In a message dated 5/7/1 2:22:31 AM, [log in to unmask] writes:

<<  I really believe that the key to helping women take more control of their
labors and deliveries is in the prenatal education.  Lacking that, we can be
proactive and try and use other comfort measures to support our laboring
patients.  But if they beg and plead for the epidural, eventually someone
will give it to them. >>

I agree, which is why I tell pregnant women to take community-based
childbirth classes, not hospital-based classes. In all honesty, I think most
classes at all are a waste of time, since they focus on "teaching" women
about birth, rather than unteaching cultural fear-based attitudes. I have
taught childbirth classes, but found myself spending most of my time in
intimate conversations with clients unravelling their fears, so they could
embrace their own power. This is very time-consuming, but is really what
women need, IMO. Parents don't need to learn to time contractions, hear about
drugs, learn about breathing and centimeters and machines. They don't need to
be told they will only have interventions if they are "medically necessary",
which is a lie. They don't need to be told they can "try" an unmedicated
birth if they want to, but they needn't feel guilty if they want drugs.
Everyone in their lives will tell them that. They need to hear the rest of
the story. I decided that until I could find a way to "unschool" clients the
same way I "unschool" my children, I would stay away from formal classes, b/c
I am not convinced I wasn't participating in the harm that our current
birthing practices have on women. I found personally that the further I moved
away from the (cultural) "facts" about birth in my own birthing, the more
simple and painless my births became. But, this was an internal process and
childbirth classes are generally an external process.  Classes tend to give
fathers all kinds of numbers and gadgets to gang onto when the mother is in
labor, leaving the mother even more on her own. In other words, we fill the
mother's head with "stuff", instead of freeing her body from the fears in her
head. It really does seem utterly absurd to me.
    In most childbirth classes, we say that most women need no interventions,
but most women have them. We say babies come in their own time, but over 80%
of births are now "augmented". We say the need for cesareans is about 5%, but
over 25% of women have them. We say women's bodies are meant to give birth,
but (the last stat I saw on this) fewer than 1% of hospital births are truly
without any intervention. We say what we say, but we as a culture teach fear
(and IMO reinforce it in most classes). Most women actually believe they need
whatever intervention they got, even though they believe most women overall
don't need them. So, if every woman believes she really needed the c/s,
forceps, pit, etc, where are the women who didn't need them?
    When women tell me they are going to "try" to labor with "nothing", I
tell them that is not a good idea. `I say that the idea is not to "go
without", but to go with all of the love and support and faith in oneself
that every woman deserves. So, I at least try to encourage reading good books
and doing the work of releasing cultural fears and having labor support, even
though a homebirth is really the best likelihood of normal birth (in the US).
If they go in with nothing and try to get through with nothing, they will
almost always get drugs. Instead, that "nothing" needs to be filled with the
knowing women have had from the dawn of time about how to give birth. I
haven't figured out how to teach that in a series of classes.
    I also used to do labor support. My clients did avoid almost all
medicalization, but it was such a huge effort to make that happen, except
with two particular practices in two hospitals. And I did an enormous amount
of prenatal work with my clients (which most doulas don't do, nor are they
trained to do it). It is just way too much work in American hospitals to
safely have a baby (unless, as Gail said, they are parking lot babies). I
think safety, BTW, goes far beyond a live mother and baby, to address all of
the aspects of human well-being.
    Nancy Wainer ("Silent Knife") once told me about a time she spent
catching babies at a huge hospital in Jamaica. She said that the midwives
were expected to avoid cesareans b/c the operating room was too busy for
something as normal as having babies (too many gunshot wounds, it seemed).
So, they almost never needed cesareans. Some people would read into this that
mothers didn't get the care they needed, but everyone else will get the real
point.
    Even without the interference with bf, which cannot be in doubt for
anyone who sees the difference between epidural babies and homebirth babies,
the fact that most babies begin their lives drugged and women begin
motherhood drugged has got to make us wonder who is truly served by this
insanity.

    Pam wrote:
"Not everything in my practice is supported by scientific evidence...so I do
take your anectdotal evidence seriously...but have concerns about what we
might inadvertily
suggest to women who choose to have labor pain relief.  I also believe that
this "choosing" mentality will put the medical establishment at the
defensive."

I will admit I take the opposite approach. I don't care about making anyone
mad. I am mad that women are being lied to about birth the same way they are
lied to about cow and soy formula. Interfering with birth and babies is not
safe. I want women to know that birth is inherently safe, that drugs in birth
are not and that they don't need them. Drugs are not "labor pain relief";
they are interference in birth which leads to more and more and more.
Besides, as Kathy spoke of, the very idea of "labor pain relief" accepts as
true the premise that birth as our culture views it (in fear) is birth as
Nature designed it, which it is not. Fearing the conclusions women will draw
if they are told drugs usually affect bf is like saying you don't want to
tell women about the hazards of cow or soy formula before they give birth b/c
they might need to use it afterwards and they might expect it to make their
babies sick. Well, it probably will make their babies sick. Most mothers
don't need to ever use cow or soy formula, nor do most mothers need medical
intervention in birth. There is an incredible amount of information being
gathered on the impact of medicalized births on babies, mothers, families,
etc. It is a shame that birth and breastfeeding have become so separate in
our culture that we have to debate the common-sense obvious truth that what
is done to birthing women and their babies is a very big deal, no matter what
our profession.
Jennifer Tow, IBCLC, CT, USA

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