Sunday, October 23, 2011

Please Check Your Judgment At The Door

During our infertility journey, I spent a lot of energy struggling with feelings of guilt and shame surrounding the choices we were making regarding methods of achieving pregnancy.  From making the decision to undergo multiple IVF cycles, to the life-altering decision of choosing to pursue the use of donor eggs, I spent many hours reading and listening to opinions people have about ART.  I probably should have done a better job screening what information I allowed myself to take in during that time, as many of the opinions were filled with negative inferences and passive-aggressive slights against “the infertile” and how “unnatural” ART is.  Recently, I have realized that I am seeing the same trend during pregnancy.  There is a lot of information out there, for the consumption of pregnant women, pushing guilt onto women who choose to birth in any method other than a “natural” non-medicated vaginal birth. 

I now am at the stage in pregnancy where I occasionally panic about the idea of labor and delivery (and by "occasionally," I of course mean any time I am not actively thinking about something else).  In an effort to calm my nerves, I have followed my usual path of ingesting as much information on the anxiety-inducing subject as I can.  The interesting trend I am noticing is that the majority of information I am coming across pushes (no pun intended) a medication-free childbirth.  If I talk to friends and acquaintances about their birth experiences – “natural” and otherwise – the vast majority tell me to get the epidural as soon as possible, to avoid the pain at all costs.  But, when I read a book or watch a movie about medicated vs. non-medicated birth, all of the women offering an opinion, who have had both experiences, strongly recommend non-medicated birth.  Can my friends really be so different from the norm? 

Not according to the majority of pregnancy message boards.  The majority of those women who have “been there…done that” recommend an epidural.  Shockingly, there will occasionally be a post, in response to those women recommending an epidural, “informing” all of the mothers-to-be on the forum that they are putting their lives and the lives of their babies at risk if they choose the “selfish” route of getting an epidural to avoid temporary pain.  No kidding!  That is the exact language used.  It reminds me a lot of the crap I’ve read about the “selfish” women who wait too long to have a baby and then “exploit” young and under-privileged women, by subjecting them to unnecessary surgery, to take the young women’s eggs, instead of adopting the thousands of babies waiting for loving homes.  It’s BS of the worst kind…attacking women who are emotionally vulnerable on very personal issues they already worry about.

What led me to write this particular post was something I read on the baby-gaga website.  Here is an excerpt from Week 34 pregnancy information (Yes...I clearly jump ahead in my pregnancy readings) on that site: “The epidural process: a six inch needle will be inserted into your spinal column as you're curled up in a fetal position to expose your spinal nerves to the technician. Once the drug has been administered, the numbing effect (if it works, which it might not) -- will relieve your labor pain, but it will also render you immobile and effectively chains you to your bed, forcing you to labor and birth on your back while psychologically numbing your mind to the process at hand, inhibiting your milk let-down and interfering with the postpartum endorphin release that combats postpartum pain and depression.  The take-home message: an epidural can provide much-needed pain relief during labor, but is not without serious risks including: long-term back pain (20% of women experience nerve damage), slowing labor and significantly increasing your risk of c-section.  It also inhibits the entire postpartum release of endorphins, which may negatively impact your postpartum recovery.

Does anyone else see a problem with the tone of this information?  Baby-gaga doesn’t hold itself out to be a site that supports medication-free birthing, but it is clear (to me at least) from this very biased use of language regarding epidurals, that the site is promoting an agenda (you should see the site's "Pro's and Con's List regarding hospital births vs. birthing at home).  I also have a SERIOUS problem with the “facts” stated in the excerpt.  For example, “20% of women experience nerve damage”???  I would love to know where they got that information from, because having practiced in the medical malpractice field, including cases involving epidural needles not getting where they needed to be or the catheter snapping off…I can say with some certainty that the chance of nerve damage is not 1 in 5, or even 1 in 500.  Even a 1 in 5000 estimate would, in my opinion, require a very generous use of the term “nerve damage.”  But if baby-gaga is your only source of information about epidurals, you are now going into labor terrified that your choice is deal with the pain, or have a 1 in 5 chance of "nerve damage."

Another quick example of the ridiculous rhetoric is from the book my doula gave me about the Bradley Method of birthing.  Granted, if you pursue the Bradley Method, you likely have the goal of a medication-free birth.  But, if you are like me…someone just looking for labor techniques to help with the pain, even though the possibility of using pain medication has not been ruled out…the Bradley Method considers you a failure….from the get-go.  The introduction of the book involves a comparison between Lamaze and the Bradley Method.  The author states that the Bradley Method rejects Lamaze’s statement that every woman’s measure of “success” during labor is different.  The author considers Lamaze’s stance to be a “cop-out” and considers use of any pain medication to be a failure of the Bradley Method.  The author states that “Many women have deeply regretted going successfully through hours of hard but rewarding labor, only to accept medication and its consequences just moments before birth.  Teaching an expectant mother how to avoid this pitfall is one of the main things that separates Bradley from Lamaze. 

So…let me get this straight.  I am a success if I go through hard labor for hours.  If I get an epidural, it’s not because I chose it, it’s because I "accepted" it…and, if I am like many women, I will regret accepting it.  The medication has "consequences."  Oh…and accepting an epidural is a “pitfall” to be avoided???  At least the Bradley Method book author isn’t pretending to be unbiased.  But still…is all the guilt and scary language really necessary?   

