Making Hospital Birth Better

Last week I watched Pregnant in America. It was a good film, with a very similar message to The Business of Being Born. My brief summary would be that, often, decisions for labouring women are made because of expediency or the fear of litigation, without taking the mother’s desires into account. Statistics like the rising cesarean rate seem to indicate that birth is highly-medicalized in many cases, although I am in no position to speak authoritatively on this subject.

Watching movies like this, and reading natural birth articles and blogs, homebirth is often promoted as the remedy to problems that can occur in a hospital. Many of my friends have chosen homebirth, and were very happy with it. I think it can be a great option, and I believe that it is as safe as hospital birth when experienced help is on hand and medical care is nearby. I am glad to see homebirth advocates fighting for birthing women, and ensuring that they have a choice of care providers and birthing environment.

While I believe in natural* birth, I know that homebirth is not an option for everyone. My first child was born at 34 weeks, and so the only responsible choice was to head to the hospital. Approximately 1 in 8 babies are born prematurely in the US each year, which is not a small number. And while most health authorities agree that the cesarean rate is too high, even if we reduced it by half, more than 1 in 10 women would have a surgical delivery. Homebirth is not the first choice for most folks when things go well, either. It could just be personal comfort level, it could be that homebirth is illegal in their area, or it could be that medical insurance won’t cover it. Even finding a homebirth provider can be a challenge, as demand for midwives frequently exceeds their availability. One way or the other, people are going to end up giving birth in the hospital

Watching Pregnant in America I wondered, once birth becomes a medical event, is it possible to retain its humanity? No matter what the circumstances are, no matter how many machines are in the room or how many masked and gloved surgeons are on hand, this is still about a family welcoming a new member. You will remember the events that unfold and the things that people say for the rest of your life. When things don’t go well, when you’re vulnerable and scared, that is all the more true. I will never forget the nurse who chastised me for being in labour at 34 weeks. I’m sure that she didn’t mean harm, but her offhand remark stuck in my head, and the message that I was at fault is something I still carry with me.

As it turns out, I gave birth prematurely because I had an acute infection. Another consequence of that infection was that I hemorrhaged severely following my daughter’s birth. Had I given birth in 1805 instead of 2005, I would not have survived the experience. The combination of antibiotics, synthetic oxytocin administered after I gave birth to stop my bleeding, and a blood transfusion likely saved my life. Modern medical care certainly has its place in childbirth. But so do compassion and gentleness. A kind word, instead of an unkind one, will not compromise someone’s care, but it can make all the difference.

I fear that there is polarization in the way that we approach birth today. There are people who advocate for natural birth and reduced interventions, which are great things. But they are often at a loss in terms of how to address a situation once it has already been medicalized, particularly if that medicalization is necessary. Then there are people who want all the bells and whistles and pain medication and machines that go ping. Their message is about protecting the health of babies, which is also incredibly important, but it doesn’t always acknowledge the emotional and psychological dimension of birth. I wish that there were a larger middle ground between these polarities, because I suspect that’s where most mothers actually fall.

I don’t have good answers, and I wish I did. I do think that as progress is made and women make their desires known change can happen. I hope that it does, and that it happens in such a way that all birth options are protected, and all mothers are treated respectfully and thoughtfully in childbirth, no matter how or where they birth.

*I don’t particularly like the term ‘natural birth’ because it is ambiguous and somewhat loaded, but it was the best I could come up with, without heading off on a major tangent.

