Friday, January 25, 2008

The Born Business

I cannot wait to see this film, The Business of Being Born. It has received a lot of hype because actress and talk show host Rikki Lake is an executive producer on the project and is featured in the film. I think that is fine--as long as it brings attention to the subject.

Now, let me say first of all, I respect the choice of every woman in giving birth whether she does it in a hospital, birthing center, or at home and whether she utilizes tools like C-sections, epidurals or other pain medication, Lamaze techniques, the Bradley method, or birthing balls. I also respect a woman's choice to birth under the care of a doctor or midwife. What matters most is a healthy baby and a healthy mother.

That being said, I certainly think there is room for discussion and exploration when it comes to modern birthing practices in the United States. Lots and lots of exploration. I think that emergency medical care and surgical care is a necessary and vital part of our birthing practices and I applaud the valiant and dedicated medical professionals who do such excellent work to bring healthy babies into the world and preserve mothers' lives in the process. What I want to talk about though is not the ten or twenty percent of births that need this kind of medical intervention but the nearly 80% that are normal, healthy deliveries.

I think that birth is such a mind-altering and perspective-changing experience that we need to give women every opportunity, every advantage, and every option available to them to make their birthing experiences positive and empowering. And that is where I think a movie like The Business of Being Born is a great introduction to the discussion.

Newsweek recently latched on to this subject in an excellent article "Birth, The American Way".

Amid the controversy over what constitutes an ideal birth experience, doctors, researchers and natural-birth advocates agree: Caesareans save lives when medically necessary. But defining medical necessity is complicated. Natural-birth advocates cite a "cascade of interventions" caused by hospitals' practice of using the drug Pitocin to stimulate labor. The drug can cause painful contractions, which doctors treat with an epidural painkiller. The epidural can then retard contractions and lead to more drugs, fetal stress and the doctor's recommendation of a Caesarean. Natural-birth advocates say that hospitals, driven by profits and worried about malpractice, are too quick to intervene.

I think what needs to be explored, discussed and noted is how to assist women who want to deliver naturally and how to support them.

I've never been pregnant or delivered a child. But I've participated in one remarkable birth and been a loving supporter of other women who have been through childbirth. One thing that I find stunning is what happens when I talk to some of my pregnant friends who want to deliver naturally. They say things like "I hope I can do it without drugs" and "I'm going to try to do it naturally" with the emphasis on words like "hope" and "try." In the modern medical practice of birth and delivery, most women are not supported if they want to give birth without the aid of drugs or intervention--hence words like "hope" and "try."

I used to think that giving birth naturally meant a woman would go to a hospital, lie on her back in a hospital bed, grit her teeth and scream loudly with all of her force and willpower until she pushed the baby out victoriously. She had to do all of this while refusing drugs and most of all without the support of her doctors or the nurses attending her. It seemed a very solitary journey.

I had it all wrong.

How I envision natural childbirth now is a woman choosing first a health-care provider who is not only knowledgeable and experienced in natural-birth practices but a whole-hearted supporter of them. Then she has to choose a location for childbirth--whether it is a hospital or birthing center or her home--where the support team (nurses, doctors, midwives, family, friends) is behind her 100% in her decision and assists her in every way to have the experience she desires.

That means these professionals have to be knowledgeable in techniques--water, birthing balls, birthing stools, massage, counter pressure, visualization, relaxation, dimmed lights, gentle music, soft voices--and positions--walking, sitting, squatting, hands and knees--so they can truly assist the laboring mother as she focuses on her body and her baby.

This new visions sounds and feels like a remarkable journey. I hope to have such an experience someday.

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