Getting Qualified Care: Titles and Education

13 01 2012

This is part of a series called Getting Qualified Care, where we examine the anti natural birther movement of storming the internet to dispel what participants within feel are lies and misinformation about birth. We are discussing just what constitutes quality care from qualified providers, the subtext being “who gets to decide this” — mainly, would you allow other individuals from a movement with their own set of biases choose for you what your standard of care should be?

What makes one “qualified”? Is it a prestigious educational background?


 Maybe it’s a rank or a title, like “Doctor”.

Amy is Harvard educated AND a doctor. Impressive.

Amy informs someone that college and medical background means you cannot disagree with them and possibly know what you're talking about. Interesting. Only a fool would disagree with a doctor!

Here is Amy telling us a Doctor is wrong.

Here is Amy telling us a Doctor is wrong.

Here is Amy telling us a Doctor is wrong.

Here is Amy beginning to tell us that yet another Doctor is wrong.

Don't want to ruin it for you, but, another wrong Doctor, according to Amy.

I could go on, but I think you get the point– Dr. Amy, 5, Other Doctors, 0.

It can’t be the Doctor credential and the years of medical training and background that is making people credible or qualified. Then again, I guess any glance at My OB Said What?! could have shown us that:

Just one example of real-life anecdotes submitted to popular website My OB Said What.

All doctors come to the table and present their “evidence”. How do you know who is telling the truth, especially in a world where we’ve considered that doctors are capable of being flawed?

Maybe it’s in the licensing of that title, to validate it.

Most of the “Fed Uppers” are on a(n in)quest to end midwifery that does not belong to the CNM (certified nurse midwife) category. They believe that all other forms of midwife (usually designated as CPM, or certified professional midwife) are a joke and disservice to women. It needs to be noted here that a lot of this stems from personal bias and bad experiences or trauma the women have faced with natural birth. Differing regions (particularly in the States) have varied regulation in terms of education and practice standards, but in general, much training and years of education are required for one to become a licensed midwife of any title. Yet, one of the main purposes this group claims to promote is eradication of what they deem less qualified midwifery in favor solely of the CNM model. Unfortunately, CNM’s largely practice in birthing centers and in hospitals. What I see as the real goal in mind is the eradication of home birth.

Is a midwife more qualified just for having gone to nursing school beforehand? Is a midwife more qualified for taking a more medical approach to birth? If no other midwife licensing is allowed or considered “qualified”, will that ensure everyone has more qualified care, or will it eliminate options and force women to choose between clinical birth and freebirth? Who gets to decide what kind of care a woman must receive, if not the woman herself? Who gets to mandate which one and only kind of education is valid and acceptable? What if midwifery as we know it became illegal?

Maybe it’s in the current state of practice.

Some argue that a midwife who refuses to renew her license recently is no longer a midwife and shouldn’t be allowed to practice. It doesn’t matter that her skills are still fresh in her memory, and that her choice to not renew is believed to be a political statement against mandating with whom and where women may give birth. To add controversy, suppose this midwife was unafraid of taking cases labeled “high risk” in order to give women more options for their labor, understanding the high risk cases could potentially result in a loss whether or not she presided over the care? If you knew a tragedy could be inevitable regardless, would you choose to stand by your patient, or would you CYA?

Others would argue that an out-of-practice OB/GYN who’s been retired for almost 20 years now, although still given the title “Dr.”, is no longer up to date enough to be giving accurate medical advice, opinions, nor to be weighing in on birth today and facts presented by others who are more current and active in the field. Indeed, birth has changed a lot since the 1990’s. For better or for worse, the skills, policies, drugs, and technology would be greatly different. A doctor who stopped practicing back then, in this fast-paced profession, would undoubtedly be considered old school or maybe obsolete to the hospital crowd.

Being fair, we could say that neither one has “lost” their skill set. Are either of them any less of a doctor or a midwife? Only in technicality. In our own minds, it’s up to our own judgment to ascertain this wisely. Who would you rather have– the latter, or the former– look after you? What would seem more “qualified” to you?

I think education is nice, licenses, degrees, and titles are all very nice… but at the end of the day, it isn’t any one thing that promises to provide you with “qualified care”. Everyone is equally capable of incompetence. Truly understanding this leads to resigned acceptance of freedom to choose the care you think is best, without harsh judgment or scorn.





Sexism and Childbirth Choices

26 11 2011

QUESTION:  Is natural childbirth

sexist? Is medical childbirth sexist?

