Monday, February 15, 2010

If you are happy with your choices, why does mine bother you so much?

I'm not usually one to go on a rant. Not that people who rant are doing this, but when I do I always feel like I am jumping to conclusions. Perhaps I over analyze things for fear of making assumptions. Having said that, I feel a rant brewing. I believe it's been cooking up from weeks of reading articles and then foolishly going through the dreaded comments section. Seriously, if you for some reason want to change positive energy to negative energy, read the comments section of any controversial story and that outta do trick!

My rant is about peoples choices. Yes, I write about choice a lot, because I, like the great Morpheus of the Matrix, believe everything begins with choice. Let's examine the word for a minute. Choice in it's most stripped down form, implies ownership, yet I don't think people always own their choices. They may think they do, but their actions, emotions, and words say otherwise. I believe when people don't own, or take responsibility for their choices, it's usually because they are not happy with them. When you are happy with your choices, you don't feel the need to defend them or explain them. Or my favorite, get defensive and hostile when a person makes a choice opposite yours.

Example #1. I chose a natural birth. I blog about my experience and my satisfaction with my choices. You, having chose a medicated birth, read my blog and immediately become defensive. You launch into explaining why you had the birth you did. You also accuse me of trying to make people who don't birth "naturally" feel bad.

So, not only are you seemingly unhappy with your choices, you are also not owning your feelings, by blaming me for how you feel about your choices.

Example #2. A story is written about the high induction rate, and how many of the inductions done are not medically indicated. The article talks about the risks of inductions, one being the cascade of interventions that can sometimes lead to unnecessary cesarean sections. Again a woman who chose an induction reads the article and feels attacked. She explains her baby was suspected to be too big at 39 weeks. She needed an induction. Later as the induction failed she found out her baby was in danger and she needed an emergency c-section (that took 2 hours to happen from the moment the doctor say c-section time, to the moment she was on the table). The baby is delivered and low and behold her baby was 8lbs and she is only 5'4! She is pissed that anyone would assume her induction and subsequent cesarean was unnecessary!

In that scenario, one might argue that the women really didn't have a choice, because she was not given true informed consent and while I can agree with that, I don't agree that she sees it that way. She is angry that her decision to have an induction is questioned, and so again I have to wonder how secure she is in her decision. Perhaps maybe she feels she didn't have all the facts. Perhaps she secretly wonders how necessary her cesarean section was, but if she allows herself to question the events, she questions her judgment and role in the events that took place. That is an admittedly hard thing to do.

There are other examples I could give, but I'll stop with those two. The bottom line is that when a person is happy and secure in the choices they've made, another person words or actions can not make them feel otherwise. If you've felt defensive, angry, or guilty about choices you've made, you have to explore why, instead of blaming others. Own your feelings and take ownership of your choices.


  1. Can I just say, I love this? I think you've done a great job of adressing possibly the most essential part of all this birth story 'drama'. Thank you :)

  2. Why do you think I NEVER read the comments section ? I vowed to my kids and hubster that I wouldn't read them anymore --at least not while I'm looking after the kidlets all day long. Reading comments makes me feel horrible. Seriously, it turns me into a bad parent. My mood switches instantly and the kids suffer for it. :( I've decided to avoid reading comments until the girls are all of school age and grown, and until then I'm just going to live in my bubble of joyous SAH-mothering, keeping things groovy and upbeat for my girls throughout the day (but truth be told, I might read comments at night, once they're safe and tucked away in bed, and I can rant away to hubby :P). My girls NEED me to be this way for them right now. Not to worry, though - I'll be getting back into the "fight" once they're a bit older and less needy, less dependent on MY moods, IYKWIM :D For now, I am choosing to focus any remaining energy I have on the positive. As you know, I make it my mission to strive to have women and families making informed choices. Precisely so they can AVOID those feelings of guilt (because they do nothing to help you get through the years as a parent - what a horrible burden to have to carry while mothering small children !). I wholeheartedly believe in INFORMED choice, at all times (hence the name of my group on FB). Only from making truly INFORMED choices, can we escape from the dreaded guilt. The REGRET. It's why I strive to get the info into the hands of those who are seeking it, so that they never have to go through the long years of parenthood feeling regret, or the dreaded "guilt". I totally agree with all you say about owning your feelings, too. But so many people don't get it. The thing is, no one person can *make* another person feel guilty. As I always say, you either feel guilt, or you don't. And guilt can actually be a very good thing, indeed ! It guides us, keeps us in line with our core values, our principles. We feel guilt when something is off - think of it like a warning signal for you to get back on track, get back in line with what you really believe and want for yourself (for your family, etc.). As you say, when you are truly sure of the choices you have made, you will never feel guilt. Guilt seeps in when informed choice was absent, OR when you *know* you made a decision that didn't sit right with what you OUGHT to have done. Never because of someone ELSE. Time to own up to one's feelings. I couldn't agree more with you on that, friend. :)
    Great post, Patrice - thanks for sharing.

  3. I have been trying to articulate this exact sentiment for MONTHS now and have not been able to say it in such a succinct way, worthy of publishing to the rest of the free world. THANK YOU. I'm totally sharing this.

