advocate too, to help them navigate the system and participate fully in those highly dynamic and evolving circumstances. I'm thinking maybe I should look into becoming just such an advocate, once my kids are in school and I have the time.
posted by KathrynT at 12:03 AM on September 24, 2011 [1 favorite]

I won't say there isn't a benefit to being ready to pump in fluids without delay, but we had decided the overall cost in discomfort and limited mobility wasn't worth it..

That is awesome, and I'm glad you were able to get what you wanted! Everything is a risk; I have had three vaginal exams to check for dilation even though they're useless beyond curiosity and increase the risk of infection.

My problem is not with any individual choice. It's about the overarching theme that medical staff just make stuff up to torture pregnant women. Over the years the shittiness of OB has really earned a lot of that reputation. There's a lot of lie-there-and-shut-up-or-you'll-die paternalism and there are some truly dangerous practices are out there in common use.

However, I hate to see that kind of bullshit replaced with misinformation in the other direction: most significantly that there's no risk and it doesn't really hurt. Because there is risk, and it does hurt for the vast majority of women.
posted by the young rope-rider at 5:28 AM on September 24, 2011

the group of doulas I found around here were of the die-hard "hospitals are EVIL!" sort and minimized my own gynecologist saving my life with emergency surgery (not at all pregnancy related). So yeah, I kind of gave up on that.

Seconding KathrynT, with the added point that some women simply prefer to give birth in hospitals for various reasons (for example, my neighbors are total assholes and they don't have good drugs).
posted by the young rope-rider at 5:32 AM on September 24, 2011

I touched on this before... Although this can come off as "Doulas" vs. "The Hospital", at it's heart is Mother's Advocacy vs. Hospital Patient 'Mechanization'. By that I mean treating labor and delivery as a medical problem. Blind adherence to checklist items of arguable utility in may situations, etc..

I mentioned it before. Nurses have their own flow. IF that's a problem for you, the solution is to make sure your OB will be there for you, because what she tells the nurses to do. the nurses will do. ( e.g.: Don't put in an IV right now. Don't bother monitoring for the next hour, then we'll try to get a few good minutes before letting her pace again... etc... )

Really. If you're not in love with your OB, haven't shared your concerns, and don't trust that she'll back you 100% given that she doesn't have any actual medical concerns ( trust is a two way street. You need to trust that if she says, "Time for a C-section", that there's no other options realistically available ).

I understand that some practices have multiple rotations, and you're not sure who's going to be on call. We wouldn't go to that practice ourselves, but the take-away here is: "There are options between "Hospitals Bad" and "Hospitals Good" where Hospital experiences which could be good turn out bad because of miscommunication. And know that in a hospital effective communication goes: Dr -> Nurse -> You. Therefore the trick is to get ahead of the process and ensure that You -> Doctor -> Nurse works right.

And then you can hang out for some hours. Listen to music. Shoot the shit, and deliver yourselves some great babies!
posted by mikelieman at 1:01 PM on September 24, 2011

Mayor Curley: This modern Cult of Maternity is bullshit. Human birth is no more special than any other thing that happens millions of times a day, or any other mammal birth for that matter. The truth of the matter is that overfocus on birth, breastfeeding and childrearing is merely a convenient proxy that narcissists can use to further their craft.

I know I'm chiming in and replying to a comment from over a week ago, but I've been thinking about it, so I'll vent my thoughts here.

Birthing, breastfeeding and childrearing are scary things. For many new parents, giving birth and then caring for their newborn child is overwhelming. They're (young) adults, dealing with a truly helpless thing for the first time, and they don't have a point of reference for what is normal, or someone to turn to for help at any time. Or if they do, the new parents may feel like failures for not knowing what to do. It's birth, it's a natural process! Why worry? Oh god, my child can wrap his or her own umbilical cord around their necks, choking them in the birthing process? They can be pointed the wrong way and try to come out feet first? Etc.

But the parents get past that, somehow. They're in the hospital, with nurses on call, checking in every so often. Or they're at home, with a midwife talking to them about what to expect. The parents are calm, there's someone here who knows what the hell is going on. But then the parents go home with their child, or they are alone at home for the first time, just the three of them. No what? Breastfeeding, OK. The kid sucks on the nipple, eats its fill, and later poops it out. But he's not latching on right, and this really hurts! Is that normal? She's falling asleep at the tit, and doesn't seem to eat much. Or she is furious and her arms are everywhere, how can she eat like this? He's eating, but he's losing weight! What's wrong? She's snuffly and sneezing, why does she do that? And SIDS, oh dear god, SIDS!

The overfocus on birth, breastfeeding and child rearing happens, I believe, because most people aren't involved with babies more often than seeing them in public. Extended families are great, providing a support network and a chance to deal with a real live baby or two, before having your own. Because without an idea of what's normal and what isn't, birth, breastfeeding, and child rearing can be endless sources of concern, worry and self-doubt. And if you're a full-time parent with a newborn, that is all you do and think about. So getting a chance to look at people in pretty dresses can be a pleasant break from baby on the brain.

With all that, are you surprised that new parents talk about their kids all the time? Oh my goodness, he smiled, and he's only two weeks old! He's still alive, and he smiled! How can you not share that joyous news?

/new parent who had a fitful night last night
posted by filthy light thief at 12:20 PM on September 30, 2011 [1 favorite]