I want to have a medication-free birth.  In fact, I am praying that our baby decides to come out naturally a day or two before our scheduled induction, so I can avoid taking the medications necessary for induction.  There are side effects, some serious and others not as serious, associated with all medications…including those given in an epidural and those given to induce labor.  I would prefer not to expose myself or my baby to those side effects.  But…I am realistic.  Delivering our baby before his due date reduces the risks to the baby’s health…real risks that have a higher chance of occurring than the induction medication side effects that I find worrisome.  I also am realistic about my pain threshold.  I likely won’t be able to make it through a Pitocin-augmented labor without some type of pain medication.  My goal going into this labor is to employ as many natural pain-relief techniques as I can, and to hold off on an epidural as long as possible.  But…I am NOT a failure if I ask for an epidural at some point because I decide that the pain is more than I can tolerate or I decide that I won’t be able to effectively push when the time comes if I don’t get a break.  My idea of a “successful” birth is not dependent on whether I am “strong” enough to endure the pain of childbirth without medication.  My definition of “success” is bringing home a healthy baby…a baby I worked so hard to conceive.  And frankly, I am a little angry that anyone feels entitled to judge me about my choices regarding how I conceived or how I choose to bring my baby into this world.  Information is a good thing…and everyone is certainly entitled to their opinions.  But people should check their judgments at the door when it comes to conception and childbirth.  Have an opinion about what is "best" if you must, but stop short of telling women that they should feel guilty if their "best" is different.  The guilt is not welcome or warranted.  At least that is MY opinion. 


Endo_Life said...

I am sorry if you are having to deal with this, which from your post, it seems like you are!

Even if everyone has a different opinion it doesn't make any of them wrong. We are all different and we must choose what is right for us.

I hope you choose what is right for you and ignore everyone else's opinions x

Willow said...

Totally agree with you. There's a lot of anti-epidural rhetoric out there, but I did a lot of research too and there's no good reason (for baby or mom) NOT to get one. As one of my friends (who had one) pointed out, you wouldn't refuse pain meds for a dental procedure, so why for this? People should do whatever feels right to them, but the judgements of others choices need to stop. I had an epidural and it was great. I could turn from side to side, which was as much movement as I wanted (did not feel up to walking around!) When the epi briefly wore off at one point, the pain was so awful it made me puke (which I never do), whereas with it, I could relax and not be traumatized by my own labor. I'm thrilled I used it! Good luck as you move closer to labor & delivery! I was scared too, but you're right that going home with a healthy baby is all that really matters.

Anonymous said...

I TOTALLY agree with you! I'm in California where I'm attending a birth class via the hospital I plan to give birth because I don't want to be perceived like a failure of a woman if I do indeed choose an epidural. A girlfriend of mine didn't have the chance to have an epidural for her first but did for her second child. She said the second time around she was less exhausted when the baby actually arrived as a result of less pain. Do what works for you; you've had a "rough" time to get to where you are for someone else to judge and tell you what's important. Thanks for sharing- it's important to feel empowered either way!

infertilenanny said...

I LOVE this post! And I completely agree that a successful and good birth plan is: healthy baby, healthy mama. :D

China Doll said...

I totally agree - I would love to have a medication-free, natural birth but, when the time comes, if I need pain relief, then I'll have it and won't feel guilty about it! xx

Anonymous said...

I am de-lurking because this is something that sets me on fire. First of all, congratulations on your pregnancy! I hope you have a wonderful delivery, regardless of the route. I have had 2 deliveries- one completely without medication, and one with an epidural. I would take the epidural delivery without question. I do believe it is completely worth the pain, but I would not choose to experience that much pain. And all of the stuff that gets crammed down your throat was completely untrue for me. With my epidural, I could still feel contractions, and feel the baby descending without the blinding pain. Afterwards, the baby successfully nursed immediately, and I was walking in under an hour. I had no side effects (or nerve damage). I am not trying to push the epidural, but I wanted to offer my perspective having delivered both ways. In the end, the only thing that matters is doing what is best for yourself and your family. Even if your plan changes as you go. Good luck!

Anonymous said...

I feel like this is a huge debate and I'm on both sides. However I feel like most women who are pregnant just go along being pregnant until the day of delivery and then poof, they are in a world they did not research, they do not understand, have no cooping techniques and then the horror stories come out and thank goodness they could get an epi or whatever they choose.

I know someone who is about to give birth within days and just now "thought" to figure out if the epi is right for her along with other drugs options and techniques to get her through labor. Really? Kinda late in the game to be thinking of this isn't it?

No wonder there are so many labor horror stories. If so many women just blindly go through their pregnancies expecting people to tell them what to do when they get there. They have no idea what they are in for. Of course it's going to be horribly scary. It shocks me how many of my close friends had ZERO clue about labor, did no research and then came back with the horror of pain and so grateful their were drugs. I feel like the other way of giving birth isn't even given a real chance when someone isn't even a bit mentality prepared to take on the challenge. Going into labor and saying "ouch it hurts" and "I tried without drugs" feels like a cop out. You wouldn't go into a major test without studying and being prepared...why is it okay to go into child birth so unprepared and have it acceptable because we have drugs? I'm not saying that women are less than for taking drugs, I honestly don't feel that way. But I feel that our society pushes drugs as a more simple solution than other options. Maybe I'm mean but I wish more women where educated on the birthing process instead of showing up and saying "I'm here, do what you need to do".

Kristen said...

This is such a great post...thank you for taking the time to compile all the information and to write it.
You are right, there is so much judgement out there, and misleading information, like that 20% statistic you quote...makes me mad that people can put out basically whatever info they want and most people don't know how to vet it/look at it skeptically (like you do because of the medical malpractice exposure you have had.)
Me personally, I know I have a VERY low pain threshold, and I haven't decided if I'm going to try without drugs, but I know that drugs are a very real possibility for me. And I'm grateful they are available.
I totally respect those who want to do natural childbirth...I just hate the "I'm better than you" attitude that often goes with it...