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"I have need of the sky. I have business with the grasses. I will up and away at the break of day to where the hawk is wheeling lone and high and where the clouds drift by."   - Richard Hovey, 1894-1961

Sunday, January 20, 2008

The Business of Being Born




A few Saturdays ago, Mark and I went to see "The Business of Being Born," a film produced by Ricki Lake about birth culture in America. After the birth of her first child, which was in a hospital with unwanted medical interventions, she began doing research about birth because she believed there was another way for birth to be. Her second child was born in her home bath tub with a mid-wife present. This film is the result of her research.

I've been fortunate enough to have a very good friend who became a doula. A doula is a birthing coach, a mother for the mother, a support system for the new parents. So, I easily know more than the average person about what birth can be like. Even so, this film was very powerful for me. What I learned made me feel awe and anger, and lots of things in between. As Mark and I look at getting pregnant sometime in the next while (being purposefully vague) and as my friends become pregnant, the issues looked at in this film become even more important.

Here's a summary of what I learned:

early 1900s - 95% of births in the US are in the home with a mid-wife; more people go to medical school and get degrees in obstetrics; doctors led a smear campaign against mid-wives, calling them dirty, ignorant and everything bad associated with the "old country" and touted hospitals as clean and gleaming; fact is most doctors had never seen a live birth

1930s - half of births in the US take place in the hospital; xrays were taken of the pelvis which caused cancer in newborns

1940s to 1960s - women were told birth was painful and that there were drugs they could take to take away the pain, because they were "modern, liberated" women, they wanted drugs, not pain; fact is the drug (scopolamine) that was used didn't erase the pain, just the memory of the pain by erasing self-awareness and self-control, which meant women has to be physically restrained (tied down) during birth, all of which resulted in post-traumatic stress type memories

1970s to 1990s/now - drugs whose long-term side effects continue to be administered to women giving birth, thalidomide for morning sickness led to birth defects, cytotec to stimulate contractions caused ruptured uteruses

Now - 99% of births take place in a hospital, 8% of births are attended by mid-wives, 1% of births take place outside a hospital; the US has the second worst newborn death rate in the developed world; in the five coutries with the lowest infant mortaility rates, 70% of births are attended by midwives.

What birth is often like in a hospital
* a woman is laid on her back with her feet up in stirups, which is the most dysfunctional position for birth because it makes the pelvis smaller and makes it difficult to use stomach muscles to push
*a woman is in a room with lots of people she doesn't know and is told to hurry up
*she's given an epidural for the pain of the contractions, the drug retards contractions, so she's given pitocin to stimulate contractions that are longer and and stronger than natural contractions, so she gets another epidural, then more pitocin, by now the baby is stressed, so she "must" get an emergency cesarean section, which is major surgery and puts her at higher risk for uncurable infections (staph) most commonly caught in hospitals


Over 30% of babies in the US are born by c-section.

What a natural birth can be like
*a woman is surrounded by people she loves and trusts in a place where she is comfortable
*she can move around which helps the baby get in the right position to be born
*she's not rushed
*she experiences the pain of the contractions, but is better able to experience them because she has the support of a doula and midwife who remind her that her body was meant for this, her body can handle it, her body is strong
*she can catch her own baby
*she can hold the baby immediately after being born and fully experience the highest rush of oxytocin that she will in her life, oxytocin is the hormone that is released during orgasm and bonds us to another person, after a birth oxytocin bonds the mother to the child and triggers the mothering instinct

Epidurals dampen the oxytocin release. C-sections completely bypass the oxytocin release. Think about it.

For as long as I've been thinking about these things, feminism, body issues, vaginas and the like, natural birth always made sense to me. What really pisses me off is how our culture tells women that we're not strong enough to do the thing that we're built to do, that we have been doing for millenium (very well or we all wouldn't be here) without any "help" AND that we haven't questioned it. Our culture is scared of women who know their power - women who know and love their bodies. Giving birth is the most substantial way we have that we can know our power. A common theme in the film and in other birth stories is how transformative giving birth is. It is a rite of passage that our cultures ignores and devalues.

