Giving birth

So it turns out that Misconceptions: Truth, Lies, and the Unexpected on the Journey to Motherhood has a younger, more even-tempered little sister. She is Giving Birth: A Journey into the World of Mothers and Midwives. Granted, author Catherine Taylor stays far away from the wider social commentary that was so irksome to me in Naomi Wolf’s book, so perhaps there is just less to annoy me with in her subject matter to begin with.

Still, I found Giving Birth to be a very interesting, if not always fascinating – and certainly not as fascinating as Baby Catcher – “journey,” if you will, into, you guessed it, the world of mothers and midwives. As with most any book, I found I had to accept from the beginning that some of the author’s opinions would not agree 100% with my own. But that’s the point of reading books like these, isn’t it? I was curious about this woman’s experience shadowing midwives, becoming a doula, and eventually giving birth to her second child at home (that last part should probably have a spoiler warning. Sorry).

My in-your-face-feminist radar started tingling early in the first chapter when I read this sentence, in which the author is trying to explain how she was feeling when she decided she wanted a second child:

“I wanted to be special, taking up space in the world, my power written on my body, people smiling at my belly, holding doors, and offering seats (even as I want to reject the stereotype of the weak female).”

That parenthetical aside seems absolutely wedged in there, like it’s actually the main message of the chapter instead of, well, a parenthetical aside. I am more than happy to let her preach about her own sentiments in what is, after all, her own book – but this felt like shoving it down my throat.

Fortunately, it got better from there. Ms. Taylor gives us a very interesting behind-the-scenes look at modern midwifery practices in America, and modern attitudes about birthing from a wide range of women. She draws heavily on personal interviews and gives away entire paragraphs to quotes from her real-life characters, often not interrupting with editorial comment at all. In many ways, it is like a documentary in book form. A few narratives are followed from beginning to end, interspersed with smaller segments of stories that serve to illustrate key points.

One of those key points is that home birth is safe. Specifically:

“[R]esearch has shown time and again that, statistically, home birth for a healthy woman, attended by a qualified individual within a system that allows for hospital backup when necessary, is as safe as or safer than birth in the hospital.”

I believe her when she says this. In fact, I believed her every single time she said it in the book, which was probably more than a dozen times. However, cited research notwithstanding, the claim takes on just a tinge of disingenuousness because when you think about it, the process of deciding to home birth self-selects the kind of woman who is going to have a successful birth outcome. She is almost certainly educated about the birthing process, healthy throughout, and determined to make it work. Also, high-risk pregnancies/births similarly self-select to take place in a hospital – thus raising their rates of less successful outcomes.

Another statistic Ms. Taylor is fond of citing - that of America’s seemingly abysmal infant mortality rate, especially when compared to European nations who rely on a less medicalized model of childbirth – is skewed for this same reason. America’s childbearing population is probably much more diverse (and thus unhealthy, or high-risk, or whatever) than any of the childbearing populations in these countries. Also, it could be argued that US obstetricians are more often involved in extremely risky births that may not even be attempted elsewhere in the world. Again, these mitigating factors receive no attention from the author.

The subject of epidurals comes up often and it is, of course, a divisive one. After 24 hours of labor with Miriam, I finally had one administered, and there are times when I feel guilty about it. I at least have the consolation (?) that it had worn off by the time I was pushing, with the additional bonus that I was able to walk to go to the bathroom by myself shortly after delivering (woohoo!). Do you see how I feel like I have to justify it to you? There really is no reason that I should feel guilty about it – no one I know, even those who have delivered without drugs, has ever made me feel that way. But on some level, I still appreciated the validation I received from Ms. Taylor when she said,

“Still, [my doula instructor] is careful to begin by pointing out times when epidurals are worth the risks, including sheer exhaustion and discouragement, extremely long early labors, when labor is really stuck, if you’ve tried everything else and you still need help, if you have a caesarean, or induction when the cervix is not ripe.”

I read this and almost laughed as internally, I checked off each of these factors, save one (no C-section, thankfully) as being present at my labor with Miriam.

Finally, I was glad to read several accounts of home birth by someone who was at first fairly removed from the process. (Baby Catcher is full of home birth accounts, but they are almost all given by the midwife who was attending.) It is amazing to me to observe the evolution of my opinion on home birth. It wasn’t even on my radar until my good friend Kristen had a beautiful home birth experience at the end of 2006. At the time, I thought it was kind of strange, but good for her. Somehow, over the past year and a half, I have really come to appreciate at least the thinking behind home birth, if not the actual practice itself, at least not for myself. That’s why I am so glad to have a freestanding Birth Center here in Tucson – it provides a sort of “in-between” option for those of us who embrace the general philosophy behind home birth without necessarily wanting to scrub birth mess off of our own bathroom floors (I’m being completely facetious with that last bit, Kristen and Sarah!).

If you’ve already read books like Birth (a must!) and Baby Catcher, Giving Birth is another one to add to the pile. It is a fresh look at the same old thing, and it also has the dubious distinction of being the first book I’ve ever read that features a woman’s bum cleavage on the front cover. Perhaps you can’t say the same?