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  1. Hi Amber,

    I think “retaining the humanity” of medical births is key. I know people who had wonderful medical births but my experience was less than wonderful. It was in a hospital with a fairly liberal/open attitude about birth and known for it’s birthing centre. After my first “medical” birth there (enduced, spinal epidural, episiotomy, vaccum birth, blood patch, iv’s) I did a lot of research about natural birth (I read 8 books on the topic) so I could avoid a medical birth in the future. One of the things I found out was as soon as medical staff intervene (enduction, epidural, breaking waters) that it causes other medical interference with the birth such as it was in my case (episiotomy, vaccum birth, blood patch). As you said, and I agree, sometimes you can’t avoid a medical birth. With my second child I had a midwife and the main reason was because I was allowed to leave the hospital whenever I wanted too following the birth. But the benefits were also the wonderful support, my midwife didn’t do much but help me put on a gown, make sure I was comfortable during contractions, keep me company in the shower, help me on with my undies and come to visit me at home the next day. The medical support I received was brash and unfeeling. There were six people I didn’t know doing things to my body without my permission. I was checked on once every two hours after giving birth to be told to BF my daughter and for my blood pressure to be taken but not to ask how I was feeling. I had trouble sleeping in a room with someone who snored but the nursing staff would not move me to the ward so I didn’t sleep for two nights. No one helped me to the bathroom, make sure I was comfortable after birth etc. but my husband, and thank goodness he is so wonderful because I couldn’t imagine what I’d do if he wasn’t there. The other wonderful thing about having a midwife is that you CAN have an epidural if you want one and giving birth in a hospital ensures that if you require medical attention the midwife can give over the birth (and still stay to support you) to the medical staff. I think this is the best option for anyone, home birth or not.
    .-= Tanya´s last post ..Perspective =-.

  2. Amber, I think this is a great post, thank you.

    I agree that many of us fall into the middle ground. I was lucky to have a ‘natural’ birth with my daughter, but my experience was less then ideal because of the way I was treated in the hospital. In retrospect I believe that this negative treatment in the hospital has a huge impact on my first couple weeks as a mother, particularly my ability to breastfeed. (Which I did everything to make work- but stopped at 3 1/2 months when my daughter was still not gaining weight well.)

    I don’t think it is just about if you have a ‘natural’ or ‘medical’ birth– it is about the type of care we receive, the focus of the hospital staff and how our wishes are respected. To me, it is all summed up by this statement in your post: “decisions for labouring women are made because of expediency or the fear of litigation, without taking the mother’s desires into account.” If we can change that then both the c-section rate will come down and all mothers will have a better birthing experience, natural or not.
    .-= kathleen´s last post ..ControverSundays: TV =-.

  3. My thoughts on birth have mellowed recently: whereas I was all for natural birth, I now realise that a medicalised hospital birth can be just as satisfying provided that the mother feels part of the process and retains a sense of control over what is happening to her. Kind midwives, nurses, doctors and doulas can make the difference between a traumatic birth experience and a satisfying one. I would still choose to birth at home, but I understand that hospital births are OK for lots of people. Maybe a birth centre, staffed by midwives rather than doctors, is the ideal compromise.
    .-= Cave Mother´s last post ..Busier, More Popular, Nicer, Richer, Thinner etc =-.

  4. Oh, I wish I could find a post I read recently! It was a birth story that left me absolutely agog with how “welcoming” and “celebratory” the whole event was. It was definitely not here in Canada and I’d hazard a good guess that it was in a very expensive private setting in the USA.

    And I think that might be a big reason — money. When nursing staff are stretched too far it makes it hard for them to do those extra little things like help people into their undies, the shower, etc. They are forced into a postition to cover off the basic medical checkmarks to ensure the health safety of the mom and child (yes, litigation risks too). In many cases, people are far too human and when under stress say things that are blunt or even unkind. I can’t say that either of my birth experiences were particularly “warm and fuzzy.”

    Interesting post and I look forward to reading the comments and discussion that will follow.

  5. I wish there were more options for some middle of the road women who feel unsafe without prompt access to medical care. I chose a birth center, which for me was the right choice. I did not want to be arguing with doctors and nurses during labor and I wanted a peaceful birth. I switch to a birth center at 34 weeks, prior to which I was planning a hospital birth at a local hospital. I spoke to my doctor about my wishes and she actually said to me, “if you want a natural birth, why are you going to the hospital?” That did it, I switched! She did not have hardly any experience with natural childbirth in her almost 30 years of practice! The hospital where I was to deliver has over a 40% c-section rate!
    A middle ground, I think would be more hospitals with independent birth centers attached! I say independent because this way the midwives can have a say in the procedures, and you don’t have to follow hospital policy!

