February 27, 2006

It's a Hat Day...


This is me in my red knit hat...
My DH, my children, and my dog all know what it means when I declare it a "hat day".
(I'm grumpy about something, I need a little time to stew, and to go into deep, dark thought.)

Here's what's on my mind.
During the early 1900's a great effort was made by many "obstetrical doctors" to eliminate midwifery. They spread word to women's clubs (like the WI and the Women's Christian Temperance Union)all across North America that midwife assisted births were dangerous, unclean, and inefficient. Quotes like the following were not uncommon.
The midwife is a relic of barbarism. In civilized countries the midwife is wrong, has always been wrong. The greatest bar to human progress has been compromise, and the midwife demands a compromise between right and wrong. All admit that the midwife is wrong.
- Dr. Joseph DeLee in his paper, Progress Towards Ideal Obstetrics (delivered in Chicago in 1915).


I read this quote during my reading in Wolfville and then went on to say, "thank goodness we are seeing more progressive attitudes today...that we live in a time where doctors are seeing the value of midwifery, where tradition, wisdom and science are coming together."

Imagine my dismay when I read the following in a recent column by Jonathan Kay in The National Post:
A little while back, I asked a doctor friend for his take on natural childbirth. He rolled his eyes, as if he'd heard the question once too often.

"Parents forget how many things can go wrong," he told me. "Delivering a baby is a major medical procedure. It's potentially dangerous, and it hurts like hell. Who do you want to be on the receiving end -- a trained doctor backed up by modern life-saving machines and painkillers, or some woman with a Guatemalan hat?"
- from Natural Childbirth? No thanks. Jonathan Kay for The National Post February 20, 2006.


yikes.

(At least Mr. Kay went on to say he thought the physician's statement was harsh...)
On the other hand, while I respect his wife's choice of giving birth any way she pleases, I feel that Mr. Kay gave a far from accurate picture of midwifery, thereby misleading those readers who may face similar choices of their own.

I Never Knew
I haven't always been an incense-burning (he sarcastically called some doulas "incense burning wiccans", Guatemalan hat lovin' gal...
In fact, when my first child was born, I was 25, in graduate school and scared. I didn't even know midwives still existed. I was ushered into the world of "here's what piss-poor grad students get when they get knocked up and can't afford a posh OB/GYN in the States."

Long story short, I learned that sometimes (by the way, I know some amazing OB/GYN's who work shoulder to shoulder with midwives. I'm not anti-OB)in the world of modern life-saving machines and painkillers, one thing soon leads to another.
An induced labour (no one ever suggested a dose of Castor oil or a round of accupressure to move things along) led to being confined to a hospital bed and being hooked up to a fetal monitor and an IV drip, which led to a sluggish labour (nine hours in they told me maybe they should stop and try again tomorrow?!), which led to the doc. cranking the Pitocin up to the point of my having excruciating contractions, which led to me saying 'yes' to a hit of Morphine (when I really didn't want to), which led to me feeling worn out when it was time to push, which led to them whipping out a vacuum extractor and wielding the knife for an episiptomy, which led to talk of a c-section, which led my labour nurse to say: 'don't listen to them' (four doctors had come into the room to witness the use of the vacuum extractor, which didn't work afterall) -'on the next contraction...push like hell!' Thank the goddess for that woman!

I am not alone in this sort of birthing experience. I've had many, many women tell me similar stories, most of them wondering...is that normal?

What I Know for Sure
If it hadn't been for the stories of a legendary midwife who had once lived in my Nova Scotian farmhouse, I probably wouldn't have sought out a midwife for the birth of my second child. What an amazing experience. Every pre-natal visit was at least an hour long. With over 200 births under her care by the time I came to her, I soon discovered the practicing midwives of the Canadian Association of Midwives are highly-trained, competent, skilled, wise, and compassionate professionals.

