A letter of appreciation

This email bounced.

So I’m hoping to invoke the powers of the fabled seven degrees of celebration, sorry – separation! – in order to get it to its intended recipient. Or just to spread the appreciation.

Please could someone pass this onto Naomi Wolf, who wrote Mis-Conceptions:

Dear Ms Wolf

Thank you for your extraordinary book Mis-Conceptions. Reading it has been a revelation. Your account led me with intense familiarity back along the road I walked nearly two years ago. You have beautifully, honestly revealed to me much of my own experience that I remember acutely but have never put to words. Thank you for articulating the terrible, marvelous nuances of the experience – especially the fluctuations between peace and turmoil, between anticipation and fear, between the desire to be the successful textbook mother-to be and the uneasy sense that the textbooks were skipping out huge swathes of something crucial but un-utterable.

Your book also had me weeping with gratitude for my own experience and with anger and outrage for the millions of women that routinely get cheated of that experience by the medical fraternity. Entirely by a series of chance encounters, I ended up opting for home birth. I was, at the time, a South African living in the UK, and had the support of a lovely NHS midwifery team as well as my doula. It turned out to be an extraordinary, marvelous, spiritual experience. Bloody, exhausting, ferocious, excruciating – and entirely possible. There was no need for medication or any intervention – and that felt normal, not remarkable at all. Not because I’m stoic (I’m not) and not because there wasn’t pain (there was); it just felt I’d completed some sort of gruelling marathon or endurance event – with exactly the right support team there to coax me up every last hill.

In the aftermath of that experience, I had the evangelical, elated glow of the converted when anyone mentioned home birth. The endorphins took months to wear off and carried me through the early days of my child’s life in a kind of blurry glow. And yet I also felt curiously silenced about the experience by the overwhelming prevalence of the very myths you list in your section on birth. I didn’t feel I was allowed to share my experience in case I offended someone who’d suffered the far more common medical-trauma style of childbirth. It’s more than good fortune though: it’s about information, the right kind. Your book comes as a welcome breath of fresh air. I only hope it is being read and heard my expectant mothers in the developed world, and is inspiring them to claim back their trust in their own bodies and instincts.

Much gratitude
Lisa Greenstein
Cape Town, South Africa

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About Lisa

I live in South Africa with my husband and two small children, doing things, thinking about things and sometimes writing about them.
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7 Responses to A letter of appreciation

  1. Kiki says:

    I read this book too, during my first pg, and it opened my eyes to so many things. Like you, i opted for a home birth (and am now planning #3 for this spring).

    During pg #2, I went back and reread the book and couldn’t help but being a little irritated. Although NW sheds some much needed light on the current practice of OBs in USA, I took offense to her stereotypical description of homebirthers or anyone not wanting drugs or interventions, regardless of birthing location.

    You say it best and I wish all could realize: “It’s more than good fortune though: it’s about information, the right kind.”

    How right you are…

    And yes, I too found myself on an unexpected endorphine driven high for months after the birth yet at the same time feeling like I offended 99% of women b/c I didn’t birth the way they did and they were constantly validating their medical experiences to me. It is an all too common issue, but oh well.

    Great post….:)

  2. Lisa says:

    Thanks for the feedback, Kiki! I have frequently heard women insisting that their labours were so drawn-out or unsuccessful that they were fortunate to have the doctors on hand otherwise they would have died/lost the baby/gone into distress and so on. And I’m sure that they’re speaking the truth. I’m just not sure that it would’ve been the truth if they’d been in an environment more conducive to easy labour. Having seen the stats from places like Ina May Gaskin’s birthing centre (where fewer than 2 out of every 100 women require medical interventions for a successful natural delivery), it becomes obvious that in 97% of cases, the interrupted labour and complications are a consequence of being in an inappropriate environment for birth. Cats give birth hiding in dark cupboards or boxes. Birds go into cosy nests. Westernised humans go into bright, sterilised rooms with strangers looking on wielding sharp instruments. No wonder so many women have a tough time persuading their babies to emerge easily.

  3. Adam says:

    L, my son’s birth happened in a hospital, at Vincent Pallotti. The birth, though hard, was natural. The hardness was partly just the birthiness of it all, and partly a simple mechanical thing (an inflammation that arose, that was identified with an examination, and that was resolved by not pushing until it went away). There was also a complication toward the end.

    Durand (the one who provided the stats with respect to Gaskin) found that ‘Hospital births have a safety advantage in cases in which life- saving technology is immediately required’ and that ‘the results of this study suggest that, for relatively low-risk pregnancies, home birth with attendance by lay midwives is not necessarily less safe than conventional (hospital-physician) delivery’. They ultimately conclude ‘under certain circumstances, home births attended by lay midwives can be accomplished as safely as, and with less intervention than, physician-attended hospital deliveries’. That is quite a string of caveats. (See: The Safety of Home Birth: The Farm Study; Am J Public Health, 1992;82:450-452 – accessed here: http://www.thefarm.org/charities/mid.html.).

