Sunday, January 25, 2009

What Shocks Us

It's interesting to me how different people can be, and how this difference is reflected in our perspectives or attitudes. For example, I avoid watching the very common CSI-type shows because it seems to me that almost every show has has a plot line and/or images of violence against women or children.

When I see or hear blood, screaming etc. on the television, I cannot help but think of myself or my sisters/mother/friends or our children in this specific situation. Watching too much of this type of television would undoubtedly make me paranoid!

But! I can watch any graphic woman-centered childbirth video without upset, even while snacking or eating my lunch. Full-on crowning shot? No problem. Triumphant birth howls? Sure. Deliriously happy mama embracing her blood-streaked, vernix-covered baby for the first time on her bare skin? Terrific! Yes, I may get a little teary, but those images are beautiful to me. However, from what I hear casually, as well as from friends and family, most people in this culture would be much more uncomfortable and/or shocked by this type of video versus the graphically violent images on CSI-type shows. Interesting, isn't it?

I got the chance to watch 20/20's "Extreme Motherhood" show when it aired, January 2nd. My first thought was that it seemed bizarre to combine orgasmic birth, women who nurse their children beyond infancy and babyhood, and women who birth at home with midwives (which for some reason 20/20 labeled as "unassisted") with the much more rare women who mother the uber-realistic (creepily realistic, to me) baby dolls called Reborns, and who are "serial" surrogate mothers.

Anyway, clearly all of these topics were supposed to be "extreme" or shocking!! in some way.

Let's look at the whole "orgasmic" childbirth thing. Here is the 20/20 clip: Orgasmic Birth, it's about seven minutes long. There are two things in this clip that, in my opinion, might seem shocking.

The first is simply connecting the idea of an orgasm (sex) to the idea of childbirth (a baby). You just don't hear those two words together very often, I don't think, especially on network television.

The second one is the idea that childbirth could be "orgasmic". But really: it's the same body parts... the same hormones... and childbirth is a direct result of having sex. Is it really such an extreme position to take that childbirth could be pleasurable instead of painful? Because that's what the clip is really suggesting, I think. "To actually experience an orgasmic, or pleasurable birth, Northrup [Dr. Christiane Northrup] says it's important for women to lose their fear and their inhibitions." A mother interviewed for the show explained, "I hope women watching and men watching don't feel that what we're saying is, every woman should have an orgasmic birth," she said. "Our message is that women can journey through labor and birth in all different ways. And there are a lot more options out there, to make this a positive and pleasurable experience." It seems to me to be more of a media-type attention-grabbing trick to stretch the label of pleasurable to orgasmic (though I do not doubt at all that orgasmic birth happens!).

Why the idea of childbirth as pleasurable is shocking is because the vast majority of American women labor under conditions that would make it almost impossible to experience pleasurable sensations during labor and birth. Many are tied to a bed via an IV, continuous fetal monitoring, an epidural, and a catheter. The epidural numbs them to the sensations of birth: can you imagine if it was the norm for virgin young women to be given an epidural during their first sexual experience because it might hurt? Add any number of other factors, including a lack of exposure to labor/birth as normal, fears from watching the many emergency-birth shows on tv, lack of support, threat of cesarean, time limits etc. & etc. Contrast these scenarios with the births discussed on 20/20 - they're day and night, and, in my opinion, go a long way to explaining why many women feel pain and fear and the few who labor unmedicated, with support, upright and moving, with water - with true woman-centered care, may experience pleasure during their births.

What's shocking to me is that so many women labor and birth the hard way.

Or how about this for shocking?

"Best Practices in Maternity Care Not Widely Used in the United States"
WASHINGTON (January 7, 2009)— Despite best evidence, health care providers continue to perform routine procedures during labor and birth that often are unnecessary and can have harmful results for mothers and babies. The Centers for Disease Control’s (CDC) most recent release of birth statistics reveals that the rate of cesarean surgery, for example, is on the rise to 31.1% of all births—50% greater than data from 1996. This information comes on the heels of The Milbank Report’s Evidence-Based Maternity Care, which confirms that beneficial, evidence-based maternity care practices are underused in the U.S. health care system.

Research indicates that routinely used procedures, such as continuous electronic fetal monitoring, labor induction for low-risk women and cesarean surgery, have not improved health outcomes for women and, in fact, can cause harm. In contrast, care practices that support a healthy labor and birth are unavailable to or underused with the majority of women in the United States.

Beneficial care practices outlined by Evidence-Based Maternity Care, a report produced by a collaboration of Childbirth Connection, the Reforming States Group and the Milbank Memorial Fund, could have a positive impact on the quality of maternity care if widely implemented throughout the United States. Suggested practices include to:

Let labor begin on its own.
Walk, move around, and change positions throughout labor.
Bring a loved one, friend, or doula to support you
Avoid interventions that are not medically necessary
Choose the most comfortable position to give birth and follow your body’s urges to push
Keep your baby with you – it's best for you, your baby and breastfeeding.

Lamaze International has developed six care practice papers that are supported by research studies and represent “gold-standard” maternity care. When adopted, these care practices have a profound effect—instilling confidence in the mother, and facilitating a natural process that results in an active, healthy baby. Each one of the Lamaze care practices is cited in the Evidence-Based Maternity Care report as being underused in the U.S. maternity care system.

Debra Bingham, MS, RN, DrPH(c), Chair of the Lamaze International Institute for Normal Birth says, “As with any drug, we need to be sure that women and their babies receive the right dose of medical interventions. In the United States we are giving too high a dose of cesarean sections and other medical interventions which are causing harm to women and their babies. Yet there are many countries where life saving medical interventions are under dosed which can also cause harm. Every woman and her baby needs and deserves the right dose of medical interventions during childbirth.”

The research is clear, when medically necessary, interventions, such as cesarean surgery, can be lifesaving procedures for both mother and baby, and worth the risks involved. However, in recent years, the rate of cesarean surgeries cause more risks than benefits for mothers and babies. Cesarean surgery is a major abdominal surgery, and carries both short-term risks, such as blood loss, clotting, infection and severe pain, and poses future risks, such as infertility and complications during future pregnancies such as percreta and accreta, which can lead to excessive bleeding, bladder injury, a hysterectomy, and maternal death. Cesarean surgery also increases harm to babies including women giving birth prior to full brain development, breathing problems, surgical injury and difficulties with breastfeeding.
Read more about Lamaze's Six Care Practices that Support Normal Birth here.

To read other reviews of 20/20's "Extreme Motherhood" show, visit Kathy's blog article at Woman to Woman Childbirth Education or the Navelgazing Midwife's commentary.

Or read this short review, "Orgasmic Birth: The Natural Reality Behind the Hype", which offers a gem of a quote from Debra Pascalli-Bonaro, the filmmaker of Orgasmic Birth: the idea that orgasmic birth "sounds strange in our culture because we're used to seeing birth dealt with on an illness model, rather than a wellness model. Birth is part of a woman's sexual life."

More to be shocked about coming soon.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

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