  4. I would like all the "natural" birth haters to remember that was it not for leaps and bounds made by modern medicine and science we would still be delivering the way our grandmothers and great grandmothers delivered- 100% natural. Sure modern medicine is great and all but I think we need more of take back control of your birthing event mindset. Labor is called labor bcse it's work. If it was meant to be a cake walk it would be called something else and experienced as such...

  5. Nicely said! I have not ever read your blog before, but a friend of mine had it linked on facebook. I think I will find myself back here often.

  6. Your thoughts were well written and sane, but I have to chime in, here. I'm a woman who is constantly on the defensive. I've been called everything from a hypocrite to a sellout(I'm on the path to midwifery,) a poor mother to selfish and stupid.

    Both of my births were induced, and one by my request. Both were medicated. I made these choices fully informed, though. Let the word leak that I committed these birth "sins" though, and it's like the fuckin' crusades opens up on my front lawn.

    I defend my choices because I DO own them and I WAS informed. Hell, I was more informed than my physician in the case of my first birth. I chose to be induced because I was a prima para at 40 wks, going through prodromal labor with a large babe. (She was 10 lbs., and as it was her collar bone and my coccyx were fractured due to her angle even though my pushing was self directed.) I also requested an epi, because at that point I hadn't slept in nearly 72 hours, and being bipolar, the lack of sleep could trigger a manic episode that when combined with parturative hormone changes could result in post-partum psychosis.

    I was induced for severe pre-e with my second, and I pushed off the induction as long as I could safely do so, even though it meant a nearly four week inpatient stay for bed rest. I labored through the worst of the pit contractions unmedicated, and finally chose an epi again because I knew when I had to draw the line in regards to what point the exhaustion got to.

    No one seems to hear these things, though. All they hear is that I requested these horrible interventions and jump to the conclusion that I'm a shitty person. So, yeah, I do defend myself. I defend the fact that I'm educated and did the best for my children and myself, and that no one but me made those choices. :)

    Just wanted to remind some, if not you necessarily, that sometimes defense isn't bad.

  7. Thank you ladies for taking the time to read my blog and also comment! I really appreciate it. I love having a good dialogue about the many issues, topics, and ideals surrounding pregnancy, labor, and birth, and as always I can count on intelligent articulate women such as yourselves to makes points I missed or haven't yet explored.

  8. Yes, this is an age-old issue, especially obvious in other conception, pregnancy, birth and parenting topics such as breastfeeding and circumcision.

    These women need to realize that they do have a right to be angry. They were misled, uninformed and thus had their bodies invaded and their babies potentially harmed. They should be angry, they should be unhappy. AT THE RIGHT PEOPLE. Instead they want to keep it all hidden and stay in their own bubble of reality. So they don't get mad at the person who hurt them. They don't get mad at the system that dehumanizes women and infants. No, they get mad at the people who would dare pop their bubble of psuedo reality.

    This is not good for their mental health and it is certainly not good on a societal level b/c as long as we remain silent on these issues, more women and babies will be victimized.

  9. Thanks for posting this! I am currently reading Ina May's Guide to childbirth and love how frank she is about birth choices as well!

  10. AMAZING!!!!!!! you hit it right on the head!!

  11. Thank you, Patrice. This was a beautiful, positive post. I hope it can help bring peace to at least a few mammas who turn their defense into an offense, too. Supporting each other in our choices will help create informed consent, but it does begin with owning your own part it in it. That is challenging to your core self and not all are going to be able to do it.

  12. Well said, Patrice. I like the point that Accidentally Mommy brought up, it made me think. There's a big difference between becoming defensive because you're being criticized, and becoming defensive because someone else shared their different choice, though. We should certainly defend our choices when they come under attack; we should not feel defensive about our own choices when others choose something else.

  13. Ive been told I am stupid for wanting a home birth or a birth with out drugs for my next child..."why not use the numbing drugs, they are there for a reason"...I hate comments like that. With my first and only I was forced into an uneccesarry c-section through lies and manipulation. NEVER go to an educational hospital to have children, if you go to a hospital at all.
    Because of my experience I want as far away from traditional medicine as possible. I know that it is there to help if its needed but I don't think that it was ever really needed in my case.
    I don't blame other mothers for my choices...that is ridiculous...I will own it but I will also say that there are docs out there that will push drugs on you...

  14. @ Anonymous (12:25pm) You made the point that I was going to make in response to Accidentally Mommy. There is a difference between defending yourself when being directly attacked, and getting defensive when someone else mentions their own choices that are opposite yours.

  15. Accidentally_Moomy, sorry you had those complications with your labour. It sounds to me that indeed, you did make an informed choice, a choice that you wre comfortable with and that was right for you and your babies.

    I can attest to the fact though, that many, many women do make choices about inductions, epis, and so forth, without knowing the full danger and the risks associated with each medical intervention. And then, they are perplexed that they end up wish an emergency c-section...

  16. @Patrice and Anon No. 1: Thank you. When I initially read this post, I interpreted the tone incorrectly. Having gotten a bit more sleep, I see the correct point being made. ;) Again, well done on THIS point, as well. ;)

    @Anon No. 2: You're quite correct, and it's so beyond unfortunate that maternal/fetal care lacks the basic transparency found in other "first world" countries like our own. Go forth, make these choices... but make them as an informed participant, which is the age old and much-discussed thing that Patric, you, me, and so many other women are desperately trying to get across. *sigh*

  17. Love, love, love. I agree, I don't understand why people get so defensive when we talk about choice. I also hate how people blame this information for "making" them feel "guilty" about their own choices. It's just ignorance trying to silence truth - that's all. Those people need to come to terms (or not) with what happened to them and stop trying to shut those of us up who actually care about helping women.

