Can I just please beg that we stop using "natural" in any way in any debate about birth and feeding? Are you a human? Did a human grow and then exit your body? Then it's natural. Despite best intentions it is impossible for judgment not to be conveyed as long as we make this word part of the conversation. And feeling judged keeps folks on the sidelines of this fight.
I also think we really need to interrogate why folks in this space seem to insist on pain as a requirement of the most virtuous and praiseworthy birth. It bugs me on a visceral level.
Hey Jessica - you're absolutely right - my point in phrasing the one question that way was to invite a conversation about how it's a reductive term. I could've been a lot more clear on that point. It's also hugely problematic when we talk about infertility and conception. Appreciate you bringing this point up!
Thanks. Unfortunately Alison used the term as well, so the point was really missed ("naturally, vaginally"). We end up so bogged down in debates about c-sections, epidurals, and formula when we all actually AGREE on the outcomes that really matter and we all want: less trauma, lower morbidity and mortality, for all pregnant and birthing people. And not thinking there's one direction or philosophy that gets us there, because birthing people are all different! That's exactly what the patriarchy wants--to keep us divided and debating each other so we take our eyes off the ball.
As a person in public health, I totally agree that there are major, documented issues with the overmedicalization of birth in the US, and the resulting outcomes. I’m always glad when a light is shined on the issue!
Yet as a counterpoint to the idea that the “best” birth is an unmedicated vaginal birth, that’s not always true even when medical interventions aren’t urgently needed to save a life.
My first child was an induction with an epidural, and I was able to push him out in a quiet dark room with a midwife attending, watching in a mirror as he crowned and truly marveling at the experience. My second birth was unmedicated, vaginal and totally healthy (thank goodness). But it was fast, terribly painful and a bit chaotic. I wasn’t even able to appreciate my sweet baby girl for several minutes after her birth because all I wanted was for the pain to stop. If I did it again, I’d opt for the more “medicalized” version I had with my son every time, it left me feeling far more empowered.
Here’s to everyone getting the birth that they want and deserve, and thanks for continuing the conversation!
Yes yes yes could not agree more and thanks for steering the conversation to what’s best for each individual (rather than each of trying to fit an external concept of “best”)
I so appreciate this conversation and also noticed the unintentional value placed on unmedicated vaginal births. I know many birthing parents who carry extreme guilt around their C-sections (which were necessary and medically indicated) because of the stigma against them.
Thank you for this Ellie - I agree and could absolutely have been clearer with my language. I think it's also worth pointing out that we shouldn't assume everyone wants or prioritizes, like, a transcendant birth experience. The goal is always respect and bodily autonomy - so like, if someone feels respected and in control of their experience but also doesn't look at their birth as this big, empowering thing, that's just as valid. Just like birth isn't a one-size-fits-all situation, nor is what we think or feel about birth. For some it's a simply a means to an end (a baby!), for some it might be a big life moment (and also a baby lol). Neither is better or worse. Hope that makes sense!
I went in flexible, with an open heart and a true belief in leaving the hospital with a "healthy baby, healthy mom." I was induced - water broke at home, but contractions were minimal, and hospital policy was GBS+ means baby has 24hrs to come out. His HR dropped several times, both times crash teams swarmed me and commanded me to reposition in ways that were practically impossible with a completely numb leg from the epidural (which also caused a ton of excruciating shoulder pain, so they had to rework the formulation). I didn't feel treated with any kindness or gentleness, more like a clinical case to be solved. Throughout the labor I was bleeding more than they liked - I'm convinced they went too hard on the Pitocin and ramped me up too quickly to beat their 24hr limit - and at one point experienced what I now know to be a tetanic contraction (what felt like my entire torso was wrapped in one giant contraction that didn't stop). At no point did anyone name this for me or reassure me, instead I had to repeatedly beg for help/relief and felt like they weren't believing me. The second time his HR dropped, I had reached 9cm and there was concern about plancental abruption (again, something I barely remember hearing discussed near me, but never to me, and only learned by reading my hospital notes) and it was decided I would need to be a c/s. But no one told me what was happening, if I was asked/consented I don't remember. My doc was in my husband's ear explaining it to him, but no one was in mine. Thankfully, the anesthesiologist realized I was lost and needed reassurance and information, and stayed in my ear during the procedure. All of this ended in a traumatic "splash and crash" c/s, which resulted in a severe bonding detachment from me for quite some time. The postpartum care at my "top ten hospital in the country" was beyond lacking - no LC support for days (had to literally hunt down a breast pump for hours for me), a nurse that left my breast bruised trying to support me in feeding positions, waking me at 2a after the baby's 24hr check-up breathlessly telling me he had lost 8% of his bodyweight (which was less than the 10% threshold of concern/feeding intervention, and more common in c/s babies). I sobbed in that moment and the nurse just stood there. The reactions to every question I asked or thing I asked for (like a new sheet for the bassinet when he spit up on it) made me feel stupid or weird for asking. I'm able to process the absolute disregard for my body and heart now two years later, but I have a lot of resentment and anger towards that hospital and the lack of options I (and other women) have in birthing locations. I'm grateful for a healthy child and that my c/s ultimately healed well, but my body remembers.