    For my next birth, I am considering a homebirth, for no other reason other than the fact that the birth center was a 1 hour drive, and I almost gave birth in the car! I

  6. quazydellasue says:

    I think that a supportive, positive, natural hospital birth is ABSOLUTELY possible – I say this because I had one. And even though it was a big urban hospital with a high C-section rate, I never had to deal with any pressure or coercion or any of the nasty stuff you see in these documentaries. I got to the hospital, staggered up to L&D, and labored and birthed in my room. No wheelchairs, no needles, no nothin. I had a long, difficult birth, but it was exactly what I had wanted.

    How was it possible? I had the right people with me. I was laboring not with an OB, but with an excellent nurse-midwife, who had a prior relationship with the hospital (and they were fine staying out of her way). I also had a very experienced doula, and the hospital nurse assigned to us was someone my midwife knew and trusted (she actually rejected anyone she didn’t think would be good for us). Without all that support, who knows? But I’m glad I don’t know. I was protected by those women and they ensured that my experience went well. It was basically a home birth – just in a hospital room. There were no doctors around that I could see, but they were there in case of emergency (as was the NICU), which I appreciated.

    But next time I’m going to have a home birth with the same midwife. Why? I personally find hospitals uncomfortable. I’m a major homebody and I like the warm comfort of my own space. But I am not down on hospital birth and I think the experience can and should be better for all women – not just those who can afford the best support team.

  7. I think a good first step would be to respond to the woman and her situation and not use a checklist of protocols.

    After I gave birth to my second son and was not bleeding heavily, one of the medical personnel in my room said, “She needs an IV.” My doctor said, “Why? What are you going to put in it?” He said, “It’s protocol.” There was no time to put in an iv before he was born, but apparently every woman needs one no matter what even if the situation doesn’t call for it. That was very disappointing to hear.

  8. I had a similar experience to quazydellasue, above. I had a natural, non-intervention delivery in a hospital. And though I was prepared to fight tooth and nail to get it, it turned out I didn’t have to.

    I went to an OBGYN practice (seven woman doctors) who were supportive of my desire for a natural delivery. I got to the hospital at 6cm and had one nurse who was instructed to get me some water and leave us alone. No IV, monitoring every hour and a half for 15 minutes. I literally only saw my one nurse and my own doctor the entire time I was there. It was great! My doctor let me labor and push on my own schedule and 10 hours later I gave birth to my *posterior* baby boy.

    I know my story is not the norm, but it IS possible. I don’t know if all the stars aligned perfectly or what but I had a great experience in one of the largest hospitals in Ohio. I think it was the staff that made all the difference. My nurse had a great patient attitude about birth that probably saved me from some unwanted interventions.
    .-= the Grumbles´s last post ..exploration: now with more banana =-.

  9. I think in Canada, birth centres could be the answer for all these women that fall into that middle ground. Especially birth centres which might be attached to or across the street from the hospital for instance.

    Otherwise, for more emergent situations like yours, I think it really comes down to maternity care professionals realizing that their bedside manner and strict adherence to “protocol” can be damaging to women. Birth is a major rite of passage, not a procedure like getting your gall bladder out. It should be treated with reverence no matter how it unfolds.

    I have even read some articles about “natural cesarean birth” – I think they didn’t have the curtain up or the mama’s arms strapped down and they tried to follow gentle birth guidelines as much as they could given the situation.
    .-= BluebirdMama aka @childbearing´s last post ..Trick of the Light =-.