It depends. Before labeling, you really have to be fair and consider the source.

Michel Odent has been called or implied sexist by a certain infamous Dr. and anti-NCBers for providing info to empower women through realizing how to give birth naturally and the beauty of it.

The logic seems to be that he’s old, he’s a man, and anyone who would deny women of pain relief (medication) in childbirth is a sexist who believes women should suffer in childbirth. They also take issue that these philosophies “remove choices”, but I argue that a) so do anti NCBers, in trying to more strictly regulate birth options, and b) we are for INFORMED choices, but we disagree that all women’s choices are actually well-informed.

That’s not what natural birth is about, though. It’s not about being cruel and making women suffer. It’s not about removing WELL-informed choices. It’s about providing right info, and putting power that is life-altering back into the hands of women. If women knew just how powerful they were, this would actually be a threat to the patriarchy… !

So, no, I promise you, none of us thinks women should be in pain and suffering for their birth. In fact, I’ll be the first one to tell you to be kind to yourself. If the pain is unbearable to you, take the meds. And don’t be hard on yourself for making that choice. I don’t want to see women suffer, and I doubt that’s Odent’s intention, either.

So what IS this Odent physiology stuff about? It’s about the fact that women don’t automatically suffer just because the paternal obstetric model doesn’t relieve the poor, weak woman with pain meds. That’s right… not every woman is some poor, suffering child whose pain can only be relieved by some white (-coated) knight, who mercifully swoops in to bestow his paternal hit of drugs.

I have done it both ways (drugged and not). I have received pain meds and been ever so grateful. I have also wished I would lose consciousness and had an excruciating “natural” birth. And, I have been liberated from the cycle by owning my birth and surrendering to it– naturally and physiologically. Guess which birth was best?

I’m going to show you some things and then I want you to decide what is truly sexist: Giving power and information TO, or degrading and expecting less FROM?  These are merely examples of the rhetoric, and the personalities behind the rhetoric. Some opinions and values are shared by their friends, and some are not.

This is a point about what IS sexism and what IS real feminism; when people cry “sexist”, we need to consider the source.

[Values include: being a MILF (and making sure everyone knows you are)…]


Because only a twat would think that inductions weren't such great ideas.

Take away: Even Dr. Amy puts the smack down on rampant sexism coming from Aleah and friends.

 

This one needs explanation. Someone who left critical comments regarding my book also reviewed another book (which is what you are reading here, from Amazon). I think their words give added insight to their attitude towards feminism. I lump them in because these are all critics of NCB and usually self-proclaimed "feminists" or believers in equality and choice, and I think this is not always quite accurate.

These are just some examples of the differences between “sexism” in natural childbirth and sexism in anti-NCB. I know that some believers in natural birth happen to be sexist or perhaps even come from a women-as-subservient place, but you are certainly not finding any of that with me or Odent. We are champions of women, and it’s wrong to falsely paint these principles of biology as misogynist. I am a progressive, believe in freedom and equality, and have been called a feminist since I was a child– and I am proud of that. I believe women are amazing goddesses and deserve the utmost respect. I believe in a return to our innate maternal wisdom.

Okay, so Odent is a sexist for playing into woman’s birth goddess “fantasies” and putting women on a pedestal to encourage them to take back birth from the medical model, but people like those shown above are not sexist? Odent may have a penis, that is true. A man can be a feminist just as sure as a woman can be a chauvinist, however.

I’m not trying to be mean, honest. I’m just trying to say that…

It’s hard for me to really take seriously the opinions of people crying “misogynist” who think the standard of beauty is being a dyed blonde, breast job having, diamond wearing MILF nurse; who think “pushing a baby out your vag” is no big deal and even something to ridicule, and constantly calls people in a condescending tone “honey”, “love”, “sweetie”– when she isn’t busy using her favorite insult, “twat“. You dig what I’m saying?

Why should anyone take seriously opinions on Dr. Odent coming from these folks? All things considered, if these are your attitudes in life, your idea of what is “misogynist” falls a little flat with me. These to me are not true feminists and not actual advocates for women. These are the biggest misogynists of all. I certainly won’t listen to what SHE thinks WOMEN aren’t capable of. I wouldn’t even trust the limitations she puts on herself.

It’s worth noting that these are the same people who call my friend an “attention whore” for talking about her rape to explain her birth views, and bring it up as another source of ridicule.

These aren’t healthy, credible sources. Before you call misogyny, you must consider the source.

