Saturday, September 29, 2007

Thoughts on Birth, The Play and BE BOLD (very long)

Yet another month has slipped past faster than sand through an hourglass. I somehow managed to survive this month, though I think I did so only because I cried. A lot. There have been many sleepless nights and much soul searching going on this past month, yet I don't feel like I'm any closer to where I want to be than I was when this month began. For those of you here for family updates (all is well, kids are growing), I'll post that separately...maybe tomorrow, Scarlett. Tonight, I need to put text to screen in an effort to process tonight's play. If you care about birth ( thoughts on it, anyway), read on...Otherwise, I see you again soon, my friends. Hopefully with pictures, because, kids are cute. :)

Tonight was a presentation of the play Birth, by Karen Brody. I had previously seen the play as performed by our birth network last fall. It was moving then as performed by members of several chapters of our organization for a small group of us from out of state and those locals attending the conference that preceded the day. Tonight's performance was well-rehearsed and planned and incredibly well done as a part of BE BOLD (birth on labor day) going on across the country this month. Next weekend is the Red Tent Event that goes along with the play. Following the play was a panel of speakers -- an OB/Gyn, a certified nurse midwife, a doula/childbirth educator, and an independent (homebirth) midwife. During the play, listening to the characters tell the stories of their births and how they got there, the frustration I have with the current system of maternity care and how our society treats birth really got to me. The play details the stories of several women, all of whom could be any low-risk woman seeking maternity care, and their journeys through birth. The main character goes from being a spectator in the process to a real participant empowered by the birth of her fourth child. There are a variety of experiences portrayed, from the "I want to schedule my c-section," to the closet "my body rocks" unmedicated birther, to the woman with an episiotomy forced on her. They talk candidly about how their labors and births affected them and the actions of those around them during the process, and it was easy to get emotionally involved and wonder how these women got to where they were.

Everything I've experienced as a human being has helped to shape who I am. My own birth, my childhood, having two loving parents who cared about me and believed I could do anything I set my mind to and put me to doing just that, losing one of those parents before I'd really become an adult (or really got to know who he was for that matter), finding that one person who I knew I wanted to spend the rest of my life with (and who would want to do likewise), and, at least for now, growing and birthing three beautiful children in a way that celebrates them as human beings and not as a medical event. I could go further on how raising those children even still is moulding my beliefs and being...but that's for another day. But thinking back on the births of my children, what I different person I could be if they had gone differently. If I hadn't cared. If I didn't believe that "My body rocks." If I'd put all my trust into a system that has acknowledged that it's broken. Realizing that, and that there are women out there every day who don't believe in their bodies and put their faith in a broken system...well, it just breaks my heart because I know what they are missing out on.

I never pegged my mom as being a feminist (and I know she'll say that she's not). It's not like I grew up listening to Gloria Steinem or anything. But growing up she did want me to be proud of my being a woman. As a woman, I can do things a man can't do. I can carry a baby and give birth. She always spoke matter-of-factly about my and my sister's births. She never made it sound scary, nor did she talk about it in an ethereal, Ina May Gaskin kind of way. It was something that was hard work, but was a part of what you did as a woman becoming a mother. I got the feeling that she was proud of her body's ability to do what it did....and the fact that she birthed a breech vaginally, which was well on its way out when my sister came into the world ass backward. She never talked about womanly things as something to be ashamed of. Never made it sound like it was something you just put into the hands of a doctor and said, "'s up to you. What do I do now?" So surely this has something to do with my own confidence in my body to do what Mother Nature gladly made it able to. What of those women who didn't have that growing up? If they have confidence where does it come from? If they don't have it...are they capable of finding it on their own without having a horrible experience to learn from first?

I usually have a table at baby fairs either for my own childbirth services or for our network, and I'm completely blown away every time by the women who don't know that they have choices to them in labor, that birth can be a beautiful, empowering process (even if you're not crunchy like me), that the folks in white coats (or scrubs) are human and do make mistakes and are many times misinformed, that it's your job as a healthcare consumer to figure all this out and know the right questions to ask, and that some of what the healthcare machine usually does is for its own convenience (and to save their asses) and not what's best for mom and baby. Sometimes I just want to scream at them to take charge of their bodies before someone else does...and does things to it that they won't like.

On top of this...I have been having the "where do I belong?" debate. Tonight's panel with the four attendants really was my list of options (well...there wasn't a family practice/OB, but close enough with the OB/Gyn as far as education goes). None of them seems to stick out as the perfect option, except that they are all where my heart is -- involved with birthing families. I'm only a step away from medical school, and right now, with all the second-guessing I've been doing elsewhere in my life, I'm completely scared about making the leap into medical school only to find out that it was the wrong move. On the other hand, being a physician would lend me more credibility and hopefully more power to do something, only partly because if it comes from the mouth of a physician, must be golden. Midwifery speaks to my heart because it is the epitome of how I wish to practice. With woman. Guiding her. Helping her. But CNMs in our state can't legally do homebirths, and it's hard to find docs to work with. Some of our nurse midwives were having a hard time keeping their jobs due to budget cutbacks. Funny how the hands on approach that saves money is the first thing to get the axe. Then there's the independent midwifery, which would guarantee fantastic births to go to, but doesn't effect much in the way of change (well...except maybe making homebirth more of an option, but the population who's interested in that is much, much smaller than a majority). Then there's the educator/doula. A holding pattern, as that's right where I'm at. I could just chuck the whole thing and hang out with the status quo indefinitely. Keep teaching and attending births, knowing that I can only educate to a point and that it's really up to the caregiver that the woman has chosen as to how her birth will go. Keep running the network and hope that women will somehow start to get the message that they need to be informed and will take the initiative to do just that before they have a bad experience. At this point, it's a good thing my scores are good for a while yet. The above are only the considerations of choosing which would be the best option for effecting change. This debate doesn't even include familial considerations, which is a whole 'nother crap shoot.

As far as the panel went, once the four were introduced, no one in the audience seemed anxious to ask questions. Out of a room of probably 150 people, I raised my hand first and threw out a question to the OB (brave of me to dive in like that? Or just nuts. The latter, I think.). Asked her what she saw for future medical students who believe in normal birth and if she thought it possible to get through medical school and still believe that normal birth is possible. She seemed to think so, which was heartening. Yet...she was still the first one to throw out the danger, danger scenario when it comes to VBAC and states that she can't work with moms who choose homebirth because of liability. There were several other questions, which the panelists gladly answered, and most of it came down to recognizing that the system is broken, but no one really knows how to fix it. No one can really practice the way they should because of liability. Truly is a pity. Hubby tells me if I really want to effect change that I'm looking into the wrong career, but if there's one thing I'm not cut out's politics (or insurance!).

If you've gotten this far, congratulations. I know it probably was a bit disconcerted, but it is 2 a.m. after all and dash-it-all but I'm tired. Thanks for listening. We now go back to our regularly scheduled dysfunction.

1 comment:

Kat said...

Ahhhh... And so we sit in limbo together, my friend... Having had a CNM at my last homebirth, I am quite heartened by the possibility of the CNM path being what I want. And less medical-programming and more midwifery training (at Frontier or something like it). Plus, having a husband who runs a nursing agency sort of helps with getting the experience I need. And there's the possibility down the road of opening a birth center, seeing as I'm married to a medical administrative-type. But either way - we are true dyed-in-the-wool birth junkies, you and I - we will change the world. Birth matters - tell everyone you know!

Love you,