If you plan a home birth and take a home childbirth class, like I did, here are some things you might hear:
- 20-25% of births are by Caesarian section
- Medical interventions can slow the process down
- Technology designed to aid in childbirth is for the convenience of practitioners and doesn’t lead to better outcomes
Now, I had a C-section with my firstborn, following a sequence of medical interventions that I was completely unprepared for, since I was planning to be in the 75-80% of women who give birth vaginally. (Some people use “natural childbirth” to mean the same thing as “vaginal delivery”; some people only use it to mean “intervention-free” delivery. I use “vaginal” because it’s accurate and clear and gives me the opportunity to further the normalization of vaginas and their name.)
Because I had planned a home birth, I ignored pretty much all information about hospital birth. Once I transferred to the hospital after a day of laboring at home with high blood pressure and little progress, my midwives became friends, part of my support team, disallowed from participating in any medical procedures. As SM said, “I was itching to get my hands on your cervix the whole time!” The good news was that I had two loved ones and two midwife-friends on hand to help make decisions, which I would have needed no matter how closely I had paid attention in class. And the kind of advice my midwife-friends were likely to give me, and gave me, helped me get comfortable with hospital interventions.
There was one intervention that was more like interference than assistance, and that was the fetal heart monitor. First of all, to get strapped into it, I had to sit up. The Evil Nurse refused to help me up, and I can understand she might have been afraid of assisting a 200-pound patient, except for the fact that all women coming into Labor & Delivery were heavier than usual, and that seems to me to be part of the job description.
But that was just the tip of the iceberg. The iceberg that the Evil Nurse was frozen into was vast and variable enough that she managed to piss off me and every member of my team in a different way, and she was only on our team for about 2 hours.
I didn’t realize how short her time had been until a year later when I read the hospital record. That record also revealed what I had known from being in the room: She paid more attention to the machine than she did to me. I was having what I thought of contractions that resembled Drawing Number One from The Little Prince, also known as a picture of a boa constrictor digesting an elephant. The contraction would start, continue, apparently peak, begin to die down, then start to peak again, then finish up. Nurse Evil, staring at the machine, said, “You can stop your breathing; the contraction is over.” Which she knew from looking at the monitor, not from looking at me.
More good news: Evil Nurse was replaced by Angel Nurse, not only that night but my second night in the hospital. Angel Nurse was actually a midwife working as an L&D nurse AND she was the wife of my favorite high school English teacher. Her note in my hospital record shortly after coming on shift was “patient relaxed and breathing through contractions.” Evil Nurse had recorded a note just before going off shift: “patient unable to relax.”
Thank you, we won’t be needing your services any longer.
This story, like many of my stories, is a long way around to a different point, not a point about giving birth in Seattle / a hospital / this country / the late 20th century. It’s more of a point about technology, measurement, and health care: When you have a machine that measures something happening in the human body, you tend to replace attention to the patient — or person — with attention to the machine. What can be measured gets attended to. What is measured becomes important and easy to understand. Unlike an anomalous contraction pattern.
This came up today when I was working with my sister on our memoir about our father. There was a period of time when we were worried that he would have a stroke, and there was a period of time when we were worried about his blood pressure. He would be sitting up and have to lie down because he felt terrible. We would take his blood pressure and see that indeed, his blood pressure was probably making him feel terrible. So he would lie down. We worried that he would have a stroke, something his blood pressure measurement would show, along with him having trouble speaking and lifting both arms equally.
Once he’d had a stroke, been hospitalized for it, had a stent installed (a procedure that was approximately as life-threatening as him having another stroke), gone through rehab, and gone home, we were no longer afraid of him having a stroke, and therefore we stopped taking his blood pressure.
I wonder sometimes if you have to go through Point A to get to Point B, if you need to go through the whole procedure of a medicalized, technologized birth to prepare to refuse technology, if you need to have your worst fear realized (what if Dad has a stroke?) to learn that it’s not the real problem. Could we have gotten to Point B — deciding that if Dad had another stroke, he was not going to go back to the hospital, and that it was unlikely to be the ultimate cause of his death, and that since he was going to die, if it had to be “at a stroke,” that would be okay — without the confusion, stress, uncertainty, and just plain learning that we had to do in Points A, A1, A2, … An?
Most of the time, we have to do our own learning. For some of us, book learning works, but for me, experience is probably the only teacher I’ll really listen to, and real-world trials are the only tests that matter.
Birth and death are two experiences we become aware of from the outside, as observers, and if we observe through a machine, we’re likely to miss the nuances that really matter in life.