Ina May Gaskin – A Mama's Blog

Since the five years I have had my C-section, I was told many times that I should just be grateful my baby was okay, and I should get over the negative feelings that I had regarding the experience. I noticed that almost every woman who responded to my questions had something about her C-section that she was not happy about, or had been unprepared for.

I think our society is very harsh with mothers who have given birth by C-section in this regard. A C-section not only brings a new life into the world, but it is also a major abdominal surgery. If a heart patient has a negative experience with heart surgery, their feelings are usually not discounted and told to get over it. Of course all mothers are happy their babies are born healthy, whether they are born vaginally or by C-section. But that does not, and should not invalidate any negative feelings a mother may have giving birth by a surgical procedure.

Simply saying a mother should get over it, and be happy her baby is healthy is like telling a survivor of an awful car wreck, “at least you didn’t die,” or “you should be happy you are alive.” That is a given- but the pain and trauma from the experience also needs be to validated in order for the survivor to heal. We acknowledge the pain and suffering of car accident victims all the time. We do not invalidate the victim’s feelings just because they are alive.

Yet that is what happens to women over and over again, who share their negative C-section feelings. Their feelings are invalidated and they are told and expected to dishonor any negative feelings they have about their C-section births.

Birth is one of the most powerful things a woman experiences- what kind of message does that send to a mother when she is told her feelings she has regarding her C-section are not valid?

The C-section rate continues to rise in the United States every year. According to Childbirth Connection, in 1965 the C-section rate was 4.5%. It is estimated that when the 2007 figures are released, they will show the rate over 30%, or one in three births are a C-section. In some hospitals, the C-section rate is 50%.

My C-section made me doubt my body. I trusted my doctor more than myself. Doctors are experts in medical procedures, and we are all grateful to have them for medical emergencies. However, women are the experts on their bodies. For thousands of years, midwives- other women- assisted during birth. Birth is normally not a medical experience or emergency. Yet, that is how the entire process is generally approached. Women are made to feel that they are not capable of giving birth without a doctor present in a hospital.

Ina May Gaskin, one of the most famous midwives in the world, who has her own birthing center in Tennessee, did not have a woman who needed a C-section until the 187th birth that she attended. The next C-section birth didn’t come until after the 300th birth. Contrast that with one in three births being a C-section today.

It is my opinion that women are losing the ability to believe that their bodies can give birth, and birth is not a medical condition. Add to this, the women that are told to “get over” their negative birth experiences and not acknowledge their feelings. How does this attitude in our society prepare a woman for her next birth? How does this psychologically affect her? Is she more likely to believe in her body for the next birth or decide she needs a C-section?

C-sections have their place, and I am the first to acknowledge that. But with every C-section that is performed that is not a true medical emergency, I believe we are teaching women and girls- the next generation- that their bodies are inadequate- incapable of giving birth without a major surgery. As long as women allow doctors to make the calls for them, the C-section rate will continue to grow, and our choices for birth diminish.

Women need to support each other and share their birth experiences. Perhaps one story of a successful VBAC will encourage another woman to try a VBAC. One story of a woman’s experience with a C-section will help another woman avoid one. We can support each other and learn from one another. By sharing the good and the bad of our birth experiences, we lay the groundwork for allowing women and girls to trust their bodies. After all, women are the experts in childbirth. Who better to learn about birth from than another woman who has experienced it?

Karen Walker, a midwife, believes that “obstetricians will continue to encouraging the birthing mom to sacrifice her body on the operating room table until women begin to take the responsibility of her birth upon herself.” She says, “Doctors will get off their pedestals only when women get off their knees.”

The Unnecesarean.com was the first place this week that I read about Lauren Plante of Thomas Jefferson University’s essay, Mommy, What Did You Do in the Industrial Revolution? In her essay Plante compares industrial obstetrics with the industrial revolution. One profound statement she made when comparing modern obstetrics:

Industrial obstetrics strips the locus of power definitively away from women. The history of childbirth in America reflects a persistent trend of increased control by physicians and increased medicalization. Childbirth moves, first, out of the home, and now out of the vagina. (bold print mine)

It is interesting to note that Lauren Plante is an OB/GYN.

It is my hope by sharing my C-section experience, other women’s experiences, and by continuing to write about C-sections, that women who are considering a C-section for a non-medical emergency, can find real life experiences, thoughts, and information from other women that will enable them to trust their bodies can give birth.

We each are given the power over our bodies. The power is there- in all of us- to give birth to our babies. We have to trust that our bodies can do what they were made for. We have to get the information we need to feel confident in our bodies. When will we feel we have given enough of our birthing power and choices over to the medical industry? When the C-section rate nationally is at 5o percent? 75 percent? 100 percent?

