Whither 'Tis Nobler To Shun Intervention in Childbirth, Or Just Have The Damn Baby, Whatever It Takes

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I'm due to give birth in about three weeks. Possibly sooner, if this massive baby gets his way and manages to punch his way out before then. I'll be giving birth in a hospital, attended by our family doctor, and, yes, there will be drugs. Epidural me, baby. PLEASE.

All of which is to say, I'm not using a midwife. I had a labor doula for my first child, and would consider having one again - she was beyond awesome and was a tremendous help in that birth - but otherwise, it's doctor/hospital all the way. I might have been talked into using a midwife that last time around - maybe - but that birth was a very difficult one with multiple complications, one that ended - well, thank god - in an operating room with respiratory specialists and other medical types, and for that reason alone I'm just going to feel ten thousand times more secure giving birth with my nice doctor (a woman, who, for the record, I have a massive girl crush on because she is THAT AWESOME) and with teams of medical experts on hand.

Which, I know, is the complete antithesis of a natural birth that celebrates womanliness and the Eternal Feminine and go woman power rah, but that's just the way it needs to be for me. I tend to paranoid hypochondria.

For some women, though, the decision to go au naturel or not isn't so straightforward. Housefairy has written movingly about wanting her fifth birth (after three that involved serious intervention and one that she was able to do at home) to be a natural, midwife-assisted birth, but being worried that she just can't:

I worry. I do understand and yet I worry. I keep on top of things with
the very real gratitude that the baby is healthy and that I have such a
great midwife. I just feel so disturbed that I cant or maybe cant or
blablabla just have a baby. The lump in my
throat battles with the bravery most of the hours of my days. I hate
being 32 years old and having to pretty much just "hope it doesnt
suck".

She wants her fifth birth to proceed without intervention, but is gutted that it just might not work out that way, and struggles with reconciling herself to just having a birth that 'doesn't suck.'

I feel for her, I really do. I don't empathize fully - that sounds harsh, but bear with me - because for me, any birth that gets this baby out alive and healthy and with as little physical trauma to me as possible is a good birth. What sucks is maternal or infant mortality. That sucks. Me having a SWAT-like team of medical professionals saving my child's or my own life doesn't suck at all.

What I do get, though, is the idea that there's something less than satisfactory about becoming disempowered in the whole birth process, a process that is or should be uniquely feminine, the special domain of women. Why shouldn't we be able to give birth on our own, with just a community of skilled women around us? What does it mean that birth has become so medicalized? Has some power been taken away from us?

Kneeling Woman has written about a tension between the push to 'professionalize' and remaining committed to an idea of birth as naturally safe:

I've sat here with the book open on my lap, concurrently looking up at
the computer screen to read a painful letter from another midwife being
attacked, in a torrent of angry accusation and rejection; by another
midwife for speaking out about Midwifery education and about concerns,
many of the same I have written about in this space, that Midwifery is
not set up to be a sustainable health care profession that we can pass
on to our daughters and granddaughters knowing that they will have
something we have not had: a unified, profession of midwifery as the
basis of our maternity care system in the U.S.

Continuing to read.. "A Midwife must be an
avid student of Physiology and Medicine. She should read and study
constantly in a never-ending quest for new information. She should
never assume that she knows everything there is to know. A new piece
of information she learned yesterday may be essential and life-saving
tomorrow." I can remember reading those words breathlessly and I
took them to heart. I wanted to know everything and I worried that
there would be something, at some critical moment, that I didn't know
and my greatest fear was that I would fail a mother or baby who had
entrusted themselves to my care... It never occured to me... that
"birth was safe" and that's all you need to know, or believe. It was years before I ever heard the "birth is
safe" mantra and even though my experiences had thus far validated that
claim, I continued to believe, and practice, with the idea that the
most important thing I had to know how to do was respond appropriately
to a complication or emergency.

If I were going to have a midwife, I would want Kneeling Woman.

The idea that 'birth is safe' or that a woman like Housefairy might have something wrong with her just because she can't give birth without medical assistance isn't, to my mind, empowering. Women are uniquely gifted, as a sex, in their ability to create new life and bring it forward. But that gift doesn't imply - despite what we might like to believe - the possession of superpowers. Giving birth can be a difficult and dangerous process - just ask women in less advantaged countries where maternal and infant mortality rates are staggeringly high. There's no shame in wanting the best medical expertise available when there are lives at stake. But as Kneeling Woman points out, expertise doesn't necessarily mean all doctors, all the time. A conscientious midwife with a solid education and training who knows when to bring in extra medical help can be as good as a family doctor in providing maternal care any day.

The United Nations Population Fund has declared today International Day of the Midwife.

So, regardless of whether you have a midwife on your birth team, or, like me, are sticking with their family doctor and anesthetist, take a moment to give a midwife her due. Check out their blogs - or blogs that discuss midwifery - for a start. Here's a few:

Pam, A Midwife (formerly SageFemme)

Hathor: Cow Goddess

Homebirth Diaries

Midwife-ette

Let me know about other good mdiwifery or natural birth blogs in the comments. And if you've got strong opinions about midwives versus hospital births, I'd love to hear them.

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