Sunday, January 10, 2010

"natural" birth?

I saw a Tweet on Twitter today in which a doula said she hated it when women claimed they had a natural birth, when truly it was not "natural", but "vaginal" with an epidural. Just to say before I go on, I took this single phrase and am running with it with impunity...I am using it as inspiration to create an example to illustrate something, most likely out of context of what she actually meant. Doula sister, if you're out there, please know I'm not chewing you out. In fact, I thank you for providing this phrase as friendly blog fodder.

It IS frustrating for natural birth supporters to be part of a culture in which birthing vaginally, compared to the insane rate of those experiencing C-section births, is starting to be considered "natural", even if all kinds of other medications were used. It's brutal, in fact.

However, I think we need to be careful about how we express frustration of this nature. I often get criticized because I tend to tread carefully and walk the line of diplomacy instead of standing up fiercely for my beliefs. The thing is, is that I do stand up for them...just not with ferocity many can obviously perceive. I tend not to go for "shock value". If nursing my 3 year old in public caused shock, well, that's another story, but, like all mothers giving their toddlers a little snack, it was not with the intention of making waves, it was just to do the mothering that was required in the moment. Intending to shock is one thing, but causing shock because you're mothering according to your values is another....the latter is a healthy exercise in stretching our cramped cultural boundaries..

I digress. My point is that "making wrong" is not, in my humble opinion, the greatest way to create growth. In my experience, anyhow, I can't speak for everyone. If I, an excited new mom who gave birth vaginally, especially perhaps if I were told that my chances of having a C-section was up to 50% depending upon where I lived, and I went up to you and said, "I had a natural birth!" and you said, "well....maybe it was vaginal, but you took an epidural and synto, so you can't really say it was natural, can you?" I would either a) get very defensive and never want to share anything with you in enthusiasm again, b)feel stupid for making a "mistake" with my words and the little bubble of maternal pride around me deflate, or c)dig in my heels, claim that indeed having a vaginal birth was natural in this day and age, go off and tell others what a hippie and natural birth "nazi" you were, and widen the divide in order to escape the pain you caused by your criticism of me.

I can tell you what I wouldn't do. I probably wouldn't say, "thank you for enlightening me to the fact that my natural birth wasn't natural at all. I am a product of my culture, and was in the wrong. I now know the way, and thank you for showing it to me. I will be inspired now to truly have a natural birth next time." We may hope that our passionate opinions enlighten others, and we enthusiastically promote them with the hopes of changing the world for the better, but I find there are more effective ways to convey them.

To my doula and midwife friends I may certainly vent my frustrations about what we as a culture consider "natural" birth. But to a mother who had just had her "natural" birth, it would be a different thing. I would say, "Wow, CONGRATULATIONS! I hope you are SO proud of yourself! It is certainly something to celebrate when your baby is born vaginally!" This doesn't enable a new mother to go on thinking the way she does, it fills her full of the joy she deserves to feel for having had a baby. When you make her feel good about herself, it opens the doors to communication instead of shutting them in your face because you have created defensiveness or shame.

Also, there are other situations to consider. I have had a few ladies who have gone through very long labours naturally, and who had extremely long second stages (pushing), and in the hospital the clock was ticking away the minutes until an inevitable C-section. Some of them took the epidurals that were recommended in order to have a break for a while, and then resumed pushing, all of them ending in vaginal birth. Would I NOT "allow" these women to claim natural birth for themselves because, technically, they had taken an epidural after having been 10cm for a few hours and pushing for a few more?! I don't think so. How about women who labour for days at home, experiencing intense, almost constant back labour, and then going to the hospital, having an epidural for a few hours and pushing the baby out? Okay, technically they are vaginal births with epidural, but given these women have gone through more hardcore labour than the average woman having a garden variety epidural free birth, does she not have a right to say "natural" birth without having to clarify to everyone? These types of birth deserve all the celebrating you can give to a woman who has gone through one. Personally, when one of my clients goes through something like this and I'm with her when someone asks her if she did it "naturally" and she doesn't really feel like giving the whole story but wants to honour herself for doing the equivalent of 3 labours in a row but had an epidural for a couple hours near the end, I'll just wink at her, encouraging her to own it however the hell she wants.

I am reading Ina May's Guide to Breastfeeding, and am really loving its tone. It is full of information about how breastfeeding is the very best thing for the vast majority of babies, and communicated with passion, honestly citing the dangers of formula feeding. But there is also an undercurrent of real compassion for those women who chose, for whatever reason, to not breastfeed their babies. Her language is very careful in not trying to make anyone feel like an idiot or a bad mother for having made different choices. In trying to educate the public, you can't use language you might use when you are preaching to the choir.

I learned a lesson in judgement towards mothers that I have never forgotten. One day I was at a restaurant with my husband, and I saw a woman bottle feeding a newborn. I was appalled! I was mortified! I was shocked! I was so thickly surrounded by my cloak of self righteous indignation and anger at this mother for her stupidity in NOT breastfeeding, I didn't even recognize her. She saw me, smiled, and approached me. I was mortified to realize it was a LOVELY woman I had met at a La Leche League meeting. She was physically, because of some congenital breast issues, unable to provide milk for her babies. She attended the meetings to get support, because even though she couldn't provide nearly enough milk to nourish her child, she still nursed after the bottle was given, for superior physical and emotional connection. She didn't need my judgement, she needed my support. I am so glad this lesson was put in my way, as it changed my approach to communication a lot.

Most of my clients come to me not being sure about whether or not they will choose an epidural for their labours. It is not true that only granola types approach doulas for support...it is often women who are terrified of pain and whose husbands are not sure how to help them. If I jumped in and lectured them about the evils of epidural, I probably wouldn't have such a low epidural rate. While I don't think we need to simper, pander, and enable, I do think we need to honour, love, and respect. During birth, what helps a labour go more efficiently? Is it criticizing a woman about how long it's taking, correcting her when she expresses her pride in herself at how she's managing, only to be told she ain't felt nothing yet, or giving a woman praise and encouragement?

There are many paths to enlightenment, and I'm only talking from my experience. I'm not trying to tell people how to speak or how to be. It takes all kinds to change the world. I'm just saying that I think there is value in gentleness and tending to the here and now feelings of others, putting the desire to be "right" lower on the priority scale, even if that desire is motivated by good intentions.

That's my story, and I'm sticking to it!

'nite, all!