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Looking glass Alice examines birth and parenting in our culture.

• 12/5/2008 - Forgiveness?? Who fucking cares.

 

I'm supposed to be writing about forgiveness today. I owe an article and it's been sitting in the back of my mind, stewing in the detritus of the parenting and activism which lives back there. Forgiveness and birthing women. Learned authors I consulted on this topic like Desmond Tutu and Starhawk seem pretty clear that forgiveness is a part of a longer process involving survivors speaking out and someone listening and actually caring about the pain inflicted. So that's my sticking point, I guess.

 

Forgiveness is impossible in the war zone that is birthing in the western world.

 

Sounds so dramatic but well that's how it is! Imagine gatherings like the South African Truth & Reconciliation meetings where victim/survivors and perpetrators came together to listen, communicate, discuss, take responsibility and eventually offer forgiveness. Birthing women could stand up and through their grief, describe how it feels when people with absolute power over you inject you with drugs without consent, or how it feels to have your vagina cut open for no reason, without consent and without anaesthesia. Or how it feels to listen to your baby screaming while strangers poke and prod them and then take them away for you while you beg for them to be in your arms.

 

Imagine surgeons and medwives standing up and saying "I cut a woman's belly so I could go on holidays" or "I made fun of a woman's birthing noises because it made me uncomfortable." Imagine midwives actually saying out loud, "I gave that woman a VE because Doc X said I should even though she didn't want me to and I felt terrible doing it." Imagine the opportunities for healing their own experiences of birth trauma which lie unaddressed when midwives could say, "I insisted on washing babies because my babies were washed and I couldn't bear the thought that other women would get what I missed." Imagine homebirth midwives saying, "I'm sorry I insisted you transfer for no real reason, I just had a bad back and felt overwhelmed." Ah so much possible insight, so little likelihood.

 

Of course this stuff will never happen in the current climate. Not while birth reformers are meeting with surgeons and reassuring them that they're not like those Angry Women who might get all uppity and start making "demands" instead of having birthing "wish lists". Scuse me while I vomit into my keyboard. I figure the adequate socialisation of most of us which means we don't get angry about stuff, we get cancer instead, means that some of us have to do extra Angry Duties like teachers who do extra playground duty as favours to friends. I'll do some angry for the women who are dead now because of obstetricians since they can't do it and no one seems to want to talk about them.

 

I don't forgive the people who perpetrated my birthrape. Fuck that. They don't give a shit, they've gone on doing it since then, what good would forgiving them be? I'm not eaten up with anger, it's not gnawing at me, it bursts right on out in wildly appropriate ways like blogging, activism or running forums that seem to scare the hell out of casual observers. ("OMG did you see?? They say OUTRAGEOUS things on those forums!!")

 

Yep outwaaaaageous things like "Only you give birth, only you decide where." What we don't talk about is the advanced certificate in forgiveness a woman might require when her husband has decided she'll have an out-of-homebirth which goes to shit. How can a woman forgive herself and him for insisting she go to hospital when the damage can be so terrible? Will that woman be able to forgive her husband when she lives with the daily reminders of her surgery or other birthrape? When she sees the scars on her baby's mind and body will she forgive him? The worst of all is she'll probably just live in denial for years and not even tell him how angry she is that she let someone talk her out of birthing safely.

 

What can we do?

 

Go be angry. Warm the cockles of my cyberheart with the flames of your righteous anger. I'm beyond rage at how women are treated in birth in Australia. Let's do anger together, sisters. We have nothing to lose but our denial and apathy.

 

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• 13/5/2008 - Untitled Comment

Posted by Anastasia
Precisely why I cannot write an article on forgiveness! I'm with you on this one!
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• 14/5/2008 - Untitled Comment

Posted by wildmama
Let's grumble together then! ;-)
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• 17/5/2008 - Untitled Comment

Posted by Anonymous
I personally don't know that something like insisting to wash a baby after birth is enough in itself to be considered birth trauma...rather just disrespectful of the mother's/parent's wishes.

