The NYT Motherlode blog posted “Debating Home Birth,” following a flame war on the parenting website Babble that ended up pulling in two of the most recognizable names to those who follow that debate in the US: Dr. Amy Teuter of The Skeptical OB and midwife Ina May Gaskin, founder of The Farm Midwifery Center in Tennessee (which, it should be noted, has low cesarean section and maternal mortality rates that should be studied by hospitals everywhere). I wasn’t involved in this wild flame war. I try to avoid becoming wrapped up in cases of people being wrong on the internets.
It’s a problem that will never go away. But when I read Dr. Amy’s comment on Motherlode, I had to reply.
This isn’t a post about numbers. This isn’t a post about the maternal mortality rate – those startling and disturbing numbers have been reported over and over. This isn’t even a post about how a gender studies nerd banged her head against the keyboard over the continued misuse of the term “radical feminism” to describe any sort of feminism the author doesn’t like, and that it’s not the same as the essentialist feminism that Dr. Amy dislikes (as do I) so much. This is about why I chose a natural, low-intervention birth. I’m giving Dr. Amy the benefit of the doubt that she has simply only encountered those in the natural childbirth “movement” who fit her view of it. I’ll give it once, state my case, and let it be after that.
My spouse and I are rational people. Arguably, he’s more rational than me. I’m the one who insists on garden gnomes to ensure a bumper crop of lettuce and cilantro on the porch. But we’re pretty average when it comes to healthcare. We visit a local family practice clinic run by a local university health system. We follow the CDC vaccine schedule.
I didn’t want a natural birth for any spiritual reason, or to prove or lay claim to some essential “womanliness.” I wanted a natural birth because I didn’t want a cesarean section. I wanted to breastfeed. From my reading and research, everything I found showed that getting an epidural could reduce those chances. So, rationally, what would be the best way for me to meet those goals? Forgo the epidural, prepare for a natural birth.
I should insert here the caveat that I am also aware of the privilege and plain dumb luck that played into my ability to meet these goals. I was already interested in natural birth, in the process of becoming a doula. My spouse had a job with great health coverage, and I found out I was pregnant during open enrollment, so we could switch our coverage to a plan that covered midwife attending births at a local hospital. Heck, I HAD health insurance, which is lucky in and of itself! We were able to afford private childbirth education classes with a local Bradley instructor. I could afford healthy food. I could take time off for prenatal appointments.
I was also a voracious reader. Every book I could get my hand on from the library or our childbirth educator or the local La Leche League. I exercised. I ate very carefully (once I got past the morning sickness and Taco Bell craving phase).
I was healthy, and an informed consumer of my healthcare. My pregnancy WASN’T a disease, it was the healthy function of a healthy body. It didn’t require the management of a surgeon. It needed the supervision of someone who understood that it was a normal, healthy function, and who could be aware of potential dangers, but also aware of the relative low risk. That person was a midwife. Frankly, it seems irrational to me to treat pregnancy and birth as a catastrophe just waiting to happen when, most of the time, it’s just … not. It’s not irrational to desire a healthy outcome for both myself and my child, both from birth and for the initiation of breastfeeding.
“In nature, women give birth in agony,” Dr. Amy writes. But I didn’t. I was in labor for 24 hours, pushing for the last 4, and I wouldn’t describe it as agony. In the early first stage, I labored at home, knit, grocery shopped, bounced on my yoga ball, talked to my mom, sister, and friends. I carbo-loaded. I took a bath. Once at the hospital, I walked, took a bath, ate and drank and moved as I chose. I was exhausted. It was hard. Sometimes it hurt. Sometimes it hurt a LOT. But so does running a marathon. So does doing the Ironman. And when it was over, it was over, and I was fully aware and engaged in what was happening. And Liam, well, he was perfect, obviously (but really, what shiny little newborn isn’t?). I felt good, strong, happy.
And Dr. Amy, in declaring that women should “take back” childbirth from the extreme minority that labor without pain medication and/or birth outside of a hospital, seems to deny the existence of those of us who don’t fit into her worldview. Furthermore, by pushing us aside, she further denies those women who have been brutalized -brutalized- by doctors and hospital systems, and as a result feel that their only option for a safe birth is outside of those systems. It ignores that cesarean sections are major abdominal surgery that come with their own risks. Yes, I know women that benefited from quick access to surgery. I think we all do. And I can’t say how grateful I am that they had that option and are healthy and happy. And that’s what cesareans are for, not at the rate many hospitals parcel them out.
As many of the commenters at Motherlode point out, perhaps there’s a middle way – giving pregnant and laboring patients more options in midwife attended, low-intervention birth in a hospital setting. Perhaps there could be a meeting of the minds between OBs, midwives of all stripes, birthing people, and public health experts to find a way forward that would ensure the health and dignity of the birthing experience for all, addressing the roots of racial disparities in maternal and neonatal health, and overly high cesarean rates.
But Dr. Amy isn’t fostering that conversation by calling me irrational for desiring and having a healthy, normal, natural birth.