Thursday, February 11, 2010

Birth Performance Anxiety, or, unassisted in a yurt with Enya in an owl-sanctuary

You know how being a mom to wee ones can sometimes feel so very lonely even though the amount of time you actually spend alone is nil? I am literally within arm's reach, if not physically attached to at least one other human being at all hours. Little people follow me enthusiastically into the bathroom whenever I gotta go hoping that I'll entertain them while I poop.

But still. 

And so I went to one of those groups for new moms that the midwives who delivered baby Josephine hosted. And about 60 seconds after arriving I remembered why I avoided those groups. It was just a handful of shell-shocked women exhaustedly attending to their newborns while one Chatty Cathy talked about her birth experience and her sensitive nipples for an hour and a half without any small pauses in her stream-of-conscious narrative lest some other mom take advantage of her need to breathe between sentences to steal the floor from her as she had an awful lot to tell us about her birth experience and, of course, her very sensitive nipples. Why is there always one of those?

No real connections were made. Any camaraderie was just so very forced. And I left feeling even a little lonelier than before.

Not that it was such a big a deal as all that. I could easily just forget about the whole thing.

But.

I can't shake off something that Chatty Cathy said. I just found it so very disturbing.

She had formulated herself a lovely birth plan but things don't always go as we plan and after a gruelling labour she was transferred by ambulance to a hospital for a C-section. She told us all about it. And she's had a difficult recovery and is still in a lot of pain even though her doctor says she shouldn't be. She told us all about it. And breastfeeding is going okay for her in the sense that her baby is thriving but not okay in the sense that it hurts so very badly every time her baby latches on that tears roll down her face and she flinches and whimpers and sobs.

She's been to the lactation specialist that all the midwives rave about and he said she's doing everything right but simply has ultra-sensitive nipples and so is part of a very small percentage of the population for whom breastfeeding is excruciatingly painful.  That's not what I found disturbing though. Nor was it the turtleneck sweater with the Santa's reindeer print on it that she was wearing. While these things are disturbing to anyone with a shred of empathy or an iota of fashion sense, the part that really got me was the reason she gave for continuing to breastfeed.

She said, "Whatever, it hurts like holy hell and I am in so much pain but I'm going to keep doing it anyway. I mean, I screwed up the birth so badly I'll be damned if I'm going to screw up breastfeeding too."

Guh!

Of all the pain this woman has experienced lately, and believe me, she supplied us with a lot of detail about a lot of pain, the lion's share of it is a sense of having personally failed at childbirth. And she is riddled with anxiety over failing at breastfeeding too. Meanwhile, in bizarre contrast to all this "failure" there is a chubby baby in a pink furry outfit with bunny ears bouncing on her knee.

I've written before about how normal I think it is for women to want to be good at all the fertility and childbirthy and breastfeedy type stuff that goes along with making babies and how effed it is that our culture lacks a vocabulary to even discuss this desire. I made up a word to describe a women's sense of sexual potency in this regard: Venusimo.

One thing I love about the natural childbirth community is the way it respects women's desire to be and feel sexually capable. It respects our Venusimo.

One thing I despise about the medical model of childbirthing is the way it pays no heed whatsoever to a woman's Venusimo. Doctors deliver babies in a timely manner as opposed to women bearing babies in whatever way is healthiest for them physically, emotionally, and spiritually. When women try to communicate to their doctor's a desire for, say, a VBAC, it is frightfully easy for the doctor to belittle her desire or to demonize it as perverse, dangerous, and unhealthy. And we just don't have a normalized vocabulary to defend ourselves.

But.

Something is way wrong in the natural childbirthing community if the pressure women feel to "succeed" at childbirth and breastfeeding is so intense that it can overwhelm her experience completely. And honestly, where else would you hear a woman talking about how she "screwed up" her birth then in the natural childbirth community?

I've actually witnessed a midwife explaining to a woman why her difficult birth was her fault. It was in one of those new moms groups. Sigh.

I had my second baby at a centre that specialized in waterbirths. There was no anaesthesiologist or surgeons available there. Going into the program the midwives explained that about 1 in 10 women would have to be transferred out to an ob-gyn either before their labour (for something like high blood pressure) or during (because of a medical emergency.) We did a lot of group care in the program and so I got to know about a dozen other woman who were all due in the same couple of weeks. After our babies had arrived we had a follow-up session to talk about our births. 