Oh my gosh Hillary thank you so so much for sharing this. I'm so mad on your behalf and so sorry. So many parts of this story are harrowing and so many of them could've been remedied by people treating you like a PERSON instead of a problem. It also illustrates how individuals make such a different. Like, if the nurse hadn't looked at you blankly when you requested a new sheet, or if the anesthesiologist hadn't been there to talk to you when no one else would. Sending you so much love.
I planned an unmedicated birth but I was open to the epidural. I made it 9 hours before I was so spent and exhausted and could no longer regulate my breathing so I got the epidural. The nursing team was incredibly encouraging and made me feel confident in my decision and not like I gave up. The baby kept get stuck on my tailbone and kept having to be turned. After about an hour, my male Boomer doctor told me that the baby's heart rate was dropping and that they could use forceps now or I could "keep pushing for two more hours and maybe still might need a C-section." He wasn't aggressive, he didn't push it, but he made what seemed like a very reasonable explanation for their use. He used them, my son's face was bruised, he had jaundice for about a week but otherwise was completely healthy. My husband watched it and was completely traumatized. Thankfully I saw nothing. We'll both always wonder if the doctor really believed it was necessary or if he just wanted to end the day at 2:30 and go golfing. I read books, I took a natural childbirth class, nothing said anything about forceps! We didn't even know they were still used! A friend had a similar experience here locally but in a different hospital. Our son is now almost 4, we're all happy, but I'll always wonder.
Ugh YES - the wondering! And chilling re: golfing. As Allison writes in the book, so often these interventions are suggested in exactly the way you frame them - totally reasonable - which I think (unintentionally or not) place the patient in a position of self-doubt. So hard.
I know that you prefaced this interview with a note that it wasn’t perhaps as nuanced as you would have liked but I don’t think the way hospitals and doctors and other medical providers were portrayed was just. The author of the book is not hiding her bias in saying that a “natural” birth is a vaginal and unmedicated one (the Pitocin allegedly making contractions more painful statement is not based in any scientific research because a)it is a synthetic form of oxytocin, the hormone we produce and need and b) pain is unfortunately subjective and impossible to measure in a clinical context) and went into birth spending 8 weeks learning how to “defend” herself against the doctors and the hospital. With this in mind, it’s a stretch to assume she will be able to offer an unbiased and objective assessment of the birth process in the US and how it could be improved for the benefit of all, not just those with money and lots of time and a certain mindset. What pained me was that at no point during the interview you, Sara, tried to interrogate whether “doctors peacing out for dinner” was truly the reason behind the sometimes rushed treatment. It seems to me that this reads as the failures of the medical system (powered by CEOs and private insurance companies and managers) were presented as the moral failures of doctors and nurses who just want to clock out. I wonder what happened to the praise for the essential workers only a few years back who, quite literally, risked their lives and lost their lives, to Covid or burnout, volunteering their shifts and living in hotels never returning home to their families ? I know that malpractice happens everywhere but when statements that doctors knowingly harm patients in order to get home faster go unchecked they can do real harm to pregnant people who may be afraid to seek care. Yes, we all need to be aware of our options and educate ourselves but sowing distrust of medical professionals will do nothing to improve patient care in a country that is already deeply polarized in this regard. It is the author’s responsibility to communicate her point of view but I think it’s the interviewer’s responsibility to question, ask for clarity and seek out nuance in what is being said.
Hi Daria, Thank you for taking the time to write, and I totally agree that it's an interviewer's responsibility to press their subjects for clarity and specificity, especially when discussing sensitive topics that can be viewed from so many different angles and perspectives. And YES to this comment!! "It seems to me that this reads as the failures of the medical system (powered by CEOs and private insurance companies and managers) were presented as the moral failures of doctors and nurses who just want to clock out." In hindsight, that would've been an excellent follow-up question to ask, and one I'm sure would've led to a more nuanced, clarifying discussion.