And as far as a wife being able to forgive her husband for insisting she go to the hospital - will husbands who listened to their wife's insistence to birth at home then have trouble forgiving his wife if the baby dies or is severely brain damaged or if the wife dies?

Neither home or hospital are perfect, ya know.
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• 17/5/2008 - Untitled Comment

Posted by wildmama
Given that the odds are far greater of injury in a hospital than at home, that's rather a moot point. Given that women alone birth and women alone bear the scars of unnecessary interventions on our bodies, it's pretty obvious that only women should decide how and where to birth. Sometimes at birth, regardless of location, babies die. We have lost sight of that in our surgically obsessed world and assume that we have the means to save all babies. We just don't. Death rates are always higher in hospitals though so that's a good place to avoid if you fear death and injury to your baby.
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• 18/5/2008 - Untitled Comment

Posted by Anonymous
I'm sorry wildmama, but there is no way I will ever believe having the baby at home is safer than the hospital, especially for the baby. And since I would risk life and limb to ensure the health of my baby, home is no longer an option for me.
Even for women who show absolutely no signs of complications all the way up to starting labor, a life-threatening complication can arise in moments. Even if noticed right away, some complications cannot be helped at home (a true shoulder dystocia, for example, that cannot be resolved by changes in position) and the amount of time the baby can be in trouble is too much at home. First, while mom and MW try changing positions to free baby, then while they make decision to call for help, then they call, then an ambulance must be dispatched, then they drive to you (while your baby is in distress, possibly with no oxygen), then they must load you in the vehicle, drive to the hospital, wheel you in and then finally they can rescue your baby, which at this point, may have extensive brain damage, or be dead.
Yes, chances are everything will be fine and beautiful for mom and baby...but there is also the very real chance that it will not be, and in that case I want all the help I can get to make sure I don't lose my little one. This does not mean I believe all babies can be saved...of course some will die, no matter what. But I want to know I did everything to save my child.
And you can tell a child with cerebral palsy from a prolonged labor (whether it was at home or in a hospital) that "women alone birth and women alone bear the scars...on our bodies"...you're not the one being squeezed through a tiny bony pelvis and possibly being deprived of oxygen every here and there.
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• 19/5/2008 - Untitled Comment

Posted by april
What a fabulous post! I can't believe I hadn't read it until now.
I don't get forgiveness...wtf does forgiveness do for me?
Again you sum things up so well.

btw anon...pelvises are not fixed ;)
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• 20/5/2008 - Untitled Comment

Posted by Anonymous
"btw anon...pelvises are not fixed ;)"

Thus my inclusion of the following sentence in my above post "(a true shoulder dystocia, for example, that cannot be resolved by changes in position)"

The pelvic OUTLET can be changed some in size and shape by movements made by the mother...but not ALL babies will make it out, even after these movements...and for those babies, a CS is the only way they will have even a chance at survival...otherwise they will simply die in the birth canal. And since there's no way to know which babies will make it through with some changes in position and which one can only be delivered via CS...I cannot believe that I will be just as safe at home as I would be with the equipment to save my child's life literally right down the hall. Even living a few miles from the hospital is not the same as RIGHT DOWN THE HALL.

Maybe if you lived, literally, right next door to a hospital and could walk there under 2 minutes...but then, that is only if the MW (or yourself, if UC'ing) was able to recognize very quickly that the baby was indeed stuck.

When a baby's brain is not getting oxygen...every last second counts.
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• 1/6/2008 - Untitled Comment

Posted by Anonymous
How is a Caesarean going to resolve a shoulder dystocia?? It takes quite some time to setup for a Caesarean. Are you referring to the Zavanelli maneuver? Are you aware of the dangers inherent in that procedure?
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• 3/6/2008 - Untitled Comment

Posted by Anonymous
"How is a Caesarean going to resolve a shoulder dystocia?? It takes quite some time to setup for a Caesarean. Are you referring to the Zavanelli maneuver? Are you aware of the dangers inherent in that procedure"

The time it takes to set up for a CS depends on the hospital...some may have a decision to incision time of 30 minutes, some are 5-10 minutes. If in a hospital, however, there is the ability (that is, I’m not saying how often this might happen) to set up the OR "just in case" if the OB/midwife begins to suspect something may be wrong, which means they could get the woman into the OR immediately when the decision is made.