One woman had laboured intensely for over 24 hours at the birthing centre before she was transferred to a hospital by ambulance.  It was her second child and she knew, she told us, that something was wrong and had been saying so all along. Her midwife was not, she insisted, taking her seriously. She described a very intense relief when she finally arrived at the hospital and the obstetrical team there told her that everything was going to be all right, that they were going to help her now, that she was in good hands and would be taken care of. The midwife didn't like this part of the women's story at all. She harumphed and shot the woman a nasty midwife look.

The woman concluded her story by saying that she knew this kind of thing happened and she had wondered if it would happen to her. She wondered how awful it would be. She'd imagined it would be pretty awful and it was.

"See?" said the midwife. "And in 100% of these cases the woman will say that her mind went there. That she was envisioning all this negative stuff happening to her. And then it does. It says a lot about the powers of our subconscious minds, doesn't it?"

I was shocked and disgusted that anybody, much less a professional midwife fereffingcrissakes, would accuse a mom, in the rawest state of post-natal recovery (her baby was less then a week old)! of basically "deserving it" because her mind had "gone there."

It was another Guh! moment.

I mean what sort of preggers lady hasn't mentally "gone there?" Of course we imagine every possible horrific scenario. I sure did. I also spent much of the later part of the 80's imagining that Corey Hart was madly in love with me and sending a helicopter to my junior high school to take me away from it all. It didn't make it so.

There is a sort of conundrum inherent in wanting to empower women with the sense that birth is something we do, not something that happens to us. But how do we give women full ownership of our birthing triumphs without insisting we are personally responsible for things going wrong?

I dunno. I think we just do.

I don't think we need to blame women who need help during childbirth. I don't think they have personally failed. I don't think they have sullied the natural childbirth movement. I don't think they should be dismissed or accused or ashamed. I don't think they should be shut-up. I don't think their stories should be swept under the carpet.

Do you think performance pressure is too intense within the natural childbirth community?

I know I feel I have to step lightly around friends of mine who have had very medical births. I think they feel I might try to belittle their births or suggest they are somehow inauthentic compared to my waterbirths and my homebirth. But, Honest 2 Betsy, that just ain't how I roll.

I am also disturbed by this trend I see towards unassisted births. I mean, I'm just not getting it. To me it just seems like there's a sort of arms-race going on towards the most "authentic" birth experience. i.e.. I birthed in a hospital with a midwife. Well I hypnobirthed in a centre with a midwife and a doula. Well I homebirthed with a midwife and a shaman. Well I had an unassisted lotus-birth in a yurt with Enya in an owl-sanctuary.

In case you haven't heard, a lotus birth is when you don't cut the cord. You keep your baby attached to the placenta and you co-sleep with your baby and your festering placenta. When they are old enough you put your baby and your placenta in an organic bamboo sling and take them to a folk fest.

Are there natural childbirth over-achievers out there? I think so. Do they make us all look like kooks? Totally. Is that their aim?  Probably not. 

What motivates a woman who made the healthiest possible choices and has a perfectly healthy baby to state that she "screwed up" childbirth. Is that particular woman just way too Type-A? Or is there birth performance pressure coming from elsewhere? Have you felt birth and birth-related performance anxiety?

12 comments:

  1. Placentas don't fester! Lotus birth doesn't mean you have to folkfest either, funny as it may sound. I enjoyed your blogpost and I think you raise an important issue, but I think you do a disservice to lotus birth to dismiss it offhandedly that way.

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  2. Yeh, I know I'm being totally ignorant about lotus births. And they don't fester, they just get "earthy." And I'm totally kidding about taking your placenta to the folk fest.

    But lotus births seem more in the realm of birth fashion and fad to me then something practical. And it wouldn't be a big deal to me -- sleep with your placenta, sleep with your toenail clippings, whatev -- but it's hard to get to get people to take natural childbirth seriously when the new big splashy thing is unattended lotus births. That's all.

    I do appreciate your comment and your compliment though.

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  3. I do think that there can be over-achieving, one-upmanship and guilt over how a birth turns out. In my circle everyone homebirths, except me. My first birth was at 34 weeks and homebirth was not an option. Following the birth I hemorrhaged severely and it freaked my husband out. Understandably so, and so I had my second (full-term, non-massive-blood-loss-inducing) birth in a hospital, by choice.