  10. By the way, great post!
    .-= BluebirdMama aka @childbearing´s last post ..Trick of the Light =-.

  11. I agree that there has to be a happy medium. I’m planning to give birth (in the next few weeks, wow!) in a hospital that is progressive and supportive of natural labors and births. My only regret was that I wasted so much time listening to people from wherever and planning to fight with my hospital than listening to people who had actually given birth where I’m going, and who have had very positive experiences.

    I think it’s hugely important to have a baby where there is emergency help available, for situations just like yours.

  12. Very well said. Thank you from a "natural" hospital birthing mom.

  13. Even though I gave birth to my second baby at home, I found myself needing to reflect for a long time on whether or not the decision made me feel more empowered. During my first birth (an induction at 37 weeks), I felt powerless because doctors were making decisions for my midwife, who nonetheless, did an amazing job and made me feel great during the birth. I had developed a great relationship with her. One of my nurses during the hospital birth was nurturing and compassionate . . . another few were not.

    At home, I experienced a hard and fast labor with a midwife who was overworked . . . she even commented that she was “impatient” during my birth. This really saddened me and made me feel even more vulnerable during an already vulnerable experience (being on the brink of life and death and bringing a fragile new life into the world). My doula though was warm at times, and then, oddly distant at other times.

    I know we’re (as a society) in a place where the women we know and love and who are our family are not necessarily the most knowledgeable or prepared to help us birth . . . so we need to make the best of the circumstances we have.

    I think if I ever have a third baby, I will likely establish a good relationship with one midwife who I trust and deliver either at home or at a birthing center.

    Great article, Amber. You really do always make me think.
    .-= Jessica´s last post ..busy, busy, busy =-.

  14. Living in a country with access to top-of-the-line free medical care has saved my life and the lives of many I know — including a little boy who had a rare bone tumor grow in his face when he was 2 — doctors removed it for him and it hasn’t grown back. If it wasn’t removed it would have grown into his brain and killed him. Can you imagine anything more agonizing than watching your baby boy die slowly like that? I can’t.

    But i love the natural childbirth community. I love how it empowers women and earnestly tries (and succeeds) at preventing birth trauma for so many.

    But there’s too much hostility and ideology on both sides that has got to go. I’ve heard both sides say such idiotic and hostile things about the other based on nothing really but ignorance.

    I think the dichotomy between natural parent and unnatural parents? super-natural parents? mainstream parents? is a little overblown. I think pretty much everbody is more in “the middle” which is a smart place to be.
    .-= Betsy´s last post ..Birth Performance Anxiety, or, unassisted in a yurt with Enya in an owl-sanctuary =-.

  15. I feel so lucky to have had the privaledge of deliverying both my daughters in a midwife run clinic wihtin the walls of a rurual Alberta Huspital. The Shared Care Maternity program was a 1 of a kind thing back when I started having babies almst 5 years ago.

    The birthing environment was in total support of the mother an father, but still, if needed, there were interventions to be handled and as a last resort, surgery, although not done there, was very easily arranged during labour.

    My experiences were amazingly wonderful. They were serene and loving and warm and welcoming. It was everything I could have ever hoped for in a birth (both times).

    I think it is very important for pregnant women to decided in their own minds how they would like to labour and then seek out the facility tht will best help them achieve that. It isn’t always easy because your dr. might not be in favour. The good thing is is, you have 9 months to look around and see what else is out there.

    Thankgoodness we live in a time where you didn’t die in labour Amber. I am all for medical intervention when it is needed. I just wish more expecting mothers took a strong stand and educated themselves on the birthing process from all angles. Being pregnant isn’t like being sick. I believe that in most cases a women doens’t need a dr. to deliver a baby. But, I am sure happy they are there if the need does arise.
    .-= Heather´s last post ..One Lump Or Two? =-.

  16. I have zero patience for any kind of talk about styles of childbirth (nothing personal, Amber, your post is as always very well measured and rightly inquisitive). The key thing is that a child is born. Alive. And that the mother does well. More pain, more meds, more whatever. Who cares?! … I’d have taken more of anything just to have my babies born alive.