SD is notoriously difficult to predict or “diagnose” before the babies head has been born (which is why most OB’s recommend CS when they think you have a “big baby”…estimated fetal size is one of the only ways to try and catch a potential SD beforehand, but it is still only a guess). Depending on when the shoulder dystocia (or potential SD) is recognized, a CS can be performed before the baby's head has been delivered. If the delivery is too far along, and all changes in position have not worked, then yes, the Zavanelli maneuver is the last possible chance to save the baby. And yes, I know the dangers that can entail...but the other option is let baby die in the birth canal.

Here is one "protocol" I found for what should be tried (and in what order) to release a shoulder dystocia:

McRoberts maneuver
Suprapubic pressure
Procto-episiotomy
Wood's corkscrew maneuver
Posterior arm extraction.
Zavanelli maneuver or symphysiotomy if all else fails
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• 8/6/2008 - Risks Shmisks

Posted by Emma
Risk of shoulder dystocia in a healthy non-complicated pregnancy - 0.5%

Risk of caesarian if I give birth in a private hospital in Australia? 35%

Seems like a no-brainer to me.

Then again, I can get to the hospital in the time it takes to prep the operating theatre. If I lived in a country town I may not be as complacent.

Anonymous, you say that in a hospital birth the OR can be prepped "just in case" if the midwife or ob suspects there may be a problem. What makes you think this cannot happen with home births? Do you think home birth midwives have less cerebral capacity?

I would argue that home birth midwives are much more in tune with possible problems than hospital midwives who are (in private hospitals anyway) programmed to respond to the OBs wishes. Often this means helping to bully women into an unnecessary caesar - "Do you want your baby to DIE????"

I was lucky in that I got to give birth in birth centers with a midwife I trusted. I shudder to think about what it would have been like had I been forced to lie down by a bunch of strangers like the poor woman in The Age a few months ago (not at my own computer, cannot provide link, sorry).

This article provides a summary of articles on the risks of home birthing vs hospital birth:

http://www.gentlebirth.org/ronnie/homejjg.html

or you could just type "home birth risks" into google.scholar

Most people's view of the safety of childbirth these days has been completely skewed by the media. Particularly people who say, "You had a home birth? Weren't you lucky that went well!"

No, wrong. Having something go well, when there was a 97% chance of it going well anyway is not LUCK, it's THE NORM.

If I put 97 blue marbles and 3 red marbles in a bowl, blindfolded you and told you to pick one at random. Would you feel lucky if you drew a blue one? Of course not! The bowl was full of blue marbles. Drawing a red marble though, the odds were against that, that's luck for you.



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• 11/6/2008 - Untitled Comment

Posted by Kristin
Sing it sista!
What an awesome post.
Anon, the vast majority of things that go wrong in births are caused by interventions in hospital. That's why homebirths have such fantastic outcomes. I know it's hard to accept because it's the opposite of what we've been taught our whole lives but there evidence speaks for itself. Critically research and read the literature. It makes perfect sense to me, mother nature didn't get this wrong.
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• 12/6/2008 - Untitled Comment

Posted by Anonymous
“Risk of shoulder dystocia in a healthy non-complicated pregnancy - 0.5%

Risk of caesarian if I give birth in a private hospital in Australia? 35%

Seems like a no-brainer to me.”

So you would take the .5% risk that your baby might die or suffer sever brain damage that will cause them to be dependent on other people for the rest of their lives, rather than undergo a surgery? Sorry, I can’t agree…I, personally, would do anything to save my child. Even if the chance that my baby will die/be brain damaged was.0001%...I would much rather suffer than have my baby suffer.