    It was re-assuring to know that if one of those difficult things did happen – an umbilical cord prolapse, severe dystocia, uterine rupture – there would be medical and, if necessary, surgical, help *there*, not across town.

    As it turned out, my wife’s uterus stopped contracting entirely (it will do that if you have been at it long enough…). It was nice to be somewhere where a drip with the suitable drug could be put in. The doula (30+ years experience) and the midwife (35+ years) both said at the time that there was nothing further that they could do to get the baby out. The baby was then quite distressed, something we knew because we had a foetal monitor, which we would not have had at home. Quick steps were needed and available. Had we been at home we would have been poked.

    Isn’t the issue here between natural/not natural; not home/ hospital? Should we not be going for ‘as natural as circumstances allow’ (because there are coherent reasons to do so, not just because it is ‘natural’) and not stress as much over *where* we should be doing it? Surely there’s no magic in *where* it happens; the magic is in *what* happens (and what you allow to happen). Birthing can be comfortable and under your control in a hospital too. That was our experience with the hospital, gynae, midwife and doula we chose; and they were chosen for that reason. No-one pressed painkillers on us; no-one was trying to hurry us along; no-one was trying to push us into surgery.

    If you are comfortable with hospitals and the people around you in them, then they are good places to give birth.

  4. Lisa says:

    I’m glad to hear you had a positive experience of the hospital. I spoke to a friend this week who also had a perfectly lovely experience of a hospital birth – I have no doubt it’s possible. It is just so rare to hear of it. Her husband told me that in their labour ward, there were ten other births the same weekend. 8 of them were Caesarians. That should not be the norm, and I believe it’s the hospital environment, compounded with the easy proximity of drugs and the ease of surgery on doctor’s schedules that makes it so.

    Yes, in my view, of course we should be going for as natural as circumstances allow. My concern is that the very circumstances that might allow more happy, healthy, stress-free labours are not necessarily those provided by the medical setting, and yet it’s the just about the only option anyone normally gets offered.

    There’s not much support in this country for home birth, and there should be – for those that want it – and (importantly) those whose risk profiles are ok for it. Sure, as you say, if you’re comfortable with hospitals and all they contain, there’s plenty argument for using one as your birth setting. I just don’t believe it should be the default setting for everyone – it’s an option, and there are others.

    Ultimately, it shouldn’t be a “home vs hospital” or even “natural vs unnatural” debate. It should be a question: What kind of support do women need to ensure the best possible experience of labour, the greatest chance of complication-free births and the kind of birth with the best possible outcomes for themselves AND their babies? I don’t think the answer is in doctor-led, hospital-dominated maternity systems. A range of options would be nice. More support for each of those options would be nice. And I look forward to the day when my experience (straightforward, uncomplicated home birth) won’t be regarded an outrageously far-left-of-hippie scenario, but rather a pretty everyday way of having a child that more women could look forward to.

  5. Carrie says:

    During my first and only pregnancy, I was speaking to my friend about hospital vs. home birth. I was single and living with roommates and had very awful health insurance, so a homebirth was not possible, and my insurance wouldn’t cover anything but the mainstream, hospital way of things. While pregnant, I had every intention of having a natural childbirth, not being induced, and not having a c-section.

    Well, my circumstances changed when I found out my son had passed. I was induced and 36 hours later, dilated to just 4cm, was carted away for a c-section.

    I believe that homebirth is the way things should be, and I would love to have that experience. However, now, given that I’ve only ever had one pregnancy and it ended in stillbirth, it terrifies me to think about a delayed, long, and laborious labor. I had a perfect pregnancy until 40weeks and 4 days and would have had a healthy baby. The idea of ever going through that again is just more than I can bear. I imagine that in future pregnancies, if I do not go into labor by 38 weeks, I may do what I believe is not the ideal thing and either be induced or schedule a c-section just for my sanity’s sake. It’s something I will continue to think about. The decision is not made and has not be set in stone. I will cross the bridge for real when I experience my next pregnancy. Until then I will be playing on the bridge of contradictory thoughts about what I believe best vs. what I think my spirit and my mind can actually handle.

  6. Lisa says:

    Carrie, I can’t imagine how heartbreaking that must’ve been for you. 40 weeks and 4 days… what cruelty. I can imagine that anyone who has been through that kind of experience would probably feel more comfortable with a highly controlled hospital environment than with letting a labour unfold at its own pace at home. The crux is that you should have the choice, with all the support and information you might need, for whichever is your preference. Warm wishes to you.

  7. Carrie says:

    I completely agree that it’s about choice. So many people let others make their decision for them, not only when it comes to birth and medicine but a multitude of other things in life. We have entrusted the decision making to someone else, whether because we’re just too lazy to find out answers for ourselves or because we are fooled into thinking that just because a person has studied something, that that makes them an expert.

    I do believe in science and in medicine, but I also believe that if we know our bodies and we trust our instincts, that we don’t have to bow blindly to medicine and what doctors say is best.

    I will have to add this book to my list. Sounds like a good one.

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