Wednesday, February 23, 2011

Who is to blame?

I have been thinking...okay, so that's dangerous, but someone has to do it, sometimes! I have been thinking about birth and my classes and the recent tweetfest and I just wanted to get something down about my definition of natural and about ownership of birth.

Listening to the radio this morning sparked my desire to write this. As you may have heard, this morning Christchurch, New Zealand, suffered a horrific earthquake. Something that was described as a natural disaster.

Now, in the next few moments what I do not wish to do is to offend anyone caught up with this disaster in any shape or form, nor do I wish to belittle the hideous-ness of this and my thoughts go out to anyone who may be searching for loved ones or has lost anyone or is just caught up in it all.

It was the words "natural" and "disaster" that came within the same sentence that interested me and caused me to think further.

When we talk about natural childbirth, one is generally of the impression that this means someone who births without any medical intervention as nature intended. Okay, if I'm honest, from what I've been reading over the last few hours, the general consensus is that natural birth takes place out doors in a pair of sandals with lots of singing and everyone involved has a beard (joke!)

But, is that truly what a natural birth might mean?

If you take a look out of the window right now, there is not one thing in nature, not one "natural" thing that is straight or follows a straight path. So ultimately if we are to teach women about what to expect when they have a natural birth, then surely we HAVE to teach them what to expect if birth deviates from the straight path. If nature decides to create a difficulty during labour, this difficulty may require medical intervention.
If nature can decide to create an earthquake, nature can also decide to make birth tricky for some women.

So as a childbirth facilitator, it is imperative that we help our parents understand exactly what natural means, so there is no guilt if their birth deviates, but so that they also understand when this truly is the case and when it might just be the fact that the textbook situation may say that this woman should be  xcm dilated after 5 or 6 hours of labour and if their choice of birth environment is conducive to this or not.

Think about SATs for primary school kids or Early years testing for five year olds - these all tell us that Sally, a first born girl, born in September and currently 5, should be doing exactly the same thing as John, a third born boy, born in August and still only four! It sounds ridiculous when put that way because we all know that Sally and John are entirely different, but then so are two women in labour.

This is exactly the reason I chose to work for the NCT because their main aim is to teach for informed choice. I work to provide skills, practically and through knowledge for my parents to birth as naturally as they can. Each week we do relaxation exercises and look at positions, breathing and visualising. I also equip them to understand jargon and how to decipher whether their natural birth is beginning to bend slightly like a blade of grass and what their choices now are and this means I cover c section and intervention in some shape or form. I am, always limited for time, particularly for those women who choose to come to intensive 12 hour weekend classes, and the agenda is lead by them (see my previous post!)

It is also imperative, however, that women take ownership for their births. The number of forums I've been led to since the twitter debarcle that have had comments "blaming" the midwife, "blaming" the NCT, "blaming" the NHS for something that happened to them during their birth.

Let's leave aside the families who truly DO have some reason to blame, because there will be many families out there who have suffered terrible tragedies and this isn't about them, this is about those people who just feel that it is always someone elses fault because they just feel unecessary guilt.

This is about the people who were on the radio this morning, blaming the lenders for loaning them stack loads of money and about why they are now thousands of pounds in debt. Could they not have researched? Could they not have thought about the bigger picture? Could they not just say "yes, I own my debt and I am actively doing something about it"?

Why is it always that we look for someone to blame? Who feels better in all of this? Does it genuinely make you feel better if you can rant about the "noxious" NCT, "useless" NHS, "mean" midwife or "rude" obstetrician or does it just gloss over the problem.

Maybe THAT is where we start. What DO you want from your birth? Aside from a healthy baby and to be healthy yourself of course, - that is a given.

Are you attending NCT classes because you want to be proactive in your birth or just because you feel you ought to because that is what "everyone in your area does"?

Are you going to birth at hospital because you want to or because that is considered the norm?

Are you having a second c section because you want to or because you've been told once a c section, always a c section?

Are you going to have an epidural because you have made an informed choice and know the risks and benefits or just because labour is painful and...well, it's there isn't it?

All these are choices, they're not forced upon you. You are able to choose what will work for you and you alone. If you make the choice from your heart, not because you feel it is what is expected of you, then you will be happy with your choice.

Maybe it is about assessing what is truly important to you. If you want a baby, you have to want a good portion of what goes with that,  and...that will be labour.

Labour is long and labour can be painful and natural labour can result in a c section but it can also be achieved if you want it to be and if nature allows, without pain relief or intervention. If you want to learn about this, you have to give it time, you have to read, maybe you have to attend classes, perhaps you have to learn breathign or yoga or be with other women who have similar outlooks, perhaps you have to turn off your tv showing media driven birth and shut your ears to the horrid stories, after all, if you were having a root canal would people tell you the horror stories of their teeth ? I doubt it!

You have to take responsibility for achieving this, people can help you, but they can't do it for you!

After all, if you bought a car, you'd research the best one for miles per gallon, emissions etc. You'd test drive a few, read reviews, ask questions, maybe even speak to people who own the same car and probably not buy the first one you saw. However, at the end of the day, you won't expect someone else to drive it for you and you certainly wouldn't then blame the salesman if it got stolen or ran out of petrol (and I am NOT equating c section to a car crash Kirsty!)

My first birth was long. My first child came after 48 hours, an epidural and a vacuum extraction. I then didn't manage to breastfeed him for very long. Who is to blame? I was angry!

But was this the fault of my NCT teacher? Was this the fault of my midwife who was a newly qualified midwife and stayed with me two hours over her shift? No, it was NO-ONE's fault.  My natural birth, took a deviation from the non-interventionalist route and my son needed help. I am still annoyed that I remained on the bed for 24 of those 48 hours and didn't actually listen to my NCT teacher's advice to get up and in my situation maybe I could have done things differently, but I didn't and you know what, the only person who felt rotten afterwards, was me and the only way to change that was to do something about it and I did, for my next two births and in my choice of career!

Choice is exactly that. We can sit back and feel the victim when things go wrong or we can get up and think "right, I am going to try to help other women not make the same mistake I did, or, at the very least, totally understand what all their options are.

If you feel stigmatised for having a c section, please do something about it. Speak to people. There are groups out there, support groups, Sheila Kitzinger has a birth trauma line set up and the NCT also has a shared experiences hotline. I honestly do not see in life, a group of c section mums in the playground and a group of vaginal mums in the playground - no one give a shit out there, except you, honestly! If people around you do make you feel bad...change your friends, they're not good people to be around!

Don't, however, just paint a demoralising picture of a whole organisation that has forged ahead in ensuring that your partners are in the delivery room with you, that you are no longer shaved before having your baby, that you no longer have a hose pipe shoved up your rear end before having your baby, that works hard for women and their partners but that sometimes may get it a little wrong.

Speak to your NCT teacher if you feel s/he didn't cover what you wanted to know. Speak to head office if you feel you have been treated badly or unfairly. Do some research of your own if your situation has altered and you need more. Go back to your NCT teacher, they are there to help, they want to help. Don't suffer in silence and then shout the loudest about people not being there to help when you didn't ask.

Own your birth.

1 comment:

Anonymous said...

Absolutely brilliant post and one I agree with wholeheartedly x