What makes me feel awe is the capacity we have as women for giving new life, for taking ourselves to a very hard place and transforming ourselves through it. That takes courage.

It's all well and good for me to say "yes, natural birth is a couragous and amazing and women were built to do it," but that still doesn't mean I have an idea what it looks like. Because of our culture, I didn't have a context for natural birth. I didn't know the stories that make it real. I haven't known many women who have given birth naturally, so it's hard to still realize, feel, do something other than intellectualize, what it might be like.

I've been reading "Spiritual Midwifery" by Ina May Gaskin, groundbreaking midwife of The Farm in Tennessee. The first 200 pages are nothing but stories of natural births. It's amazing. It's providing me that context. It's giving me the stories. It's teaching me about birth by sharing with me the stories of other women. This is also what makes the film powerful. Several families allowed their child's birth to be part of the film. It was so beautiful.

So, see this film. It will be available through Netflix by the end of February.

Check this stuff out for yourself. There's a lot of information" out there. Don't take my word for it.

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3 Comments:

Blogger mamakohl said...

Doula Sarah here popping in to say ...

Oh Velma!! What a wonderful post.
The one thing that I do want to point out, however, is that it is possible to have a very natural relaxed birth at a hospital, too. you just really have to work and advocate and plan for it. Of course, that is more of the exception rather than the rule, but it's absolutely possible. I see it all the time as a birth professional and I had a the experience myself as a birthing mother. The truth is that birth is much much safer (and cheaper and kinder and gentler and more family friendly, etc.) out of a hospital, but I'm learning that while a midwife centered birth at home is ideal (and god wouldn't I love everyone to have one) some women for whom that isn't an option end up feeling traumatized and already a lesser mother by not being able to make that choice (for whatever reason.) As a doula, it's just my job to cover all angles.

Oxytocin release is also stimulated by breastfeeding, so even if a woman has a cesarean, she still can get that release by breastfeeding. While it's true that a cesarean does bypass a lot of the hormonal changes, I feel, as a Certified Breastfeeding Educator, that it's important to state that bonding can and does still occur through breastfeeding, regardless of whether the birth was vaginal or surgical. Cesareans are not inherently evil -they do save lives and, in those instances, we're all eternally grateful for them. It's over use of them that is criminal.

Ina May also has another amazing book out there called "Ina May's Guide to Childbirth." It's more directed towards birthing women as S.M. was originally directed towareds midwives. Not that it matters, but the Guide is less technical and more consumer friendly, but I always recommend both.

I'm stunned to admit this, but while MO has at least a 40% cesarean rate (and local hospitals have a 98% epidural rate - one doesn't have to be a professional to see the connection there...) the fact is that we're more birth friendly than some other states and big cities. In Houston, most docs have never even heard of a birth ball! It's outrageous how varied birth can be from one location to another. Talk about making the argument for informed choice of birthing location and providers, eh?

12:24 PM  
Anonymous Anonymous said...

I would like to say that the mother/child bond still occurs when a c section is performed and breastfeeding is not an option. As a parent who went through a tramatic birth, an emergency c-section, and didn't hold her babies until 2 weeks later, I feel the bond to my children was overwhelming and life changing. Pregnancy and birth and life are so fragile, and even when things are going great, it only takes a split second for nature to turn on you and things to go very, very wrong. Although I will never experience natural child birth,and possibly never breastfeed, I still think I will never have an issue bonding with my future children. It should also be pointed out that although breastfeeding is preferred, it really is the breast milk that matters. Those who can't breast feed can still pump (which can be more difficult than breast feeding) and give their babies all they need.

10:51 AM  
Blogger mamakohl said...

Very good point. I should state that while I use the term "breastfeeding," I am including *all* methods of feeding breast milk. I have helped many mothers successfully provide breastmilk to children by using expressed breast milk - some use bottles, some use cups, some use a SNS system that mimics the body position of breastfeeding.

10:56 AM  

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