  17. I don’t have the answers either. Neither one of my birth experiences were without buckets of medical care and I was never in a position to consider any other way. (In fact I wasn’t even conscious for the birth of my daughter which is about as disconnected as you can get.)

    I’ve watching ‘The Business of Being Born’ and I admit to being disturbed at how many c-sections are performed. Even though I gave birth at a supposedly progressive Women’s Hospital I felt I wasn’t given any options in my first birth experience (when there was supposedly still some choice). They had a set plan for me and I just followed along.

    Luckily, I was never one who felt I would experience something magical and powerful giving birth, so while I didn’t enjoy my experience, it also didn’t upset me to my core. I can see how some women would be forever disturbed by the birthing conveyor belt system.
    .-= Marilyn @ A Lot of Loves´s last post ..Scream. Scream. Laugh. =-.

  18. Once again, Amber, I’m impressed with your balanced view and with the thoughtful and open-minded responses you draw.

    I don’t have any hard and fast answers either. I had a c-section that unfortunately ended up being under general anaesthetic — this was obviously not my ideal birthin scenario, but my ob and all the personnel did everything they could to keep it from happening, and then to make sure I was as comfortable as possible when it became necessary. My sister had a great pregnancy with a midwifery group that she liked, had a home birth, and through a series of errors by a midwife who, it turns out, should not have been practicing alone, she hemorrhaged badly and had to be rushed to the hospital and transfused. So much depends on the individual practitioner, doctor or midwife. I’m fine with people preferring one philosophy over another, just not with people who refuse to admit that all midwives aren’t perfect and all doctors aren’t butchers who are out to over-medicalize every birth regardless of women’s wishes. I was with a midwife in the hospital for my second delivery, and had a VBAC, for which the recovery was much easier than with the c-section, so I absolutely agree that reducing unnecessary c-sections is highly desirable.
    .-= allison´s last post ..************Under Where? =-.

  19. great post Amber. i love reading your work, thought provoking and validating.

    as for the birth question (naturals vs whatever else) it all seems to boil down to competitiveness. my mummy friends were aghast that i wasn’t a more ruined person at having had to deliver by induction then c-section, but if they had stopped long enough to listen they would have found that all three of us had a very positive birth experience, surgical or otherwise, in a highly supportive atmosphere. our wee guy was born strong enough to cope succesfully with the next few months (which turned out to be fairly harrowing).

    my heart is with francesca – the end result should be a healthy strong baby that you take home with you. not a gold medal for doing without pain relief.
    .-= pomomama aka ebbandflo´s last post ..snowdrops =-.

  20. This and the way mental health consumers are made to feel in hospital settings was the final topic of my Master’s Degree application. Trauma-informed care is something that needs to be taught to health care professionals everywhere in order to lessen the amount of trauma that patients go through – whether they be suffering from a first break of psychosis or heading into L&D to have a baby. Anyway, I hope I get accepted so I can start doing something about this kind of thing. It’s something I really want to help change.
    .-= Melodie´s last post ..The Things I Didn’t Expect When I Was Expecting =-.

  21. Based on my own experience (2 kids, both delivered vaginally in hospitals; one induced, one not) what women need most when they labour is support. Like you said, one careless word or phrase can be remembered, carried, for a long time. Someone needs to be supporting your decisions, your feelings, your instincts.

    On the other hand, another commenter mentioned that nurses are overworked and it is so true. No one has infinite patience or stamina and if I was on a ward with 20 women giving birth I might snap at one of them too.

    Much as in the public health care system (again, as I have experienced it) there is little middle ground between a) wait 2 days for an appointment with your GP if you’re lucky enough to have one or b) go to emergency (and yes I know about nurseline and walk in clinics) we don’t have a middle ground for birth either. If there were freestanding medical centres and birthing centres staffed with nurse practitioners and midwives, a lot of people who don’t necessarily *need* hospital care could get something more tailored to their needs. Hospitals might be less busy, better able to support the patients who really need them. 5 women on a ward instead of 20.