  18. I've made this same "rant" many times. I hate it that on some messageboards or facebook you can't even talk about homebirth or breastfeeding without people getting all defensive! And I have to wonder why people read these things if they know it's going to upset them that much.

    Last month I posted my congratulations to my friend who triumphed over infertility and gave birth to healthy twin boys at home. You wouldn't believe the hate mail I got!

    I had a natural birth and have been breastfeeding for over 3 years and it's like I'm not even allowed to be proud of what I've accomplished because somebody will think I'm judging them just for talking about my choices.

  19. I could have written this, though not quite so eloquently. I've been saying this for a couple of years now. If people are confident in their own choices, then there is absolutely no need to get defensive when I mention mine. I do think that we have to be mindful though, of people who DO make healthy, informed choices, but circumstances lead them down other paths that they feel may feel sad about need to process (like the home birth turned necessary c/s). Sensitivity when talking about choices goes a long way. (Not say you aren't sensitive, but I know some people may have a tendency to not be.)

  20. @ Amber ~ I agree completely about having some sensitivity when we talk about certain topics, especially in mixed company. I think that tact goes a long way too!

  21. I'd like to weigh in. I've definitely seen people get hyper-defensive when faced with a choice somewhat different from their own (breast vs. bottle, for instance). Inevitably, feelings get hurt, someone gets defensive, and fur flies. Usually, the person who made the (let's call it what it is) lesser choice obviously feels guilty but is unwilling to own their say-so in the matter.

    But I've also been on the receiving end of an outright inquisition over *why I had cesarean sections, and was I one of those "rare" women who actually needed one, and didn't I question my doctor, etc.

    It's upsetting at best. I most certainly did not want a cesarean section and I was well-educated about birth, but after pushing my first son for four hours, I gave up. I was suffering from severe pre eclampsia, bed-bound for obvious reasons, and getting sicker by the hour. Four hours -- four solid painful hours -- not of labor, mind you, but of active, hardcore pushing. Maybe I didn't "need" the cesarean section. But I felt like I could push no longer, and I opted to have the section.

    My other two sections were under more or less similar circumstances, pregnancies plagued by pre eclampsia, and by the time I got to my third, no one would attend a VBAC for me, lol. I've made peace with those choices, and I certainly don't blame anyone else. But so help me, I get my hackles up every time some woman asks me, "But you know, there's really no such thing as cephalopelvic disproportion, right? You might have been able to birth him had you pushed another hour."

    Well, anyway. Loved your blog, Ms. Byers, and will be reading more.

  22. Piper, thank you for your comment. I completely understand where you are coming from. Like I said before, I don't condone the attacking of an individual or her choices and I certainly don't believe it's anyone's place to try convince any woman her choice was wrong, or that she should feel a certain way about her choices. I think sometimes, we as birth advocates can get so caught up in trying to change the system, that we forget that NOT every c-section is done under false pretenses or leaves a traumatic scar on women.

    I do thank you again for you comment and reading my blog!

  23. "Or my favorite, get defensive and hostile when a person makes a choice opposite yours."

    Yeah, but that's exactly what you're doing lol

  24. "Or my favorite, get defensive and hostile when a person makes a choice opposite yours."

    Yeah, but that's exactly what you're doing lol

  25. What would you say of a woman who has chosen (something you're purportedly big on) to have an elective C-Section with no indications? D you sa she is 'uneducated' or 'uninformed'? After all, the WHO has found that this is the form of birth with the lowest mortality and morbidity rate.

    Sure, you could say they lied about the numbers to promote medical birth. You could say this if you're into paranoid conspiracy theories. Because someone doesn't come to the same conclusion based on solid evidence than you, it doesn't mean that they're uninformed or unintelligent. Unless you really are for choice, which, based on your use of personal anecdotes as fact I don't think you are, you might consider changing the name of your blog to "Birth MY Way".
    I'm not saying natural birth is an unintelligent choice at all, because that's safe as well, all things considered. Where are all of these people who say "Birth is a disease and needs to be treated as such" that natural Birth advocates rally against? I defy ANY of you to find something and post a link to where it says this, or advocates this. I don't think hardly anyone feels that way, so why all the anger? You're safer giving birth ANY way than driving. I'm tired of women shoving their way down everyone's throat. It's none of your business how anyone gives birth, so what gives? (Not meaning this as a personal attack in any way, just wanting to promote not following any one particular philosophy blindly). If you guys really cared about helping women prevent unnecessary surgery (unnecessary as deemed so by casual observers, at that) then why not attack the plastic surgery industry instead? Those surgeries by definition are unnecessary and ALL side effects unnecessary.

  26. "Love, love, love. I agree, I don't understand why people get so defensive when we talk about choice."

    GROAN!! Because you're not talking about choice!!! You're talking about the way you think it ought to be.

