How the Natural Birth Movement is Failing Us
I invite you to sit in a circle of mothers sharing their birthing traumas.
Have you listened to a woman, with a face of steel, tell you that she could feel the surgeon make every cut during a surgical birth, but how she bore the unimaginable pain because she knew she'd be given general anesthesia and miss her baby's first breath if she didn't play nice?
Have you heard a woman admit, with embarrassment and shame written all over her, how she now suffers fecal incontinence because the episiotomy was too aggressive and she's reluctant to engage sexually with her partner?
Have you been with - really been with - a woman whose heart is broken over her struggle to get pregnant again due to secondary infertility following a cesarean section?
Have you listened to a woman whose baby was stuck in the wrong position, and who did everything she could think to do in order to get that baby to move, only to be wheeled into the operating room hours or days later?
Have you spent time understanding a woman who has come away from birth totally disillusioned, disempowered and horrified by the experience she went through? By how her body failed? By how she was treated? By what she never thought she needed to know?
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Most months of the year I sit in such a circle, listening to the stories of strangers and strangers who have become friends. Sometimes I tell my own story, about my birth center birth gone awry, about the 54 hours of back labor with a malpositioned baby, about the transfer to the hospital and the cervix that was swelling, about the way I called another midwife for a second opinion before consenting to a cesarean section, about all the things I did "right" that did not equate to the natural, vaginal birth I had anticipated.
It's been four years since I was strapped down to a table in an indistinct operating room, my arms shaking wildly, my huge belly being prepped for surgery.
It's been three years since I read my birth records, since I opened the chasm of grief, since I began my own journey to discover what happened that resulted in the birth experience I had.
I've learned a lot in three years.
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There's been a renewed push in Western culture around birthing naturally. A push for women to more fully understand the risks of cytotec and pitocin and epidurals and morphine. To become educated about the processes of birth and to forego the elective cesareans or early inductions that are so often encouraged or forced upon women.
I am unapologetically an advocate of natural childbirth. The evidence is clear that, most of the time, it is the healthiest choice for birthing women and their babies. All of the interventions that have become commonplace in birthing rooms around the world have an essential place but I am very clear that they have taken too big a place in our birthing culture. Cesareans alone account for nearly 33% of all births in the United States, even as the World Health Organization considers the ideal rate to be between 10-15% based on the risks and benefits of this surgery.
I am also an unapologetic advocate of choice. I want for all women to feel safe and strong in labor and delivery and how each woman gets there is an independent journey, one that should be cobbled together by her to the best of her ability. For some that means an army of support personnel or making use of every drug available. For others it means birthing unassisted at home.
Choice.
Such a tricky concept, yes? Because what is choice if you don't have the essential information?
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In my experience, the natural birth movement centers on a single principle: A woman's body is designed to give birth.
Or said another way: You, in the lineage of women who have been birthing since the dawn of time, with the right emotional and practical support, barring some emergency or fluke, have the inherent "goods" to give birth naturally, should you choose to.
Birth is a basic biological function. So what does it mean that women everywhere are NOT completing this basic biological function? And that most women who birth vaginally do so with a full slate of interventions?
The natural birth movement repeatedly ascribes this to some combination of the following factors:
1. A woman had inadequate support personnel.
2. A woman didn't have the education necessary about the physiological aspects of birth or interventions to make informed choices.
3. A woman lacked the inner reserves to complete the journey.
Thus it follows that educating women to (a) choose the right care providers, (b) assume the right information about the process of birth and (c) get themselves into the right emotional and mental space will change the outcomes of birth.
So tell me something. What do we make of the women who do select the right care providers? Who believe deeply in their bodies' ability to birth? Who are psychologically prepared? Who have stepped fully into the natural birthing paradigm? What do we make of these women whose bodies are STILL not birthing as nature intended?
To put a face to it, what do we make of me?
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My own story is complicated, but I use it so as not to speak for anyone else.
Three years ago, I holed myself up in a hotel room to mourn and research what had happened 12 months prior in the birth of my son. This research led me down two distinct paths, paths that nonetheless intersect and overlap in myriad ways and have since joined as one.
If you've been around awhile, you probably know that I experienced sexual abuse as a child and at the time of my son's birth, that abuse had a lid screwed on so tight above it that it was entirely unresolved.
The biological process of birth is strong, but it won't override everything, and a deep-seated inner fear is sometimes one of those things.