It is every woman’s right to attempt the birth experience that she feels is best for her baby and herself. Please don’t give that right over blindly to a doctor simply because they are a doctor. If you don’t want a C-section only because your baby is breech, then do what I didn’t do- fight to preserve that right. Seek out midwives or another doctor. If you are told your hospital doesn’t allow VBAC’s, and you want one, do what I did- find another hospital that allows it. You don’t have to settle for a birth option, just because a doctor says that is the only way.

If we, as women don’t demand better from our doctors and hospitals, then we, and our daughters, will never get anything better from them. We will never get better choices, better information, better treatment, and ultimately better births.

I watched The Business of Being Born (TBOBB) last night (available now through Netflix). This is a documentary produced by former talk show host, Ricki Lake, on the state of birthing in America. As I posted the other night, in short the summary of the film is this: (from The Business of Being Born’s Website)

Birth: it’s a miracle. A rite of passage. A natural part of life. But more than anything, birth is a business. Compelled to find answers after a disappointing birth experience with her first child, actress Ricki Lake recruits filmmaker Abby Epstein to examine and question the way American women have babies.

The film interlaces intimate birth stories with surprising historical, political and scientific insights and shocking statistics about the current maternity care system. When director Epstein discovers she is pregnant during the making of the film, the journey becomes even more personal.

Should most births be viewed as a natural life process, or should every delivery be treated as a potentially catastrophic medical emergency?

As I settled in to watch, I was expecting a “good” documentary on a subject that interests me. To be perfectly honest, I don’t watch very many documentaries, and had kind of figured this would be like The Baby Story, but in reverse. Instead of seeing high drama-hospital medical births with drugs and C-sections, I would see midwives and natural home births.

In no way was I prepared for my reaction. Shortly into the 1 hour and 24 minute documentary, I was in tears, sobbing. It was like a floodgate had been opened, and every vented up emotion that I had about my own experiences giving birth, was released.

I was in awe of the beautiful, natural, and peaceful births shown at home, with skilled and highly trained midwives. During labor, the mothers were roaming around their homes, freely and unobstructed. There was a woman who had a water birth, with her young son watching, totally calm and relaxed. There were images of newly born home birthed babies lying peacefully and contentedly on their mother’s chests just seconds after being born, gazing lovingly up in their mother’s eyes. The mother’s, though tired from just giving birth were alert, happy, and peaceful.

Those images were contrasted with the “typical” hospital birth. Women in bed, hooked up to monitors, oxygen masks, and IV’s, with drug cocktails dripping into their systems. Babies left screaming and crying in the incubators by themselves, or not “allowed” to be with their mothers immediately after birth. One scene showed an exhausted mother, being prepped and wheeled off on a gurney to the operating room for a C-section. It was not hurried, so I don’t believe it was an emergency C-section, rather more likely than not, she was not able to birth her baby in the allotted time that so many hospitals have. She had her eyes closed, totally detached from the experience, and it struck me like she was a lamb going off to the proverbial slaughter.

It was so striking seeing that, compared to the homebirths. The women at home were in control and had complete and entire power over the birth of their babies. They were the ones who decided when it was time to birth their baby, and they had total confidence in their bodies. They didn’t need IV’s, drugs dripping in their systems, weakening the labor process, constant monitoring, doctors and nurses telling them when to push, and micromanaging their labors, and they didn’t need C-sections.

As I sat there watching this, I kept thinking of the women shown having their babies at home, and THAT is what birth is supposed to be like. That is how women have given birth for thousands and thousands of years, until the last fifty years or so in America. Women should be the ones to dictate how the birthing of their child, their flesh and blood goes, not doctors, nurses, and hospitals who have to practice defensive medicine to avoid lawsuits, and to meet insurance companies criteria.

It was a powerful moment for me, and I realized how angry I have been about Ryan’s birth. I have written about my C-section before, but in summary, the only reason I had to have a C-section with Ryan was because he was breech. No other complications or problems. A C-section was my only “option.” Doctors don’t “do” breech vaginal deliveries anymore and certainly not where I lived. At the time, I didn’t consider home birth an option, and in my state it is illegal for midwives to knowingly deliver a breech baby anyway.

I trusted that my doctor was doing her best for me, but in reality she was only doing what she “had” to do. Advise me a C-section was the “safest” way to deliver a breech baby. She was in a large HMO practice, and even though she told me about doulas and exercises I could do to try to turn the baby, she probably couldn’t have told me the truth about what I was in for, even if she had wanted to. I am sure she had strict guidelines to operate under.

TBOBB gets right to the root of this terrible epidemic- women are basically forced to give away their birthing power and choices to the doctors and hospitals, without really realizing what is going to be “done” to them, because it is not explained for the most part to them ahead of time. As I watched that poor, drained, and drugged, mother being wheeled off to her C-section, I saw myself in her- I saw her power gone, totally helpless and at the “mercy” of the surgeon who was about to operate on her, because her body “failed,” and she could not give birth.