  27. @ Anonymous (7:53am) - You asked: "What would you say of a woman who has chosen (something you're purportedly big on) to have an elective C-Section with no indications? D you say she is 'uneducated' or 'uninformed'?" However, I think you've already made up your mind as to what my answer would be. To answer you question, I don't know. She may be uneducated, or uninformed. Or she may know all the risks and benefits, and made her choice based on that. You can have an elective c-section, without any medical indication for one, and still be educated and informed, and for me no matter whether I would do it or not, I can't in good conscience say that a woman can not have that choice. I advocate for informed choices.

    However this blog is about being happy with your choices, owning your own feelings. When I talk about what I believe in, unmedicated birth, vaginal birth, home birth, midwifery, the positive affects of doula care, it's not an attack on the women who choose otherwise and that's what this blog is about. I invite you, and the others who posted just above and below you, to read my other blogs on here, before decide that I am advocating for only women who do things my way.

    Lastly, I couldn't get open your link you posted about The Who saying that cesarean sections had the lowest mortality and morbidity rate. Is it possible you can re-post it please.

  28. @anonymous (7:53AM) I have had to confront my distaste for a purely elective c-section,recently. Did I jump to the conclusion that this mother was uneducated in her decision? Probably, I am guilty of thinking that most women don't put much thought into their birthing experience. Was she uninformed? I don't know, I venture to say no, because she seemed quite surprised to learn her baby needed a NICU stay because of wet lung. I advocate for a woman to be in charge of her own birthing experience, and this includes elective cesareans. I also advocate for complete disclosure of risks, and patient education. Do birthing mothers get this? Almost never.

    FWIW, ALL Plastic surgery is NOT unnecessary. Burn Victims, breast reductions, appendage reattachment, those are unnecessary?

  29. Well, I am for now going to chirp in on the last couple posts re: the c-section issue- that was posted about- can we talk about how doctors massage the truth at times DURING labor in order to speed to the outcome they are hoping for/hoping to avoid?
    I know someone will say cite stats. Or holler: “Proof please”- all I can tell you is that I know this anecdotally after hours of dialogue with birth enthusiasts, midwives from a variety of educational backgrounds- CPMs and CNMs- my wonderful and current obgyns, a trial attorney who specializes in birth injury cases. I am interested in this because of my own experiences, and interested in public health issues. I am not opposed one single intervention that is medically necessary or to save a person's life in the case of say a 40-41.5 week old baby who is literally ready to be born but having a physiological difficulty getting out (no, I don't know the terminology that is how I can explain it to the best of my ability.)

    I think a huge problem right now first in looking at maternal health care and this can be extended to some aspects of other medical specialties is that doctors/CNMs and hospitals are no longer able to truly practice medicine. I am absolutely convinced of it because of some bad care I have received in my recent past. These reasons are complex but I think because of this, the actual skill level and their ability to deliver care has suffered greatly.

    This is a huge portion of the problem in a breakdown of informed consent in maternal health specifically, birth. In labor, a doctor will explain the risks and then the benefits of a drug or procedure- but the risks because they have been so distorted by "horror stories" etc. have taken on a meaningless nature. I see this all the time in “birth stories”- it drives me nuts!!!!
    People have now become so accustomed to the risks and interventions they are being offered in hospitals as an exaggeration that their hackles go up- the minute a doctor/nurse midwife mentions them. Consumers no longer have the truth they need to make an informed decision at the time of an emergency.
    Here is a little example, I want to use because this one little tidbit hardly goes mentioned- everyone loathes the use of Pitocin during labor but, and pardon me- you bet your a@* you want it if you start to have a post partum hemorrhage. No one likes forceps or vacuum extraction but if it came down to the use of them or an intrauterine fetal demise- you would want the doctor to have the skill to not only make that call but use it too. People would plead with their doc/midwife to save their life, save their baby's life- but we have become convinced that interventions are our enemy. That is one piece which entire books could be written about. I honestly after reading what feels like hours and hours worth of birth stories (hours I will never reclaim)- that people cannot in any way imagine the other option which was that your baby died because you refused an intervention. I was moved when I finally after years of wondering what “rarity” looked like in terms of a uterine rupture-found a story where a mother attempting a VBAC in a hospital lost both her baby and her ability to bear children because of a uterine rupture. This to me was hugely enlightening. I don’t minimize the fact that a bad birth is traumatic – it certainly is and one cannot help but feel a sense of coercion, but I wish we could get more logical about it- what is the alternative- a dead Mom, a dead baby? I guess I would hope (and I have two absolutely horrible birth stories BTW totally traumatic) that we can go deeper in our discussion.