At the same time, I discovered this: the way we have used our bodies our entire lives impacts basic biological functions. Functions like breathing and digestion. Functions like temperature regulation. Functions like birth. The shoes we wear, the chairs we sit in, the bellies we suck in, the six-packs we create, the walking we don't do, the booties we tuck under, the ribs we lift up.
Every single one of these things interferes with natural childbirth.
The natural birth movement is giving women important information about their rights, about their bodies' inherent power, about the provider-choice factors that contribute to a positive experience of birth. But not talking about the way the body is used or not used is like shooting a woman in the foot at the moment she sets off to train for a marathon. It's like sewing her cervix closed. This is not meant to be a hyperbolic point. Not including essential education about the intersection of everyday movements and birthing does harm to women. It damages their bodies and breaks their spirits. It is fundamentally disempowering, another way in which control is wrested from women and their bodies.
(Note on 10/17/15: In no way do I think that this exclusion of information is intentional on behalf of those in the natural birthing community. A lot of this information is new and there will always be a lag before word spreads to the public. I do think, however, that because birth itself and birth trauma to a greater extent are sensitive subjects, that even when this information is know, it's downplayed in an effort to avoid hurting women's feelings. I think it has the power to do the opposite.)
All women come from a long lineage of strong, powerful women who have given birth. They have birthed in dirt fields, in forests, in huts, in townhomes, in birth centers, in hospitals. Most women, in the course of history, have done so without medication or invasive procedures. Some of these women have died. To birth is to enter into the life-death-life cycle and women would be wise to do so humbly and with access to qualified medical care should a need arise. This should not deter from a deep understanding that birth is natural and beautiful and basic.
But - and this is a HUGE "but" that is almost entirely unacknowledged:
We also come from a lineage of women who have moved away from what is natural and beautiful and basic. We have worn restrictive shoes our whole lives and have not squatted to cook and harvest and use the bathroom. We have forgotten how to walk long distances and to place function above beauty. We work at stationary jobs and drive cars long distances and jog on cement. We live with immense anxiety that creates physical tension patterns.
Women are coming away from birth confused and horrified by what has happened to them. We tell them it was their provider. We tell them it was their lack of education. We tell them it was their trauma.
This is not the whole truth.
We need to tell women that yes, birth is natural. But since nearly everything about the way the body has been used over a lifetime is unnatural, we also need to tell them that the body will need to be worked to enable this basic biological function. The backs of the legs need to lengthen, the hips need to be opened, strength needs to be found in the glutes, in the thighs. The nervous system needs to settle. The belly needs to relax, the shoes need to be changed, the upper body needs to be set free.
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My colleagues and I often talk about birth. Our own births, our clients' births. The future of natural childbirth. The lack thereof.
We talk about this because the dominant voices in the natural birth movement are missing this fundamental piece, this piece that will forever change the way women experience birth, this piece that would put power back into women's hands.
This piece that says HOW you are using your body is of paramount significance to HOW you birth.
This piece that says if you want your daughters to have positive/natural/different birthing experiences, you need more than legislative reform, you need to get them out of toddler heels. And chairs.
This piece that says a flat belly achieved by sucking in or holding tension is a violation of your body's basic needs and can affect baby positioning and core function during birthing.
The piece that says most fitness and athletic activities have nothing to do with the ability to complete basic biological functions like birth.
This piece that says squatting isn't optional.
Walking isn't optional.
De-stressing isn't optional.
Moving isn't optional.
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I've sat with enough women and read enough literature to know birth trauma can have long-lasting impacts. To know that it affects the emotional and physical health of children, the way women bond with their children, and the birthing choices women have moving forward. It increases the risk of post-partum depression and PTSD. It can forever impact a woman's own health and the function of her body. It can color the whole of a woman's life.
The natural birth movement knows this. It knows the deep value of empowering women so that they move through and out of the entire birthing process feeling safe and strong. So that they and their children are as healthy as possible.
It knows that we come from a long lineage of strong, powerful women who have given birth without the need for medication or invasive procedures. They have birthed in dirt fields, in forests, in huts, in townhomes, in birth centers, in hospitals.
But what's missing in the education that the natural birth movement provides - that how you move is paramount to how you birth - is part of the slippery slope that makes positive experiences of natural childbirth less and less available to women.
A woman's body is designed to give birth. Let's keep it that way.