Okay, so, what is really sexist? The natural childbirth advocate who tells women how they can have the best birth for their self and their child without trauma? Or the anti-NCBer who tells women that they aren’t special and should shut up?

You decide. Who’s the sexist and who’s the feminist?

Are you for women, or are you against them? Do you believe in them, or do you think they are ridiculous?

You have to love yourself before you can love someone else. It seems we have an epidemic in our culture… a serious lack of understanding of our true worth.

If we’re going to give birth back to women, we need to start patching that up. You are not a pair of tits and a hair color. One day you’ll be old, or fat, or ugly. For now you are a youthful woman, perhaps fertile, certainly glorious and beautiful no matter who convinced you that you’re not. Your real power and beauty is something ageless and within. What’s it going to take to undo all this damage and convince our insecure women of this? Can it be undone?

Sorry, I wanted to keep this short, but I couldn’t leave you without ending it on this note.





Misconstruing a Genius

20 10 2011

I was alerted that one of THE best minds in childbirth, Dr. Michel Odent, was being challenged by a certain infamous anti-homebirth doctor. Self-assured was I that she could not possibly intelligently refute Odent, I was shocked to see how right I was. When one cannot debunk someone properly, one must resort to smear! Also, use the word “smear”, because if you say it first, it cannot be used on you. Here’s a sampling of what was said:

Dr. Michel Odent’s claim that childbirth pain is necessary for mother-infant bonding.

Only Odent never says that. What he says is this:

The French expert said: “Oxytocin is the hormone of love, and to give birth without releasing this complex cocktail of love chemicals disturbs the first contact between the mother and the baby…

“It is this hormone flood that enables a woman to fall in love with her newborn and forget the pain of birth.”

And, nowhere does he say pain is necessary for bonding. In fact, he says with the help of Oxytocin, pain is greatly diminished for the mother. Not only does his work and literature include info on Birth and Breastfeeding in relation to Oxytocin, but he also speaks very much on the topic of orgasms. No, indeed, Odent is an Oxytocin champion– he believes in all it does for us. He warns us not to give it up so lightly when biologically, it is there to help us. He is a protector of the process, a facilitator of our easy and best births, and now he is being ridiculed by the type of people who drone on about the nastiness of birthing pools. Yes, Odent is credited with introducing these to the modern laboring woman.

Naturally, tons of idiotic commentators arrived to call him everything from a sexist to a liar. Honey, you don’t know Odent! I think he is far less sexist than the medical professionals telling empowered women they are nothing special for having a natural birth. Michel is not a misogynist– he is a feminist!  So anyway, I had to give my two cents:

You are completely misconstruing what DR. Odent is saying.  

First of all, nothing you have quoted in your attempt to paint him as this lying misogynist states that he feels that PAIN is necessary for bonding. In fact, Odent believes that the “pain” will be eased by the natural release of the Oxytocin, which is part of the function of the hormone.  

Can Pitocin do that? No. Pitocin attempts to mimic Oxytocin, but those with experience can tell you that Pit makes contractions worse, harder, less bearable. Being under the influence of Oxytocin, however, leaves many women feeling almost pain-free, some orgasmic. It IS the love hormone, the relaxation and orgasm hormone. Pitocin and Oxytocin are NOT the same thing, anymore than powdered milk or formula is the same thing as breastmilk.  

Furthermore, as someone who has experienced labor THREE different ways, I can tell you from experience that Odent DID do his wife a favor. I love and trust my husband immensely but felt the need to ask him to leave the room during my last labor. It’s not because he has a penis, but because I desired solitude. AND, I had to wake him, because the poor man was asleep. The woman needs what she needs. The intellect doesn’t have to agree with it, the body DOES. It doesn’t mean anything bad about the husband, or the marital relationship, just as you giving birth via C-section does not mean you don’t love your baby.  

That’s right– neither Odent nor I are saying that artificially-had births equate to parents NOT loving their children. There are many factors to bonding. Oxytocin is ONE, and it’s a very primal and primary one. If you think we are saying adoptive parents do not love or bond, or C section moms do not love or bond, you are hearing what you want to hear.  

What we ARE saying is that Oxytocin has an amazing, multi-purpose effect– on labor, the birth, mother, baby, and breastfeeding– and women who choose not to reap its benefits are missing out on something special. Those who have experienced it have described it as THE greatest natural high a woman will experience in her lifetime.  