    I told this all to the BC Conversation on Health Care 2 years ago but haven’t heard back yet. 🙂

    Great, thought-provoking post.
    .-= clara´s last post ..All I Wanted Was a Beer =-.

  22. Great post Amber, thanks for sharing about the movie. I agree – we mothers often have polarized views on the matter. Now that I work for a hospital, I’m amazed at how strongly hospital feel about certain things, like free standing birth centers. But they have also seen ALL the bad things that can happen and ALL the ways being in a hospital environment has saved babies lives – so I get it.

    I’ve had 2 very different hospital experiences. One a “natural” bradley-inspired birth with no pain meds – but in a hospital with nurses who were unsupportive – but a great partner.

    Then a couple years later I found a hospital with better/more supportive nurses, a midwife practice… but my relationship with my partner was not where it needed to be… and I ended up getting an epidural (even though I didn’t want one going in) and a pretty unfulfilling birth experience.

    I don’t think I’ll be having more children – but I do appreciate that while environment certainly plays a big part in our birth experience, our own personal desires, circumstances and preparedness also can make a big difference as well.

    Thanks Amber!
    .-= Missy ´s last post ..More bad signs =-.

  23. Thanks for talking about this. I hoped the comments section wouldn’t turn into “a healthy baby is all that matters…” but it did. Of course. It usually does, by the women who have no idea how devastating some birth experiences can be for mothers. And how those experiences will terrorize them for the rest of their reproductive days. It’s hard not to get defensive when you listen to insensitive comments like that. (and if those women are interested in getting educated on birth trauma, they could start by listening to Monday’s “Labor of Love” show aptly titled “A Healthy Baby isn’t ALL that Matters.”

    I would love for there to be a middle ground. It’s hard in my state because your choice is basically either Hospital or Home – no inbetween (except in Oak Park where there is a wonderful hospital based birth center.) I’m choosing home next time because you know I’m the embodiment of those hospital horror stories. I think so many of us try to communicate to women that: It. Does. Not. Have. To. Be. That. Way!!! And for the women who walk into hospitals fully informed and fully empowered, and get awesome birth experiences out if it, much of that is due to the education they received prior to showing up there.

    It seems to be a constant struggle in this country between those who choose to keep women in the dark, and those who try to force women to stand up and take back their power. If only there could be more trust in our medical establishment, perhaps it wouldn’t be this battle. But our system is, for the most part, broken, and the result is exactly what you’ve illustrated here.
    .-= TheFeministBreeder´s last post ..Coming to a Television Near You on March 3rd… =-.

  24. what a thoughtful post. watching a birth process in the jungle this year made me think about it differently and also about how much i’ve taken for granted.
    .-= jen´s last post ..see saw =-.

  25. er …… i’d still advocate on behalf of those who don’t have any say in the birthing process ie. the babies themselves.

    yes, it would be lovely if we all got the birth process we dreamt of or were educated about pre-natally

    but a lot of what i heard among my peers (ie those delivering around the same time as me) however was one-upmanship about the whole birth process from pregnant mums, competitiveness and misinformed anti-establishment rhetoric. i don’t think the mother’s wishes should supercede the interests of the baby, and i wish that a lot of the non-medical population would realise that all that happens is that doctors/OBs/nurses etc try to do their best. whilst there is a lot lacking on one side of the great medical divide in terms of individualising the whole process for the individuals (note the plural there) concerned, i do believe (having been in both camps) that there is also a great underappreciation of the stress that maternity services staff are under when they take responsibility for their patients.

    i am very sorry when i hear of less than optimal experiences, but that doesn’t come close to the sadness i feel when a baby or a mother is lost in labour.
    .-= pomomama aka ebbandflo´s last post ..snowdrops =-.

