7.09.2012

judging another woman's birth

This is a question someone asked on a birth forum about Austen's birth after watching the video, and below it is my response. The writer was very respectful and kind and I was not offended at all. She offered her opinion, and I felt it necessary to respond with my own.
A couple of things about this video confuse me. Maybe someone can clarify. They drove to a birth center to be "checked". Guessing this means having her vitals taken. Perhaps even a vaginal exam. Yet they return home. Is this because they are deemed to be in labor too early to merit being at the center? Thinkiing that a homebirth mama wouldn't have a reason to go to the birth center... Then the midwife arrives. Guessing that is because the labor went so quickly and it was safer for midwife to transport than for the mama to do so. Good call! Why why why in the world as the mother is actively BIRTHING the baby does the midwife prepare the gel and the doppler to listen to listen to FHT? Perhaps this is what hospital personnel do, but why would a homebirth midwife do this? Sure, if babe was slow to descend or had some arrest of descent but for an actively descending baby and one whose head she had already seen? No turtling, no obstacle to a swift crowning and yet a doppler brought into use. I don't get it. I've easily been at a hundred homebirths and we don't use a doppler for a quick 2nd stage. Seems like a pretty needless carryover from the medical model. If the descent took a long while and there were deccelerations the caregiver might ask the mom to contribute more uumph to get the baby born a little more quickly but when nothing is awry..why the technology?
As far as why we got in the car to go to the birth center: that morning we had our 40 week prenatal visit scheduled. We were having a homebirth, but we left for the birth center to go to our visit as planned, because I didn't know for sure that I was in labor. I'd been having a lot of prodromal labor, so that's what I thought this was. If I'd known how far along I was, I would have just stayed at home to labor. She was going to check me for a better idea of if and how far along I was in labor. She comes to the house around 5-6 cm of dilation, so that's what she was going to check. She had other clients she was meeting with, so we couldn't put our meeting off for later in the day, or the next day (if I wasn't in labor), so I decided I'd rather go to the meeting in a little discomfort than put it off, only to be in "false" labor. On the way there, we realized I REALLY was in labor! So we headed to our house and so did our midwife.

I don't know why my midwife used a doppler at that moment, I've never questioned it before, and I don't really care. I trust my midwife completely and know that she did her "job" with loving, experienced care. It was very fast-forward, so maybe that's why. Or maybe instinct told her to. Or maybe she did, simply because she felt it was safest, or because past experience in her 20+ years of being a midwife taught her it was safest to, no matter what stage of labor. Or maybe I had problems with my previous birth, or problems with my pregnancy, and it was important that she check on the baby (that's not the case -- I had very uneventful pregnancies -- but it could have been. Because all anyone sees in the video is three minutes of the birth.) I'm not against the use of dopplers during a birth, in fact I think they are quite important. My midwife arrived seven minutes before my daughter was born, so she hadn't been with me through my labor at all, and I suppose she was just checking on my daughter's heart rate to make sure everything was going smoothly. I don't think there is anything wrong with what she did and definitely don't see it as an intervention, nor do I think she should have done anything differently.

My two cents on the subject is this: I know I am in the small majority of the natural birth community that is not of the "trust-birth" mind set; I see myself as more on the "respect birth" side of things, knowing that while yes, a woman's body is designed to give birth and yes, most of the time when a woman births naturally with little intervention, everything goes beautifully, wonderfully, perfectly -- sometimes that design in flawed. In the same way our bodies are designed to work perfectly, sometimes babies are born with problems, sometimes we get sick, etc. That being said, I also believe in the natural birth community we are WAY too critical of other womens' births. I say this because I was so guilty of this in the past. "Well she was induced because her body just 'wouldn't go into labor'? Oh brother! And she got an epidural at only 2cm dilation? That's horrible!"

Everyone has their own philosophy when it comes to birth. Vaginal exams during labor? Routine sonograms? Internal fetal monitoring? It's not our place to judge another woman's birth or her choices. Period. This doesn't mean we give up the fight for better birth, or stop educating about a safer, more natural approach to those who are interested. But unless a woman feels she was treated wrongly, unfairly, or the life of her or her baby was put in danger, it's not our birth or our body... so it's not our place to judge or critique. We don't know the whole story. I'm not meaning to sound harsh, I just wanted to be honest. I know we all have the goal to make birth in America a safer, more beautiful experience for women and their babies.



edit: I just want to point out, Barbara Herrera from Navelgazing Midwife coined the phrase "respect birth," and I love it. I also love her blog and her philosophy... check it out.