  30. This is part II, I have a "big mouth"

    There is certainly a difference between saying birth is dangerous, we have to acknowledge that birth carries enormous risk. I think this is a better phrasing of it. Skilled attendants manage the risk and when they don’t there is a possibility that it will all go awry. Another part of this is when we are somehow characterized as uninformed about the need and existence of c-sections (different than the talk of it during a long or difficult labor) I have never attended a childbirth education class held in all settings at hospitals, in church basements with a DONA doula,trained childbirth educator leading it, and in OB's offices where the actual nuts and bolts of a c-section were not described. NONE, THEY ALL COVER THIS ASPECT OF BIRTH. How many of us though mentally check out for that portion? (I know I did). C-section information is available everywhere, we have a mountain of resources to inform us of every aspect of the process, yet some of us are prone to saying we were coerced, or bullied, or misinformed. I honestly think is we start to get honest about this we may make a tiny bit of progress about the choice war in birth.
    Insofar as natural birth is concerned- I am evolving in my thoughts around this. I am honestly beginning to think that if a person is able to have a purely natural, unmedicated entirely, episiotomy, and "tear free" (pardon me TMI), and absolutely no post partum bleeding etc. that and I know I have to say this carefully so I don't get attacked- you should consider yourself extremely lucky. So when we get back to what constitutes choice- you can choose a "natural" birth, but I think I need to acknowledge that in order for a labor and delivery/birth/ whatever you need to call it- to go optimally well- a literal million other things from the minute you got pregnant have to go perfectly well too. Pregnancy and birth are not inseparable which we can identify by the maladies that strike mothers either early in pregnancy or at the end. I honestly think because of these factors alone at the literal embryological level- etc. we cannot talk about berating "choices" and I certainly don't think given these variables we can try to "sell" our choices to people because we are all unique in our own physiological make up and what is good for one may be impossible for another. I think herein lies a huge part of the problem.

  31. I think a lot of people are missing the point. She is not talking about people getting defensive when they are being attacked. She is talking about the fact that people get defensive just by HER talking about HER choices. Not saying her choice is better. And her point is that if you (in general) really believe you made the best choice for you and your baby, then why do you get defensive at the mere mention of homebirth?

    I GUARANTEE you if I post something about MY experience with homebirth or breastfeeding on my Facebook status, I WILL get a bunch of defensive replies about how hospital birth and formula feeding are best for them, and how dare I say they are a bad mother or their children are less loved. I say I can guarantee it because it has happened every. single. time.

    As I said in my previous post, my FB status that said, "Congrats to my friend M for delivering her healthy twin boys at home yesterday on their due date." got several hostile replies. They were along the lines of "Well I'm glad I gave birth in the hospital or all of my kids would be dead." Somebody even said I shouldn't post something like that, because it might hurt people's feelings.

    Why would me congratulating my friend for a healthy birth of 2 babies doctors didn't even think she'd be able to conceive without IVF hurt somebody's feelings? Especially the feelings of a person who claims to be glad they chose scheduled c-sections.

    As for the suggestion that we instead focus of stopping plastic surgeries, once again, I feel you are missing the point. We are not against women having c-sections when we feel they are not medically necessary. We are against women being lied to and pressured to have unnecessary c-sections against their wishes just because it's easier for the doctor. If a woman is fully informed of the risks to herself and baby with an elective c-section and still chooses it, I don't have a problem with that. It's not a choice I'd ever make, but I respect her right to do it.

    What I don't respect is doctors upping the pit to the point the baby goes into distress and they have to do a c-section. Or telling women their body just will never fully dilate b/c their labor is taking too long or their induction isn't working. Or doctors who tell the women that their babies are just too big and don't even give them a chance to deliver vaginally, then remove their 6 pound baby surgically.

    Now if there are plastic surgeons out there who are telling women they will die if they don't get a boob job, then yes, we need to get involved. But I'm pretty sure that people getting elective cosmetic surgery are aware that it isn't medically necessary.

    As for the WHO stating that surgical birth is safer, I find that very difficult to believe since countries with higher cesarean rates have higher infant and mother mortality. Also, the WHO recommends a 15% cesarean section rate and, so it doesn't make any sense to me why they would issue a statement saying that cesarean is safer? Sorry if I'm not inclined to believe a chart from somebody's blog that doesn't say where and when the data was collected, and doesn't even say anywhere that it came from WHO. I searched the WHO website and didn't see it anywhere. So until I see further evidence, I'm going to continue to believe what I know to be WHO's stance on cesarean.

  32. SaanenMother- I almost didn't reply since this is FAR from the original topic, but I've seen many comments like yours that assume natural birth advocates have an all-or-nothing mentality.

    I've never heard anybody say that interventions don't have a purpose, or that they would refuse them at all costs. No, I'm not going to just sit back and let my child die because I want to go natural. The issue most people have is that interventions are being used routinely with no medical indication.

    And FWIW, the hospital birthing class that I took did NOT cover c-sections, other than to show us where the OR is on the tour. And since the same nurse teaches the classes in 5 of 7 hospitals in the area (pop 848,153) the vast majority of women where I lived are not informed about the details or risks of c/s. It's not that we're all just tuning it out.

    I feel bad for making a post that had nothing to do with the original topic but I had to address the previous post that made the assumption that natural birth advocates are against using life-saving measures in an emergency.

  33. @ Erin-
    I hope that my post did not polarize things too greatly that was not my intent. I just no longer accept the she was uneducated, uninformed argument in ALL c-sections because I think we have more information than we could ever want. That is not to say that everyone has access: I live in a rural area with a largely older population and I have to special order any books I want about birth, and it is conceivable that a person does not have the internet, or television. Unfortunately c-sections are emblazended in our culture. I don't even like to watch TLC anymore because all the births end in c-section it seems! I also didn't want to get on too much of a tangient but if a person is lucky enough to go their life without a major surgery- and that is the first surgery, it is horrible! That was my first birth- I hadn't even had stitches like as a kid. I hoped I acknowledged that birth can be traumatic I think even a "normal" birth can be for some people.
    Much of my c-section post was directed at one of the anonymous posters-who I think judging by the actual writing and words they use- I see that "anonymous" person posting the same stuff all over the place. If it is them they spread it like manure over a cornfield- smelly and ripe.