  26. Thoughtful post. I respect the wishes of women who wish to give birth without medical intervention, and I’m glad to see your balanced take on it. Too many times, I see doctors described as practically evil in “natural only!” articles, forgetting that it was perfectly natural and traditional for women to die in childbirth along with their babies. Like everything, there’s a balance to find.
    .-= Lady M´s last post ..Watching Gold =-.

  27. I agree with you too…I think I am one of the ones in between…I think there is WAY too much intervention in birthing and it often causes a lot more problems than there should be…but I am not opposed to intervention that is absolutely necessary either…with my second child I stood my ground and didn't opt for much interventions and the birth was great…my first was the opposite and it was very chaotic in every way…especially emotionally…

  28. FeministBreeder,

    Perhaps you didn’t read the same comments I did. The comments I read welcomed whatever choice a family desired, balance and patient advocacy. Some commenters spoke from a place of immense loss and their voices should not be ignored which I’m afraid you did.

    Great post Amber.
    I only hoped that my child and I survive. My pregnancy was high risk from the get go and I had weekly or biweekly appointments from 7 weeks on. I was fortunate enough to have a fabulous perinatologist and L& D nurse. They read our birth plan and respected it. While pregnancy was a roller coaster because of my medical condition, the L&D was empowering. It helped that my expectations of a ‘birth experience’ were low, but being an advocate for myself, having a partner that would advocate also, having a doctor that would listen and respond even if he disagreed all helped immensely. I agree, balance isn’t always present and many of us need support in being advocates for our own health care in all fields and not only maternity. The polarization of pregnancy and labor approaches does not aid women, children or family. Both sides need to take a step toward the middle. I found a doctor and a hospital who respected my choices. I had friends who themselves had the option of birth centers or home births who didn’t judge our route as any less valid than theirs. I did come in contact with those who didn’t, who devalued my route to parenthood as less than optimum. I think them rather short sighted. I rather wish efforts were focused on developing us as advocates within whatever environment we have available AND for post natal care. Home visits post delivery from home nurses and doulas.
    .-= Tepary´s last post ..Cluck, cluck, cliche =-.

  29. So I read your post earlier today and almost commented, then changed my mind because, well, something was niggling away at me and I wanted to figure it out in my own head before I posted.

    Here’s the thing…I think the title of the post should be “Making Birth Better”. I think putting the “Hospital” in there right off the bat signifies that a hospital birth is (of course) the lesser option and that other kinds of births don’t need to be made better–they already are better.

    I actually know people who’ve had bad experiences with midwives, just as I know people who’ve had great experiences with midwives. And doctors? I’ve heard of both good and bad experiences there, too.

    In almost all of the bad cases (midwives and doctors) the issue seemed to be mainly poor communication and not paying attention to the woman who is pregnant.

    I was fortunate to have two wonderful epidural-free hospital births. I think some of that was due to luck–I happened to give birth on days when the maternity ward was not particularly busy and I had no real complications to deal with. Part of my good fortune was due to the fact that I felt well-informed about what the birthing process would be, I had a husband who would advocate for me if I needed anything, and I was realistic about the fact that my birth plan might change once things got rolling. I found the nurses and doctors treated me with respect, and both births really were positive experiences.
    .-= Mary Lynn´s last post ..Do not adjust your set… =-.

  30. I have had 8 hospital births. It really helps to be friendly, but self confident. Ask the staff questions (don’t question in a rude or aggressive way, but ask). Simply saying “Why do you recommend that?” or “What is the benefit?” (instead of, “WHAT? WHY????) makes a huge difference. The respect factor.

    And, don’t take it personally. With my 2nd birth my LD Nurse was a crusty old lady who was sooo condescending. But I’m not going to let her steal the joy of that birth forever. Just let it go. Easier said than done, sometimes.

    Scripture tells us that women ponder things in their hearts – true. But, also, YOU choose what can enter your heart. Just say no, as it were.

    Although with my last birth, as soon as the LD nurse found out it was #8 she said “You tell me what to do and what you need!” LOL.