    I hear a lot of snide remarks about hospital births, and interventions that I personally opt for based on my own informed consent and medical history. It sometimes gets to me, and I feel defensive. Stories of orgasmic birth described in raptures along with phrases like 'you just need to be in the right frame of mind' can do the same thing. I'm happy for you if you had an ecstatic birth, but if you didn't that's OK, too. It doesn't make you bad at birth. I had two drug-free vaginal births and I would do it again, but the truth is I didn't really enjoy them. It's just not my idea of a good time, although it's worth it and I expect to be treated respectfully during it. My dislike of birth is just as valid as if I had loved every minute of it, I say.

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  4. ha ha, you're welcome.
    Thing is that lotus birthing in my experience is totally healthful and respectful, and that respect for my child's (and children's) autonomy has been fuelled immeasurably by one being lotus born. It doesn't have to be unassisted, it is possible to have lotus c-sections too.

    It is a coincidence that the lotus birth in our case was an orgasmic birth too. I don't have a problem with talking about it for I think (as no doubt we all do here) that the more information and experiences we have and share, the more powerful we all become, as women in particular.

    I'm a breastmilk advocator too and also have no problem with being seen as creating a problem for those who choose to formula feed their children. Breastfeeding in the UK (where I live) is not offered to 99% of babies who are six months old. I am in the minority for breastfeeding my children "beyond babyhood".
    However I see there is a massive issue with others taking offence at women like me who promote breastfeeding and lotus birthing.
    What would be wonderful would be leaving behind the divisions and emotional reactions and come together to find out a way of promoting peaceful, respectful birthing and early parenting choices that respects us as adults too.

    We are all on a journey of life and we all make different choices. A couple (or individual or mother/baby dyad etc.) with a seemingly identical situation to another may choose a different path - if those other non-standard-medical paths (for example) are not illuminated by those who have already walked them, we end up living in a world of powerless darkness. That is one reason why I love blogs and the possibilities of the powerful connections made with others via the internet :)

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  5. Oh Lordy, I forgot all about orgasmic births!

    My sis-in-law had one, but she gave birth in 2005 and it didn't become an orgasmic birth until just after the video came out. She told me all about it in the hospital when visiting my hours old baby.

    I remember her saying, "Giving birth is just totally a sexual thing for me. I loved it."

    Right before they arrived I had asked a nurse to examine my anus to assure me it had not actually turned inside out (it hadn't). And I remember wanting to bonk sis-in-law on the head with a beadpan.

    Like seriously? We're supposed to ENJOY giving birth now? In a orgasmic way?

    I remain skeptical.

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  6. Well now your blog space but yeah! Giving birth can be an part of a woman's sexual nature. Not talking about it doesn't really get us anywhere. We can be quite far removed these days from our inner instincts way of course. Anyway, your choice to be sceptical :)
    Obviously there are times and places to be talking about it. Visiting someone who has just given birth and could be be enjoying a blissful babymoon is not it seems an ideal time to talk about anything other than the mother and baby themselves at that moment.

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  7. I think the desire to birth naturally is appropriate. What I don't think is appropriate are some of the attitudes of birth practitioners who don't allow their clients some space in knowing what is right for them. Like the story above? Totally uncalled for! That kind of attitude from a midwife is no different than a GP telling a mother that she isn't capable of having a natural birth. Any kind of omnipotent, superior attitude from a person in a helping profession can be traumatizing.
    As for the mom who is beating herself up for not getting her birth right and wanting to breastfeed even though it hurts - I've been there. I had a nice home birth planned for my first daughter and wound up having an emergency c-section. Breastfeeding wasn't excrutiating but it wasn't all that fun either, and I had my share of cracked and bleeding nipples, which I never shared or complained about because I was determined to make it work. I thought that breastfeeding was supposed to hurt and by God I wasn't going to be one of those women who gave up. Luckily my midwife noticed I was cringing during one of her home visits and with some re-positioning I was fine and it never hurt again. I feel very bad for the woman if indeed she suffers from extremely sensitive nipples. But if I was her I would probably do my very best to hang in there too.
    We all want to the best for our kids and birth disappointments can be pretty powerful. Is there too much pressure? Maybe. I *am* VERY proud of my home birth after cesarean. Still, I feel a bit outdone when my friend talks about her three problem-less home births. But I think this sucks and I certainly don't go around waving a sign proclaiming that my birth was the greatest best thing ever and all you non-HBACers have lost out on the birthing lottery. I do find others do this sometimes though. I hate that. I think we should all just support each other for doing what makes us most comfortable, and that especially our practitioners need to support us in this too.