Can I just please beg that we stop using "natural" in any way in any debate about birth and feeding? Are you a human? Did a human grow and then exit your body? Then it's natural. Despite best intentions it is impossible for judgment not to be conveyed as long as we make this word part of the conversation. And feeling judged keeps folks on the sidelines of this fight.
I also think we really need to interrogate why folks in this space seem to insist on pain as a requirement of the most virtuous and praiseworthy birth. It bugs me on a visceral level.
Hey Jessica - you're absolutely right - my point in phrasing the one question that way was to invite a conversation about how it's a reductive term. I could've been a lot more clear on that point. It's also hugely problematic when we talk about infertility and conception. Appreciate you bringing this point up!
Thanks. Unfortunately Alison used the term as well, so the point was really missed ("naturally, vaginally"). We end up so bogged down in debates about c-sections, epidurals, and formula when we all actually AGREE on the outcomes that really matter and we all want: less trauma, lower morbidity and mortality, for all pregnant and birthing people. And not thinking there's one direction or philosophy that gets us there, because birthing people are all different! That's exactly what the patriarchy wants--to keep us divided and debating each other so we take our eyes off the ball.
Really great point Jessica - thank you thank you for weighing in!
As a person in public health, I totally agree that there are major, documented issues with the overmedicalization of birth in the US, and the resulting outcomes. I’m always glad when a light is shined on the issue!
Yet as a counterpoint to the idea that the “best” birth is an unmedicated vaginal birth, that’s not always true even when medical interventions aren’t urgently needed to save a life.
My first child was an induction with an epidural, and I was able to push him out in a quiet dark room with a midwife attending, watching in a mirror as he crowned and truly marveling at the experience. My second birth was unmedicated, vaginal and totally healthy (thank goodness). But it was fast, terribly painful and a bit chaotic. I wasn’t even able to appreciate my sweet baby girl for several minutes after her birth because all I wanted was for the pain to stop. If I did it again, I’d opt for the more “medicalized” version I had with my son every time, it left me feeling far more empowered.
Here’s to everyone getting the birth that they want and deserve, and thanks for continuing the conversation!
Yes yes yes could not agree more and thanks for steering the conversation to what’s best for each individual (rather than each of trying to fit an external concept of “best”)
I so appreciate this conversation and also noticed the unintentional value placed on unmedicated vaginal births. I know many birthing parents who carry extreme guilt around their C-sections (which were necessary and medically indicated) because of the stigma against them.
Thank you for this Ellie - I agree and could absolutely have been clearer with my language. I think it's also worth pointing out that we shouldn't assume everyone wants or prioritizes, like, a transcendant birth experience. The goal is always respect and bodily autonomy - so like, if someone feels respected and in control of their experience but also doesn't look at their birth as this big, empowering thing, that's just as valid. Just like birth isn't a one-size-fits-all situation, nor is what we think or feel about birth. For some it's a simply a means to an end (a baby!), for some it might be a big life moment (and also a baby lol). Neither is better or worse. Hope that makes sense!
Thank you for this interview and piece! Loved it.
I went in flexible, with an open heart and a true belief in leaving the hospital with a "healthy baby, healthy mom." I was induced - water broke at home, but contractions were minimal, and hospital policy was GBS+ means baby has 24hrs to come out. His HR dropped several times, both times crash teams swarmed me and commanded me to reposition in ways that were practically impossible with a completely numb leg from the epidural (which also caused a ton of excruciating shoulder pain, so they had to rework the formulation). I didn't feel treated with any kindness or gentleness, more like a clinical case to be solved. Throughout the labor I was bleeding more than they liked - I'm convinced they went too hard on the Pitocin and ramped me up too quickly to beat their 24hr limit - and at one point experienced what I now know to be a tetanic contraction (what felt like my entire torso was wrapped in one giant contraction that didn't stop). At no point did anyone name this for me or reassure me, instead I had to repeatedly beg for help/relief and felt like they weren't believing me. The second time his HR dropped, I had reached 9cm and there was concern about plancental abruption (again, something I barely remember hearing discussed near me, but never to me, and only learned by reading my hospital notes) and it was decided I would need to be a c/s. But no one told me what was happening, if I was asked/consented I don't remember. My doc was in my husband's ear explaining it to him, but no one was in mine. Thankfully, the anesthesiologist realized I was lost and needed reassurance and information, and stayed in my ear during the procedure. All of this ended in a traumatic "splash and crash" c/s, which resulted in a severe bonding detachment from me for quite some time. The postpartum care at my "top ten hospital in the country" was beyond lacking - no LC support for days (had to literally hunt down a breast pump for hours for me), a nurse that left my breast bruised trying to support me in feeding positions, waking me at 2a after the baby's 24hr check-up breathlessly telling me he had lost 8% of his bodyweight (which was less than the 10% threshold of concern/feeding intervention, and more common in c/s babies). I sobbed in that moment and the nurse just stood there. The reactions to every question I asked or thing I asked for (like a new sheet for the bassinet when he spit up on it) made me feel stupid or weird for asking. I'm able to process the absolute disregard for my body and heart now two years later, but I have a lot of resentment and anger towards that hospital and the lack of options I (and other women) have in birthing locations. I'm grateful for a healthy child and that my c/s ultimately healed well, but my body remembers.