    I also am disappointed to hear that you live in a place where the CBE for your area did not review the circumstances during what might start and unfold- as a routine labor that turns into a surgical event. I honestly see that as irresponsible. Their job is to educate any birthing parents on ALL their options and all the risks and benefits of each whether they agree/favor/disagree or not. I am the type to tell the teaching nurse to eiether step up her game or insist that someone else be teaching the classes.(in my area our so called most local CBE sucks- I got a video for my DH a first time father and that was more extremely thorough and actually really good excet her corny jokes.)
    The worst part of any emergency c-section- is the emeregncy part whether that happens in five minutes or a Mom waits two hours- surgery is one of the worst events in a person's life. The risks of a c-section barring a book that only features a non-intervened, non medical book are most birth books whether ones thinks they are fabulous or terrible or medical. I got the ACOG one as a a welcome to the practice gift from my docs.(It's actually not as bad as I thought it was but the risks are right there no escaping them.)
    I actually don't think that natural birth advocates are all one way or the other. I tried to make it clear that if a person has a birth where no interventions of any kind are used or even considered because things go amazingly well than this makes a person lucky as so many things can go wrong they just do this is an inescapable fact and I feel like for me the people I see who make the most ridiculous claims about childbirth refuse to acknowledge this fact. This sets people up for a horrible feeling afterwards if they don't have a perfect birth.
    I also wonder why some people down a non-intervened/natural birth when I would imagine that for the practitioners involed it would seem optimal- they literally get to fling off their gloves, make sure Mom and babe are well make sure the babe is nursing and literally go on. I don't understand when people "stamp their feet" about it If I were a doc, nurse home birth or hospital midwife I would be psyched- life happened again and everyone is okay.
    I think home birth is fine- you are preaching to the choir here. I regret that anyone would comment to you otherwise on something as personalized as a FB page. I would probably defriend them- that is one of the best features of facebook (not that one needs to surround themseleves with "yes" people- I just think you can get rid of someone just as quick.)I did defriend a birthinista b/c her fellow commenters were just ignorant- I don't know how else to say it- no love lost.

  34. part IV:
    I also think that doctors besides what people may like to imagine- are not ALL wringing their hands "pitting" babies to distress, cutting needlessly in c-sections or episiotomies (btw my friend's HB midwife "cupped" the scalpel in an effort to hide it from her at the end of her birth- she is just as scummy as a doc who threatens with the cut needlessly), I regret that people have met so many crappy docs. I have met both, some really awesome ones who do support Moms and want Moms to have the birth they want. I also was treated to the worst health care ever by an OB practice- that did not provide even a minimum standard of decent care- I just thought everything was fine. Those four in particular- need to learn to do their jobs! I just think in the polarized state of things in birth right now people can't acknowledge that docs really do hold the key to your baby's survival in a true emergency where another birth scenario (home, or uc) may not- and I mean a true, real nothing but surgery as a life saving measure for Mom or babe.(this include perinatologists too- they do not have a crystal ball)

    I also think the WHO stats. may be getting old and outta date I have to go back and read. I also think the WHO poster writes that everyehere they go- they are WHO dependent. I perosnally would rather thoroughly study a smaller sample for different areas- rural, suburban, urban. and study legal home birth and hospital births at a vital stats. office then rely on an internet report. The sheer volume of any data is prone to a margin of error as it passes through all the channels before publication.

    For instance, my doctor whom I trust with my care, I feel we are partners in my care- suggested I VBAC- instead of my planned c-section. I personally think the writing for me is on the wall I don't feel bad about my choice I feel like I would be risking too much for my risk factors to vaginally birth- I feel fina about my choice as I KNOW it is medically indicated. I think he was being helpful but I think if he analyzed my entire chart he would probably agree with me. Anyway he cited stats for stillbirth as 3 in 1000. I think this differs greatly from the stat I had which was 5 in 1000 and this is derived from 2 different reputable sources. I think in other words you have a point erin. I don't know if they found that info. on teh WHO site either.
    Not at Erin- at the posters in general:
    I think what is interesting to me is if anyone stumbles on this blog and does not routinely check in here or visit the facebook page- then they don't know about the bigger picture here. This blogger is trying to get at some core issues and also core problems that are rampant in child birth in general. I have read her now for months and I never feel like "her choices" are being pushed on me. I regret people posted knee jerk vs. thoughtful reactions. I think she posts thought provoking questions and asks us what we think. I think it's just too bad that people feel they have to turn the pointer on her and say: well these are your choices, no,I think she is trying to find a way to present CB options in a way that answers her questions and creates informed consent or opens a larger discussion of thoughtful questions we hav eto develop answers for as they are not fully answered. It is too bad they are quick to judge- contempt prior to investigation is a horrible trait.


    Here is a better link to the article showing outcomes of all types of births. Unfortunately, you have to register to read it. I know what you mean about it seeming suspect since they consider the optimal rate 15%, but they did not change the recommendation that C-Sections be carried out only when indicated. Clearly though, the stats here show safest delivery method as planned c-section with no indications

  36. "I also think the WHO stats. may be getting old and outta date I have to go back and read. I also think the WHO poster writes that everyehere they go- they are WHO dependent. I perosnally would rather thoroughly study a smaller sample for different areas- rural, suburban, urban. and study legal home birth and hospital births at a vital stats. office then rely on an internet report. The sheer volume of any data is prone to a margin of error as it passes through all the channels before publication."