10 comments:

  1. Perfectly and beautifully said! I have been guilty of this until a family member opened my eyes - it was never my heart or intention to be hurtful but I have been. I have alienated people with my bias and judgment when in my heart all I want is to educate, but the education has to be wanted. Otherwise I'm just pushing my beliefs on people and pushing them further away. I have found when I back off people actually come to me for advice, which I give respectfully and honestly.

    Great post!

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    1. Thank you! And I can SO painfully relate. For me, it was when close friends or family would make different choices, or would plan homebirths and end up having c-sections, that I realized how hurtful my attitude could be to THEM, and the last thing I wanted to do was hurt them or make them feel guilty about what happened. That did happen to my cousin, and I felt horrible that she suffered that much while I unknowingly preached about the "evils" of hospital birth. I guess that's just part of the learning stage though. You're completely right about pushing people away -- sometimes all the preaching does more harm than good!

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  2. As a former midwife (from Holland, Netherlands) I would like to react on this post.
    There always seems to be a struggle between people who guide people through home deliveries and people who guide them through in hospital. Even in Holland where home delivery is a normal choice for the 'to be parents'.
    The place of birth differs, nothing else.
    No reason not to check the heartbeat. Seconds matter at home as well as in hospital. The medical information you need during birth is not something to discuss with the woman in labor or the father... That would cause quite a stir. As the midwives brain will be very busy with all her medical knowledge, she will talk you through birth as supportive as see can, with a calm and lowered voice. Man we can have headaches after wonderful births like this, and are always happy babies come out normal. Same when we are in hospital, you can not see every default with ultrasound, not even with the newest technology. So we are not scared, we are professionally cautious at all times.
    And can be happy and cheerful at the same time, man what a job, haha! Dear mom of Austen and River (and Emma? could not make that out for sure) I am stunned (in a good way) by your picture right after the birth of Austen. This is exactly what giving birth is all about. Not leaving out all other births in less natural ways, they are beautiful as well! kind regards, Jacobien Amsterdam the Netherlands.

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    1. Thank you so much for your comment! I LOVE what you have to say and completely agree! It seems in America, we want so badly to get as far from medicalized birth as possible, that sometimes we "trust birth" a little too much. "We are not scared, we are professionally cautious at all times." -- Wonderfully said!

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  3. Thank you! You have beautifully stated the way I feel! So often when people make choices we don't agree with or fully understand we judge. I have judged and still find myself in that place. In the past few months I've come to realize that there is a place to push for more education and more understanding and then there is a place to back off because in a lot of cases the ones we are trying to educate don't want it. I have found in personal experience that I have alienated mothers that I wanted to be friends with because I didn't realize that my understanding wasn't wanted. Now I struggle to find the balance for open discussion and learning without judging and pushing mothers away and there by pushing potential friends away.

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    1. I think finding a balance will exist when one is passionate about something. I'm there with you, girl.

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  4. Personally, having had my son from my second pregnancy (first was a miscarriage), pass away during labour, dying during the emergency cesarean after he got into distress and his heart rate started dropping, I think well done to the midwife for checking the heart beat. You see every second and minute counts had something been wrong. Using the doppler may be classed as some as an intervention - but if it is it is done with the best intention - of trying to have a healthy mother and baby at the end of the birth. I would far rather this small check be made, than something happen to someone else like happened to me.

    I love your respectful reply to the post, and the reminder that we never really know the full story of anything we see online.

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    1. I'm so sorry for your loss. I can't begin to imagine living with the pain of losing your precious son. My heart aches for you. Thank you for your thoughts and the reminder that every second counts

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  5. I agree that we need to just rejoice in a woman's birth and not judge it.

    I also know that it is sometimes hard to stop judging. But it is important to try!

    I did a guest post about "birth wars" and why we need to stop. http://rixarixa.blogspot.com/2012/05/ending-birth-wars.html

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