I realized for the first time ever, that I felt like I had failed Ryan and failed my body, because I was not allowed to even try to give birth to him. Even though I doubt my doctor wanted to make me feel like that, it was recorded in my subconscious, that because my baby was breech, somehow my body “failed” at being able to get him in the “correct” birthing position, and now the only option was for her to step in and “save” me, save my baby by cutting open my abdomen and performing surgery to get him out alive. I felt totally duped and mislead.

Never mind that babies used to be born breech all the time, even when they had less technology. Joe’s oldest sister was born breech in the 60’s, and guess what? She was born healthy and Joe’s mother was just fine too. Never mind that one of my good friends gave birth at home to a surprise breech footling 9.5-pound baby boy in 2006. Guess what? Her son couldn’t be any healthier today, and she was fine too.

I was mad after seeing the peaceful homebirths that the state of birthing in this country is what it is, in that it denies women the opportunity to have the birth that they want. It doesn’t even allow for exploration of the choice, it just eliminates any choice whatsoever.

I was very impressed and surprised that there were so many doctors, and OB/GYN’s in the film saying that the current system wasn’t working either. One of the doctors at Mt. Sinai in the film said something to the effect that if something isn’t done, and if someone doesn’t step in, the caesarean rate will soon be at 100%.

Several of the doctors said that with a skilled midwife, homebirth was very safe, and was usually a good option for women.

I was thrilled to see Ina May Gaskin (the most famous midwife in the world) in the film. I had the privilege of hearing her speak in a town near me last May. She pointed out that she didn’t have a mother who needed a c-section in her care until birth number 187. Contrast that with 1 in 3 births today end in a C-section.

One of Ina May’s quotes that she had in the movie, which I loved, was right before she gave the C-section number in her practice, was an answer to the argument that women in America are different from other women in the world, hence the high C-section rate. Right after she stated that they didn’t see a C-section until birth number 187, and then they didn’t see it again until a birth in the 300’s (I can’t remember the exact number she gave). She said, (and I went back and reviewed several times what she said, and wrote it down), “That tells me the pelvis of the American woman is just fine-thank you very much.”

There was another man who was in the movie several times, with some powerful statistics and commentaries. Forgive me, but I did not get his name at the beginning, and by the end of the film I was too exhausted to go back and find his name. But he was the older gentleman with the short grey beard, and I believe he was a doctor, but am not for certain.

He was giving a lot of background information on birth in this country, and how they used to tie and strap women down in the hospital, give drugs during labor that caused children to have severe deformities, etc. He said at one point, “If you want a humanized birth, get the hell out of the hospital.”

He also drew a great analogy. He mentioned that when he speaks to groups of OB/GYN’s and tell them about home birth, he said he always gets groans and heads shaking. Then he asks the doctor’s who have actually witnessed a home birth to raise their hands. He said he has never gotten a doctor yet, who has actually observed a home birth. He said they are like a geographer who is trying to describe a country that they have never been to, but are too afraid to visit. I couldn’t agree more.

There was another doctor an, older OB/GYN in the film who was also a researcher. I didn’t catch his name, but I do remember his credentials. He was from another country, (Ireland?), and had a heavy accent, so when he spoke there were subtitles. This made it very easy to write down what he said. He had many, many, compassionate and very true things to say about birth, and how we need to just stop down the road we are going and go back to square one. He said square one starts with the midwife.

There were so many other important points and information in this movie. It was amazing. I didn’t know it was possible to make so many points about birth in just under an hour and half. It touched me deeply, and I imagine it would strike a cord with almost any woman, whether you “believe” in homebirth or not.

It wasn’t so much a “homebirth” message, but a message on birthing, and women are powerful and are capable of managing their births the way they want. It shows that there are some options that we don’t hear about very often, the option of homebirth.

The only small critique I have of the film is when they showed statistics, it would have been helpful to list the source of the statistic. It could have been listed in the closing credits, but I didn’t watch for it. I think it would have been more powerful and more creditable to list the source of the statistic when it is shown. But it is an excellent film, and one that I hope to watch again.

If you have even the slightest interest in maternity care, or why hospitals and doctors do the things they do during birth, this film is a must see. It is by far the BEST media subject I have seen on birth. If you do watch The Baby Story, watch this. You will be astonished. I am so grateful that this film was made. At the very least it has helped me in the last 24 hours come to terms with the feelings I have about Ryan’s birth.

I will leave you with a quote, which was extremely powerful for me, from the wonderful OB/GYN researcher in the film. He said so elegantly, when talking about what we are doing is clearly not working, and is not what is best for mothers and their babies was this,” When you talk with certain women who still have a sort of intuitive knowledge of the importance of what is happening when the baby is born, they cannot accept that caesarean section is the future. They cannot accept that.”