Thursday, October 06, 2005

I'm Hiding Out Over Here

Holy cow are things heating up over at the Leery Polyp. I didn't comment, partly because there are too many words there already, but partly because it doesn't seem like a discussion that includes people like me. I haven't read all of the comments (I don't have time for a third full-time job), but from what I saw, the discussants fell into two camps: the I Gave Birth Through My Vagina Without Drugs and I Am Proud camp, and the I Couldn't Give Birth Through My Vagina and I Am Hurt that You Are Proud camp.

Where's my camp? The I Gave Birth Through My Vagina With Drugs and Had a Terrible Tear and Still Am in Pain and Wish I'd Had the Damn C-Section but Really Don't Mind if You're Proud camp?

From the research I've done, in the days before modern medicine when women gave birth at home without drugs, very few women died. But a lot of babies did, or were damaged. Birth plans are really for the mother, not the baby. Yes, babies born by uncomplicated vaginal births with minimal drugs do very slightly "better" at the beginning, but this effect is small and transient. And babies born by complicated vaginal births do much worse than those born by c-section, and these effects can be large and permanent. And it's very hard to predict which way things will go. (I've always been intrigued by the stories of girls who give birth in secret and then go back to the prom -- how do they have such an easy time of it? But one of my best friends is an OB, and she's seen several such mothers after the births. She said usually the perineum is a wreck after these deliveries, and extremely hard to repair.)

Women who sense that OBs are resistant to their birth plans are usually correct. But this is because if the result of a delivery is not a healthy baby, the OB is the one who will be blamed/sued/devastated. Hardly any of my students want to go into OB now; it's not worth it.

But I'm way too chickenshit to post this over at Jo's.

18 comments:

Anonymous said...

I've never posted on a blog before but had to second this. As the mother of four (epidural-assisted births)teenagers I'm struck by how fiercely the debate at Jo's focuses on the mother and her experience. I'd have pulled those kids through my ear if I'd thought it would help preserve their brains for LIFE. It's like saying the wedding is the most important part of the marriage; the birth process is only the first in many, many steps of life.

Nancy said...

I am a selfish, selfish woman. I am 40 and will have my 1st baby in February. If I could get an epidural today I'd gladly take it. I've trained my husband to say "she'd like the epidural now" to anyone and everyone he sees from now until the baby is born.

Ms. Sheila Whotiger said...

I have to say that seven, five and almost two years removed from the birth, I realize it such a small part of who I am as a mother or woman or whatever.
I had all three through the pipes sans meds. I definetley would have had an epidural with the third but arrived at the hospitol too late. However, I would be remiss in saying that I am not thrilled at all the medical advantages available to procure healthy moms and babies. But I really believe there is a lack of informed consent in all the interventions.

Orange said...

I was delighted with my epidural. Sure, the spinal headache that followed for the next four days was the worst pain in my life, but boy, would that C-section have smarted without the epidural. I was never in labor, nobody has traveled through my vagina, and I never got past the 31st week of pregnancy, but I'm no less or more a mother than anyone who labored without medication, or who adopted, or who used a gestational surrogate, or who delivered vaginally with all the drugs known to modern medicine.

Birth plan? Ha! That is a luxury. We don't all get to choose the means of our child's arrival. (My original plan was a hospital-based water birth with a midwife.)

At the extreme of low-intervention childbirth, you've got the women in Africa who labor for days, eventually delivering a dead baby and being ripped asunder with an obstetric fistula. Which is not to say that everyone should have an episiotomy or a C-section, but these can be life- and health-saving interventions. My son probably wouldn't be here if I hadn't had a C-section, and I could have died, too. The whole debate of anesthesia vs. not for vaginal delivery involves women with the luxury of making that choice.

Yeah, I know I'm rambling here. Sorry 'bout that.

suzie said...

I laughed every time someone asked me if I had a birthplan. I've seen too many go way, way wrong, and they just seem like a way to set yourself for disappointment. I didn't get the birth I planned or imagined, but not having it on paper helped to let it go. And in the end, it was just one day- so, it's OK.

DoctorMama said...

Yay anonymous! Keep on posting!

nancy -- if it's selfish to want to avoid pain, there aren't too many selfless folks in the world.

SW -- I agree.

orange -- yeah, it is a luxury to be able to choose how you become a mother. A luxury, and good luck. And like other strokes of good fortune -- money, beauty, class -- it's best not to gloat about it. (Although I think your pride in your bodacious ta-tas is allowed.)

suzie -- a fascinating day (I love hearing birth stories), but just one of many. One thing that Jo said: "I have a hard time imagining that what I learned about myself ... will ever cease to inform the way I mother my daughter." I think this is what rankled many people, because it implies that women who became mothers in a different way are less informed somehow. I think we're always learning about ourselves, and how we behave in the hardest of circumstances is probably NOT terribly indicative of who we are.

