< they have been replaced w/ lofty sounding words
which sound fear-based and heroic. The truth about breech births is that
the
safest way to birth is vaginally>
That sounds like a pretty broad statement to me.
With all due respect to your experiences and your philosophy, Jennifer, I
still believe the best future for reproductive care lies somewhere in
between the two general views under discussion, without bravado on either
side.
More than once, albeit nearly half a century ago, I have been present in
situations where babies in breech position with legs and trunk partially
born, but with unmolded head, were unable to fit safely through the
mother's partially dilated cervix and bony pelvis.
You'd better believe we were all seized with fear and sick with regret
for the baby, the mother and the doctor alike.
One has only to hear the dreaded term "birth injury" to understand why
malpractice insurance is so high for obstetricians, and why they have
coined phrases like "platinum baby" to describe how much extra hope is
invested by the parents, and everyone else, when a pregnancy has been
especially difficult to achieve.
No wonder that obstetric texts with access to such case histories the
world over, do train physicians (and professionally trained midwives)
from a risk:benefit point of view.
None of us can change the fact that complications of that tragic nature
have happened in the history of human birthing, and can and still do
happen sometimes, if no knowledgeable steps are taken to prevent them.
I think I understand some of your passionate feelings on obstetrical
interventions. I have a history of having taken a very public
professional adversarial role against undue speed in pitocin induction,
unnecessary operative delivery, overmedication etc. in my community in my
younger days when I was active in childbirth education.
But that was then, and this is now. For me, one of the most constructive
uses of my time is in educating parents without outright castigation of
physicians.
Parents do need to understand that some practices intended for safety
present nature with delays and difficulties that must be worked through
in the initiation of successful breastfeeding.
Again, for me personally, the next most productive use of my time now is
in trying to build up health care literature that promotes better
understanding of the importance and the physiology of breastfeeding.
This includes how to deal with iatrogenic complications, which are
sometimes the price to be paid for safely managing genuine emergencies.
Most times, I meet the client "after the fact". I try to meet her "where
she is" in the here and now within her particular family and obstetric
situation.
Knowing that she has invested her trust in her physicians, I use the best
explanations, reassurances and tools available to that mother, beginning
with her own fingertips, to "shepherd" her on through to her goal.
I am a part of that mother's immediate culture. But so is her physician,
and so is each member of her family. And we all have some sort of
influence on her emerging experience that will help shape her future
choices.
Sometimes I feel successful in my approach. Sometimes I don't, but MY
feelings are not HER issue. Either way, I think very carefully about what
I say and how I say it, knowing it is not mine to control, but to
contribute a positive influence on the decisions of others.
Jean
***********************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA
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