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  8. I totally agree, Betsy. And it is of course a very personal and yet polarizing issue. I remember being completely entrenched in it. Wondering to myself if I was going to screw it up. Reminding myself that the goal was a healthy baby however the actual birth turned out. Imagine having this discussion with a woman who had lost her child to SIDS or something else. Imagine how insignificant it would all seem then?

    I look at my children and I realize that their birth experiences did not set the tone for our relationship or shaped the people they are. I do that. Each and every single day.

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  9. I think that women will always be in competition with each other over something. I thought I wanted to birth unassisted this time, but I changed my mind. Someone keeps trying to pound it into my head how she is having a unassisted birth. Good for you! I hope it's wonderful, and I love reading stories of women who do it. I like to have people around me. I love midwives, and I plan to be a homebrith midwife someday.

    I do wish that women who have had wonderful natural childbirth experiences could talk about it, w/out our friends or strangers think we are going for a medal to one up them.

    I think it is so sad that this woman doesn't want to feel like she failed twice back to back. I do understand where she is coming from though. I beat myself up for a long time, because I gave my 1st formula and thought that if I hadn't, she would've breastfed over 10 months. I even had someone tell me it was a nursing strike, and I should have stuck it out. That was said to me almost a year later. Thanks for the support.

    We've come a long way, but I believe we have a long way to go.

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  10. I actually wish I had been Ms. Chatty (without the sweater) after my son was born (homebirth gone c/s). Maybe I would have gotten it all out - like this woman seems to be doing - and gotten over it. Instead, I shut down. And I didn't have any homebirthing goddesses like you around. The ones I knew BLAMED me for my FAILURE. Of course, now I can look back and see the idiocy of it all. And for this reason I refuse to align myself with any one parenting style. I choose an intuitive, holistic approach. If I had done this w/my birth, and possibly read about what to do in case of a c/s, instead of the mountains of info. about how terrible c/s are....i may have .....blah...blah...who knows! What I do know, is that I totally respect any woman's experience of birth, her choices, her feelings...all of it.

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  11. I just really love this post and Tweeted it and then forgot to come and tell you I loved it. Because it's funny and you're being sarcastic to some degree and I get that. I think it's fine not to take ourselves and our natural-birthing culture so seriously that we forget to laugh at ourselves when it's called for or make other women (or ourselves) feel like failures and losers for operating within a set of challenging and randomized variables. What happens in a birth is partly due to culture, and it's partly due to chance (position of the baby, unforeseen medical issues, etc.), and to say it's all up to the mother's good attitude is so dismissive.

    When I was preparing for my birth, I needed to be told to have a good attitude, because what's the alternative? Freaking out and anticipating only the negative? But once it's all said and done, I want people to be happy that it all worked out ok, not second guessing every choice I made. Of course, I do want the freedom also to do my own evaluations and air my regrets, so I can try something else in the future. But I hope that doesn't mean I go around belittling everyone else for having a different experience.

    Anyway, thanks!

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  12. Oh I totally agree with you, and I was actually planning on writing something similar (but not as funny) on my blog. I think there is way too much idealisation of the natural drug-free birth in the natural parenting community. I agree that a natural birth is the best outcome for mother and baby, but sometimes it just doesn't happen, and there is nothing that ANYONE could have done about it, however well they prepared.

    To most mothers, birth is a twice or thrice in a lifetime event, and we place enormous importance on it. I think if home births were more common then more of us would have grown up seeing our brothers and sisters being born, and would perhaps have a more realistic expectation of childbirth. It is, after all, just a way of getting a baby out of a woman's body.

    A traumatic birth can have horrible consequences for a woman's mental and physical health, but I believe that her expectations also play a part in how she deals with her experience. This is why midwives often tell us to be flexible in our plans for the big day. By the way, those midwives you talk about sound awful.

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Tell Betsy...