“Then again, I can get to the hospital in the time it takes to prep the operating theatre. If I lived in a country town I may not be as complacent. Anonymous, you say that in a hospital birth the OR can be prepped "just in case" if the midwife or ob suspects there may be a problem. What makes you think this cannot happen with home births? Do you think home birth midwives have less cerebral capacity? “

I don’t know much about homebirth in Australia (I’m in US), so perhaps your midwife (assuming you have one) would be able to get the hospital to start prepping an OR while you transfer, but here in the US direct-entry midwives (who do most of the homebirths and do not have anywhere near the training required) would only be able to call 911 for an ambulance…they have no relations with the hospital and so would not be able to call and have the OR prepared ahead of time.

“I would argue that home birth midwives are much more in tune with possible problems than hospital midwives who are (in private hospitals anyway) programmed to respond to the OBs wishes. Often this means helping to bully women into an unnecessary caesar - "Do you want your baby to DIE????" “

CS is only unnecessary in RETROSPECT though. We do not yet have the means to know exactly who will be ok continuing to labor and who will not beforehand, so when baby APPEARS to be stressed, a CS is recommended to prevent the possibility that this baby might not make it vaginally.

However, I do realize and agree that there are instances where the doc is just pushing CS for reasons that aren’t pressing…and those I do not agree with.

“I was lucky in that I got to give birth in birth centers with a midwife I trusted. I shudder to think about what it would have been like had I been forced to lie down by a bunch of strangers like the poor woman in The Age a few months ago (not at my own computer, cannot provide link, sorry). “

I am planning a birth with a midwife, but there are no birth centers near me, so I will be in a hospital. I am glad your birth went well.

“This article provides a summary of articles on the risks of home birthing vs hospital birth:

http://www.gentlebirth.org/ronnie/homejjg.html “

Sorry, this is not a scientific site, so I don’t give it much credence…

“or you could just type "home birth risks" into google.scholar”

I’m pretty well versed in the risks, but thank you.

“Most people's view of the safety of childbirth these days has been completely skewed by the media. Particularly people who say, "You had a home birth? Weren't you lucky that went well!"

No, wrong. Having something go well, when there was a 97% chance of it going well anyway is not LUCK, it's THE NORM.

If I put 97 blue marbles and 3 red marbles in a bowl, blindfolded you and told you to pick one at random. Would you feel lucky if you drew a blue one? Of course not! The bowl was full of blue marbles. Drawing a red marble though, the odds were against that, that's luck for you.”

Well, if I would be shot and killed on site if I picked a red one, then yes I would feel VERY lucky if I picked a blue one, given what those 3 red ones mean…likewise, even though birth will go off without a hitch MOST of the time, does not mean that it’s anything but luck when it does. There is nothing you can CONTROL that will give you a good outcome, and therefore, it is LUCK. It is also luck when you have a good birth in a hospital (although, in the hospital, your chances of both mom and baby leaving alive and with all their brain cells intact is higher).

“Anon, the vast majority of things that go wrong in births are caused by interventions in hospital. That's why homebirths have such fantastic outcomes. I know it's hard to accept because it's the opposite of what we've been taught our whole lives but there evidence speaks for itself. Critically research and read the literature. It makes perfect sense to me, mother nature didn't get this wrong.”

Yes, the research has been done, and HB carries a HIGHER risk. Most studies CLAIM that they show HB to be as safe or safer, but the data does not support their conclusions. Next time you look at the studies, don’t just read what the authors wrote, look at the data they used and then do your own calculation and see (warning, you have to know how to do some statistics to be able to do that correctly). And, saying this as a WICCAN, who WORSHIPS “Mother Nature”…Mother Nature can be a bitch, and part of nature is DEATH. Because birth usually goes just fine 97% of the time does NOT mean it is 100% safe! Ask any woman who has lost a baby in birth (at home OR in the hospital) or a husband who has lost a wife (and maybe a baby as well)!
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