    These stats are from '07-08. This was an Asian study of over 100,000 women. If you use a smaller sample, you have a higher margin of error. It's generally accepted that in studies, the larger the sample the better. I TOTALLY agree with you on the not believing everything you find on the internet thing, but this is from the Lancet, which I do respect as a valid source; at least more so than some places. It shows that a woman with low risk also has a great chance of a healthy birth. We really are lucky that we have such safe choices and shouldn't spend all this time trying to prove each other wrong. =) C-sections can be a beautiful, fabulous experience as well believe it or not!

  37. @ anonymous:

    "These stats are from '07-08. This was an Asian study of over 100,000 women."

    Asian women- ohhhhh okay totaly different health care system right down to who pays and how health care is delivered. So this applies to the broken American Maternity system how? T

    I am too tired to go drag out my resaerch methods text from grad. school- but customarily (with my memory only as the source):

    research from 5 years previous is usually the cut-off and that usually is prone to being older than the published date-

    I would have to look up in a textbook versus the crappy internet- on what sample sizes are best- I still think until a real study is done with real and relevant collection of data- we will spin our wheels- the data as it collected and manipulated is not applicable to the American Maternity system because it varies from area to area so greatly. It also is not ethically applied- I know this may sound like heresy but I have yet to see an American Maternal Health allied organization collect relevant data.

  38. I apologize for my repeated horrible spellings.

  39. "I have yet to see an American Maternal Health allied organization collect relevant data."

    I wonder why?

    You can hardly call this study irrelevant because it's Asian women. It's the method of delivery that was used, which is the same regardless of the 'medical system.' If anything, it would just show that Asia has better OB/gyns. This is published in the Lancet, which I would hardly call a crappy internet source, and conducted by the WHO. They've been around far longer than the internet.
    I'm not trying to be a troll, and I agree with you. I'm just tired of hearing that a woman who has chosen a c-section is 'uninformed' and submitting blindly to their cash motivated medical establishment. I wanted to show that it is a very valid conclusion to come to that elective c-section is safe, and it doesn't automatically mean someone is 'uninformed.' It sure as hell does not mean someone is unhappy with their choice because they get defensive when they constantly hear the ever so condescending "hmm. Well it's OKAY to have a c-section IF you really need one." Need one according to whom? Some anonymous person on an internet message board? Facebook friends that you hardly know? Every time c-section is discussed, women have to immediately point out WHY they had to have it and prove that it was really really necessary, and they feel the need to prove that they weren't necessarily duped. I certainly hope women who choose home births or natural births do not encounter the same type of criticism, as I truly do believe in choice. Here on the good old internet people seem waaay too interested in the bodily functions of others. In real life, if you tell someone you've had a c-section, they don't really get into it this much.
    Anyway, again, I mean absolutely no disrespect to the fine woman who owns this blog...and I don't mean to bust in if I'm unwelcome with my opinions. lol - I'm a big mouth too. =) I just like to discuss and debate. I hope you all have a good day!

  40. "=) C-sections can be a beautiful, fabulous experience as well believe it or not!"

    well anonymous- you lost me with this one, fabulous? Smiley face? I have never seen major abdominal surgery with the risk of hemorrhage or a misplaced epidural needle (all surgery carries risks) and having to take narcotics afterward, as a fabulous experience- call me crazy. (ps: I have had two c-sections both emergencies. have a planned one in May, and have had illeocecal surgery in an absolute life saving emergency- (none beautiful or fabulous.)

    Let's go over some points-

    Asia is a continent so looking at a 100,000 person cross section does not satisfy what I would call a meaningful sample- as that could be China (where population growth is tightly controlled), Japan, where medical care is priced equally and all doctors can only accept what the government sets for a procedure fee from a literal governmental fee book an ultrasound in Japan 10.00, an ultrasound in America- hundreds to one thousand dollars, India, if it is southeast Asia, and then we cannot even begin to account for the rural areas-. So you can tell me that God almighty whomever that is conducted the study and I still think I would take it with a grain of salt. Lancet or no lancet- It is an inane point to use stats. that do not reflect the current climate or stats. for the c-section problem in America.

    I love anonymity but I think I would be more inclined to consider your points if you used some alias versus no alias. I think it makes people have to be a little more accountable to their fellow commenters.

    I also know full well why- what I call Allied American Maternal Health organization doesn't have relevant data- they are all too busy fighting with each other to cover up their variety of sins- to give a turd.

  41. I also know full well why- what I call Allied American Maternal Health organization doesn't have relevant data- they are all too busy fighting with each other to cover up their variety of sins- to give a turd.

    lol, ITA. I'm sorry about the anonymity factor - when I select name/url it says "Your request cannot be processed now..." What difference does it make? I'm pretty sure we don't know each other... My name is Ames Anton.