    I had a postnatal home visit, once. It was not optional and I HATED it, even though it was touted as a wonderful benefit of XYZ healthplan. I didn’t want it. I think giving women choices, and not judging those choices, is the key to having a birth that respects mama and baby.
    .-= Milehimama´s last post ..Meat Substitutes: Works for Me Wednesday =-.

  31. I should note–it’s only the title of the post that bugged me. The content of your post is balanced and thought-provoking. Good discussion, Amber.
    .-= Mary Lynn´s last post ..Do not adjust your set… =-.

  32. I keep thinking about this post and about the comments here.

    I think the post addressed two issues: 1) how to make a birth in which medical intervention IS necessary a more respectful experience and 2) why is there a polarization in the birth community and what about the middle ground.

    I addressed the first in my prior comment. But the second has been nagging at me, especially in light of all the comments.

    I am very pro homebirth, pro birth centres and pro midwifery for a variety of reasons but I do understand that medical intervention is occasionally necessary and useful. Both my children were born at home but with my first I had a retained placenta, transfer to hospital for D&C, under general for 4 hours away from my baby and the first day of his life spent feverish, drugged up and denied food or drink in recovery. It was a shitty experience but clearly it is much better than the alternative which is that like you had this happened in 1805, my husband would have been out looking for a wet nurse for a motherless baby. I am grateful that medical intervention is around, precisely for these kinds of situations.

    BUT> I think the polarization comes from the fact that the actual middle ground consists of countless women who are subjected to UNNECCESSARY medical intervention. We have the few who have natural, uncomplicated births, the few who have real emergent situations who need medical interventions and then this huge gray area in the middle. The women in the middle who are rightly outraged about these unnecessary interventions are rejecting the system as whole because it often feels like it is impossible to work for change within the system. Furthermore, the women in the middle become pitted against each other because it is often difficult to say for sure if a particular set of interventions was actually necessary. One woman might believe that her caesarean birth saved her baby while another perspective might say that avoiding an induction, an epidural, an IV and electronic fetal monitoring might have saved her baby (and the mom the caesarean). We do know that a lot of the interventions are not necessary or useful and yet, it seems almost impossible to reduce these. Some caesarean births are necessary but even the medical community agrees they are not all necessary. I definitely understand the feeling of women who have endured terrible loss that they would endure any medical intervention if it would give them back their baby…but I also understand the women who keep being told at least their baby is healthy when they feel violated and abused and traumatised by what happened in L&D.

    Honestly, I think we all need to come together as ONE to demand better maternity care as consumers (yes, even in Canada). We need to stop fighting amongst ourselves about what is the loftier goal – a healthy baby or a healthy baby AND a healthy mom – or nothing will ever change. This wouldn’t even be an issue if the medical establishment AS A WHOLE were more respectful and more measured in the care they give.
    .-= BluebirdMama aka @childbearing´s last post ..Trick of the Light =-.

  33. This is an incredibly thought-provoking post and discussion. Women as health consumers should be able to have a safe birth and a satisfying experience, both at the same time.

  34. cypress sun says:

    amber ~ you have initiated the most thought provoking conversation i have ever encountered about the birth experience.

    as someone who prepared for a homebirth, read the 20+ books to support it, and hired THE midwife, i was completely devastated when the birth of my son became one of the most horrible hospital experiences imaginable.

    throughout my pregnancy, i indignantly believed, and was coached by my midwife to believe, that i was superior in my choices and actions. that the medical community was my enemy. that submitting to anything they had to offer would indicate failure on my part, and result in a baby (and mother) with multiple problems.

    in turn, my experience taught me to respect all mothers, all choices, all experiences. unfortunately, however, i still haven’t been able to wholeheartedly believe that i haven’t failed my son in some way.

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  1. […] just love Amber Strocel’s blog! Her posts are always reasoned and well-written. In Making Hospital Birth Better, Amber examines the polarization of birth options and if there are ways to make hospital births […]

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