You can call Dr. Odent’s theories ridiculous and false, if you feel so defensive about them in your personal lives. Maybe his “theories” (based on mammalian science, accepted and understood as TRUE) offend you because they didn’t play a part in your stories and this threatens you somehow as a woman. But, for me? I didn’t understand what had happened to me and my other labors until I started reading geniuses like Odent.Then it all made sense to me. I finally “got it”. Before, maybe I would have blown it off like you and said it was not true. But yeah, he’s just totally in a fantasy world?  

Whatever. He’s one of the only true scientists in the world of childbirth. So many others, indoctrinated by their education, worship at the altar of technology and drugs as though they can do no wrong. At least Odent honors the woman and her needs above any touting of “advancement” our backwards society makes. He truly wants what is best for us, and he doesn’t have an agenda. There are no lobbyists, no drug companies, no ego-driven wars he is in bed with. It is just a man and the science he has observed. He is a great mind… so naturally, he is met with aggressive opposition.  

The only smearing I see is people here of Odent. I can’t figure out if you simply do not understand him, or if you are intentionally trying to miscategorize him to the masses.

… which, of course, immediately fell on deaf ears, as he was called not only totally wrong but a “classy” guy for leaving his wife alone during her labor. Before you judge this guy, random RNs, birthy mom types, and other MDs, please read more about this man and his career, works, and genius. He IS a classy guy. For starters, he doesn’t own any hate sites to tell non-Oxytocin-enjoying moms where to go and attack those who have experienced this amazing part of the circle of life. He isn’t part of the REAL smear campaign, to undermine the real wants and real experiences of real women, and reduce common sense, observations, and real life events to mere mythology.

Nope. He’s one of the good guys.

PS– By popular demand, here are some links worth checking out on the idiosyncrasies and differences between Oxytocin and Pitocin (besides just “brand name”).

Pit of Despair — The difference has to do with the blood-brain barrier. Oxytocin is produced by the brain and has a direct effect on brain function. But when Pitocin is introduced into the bloodstream, it does not affect the brain.

Oxytocin: The Great Facilitator of Life — In light of the prominent role in parturition and essential role in lactation, we are drawn to the view that Oxt serves the continued propagation of a species.

Thanks, Mom!— Time Magazine article:  It also helps facilitate bonding between mothers and newborns.

A relationship between oxytocin and anxiety of romatic attachment –That oxytocin and anxiety may be linked in some way in the modulation of social bonding is supported also by scattered data showing that a moderate level of stress seems to promote pair bonding in different species, including human beings [40].

“Love Hormone” Promotes Bonding — Obviously we think we know a lot about it, but should hesitate to flat out reject what little we already know (that oxytocin correlates with bonding). We are only just starting to learn how it affects us, and to blanketed deny a connection seems arrogant.

“The hormone, also known by its trade name, Pitocin, has been used for years to induce labor and promote lactation in women.  But its effects on the brain are just beginning to be understood.”

Oxytocin is a brain chemical associated with pair bonding, including mother-infant and male-female bonds, increased paternal involvement with children, and monogamy in certain rodents, according to Kai MacDonald, M.D., assistant clinical professor of psychiatry at UCSD.”





Books for Bith Canceled

19 09 2011

Due to zero recipient interest, we are unfortunately unable to carry on with the program Books For Birth, which donates literature and materials for an empowering birth to women.

While we did seem to have several people express excitement over the program, there were no official nominees. To nominate yourself or others, people had to send an e-mail to info@theperfectbirth.com.

It saddens me to announce this, as I thought this was a very good idea, a noble cause, and a great way to do something charitable and giving that would have an awesome impact on people. It seems as though the need wasn’t great enough, or perhaps I was not being connected to the people in the most need. In any event, this news has been disheartening to say the least, and I had had high hopes for the future of it. I had imagined giving away not only great books, but great materials; I had dreamed of giving a birthing pool in December for the holiday season. In light of the failure of the program to take off (or the lack of need for the program), I will be taking somewhat of a hiatus from birth issues to focus on other projects of mine that have been vying for my attention, including another book I’m writing.

We had just recently procured a sponsor, Love Lives Here, and had also chosen the selection for the month of October, Birth and Breastfeeding, by Dr. Michel Odent.





How Music Can Hinder, Not Help, Your Labor

5 07 2011

Dr. Michel Odent talks a lot about the primal labor state and the neo-cortex. When giving birth naturally, the laboring woman enters a different state of consciousness. It is essential for us to allow ourselves to become immersed in this state in order to have a fearless, unhindered, natural labor with as little pain as possible (in some cases, none at all, and entering the realm of orgasmic).

