Tuesday, October 16, 2007

"What if something went wrong?"

What if something went wrong?

This one sentiment is, I think, the real pivotal point to wrap our heads around when we contemplate, discuss, envision, consider, support, and/or choose homebirth.

For many mothers, fathers, couples, grandparents, friends, neighbors, strangers, reporters, authors, nay-sayers, and well-wishers alike, I really think this is the Big One. You know what they picture--and you know that for some people, you can tell them and tell them and tell them all about what you would do if such and such occurred, and they still wont care, still wont hear you.

So, what is really involved here is multi-layered and complex. (You know how I abhor trying to write impressive statistical scientific essays...)
You have the basic fact that childbirth in the popular culture is based in fear, secrets, and avoidance of lawsuit.
You have the basic fact that no one, not even obstetricians, knows what natural spontaneous unhindered unmanaged childbirth even looks like, sounds like, IS like.
You have the basic fact that there are huge amounts of bucks wrapped up in the system that has taught us all that we cannot think for ourselves, we cannot seek information from each other, and that only experts can save us from the perils of our life processes.
You have the basic fact that most things natural and whole are secreted away, hushed, hidden, even reviled and feared as a matter of habit and commonplace.
You have the basic fact that a dramatic "thank goodness for the doc because of XYZ" childbirth story is probably the ONLY kind anyone of your moms, dads, neighbors, pals or enemies have ever had any exposure to whatsoever.

Roll all that into this big nebulous that is the murky imagery that floats around in *most* folks' heads when they hear that you are pregnant, and then tell them you are going to have a homebirth. they do not hear you say "we are planning a homebirth", they hear "We aren't going to the hospital".

The Hospital, the big safe magical place where all the guardians are with all of their minty fresh technology and impressive masked men? You're NOT going? Wha-wha-what do you mean???

You just shook up their little snowglobes in more ways than one. Be aware of this on some level. You don't have to give one hoot, but it helps to be aware of it.

When you demonstrate to some people that you are willing to forge your own path, that you are willing to eschew popular custom, that you are willing to follow instinct and reason and personal research, you can unwillingly piss them off. How dare you do what they could not. How dare you question your reality when they could not. (How dare you succeed, lets not forget, either.)

They might see you as foolish, but if they stick around long enough to hear all of your lovingly gathered safe birth statistics, they might just get bristlier. So they will turn to fear and aggression, out of habit and needing to remain within their own comfort zones. Especially older people. Not everyone wants to take their life by the horns and bust out of the box and stand for wildly progressive change. For some people, even talking like that will upset them. Que sera.

So, in order to talk you out of your choices, in order to make their own selves get back to a more comfortable zone, they will unconsciously think "hey, why does anyone go to the hospital to have a baby--oh yeah--cuz its so safe" and then they will bust out the WHAT IF SOMETHING WENT WRONG?

A perfectly legitimate question--for all of our lives experiences, really. We try from our first waking moments in the morning to the end of our day to avoid injury, danger, and death, right? Brush your teeth, buckle up, don't grab the hot stove, careful with the knife, don't throw glass, shut your eyes tightly in a sandstorm. We try to be safe naturally. So the actual question is not so dumb--I spent every single visit with my midwives asking variants of this exact question, and the UC-ers inform their selves the same way, most likely---educate yourself on negative scenarios involving labor and delivery and then plan solutions and options.

What would granny and pappy say if you told them that babies and mothers die ALL THE TIME in the hospitals?? For alot of folks, this would end the conversation because that would be too much truth and too much radicalism and too much reality chipping away at the Big Beloved Buildings of our communities. They might counter with something about "well, in rare cases", etc. But that's just it. Birth has no guarantees, your living through today has no guarantees. Life has no guarantees. But for some of us, instead of just lining up at the doors of the local popular OB/GYN's office for 3 minutes visits by grumpy strange doctors who don't know our names, for scheduled inductions and unnecessary interventions that put our bodies and our babies and our psyches at grave risk, like so many sheeple, we stand up and choose something different. Something we researched and heart wrenched and soul searched about, some of us for years. We choose to have our babies at home, at birth centers, in water, in forests, in peace, in safety, in dignity, in wholeness, in humanity, in sanity.

If anyone ever says to me "what if something went wrong?" in regards to birth, I can tell them it already has, and then show them all my external scars. I don't care if we are in the middle of Sunday dinner, and in fact, I hope we are. They can consider themselves lucky that my deepest scars are inside of me, or Id show those, too.


Rixa said...

I am in the middle (well, closer to the end) of writing a chapter about this very issue. It is very long and still not done.

The fact that very few people have ever seen a truly "natural"--that is, physiological, unhindered, undisturbed birth where the mother is doing everything on her terms--means that making any changes to the Standard American Birth will be incredibly difficult. The reference point of "normal," the bottom line of where birth begins, is the epidural/pitocin/IV/narcotics/lying on the bed/continuous EFM/coached pushing/immediate cord cutting/clean up baby kind of birth. Maybe every so often a hospital provider will see an unmedicated birth, which often is the same as above, minus the drugs.

If you have no vision, no idea of what birth can truly be like, no understanding of her (its?) true potential, then how can you even begin to make changes?

Rixa said...

I just came across this fantastic collection of essays by Ann Oakley, titled "Essays on Women, Medicine, and Health." Here are some selected passages from her book. I've been referencing some of them in the chapter I'm writing.

page 125: “In many places in the world today, birth is considered an abnormal event. It is an episode in women’s lives and in the lives of families which is not part of everyday life, but an occasion for medical surveillance and treatment.”