Orange said...

What I learned about myself the day I became a mother? Jeeze. I learned that IV magnesium sulfate makes my crotch unbearably hot. I learned that emergency surgery can feel fairly ordinary. I learned that it's hardly fair for all the people in the OR to have masks that hide their identity, while the one person whose face is visible is the one who most wants to hide (that was when I was completely pantsless and being catheterized--hello, bright lights! Those are all my bits down there, for all to see!). I learned that a nurse anesthetist could be my best friend. I also learned what it's like to be in the ICU. You know what? None of those things inform my mothering. They sucked ass. What informs my mothering is, well, the mothering itself, day in and day out. That, and the knowledge that despite a crappy birth story, I really lucked out because I have a healthy and happy kid.

B.E.C.K. said...

My son's dad really wanted me to deliver sans drugs because it would be so "beautiful and natural." F*** that. I told him when he pushed a person out his vagina, he could do it any way he pleased. ;^)

Birth plans are nice to write, but so many things can change during labor and delivery and the plan goes out the window. But delivery day is one day. Motherhood is for life, and much more beautiful and important than one crazy day.

Denise said...

Hm, your comment spam detector doesn't like my browser.

Good discussion...as someone who couldn't even have a couple of miscarriages without surgical intervention, I don't know what camp I'm in. From the observation deck, it seems that the birth experience is very important to some, almost incidental to others. I too was taken aback by Jo's statement; part of me thought, wow, I've really missed something! and the other part thought, there are lots of experiences that shape and inform your life. You just need to focus on having them, whatever they are, and not tallying them.

bihari said...

I've always felt that birth is to motherhood as wedding is to marriage. Yes, the launch can have far-reaching effects, but it's what happens in the day-to-day for the next twenty years that really determines how the relationship (mother/child, husband/wife) develops. (With the caveat, of course, that there are few surgical options available for weddings, and not a lot of lives at risk). With my two, healthy me, healthy baby, was my goal, and it didn't matter that much to me how I got there. In the event, I wound up with two NSVDs so quick I couldn't have had drugs if I'd wanted them, which was nice and all, but didn't leave me particularly PROUD. I mean, I'm not proud I have blue eyes, either--it's just physiology. I'm grateful, is what I am--for my healthy sons, my functioning (if exhausted!) body, and my fortune in giving birth in a hospital where asepsis and anesthesia and multiple options were all taken for granted.

bihari said...

Oh, and while I'm commenting blithely away here--I just found your archives and my husband (a doctor) and I have been laughing like hounds as we nod in vehement agreement/recognition over your Sept. 14th "Impatience with Patients" post. Boy, did you nail it!

kathie said...

Wow, staying diplomatic isn't easy...even for a grounded voice such as yours...makes me feel less wimpy.

kathie said...

I'm back again, I had to comment on your thought of the girls who give birth and then return to their prom dates five minutes later...that's always intrigued me too! Denial is one hell of a drug I guess...

DoctorMama said...

I keep trying to imagine what the surgical option for a wedding would be -- forcibly stitching the couple together, perhaps?

Diplomacy -- doesn't the internet sometimes seem like the United Nations? Except you get to elect yourself.

Anonymous said...

I recently came across your blog via GeekyMom's, and I just want to second the note of appreciation about the archive. I've been laughing aloud-- you are a fantastic writer. So if the whole doctor thing doesn't work out... :)

Oh, and if there's one thing that 17 years of marriage has taught me, its that I should never express opinions about childbirth.

My *wife's* comment going into the hospital was "there's no extra merit badge for 'natural' childbirth. Give me the epidural!"

cluelesscarolinagirl said...

Great post!! I loved it.

I found myself so stunned at the thoughts over at LP that I was speechless.

Which is a rare, rare condition for me.

Menita said...

Oh where have you been all my life? Just found your blog through a comment you made over at Julie's. I fall right into the same camp - you made me laugh out loud. My birth plan was simple: live baby. Lots of drugs.
Got both.

I also just read what you wrote about the second child talk (ART, donor egg, adoption) - we are in exactly the same boat. Sleepless nights over at my place too. No answers. Dammit.

I just love the way you write, and what you have to say.

Kelsey said...

"yeah, it is a luxury to be able to choose how you become a mother. A luxury, and good luck. And like other strokes of good fortune -- money, beauty, class -- it's best not to gloat about it."

nice. and true. I teach Childbirth (natural) classes and this is the conclusion that I've come to as well. The option to go without drugs should be in the interest of your baby's/your health not to be a hero or becuase it's beautiful. ALL childbirth is beautiful, whether it's from your vagina, or a cut in your uterus. As long as you're as educated and informed as possible, then you can know you've done the best you can and the rest just isn't up to you.