Oh my gosh Hillary thank you so so much for sharing this. I'm so mad on your behalf and so sorry. So many parts of this story are harrowing and so many of them could've been remedied by people treating you like a PERSON instead of a problem. It also illustrates how individuals make such a different. Like, if the nurse hadn't looked at you blankly when you requested a new sheet, or if the anesthesiologist hadn't been there to talk to you when no one else would. Sending you so much love.
I planned an unmedicated birth but I was open to the epidural. I made it 9 hours before I was so spent and exhausted and could no longer regulate my breathing so I got the epidural. The nursing team was incredibly encouraging and made me feel confident in my decision and not like I gave up. The baby kept get stuck on my tailbone and kept having to be turned. After about an hour, my male Boomer doctor told me that the baby's heart rate was dropping and that they could use forceps now or I could "keep pushing for two more hours and maybe still might need a C-section." He wasn't aggressive, he didn't push it, but he made what seemed like a very reasonable explanation for their use. He used them, my son's face was bruised, he had jaundice for about a week but otherwise was completely healthy. My husband watched it and was completely traumatized. Thankfully I saw nothing. We'll both always wonder if the doctor really believed it was necessary or if he just wanted to end the day at 2:30 and go golfing. I read books, I took a natural childbirth class, nothing said anything about forceps! We didn't even know they were still used! A friend had a similar experience here locally but in a different hospital. Our son is now almost 4, we're all happy, but I'll always wonder.
Ugh YES - the wondering! And chilling re: golfing. As Allison writes in the book, so often these interventions are suggested in exactly the way you frame them - totally reasonable - which I think (unintentionally or not) place the patient in a position of self-doubt. So hard.
I know that you prefaced this interview with a note that it wasn’t perhaps as nuanced as you would have liked but I don’t think the way hospitals and doctors and other medical providers were portrayed was just. The author of the book is not hiding her bias in saying that a “natural” birth is a vaginal and unmedicated one (the Pitocin allegedly making contractions more painful statement is not based in any scientific research because a)it is a synthetic form of oxytocin, the hormone we produce and need and b) pain is unfortunately subjective and impossible to measure in a clinical context) and went into birth spending 8 weeks learning how to “defend” herself against the doctors and the hospital. With this in mind, it’s a stretch to assume she will be able to offer an unbiased and objective assessment of the birth process in the US and how it could be improved for the benefit of all, not just those with money and lots of time and a certain mindset. What pained me was that at no point during the interview you, Sara, tried to interrogate whether “doctors peacing out for dinner” was truly the reason behind the sometimes rushed treatment. It seems to me that this reads as the failures of the medical system (powered by CEOs and private insurance companies and managers) were presented as the moral failures of doctors and nurses who just want to clock out. I wonder what happened to the praise for the essential workers only a few years back who, quite literally, risked their lives and lost their lives, to Covid or burnout, volunteering their shifts and living in hotels never returning home to their families ? I know that malpractice happens everywhere but when statements that doctors knowingly harm patients in order to get home faster go unchecked they can do real harm to pregnant people who may be afraid to seek care. Yes, we all need to be aware of our options and educate ourselves but sowing distrust of medical professionals will do nothing to improve patient care in a country that is already deeply polarized in this regard. It is the author’s responsibility to communicate her point of view but I think it’s the interviewer’s responsibility to question, ask for clarity and seek out nuance in what is being said.
Hi Daria, Thank you for taking the time to write, and I totally agree that it's an interviewer's responsibility to press their subjects for clarity and specificity, especially when discussing sensitive topics that can be viewed from so many different angles and perspectives. And YES to this comment!! "It seems to me that this reads as the failures of the medical system (powered by CEOs and private insurance companies and managers) were presented as the moral failures of doctors and nurses who just want to clock out." In hindsight, that would've been an excellent follow-up question to ask, and one I'm sure would've led to a more nuanced, clarifying discussion.