Stimulation of the neo-cortex is then, in the case of a natural labor, the enemy.

The neo-cortex is the center for what we commonly consider our intellect. It is the part that allows us to be logical and also creates our sense of inhibition, giving us our civility and our modesty. When we are being stimulated intellectually or feel we are being watched, the neocortex is active. This is not conducive to a laboring woman getting in her right birth state. This leads to birth tensions and complications.

It is inadvisable to engage in discussion with the birthing woman. Mammals and females in labor need no distractions. They naturally focus inward and shut out the outside world. Dark, warm, quiet surroundings are critical for her to maintain this space of consciousness safely and have the best possible labor and birth experience/outcome. This is the physiology of birth that I am keen on referencing often. To not heed this would trigger her adrenaline, fight/flight, and lead to unnecessary complications and interventions.

Whether she intends to be stimulated or not, whether she consciously feels threatened or not, the presence of certain stimuli will trigger the woman to refrain from fully engaging in the appropriate state as a means of instinctive protection of her vulnerability in the primal physiological birth state. What this means is that even too brightly lit of an environment can hinder her from birthing naturally in a peaceful way.

If discussion stimulates the neo-cortex, what other things will? Television, where there will be narration and dialogue and perhaps jarring noises and rhythms. Light, as we’ve already discussed. Feeling cold. Feeling observed, so onlookers or even the presence of video cameras.

What else? Music.

Is music required during labor? Many women prefer it. When planning for our natural births, the question comes up all the time. “What do you listen to during labor?” We like to set the mood, feel we are creating a personalized soothing birth experience for ourselves. People exchange ideas on what to listen to ranging from religious music to nature sounds, world music, yoga CDs to tribal drumming, etc. And then there are people like me, who dared to merely place their iPod on shuffle. [If you want to know how that turns out, it’s in the book!]

Certain beats and lyrics, however, may cause– without the woman’s total awareness— a stimulation of the neocortex. The effects can sometimes be felt violently. If beats are too aggressive or up-tempo, the neocortex is activated. If lyrics are sung, a woman in labor may unwittingly be drawn into listening to them or giving them even the slightest attention, keeping her from the true meditative nothingness of the primal consciousness her birthing body seeks.

Odent states:

Our neocortex is originally a tool that serves the old brain structures as a means of supporting our survival instinct. The point is that its activity tends to control more primitive brain structures and to inhibit the birth process (and any sort of sexual experience as well).

The neocortex is supposed to be at rest so that primitive brain structures can more easily release the necessary hormones. That is why women who give birth tend to cut themselves off from our world, to forget what they read or what they have been taught;  they can find themselves in the most unexpected, often primitive quadrupedal posture; I heard women saying afterwards: ‘I was on another planet’. When a labouring woman is ‘on another planet’, this means that the activity of her neocortex is reduced. This reduction of the activity of the neocortex is an essential aspect of birth physiology among humans.

This aspect of human birth physiology implies that one of the basic needs of labouring women is to be protected against any sort of neocortical stimulation. From a practical point of view it is useful to explain what this means and to review the well-known factors that can stimulate the human neocortex.

Language, particularly rational language is one such factor. When we communicate with language we process what we perceive with our neocortex. This implies, for example, that if there is a birth attendant, one of her main qualities is her capacity to keep a low profile and to remain silent, to avoid in particular asking precise questions.

via WombEcology by Michel Odent – In-labour physiological reference.

 

Odent is clearly saying that we need to drastically cut out neocortex stimuli; yet music, one of the favored relaxation tools of birth, is a such a stimulus.

If you absolutely insist on having or trying music during your labor, the best kinds which will be far less likely to provoke thought and cause inadvertent stimulation of your neocortex would include anything down-tempo, without lyrics, and with relaxed, unobtrusive rhythms. Yoga CDs, nature sounds, and mild tribal drumming will probably be the most likely to do the trick. Avoid anything that may surprise you, trigger memories, or cause you to think. Static and calm from the external are the keys to entering your best physiological state. The external needs to be able to fade into nonexistence, for you. You need to be able to tap in to your more instinctive self, so give yourself the best tools you can to achieve this. Like most things in birth, less is more.

If you think your body will know what it is doing and birth this baby no matter what music you have on, you’re right… but having the wrong music versus having no music could be the difference between pain and pleasure in childbirth.