130: “Women’s passage to motherhood, which is something of considerable importance both to women and to society, is rendered more difficult by its technical management—the fact that birth is medicalized, is bereft of its normality, almost by definition. The obstetrical definition of a normal birth is just that—-the obstetrical definition. It is an expert’s view of what constitutes normality, and, as such, may or may not (but is not very likely to) coincide with other people’s.”

134: “It is often said that the point of greatest disagreement between mothers and obstetricians lies in the notion, espoused by mothers and not by doctors, that pregnancy and birth are not inherently illnesses but episodes of health.”

135: “Central to the obstetric definition of birth as a medical event is the concern to predict risk, to identify in advance those factors which will mean that something is likely to go wrong. As a matter of fact, the general failure of this exercise has led to the reduction ad absurdum of the risk approach, which is that every woman and fetus is at risk until proved otherwise.

136: “The fact that poverty is the biggest known risk to the health of mothers and babies is not something that most obstetricians wish to take on board....One of the biggest risk factors for the healthy survival of infants is the orientation on the part of many of the world’s governments to death—-in the form or arms expenditure—-rather than to life. Alternatively, we can put the risk of childbirth into the context of other kinds of risk that people voluntarily or involuntarily take: the risk of a woman in an industrialized country dying in childbirth is about the same as the risk of death posed by two years’ factory work or by riding 200 miles as a motorcycle passenger.”

138: “In the process of becoming a matter for experts, the danger is that the real expert-—the mother—-loses her own right to knowledge and control.”

Jill said...

I think I love you. <3

Housefairy said...

Rixa--thank you for all of this! I loved the one from page 134 best--pregnancy as episodes of health!!! How peace-bringing. I just read this over and over. Episodes of health. I love it.

I am letting loose so much of my anger and mute frustration with the people who have upset me in my life. What you wrote helped me to remember that "they" really don't know what it is that they are dissing, and that my sweet family is not the same as The Man. I feel very privledged to know about Birth. Sometimes I can try to change the world and sometimes it might be ok to just have personal private moments to savor in my mind and with my husband. Off topic, and not.

Jill--:D thank you.

Corin said...

Hooray to you. You just put into words everything I ever felt every time I got asked *THAT* question. Thanks.

Kelley said...

I just barely got asked that question, and rather than go into a huge, long diatribe, I changed the subject. Was I being cowardly? I don't know. I don't think so. It was a friend who is due any day with her first baby. She is going to a hospital with an OB. She wants to try it naturally, but she doesn't have anything against drugs if it gets to that point. I wanted to beg her to reconsider, but what was the possibility of that? It was easier and quicker, and may have saved our friendship, for me to just gloss over it and move on.

I hate that question. I think it is the ultimate question of ignorance when it comes to birth. So what if the cord is wrapped around the neck, or you bleed a little, or this, or that. You deal with it. You go into it prepared. You trust your instinct. You pray. You do what it takes. Argghh! I hate that question. It makes me crazy inside ever time I hear it.

You hit the nail on the head, and said exactly what I wish I could say in these situations. You are amazing.

Leigh said...

I love some of your euphanisms, such as BBB: Big Beloved Buildings.
What I want to ask people when they say that is "Yes, well what if something went wrong at the hospital?". They'd say "There are Dr's and technology there" and I say "There are Midwives and 'technology' at home too!".
As a homebirth transport who ended up with a scar, I too can say I know what would happen. And we both turned out "fine" (i.e. healthy and alive).

BUT...then I decided to birth my next baby at home. A baby who had the same "condition" as my first, which caused me a scar. A breech baby. Born perfectly, naturally, safely at home.

And you got it right, as always. It is a person's inherent discomfort in challening the status quo - in THINKING FOR THEMSELVES - that causes all these crazy responses.

Rixa said...

Check out the comments to Sage-Femme's recent post about Cesarean rates. The root of the problem really is that most people--OBs especially--have no knowledge of normal birth!

Andrea said...

Yeah, I can't see how people don't get the fact that stuff goes wrong at the hospital, too. Badly, badly wrong. Death and life-altering injury wrong. I wish I was brazen enough to ask hospital birthing women about that when I was pregnant and they started this line with me. I more often got the "you're so brave" business, but I think it's the same thing.

Sure, there's a certain risk in having a homebirth (as there is in doing anything in life, like you said), but I'm so, so sad that there's this fog of delusion in our culture that doesn't see the enormous risk in going to the hospital. What does it take to get through to people? Seriously, what?

Kelley said...

Talking about "life-altering injury..."

I remember right before we had Josh when I'd been on bedrest for weeks with toxemia, and the back-up doc for my midwife was begging us to have our baby in the hospital. I remember seriously thinking and praying about it, and deciding that, no, he needed to be born at home. Sometimes I've allowed myself to wonder if something happened then that "caused" his seizure disorder and autism, but then I think about the feeling I had at the time. I knew, knew, knew that if he was born in the hospital that something bad would happen. I knew it. I absolutely knew he HAD to be born at home. His birth wasn't perfect; a lot of things did not go according to plan, but I feel like he came out of it okay, and that he wouldn't have if we'd been in a hospital. Especially since I'd probably have ended up with a c-section for "failure to progress." It took 19 hours of labor to get past 1 cm. I was induced with Cytotech way before my son was ready to be born because of high blood pressure. I see now that was a bad decision, but I still think that the hospital folks would have freaked out even worse than my midwife did, and things would have been MUCH worse. I'd rather take my chances at home than risk what is very likely to happen in a hospital.

emjaybee said...

All I can say to your post is, damn straight.

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