Although midwives will often accompany their clients to the hospital (for instance, in Ontario, midwives have been a part of the provincial heath-care system for the past ten years), I chose to have a home birth. It was a beautiful day of sharing conversation, tea, and laughter with my family. I took a walk, I played my harp, I baked groaning cake. And, on the scale of "hurts like hell"...compared to the hours of rollercoaster-agony during my first birth, it was 45 minutes of intense pain. Risk? I was not afraid. I had no reason to be. Maybe Mr. Kay would be interested to know that in June of 2005 the BMJ (British Medical Journal) published the results of North American study finding that for low-risk pregnancies:
It is as safe to deliver a baby at home with a professional midwife as it is in hospital. "Our study of certified professional midwives suggests that they achieve good outcomes among low-risk women without routine use of expensive hospital interventions,"


As Dr. Benjamin Colby wrote in his Guide to Health (1846)
We hazard the assertion, unpopular as it may be, that the presence of a physician is no more necessary to the safe delivery of ninety-nine cases in a hundred in childbirth, than it is when a healthy woman is eating wholesome fruit.


And as for Guatemalan Hats...
I was speaking to a midwife a couple of weeks ago and she was telling me of a Guatemalan midwife whose techniques in perineal massage and support has kept every single one of her clients from tearing during childbirth!

6 comments:

Rob said...

Apologies for not commenting on the actual ideas of your lengthy, impressive, well thought-out, passionately argued post, but I just have to say -

I need hat days.

I need something to signal to everyone around me that I'm having one of those days and they'd best tiptoe on by.

Trouble is, I don't look good in hats.

Mama's Kids said...

Ahh those machines that go "ping!!"

I am quite shocked by that physician's statement. Scared of losing your job much? OR does he really believe what he's saying?

My my.

Thanks.

Abby
A birth junkie geek (and fan I guess ;) ) in Vancouver

Cathy said...

What a well thought, well researched reply to Jonathan Kay's column. As a doula I was dismayed when I read this column, but unfortunately not surprised. Women need more information about midwives and their role in natural normal birth.

Ottawa

jodi said...

This is a marvelous essay/blogpost, Ami! You oughta send it to the Post as a personal essay/riposte to Kay's article. (and I think HE could probably benefit from a dose of castor oil.)

I think I need to have hat days too...byt like Rob, I don't look good in hats. But that may be just the point--WARNING! WARNING! stay away because I'm grumpy...or only approach to offer dark chocolate or 'tea with mitts!' :-)

love you,
your Bay neighbour and fellow writer/blogger

Gritessa said...

Bravo Ami, Bravo!

I can so relate to your first birthing story and if I could do it all over again, you bet I'd go w/a midwife. My daughter is almost 6 and I am still so pissed off at the cranking up of the pictocin and no massage whatsoever - but a botched episotomy instead! Same on the c-section talk in the background, so I willed myself to PUSH LIKE HELL!! All this after my water had broke at home 2 days earlier.
And I birthed a 5lb preemie not some overdue 10lber.

Maybe we had the same hospital and 'dr'???

Midwives and/or homebirths are practically unheard of in the U.S.
But I do know a young woman who gave birth a few months ago w/the assistance of her mom and grandmom. I was so thrilled to hear of it!!

Love the hat - I do believe I am going to find myself a red straw hat and see how this works for us - LOL!

Wishing you the best of success, darlin girl.
:)
Namaste,
Grits

I, Knitalot said...

After reading the Kay article I actually searched for any blog responses. I knew there would be some good ones. What Mr. Kay does is a great disservice to women (his wife included) by perpetuating an ignorant opinion that a baby may be most safely birthed by surgery, like a parasite or tumor. He did no research on the known side effects of medical intervention such as epidurals, pitocin, episiotomy and c-section. He does not fairly weigh the benefits and dangers when a woman decides (and often does not decide) to accept these measures. To obliterate sensation is to relinquish alot of your participation. You cannot assist your own birth if you can't even feel your full bladder. You cannot help resist tearing if you cannot move around to another position. AND statistically, most babies who undergo pain intervention (what goes in mother goes in baby) and are separated from mother for more than 20 minutes almost never are able to breastfeed immediately. There are so many invaluable benefits to the colostrum that is the first milk from mother. As you can see, I could go on forever. I believe foremost in informed decision making-to know what the consequences of choices or actions may be in any setting of childbirth. I support women having a planned c-section, though as it is the most expensive method of childbirth I believe women should be given the facts to weigh all the pros and cons before spending my health dollars!