    There are lots and lots of stats and studies that show elective c-section is safe! With all the 'research' that gets done I'm surprised you're acting like I'm trying to pull one over on someone by making this up. I'm in no way telling anyone to go get any specific type of birth or experience. This study in question shows intervention free birth is safe! These data do not give me any pause as to their validity - there's nothing earth-shattering here. If you care to, I'd like to see studies that you trust saying that elective c-sect. is unsafe if that's what you're trying to say. If you don't want to bother I understand that, too.

    I had a c-section, and yes, I do look at it as one of the very best days of my life!
    I also had a natural birth (wasn't really against pain relief, just didn't have time for any), which also was one of the best days of my life! Emotionally, yes, I will smily face away. Physically, BOTH sucked ass. I was disturbed with the vag. birth that noone told me for real how fucking awful it was, seriously. I could see how it could make someone come unglued - I actually had the thought that someone was trying to torture me. Yes, you're made to give birth and yes it hurts! Can't really compare mine side by side because there is so much time between my kids I can't really say which physical feelings were caused by birth method or the age I racked up in between the two.
    Anyway, my point is and has been -
    It is unreasonable to assume that someone who has chosen a c/s is 'uninformed.' When real research (or at least research that a woman trusts to be credible)shows that it is not statistically less safe than planned home birth why are women criticised for choosing this? Why are they criticised for choosing home birth or natural birth? If you're making the argument from a qualitative standpoint I must disagree that either type is THAT much different from the other. Physically it's different but emotionally/spiritually - no it's not.

  42. "When real research (or at least research that a woman trusts to be credible)shows that it is not statistically less safe than planned home birth why are women criticised for choosing this?"

    yeah--- ames anton-whatever- you just sound a good cop to a very stringently opposed bad cop who is fighting obsolescence as we speak somewhere in internet land- I have no regard for your musings anymore. I can tell at any minute you will become a complete a-hole so--- I'm done for now- there is only one internetter who says "planned home birth" and I have better things to do with my day then play good cop- bad cop- with you.

    Thanks Patrice- I am looking forward to the next segment in your blog thank you for trying to make a difference.

  43. I'm sorry, I didn't mean to give you a bad impression..."planned home birth?" what's wrong with that? My husband was born at home, and it wasn't planned, I'm sorry if I'm being confused for someone else (?) I'm kind of hurt you think I'm about to become an a-hole, and I honestly thought we were having an interesting discourse. I guess it's true - you can come across all wrong in writing.

    I too appreciate Patrice and value her opinions and space

  44. Oh P, you have such a wonderful way with words. You have hit the preverbial nail on the head.

  45. Aaaah, this happens all the time. I only have to mention I breastfeed, and someone tells me I am making them feel guilty.
    I knew nothing about birth when I gave birth, and, I ended up with a c-section (I am not surprised)
    I don't feel guilty about it, I am mad at myself, but I LOVE LOVE LOVE hearing stories about natural births. No on can make me feel guilty except me, and while their is a time for guilt, their is a time to let it go also.
    I love this article ! :)

  46. then why do you care so much about another woman induction or the fact that she choose an epidural????
    the problem is misinformation, the risks of severe side effects or injury from an epidual are 0,0004% yet all I read all day all over NCB page are the RISKS...... how dangerous it is..... you have more chance of your baby diyng in a HB attended by a CPM, or unattended than from an epidural...yet no one ever talk about the lastest......I wonder why??

  47. THANK you! Fantastic post, well said! When we mention that we had a fantastic natural birth, and even try to help others see the light, and they think we're JUDGING them, just because WE had a GOOD experience, THEIR defensive/angry/guilty feelings come out, and maybe they don't even know it. SO frustrating! And to the "defensive" people commenting on here... we're talking about low-risk pregnancies here. Of course there are exceptions.

  48. I like this blog, I found it interesting. I have to say though I do end up defending myself sometimes because I get frustrated with the assumption from some women that because I have had 2 C sections, one emergency after induction and epidural and the second elective that I must be one of 2 things- "unempowered" and totally disappointed in how I gave birth or a bit stupid and uninformed. This is simply not true. I was well informed and happy with my choices, I enjoy giving birth by c section and I will defend the fact that yes you can have a good birthing experience without having a natural birth. I also get defensive when I hear people say that having a cesarean is not really giving birth. That is CRAP! I'm happy for anyone who has a natural birth, if that's what they wanted, but just as happy for anyone having a cesarean birth. It all leads to the same result- a baby being born so why the stigma or the negativity?. I believe all birth is beautiful and there is no way or birthing that is more special or better than another.

  49. I feel the same way. If you are mad about the way you gave birth, that is fine, but please don't take it out on me and my birth choices. I feel like every time I say how I'm parenting or what I do during pregnancy/birth, I have to say something to the effect of "I'm not saying this is the only way to do _______(whatever it is, birth, breastfeeding, parenting, etc), this is just the way I do things."
    My cousin actually defriended me on facebook because I made a status update about how I was having a hard time getting things done because I wouldn't let my then 4 month old just cry so I could do dishes. She got really upset because I kept saying that I wouldn't just let my kid cry....and she and her husband did. You could tell just by the defensiveness of her comments that she felt guilty about it. It's so sad to me. Me just having my own opinion about how to parent essentially ruined my relationship with my cousin because she felt I was personally attacking her when I did no such thing.

  50. Also, I realize that my comment had zero to do with birth, but it's still along the same lines and the only story I could think of right now. Ha.