Sunday, February 7, 2010

I'm a little pissed at the Today Show

So did anyone else catch the birth on the Today show last week?  I never watch the Today show anymore, or any TV news for that matter, because it's just depressing and BJ will tell me if there's anything important going on, and if there is I'll go read about it.  I don't need talking heads to tell me what I should think about whatever's happening...  That's not news, it's commentary, but I digress.

I was getting dressed and I could not take one more minute of the Disney channel or the related music that has spun off of the same, so I turned on NBC and Meredith Viera was talking about how excited she was that the Today was about to show a birth on TV.

Obviously that got my attention, having done birth personally I know that I would deck anyone who came within a mile of me with a video camera during labor, so I sat down to see if the mom broke the cameraman's nose.

It turned out to be a C-section.

Now I need to derail a minute, here, because I know there are a lot of sanctimommies in the world - the kind who think that motherhood comes with some kind of point system, and that if they choose, say, natural unmedicated childbirth over a C-section, they're automatically somehow a more superior mother than someone who, for whatever reason, had a C-section.

I am not this kind of mommy.  There are no points, and the measure of a mother is not in how she gave birth.  Period.  There are some really miserable mothers who have given birth without drugs, and there are plenty of phenomenal mothers who have had C-sections, induced births, epidurals, etc.  It SO doesn't matter.

I'm proud of the fact that I gave birth naturally in the same way that someone who ran a marathon is proud of themselves for accomplishing that - it was something that was hard and painful that not everyone tries to do, and even those who try often don't succeed.  But I am not a better mother than you are if you had a c-section, any more than you're a better mother than I am if you've run a marathon.  Kapiche?

I do, however, have a problem with the fact that about 34% of births in this country are C-sections.


Because I think that a lot of those C's are done for stupid reasons.  (Here's a good article about it, if you want to skip my ranting and read something rational and reasonable with numbers and facts...  But I know you come here for the rants and the pictures, so buckle up, here we go...) 

I think if doctors would just get out of the way of birth and let it happen, if they would allow women to labor in a more natural position than on our backs (we're on our backs because it's convenient for the doctor to get a good look at what's going on, by the way, not because it's efficient), if they would be patient and not get all antsy if things take, oh, longer than 24 hours from the time the water breaks, if they would stop saying things like, "Oh we'd better schedule a C because this baby is huge..." and so on and so on, we could bring that number (34%) down.  Way down.  In other developed countries it's more like 10%.  (And I'm not even going to calculate what all those C-sections are doing to the cost of health care in this country, but I think we can all agree that it is a LOT cheaper to give birth vaginally than it is to give birth in an operating room).

I think it's important to get that number down, not because I think that all women everywhere should have crunchy granola unmedicated childbirth with Zamfir Master of the Pan Flute playing liltingly in the background while everyone sings Kum-bye-ah...  but because I think that interventions (pitocin, breaking amniotic sacs manually, c-sections, epidurals, etc. etc.) have CONSEQUENCES that are non-trivial for mothers and babies....  Consequences that are glossed over.  Consequences that were glossed over on the Today show, too.

Any time you tell someone "no" when you're pregnant or in labor, they threaten you with a dead baby.  When I was on bedrest with MG, I asked the nurse who came to the house to take my blood pressure if I could go up and down the stairs more than once a day, and she literally said to me, "Sure, you can do whatever you want, if you want to kill your baby!"  (Talk about someone who deserved her nose broken...).  But in the same culture where we tell mothers that they can't eat COLD CUTS without dire consequences for their unborn children, we seem to think nothing about cutting them open to get those same unborn children out.

Doesn't anyone else think that's a little bit screwed up?

Back to the Today show...  Oh hey, there's video!

Ok, first of all, if you were that mother wouldn't you be screaming, "Shut up, who do you think you are, Sanjay Gupta?"  Forget the camera man, I would've broken the nose of the chatty doctor.  I don't understand why they couldn't have had her in the studio with Meredith instead of in the operating room annoying the parents, but whatever...

I thought it was interesting the way the doctor was constantly assuring everyone that things were "orderly," "routine," "normal protocol," and "scheduled." As opposed to vaginal birth?  Where things are unpredictable and messy and (generally) unscheduled?

Ok, then they start talking about all the different reasons for c-sections, and they get to my favorite one, "Baby's too big."

My friend Karen was told her baby was going to be "huge," and he weighed less than 7 pounds.  They don't know.  The measuring techniques are extremely inaccurate in late pregnancy.

I guess this mother was a big baby and so was her husband, and they decided to schedule a c-section.  Now, it goes against my personal editorial policy to question the medical decision of one individual mother, so I'm not going to debate whether or not this mother really should have had a c-section for a suspected big baby - that is a decision that is totally between her and her doctor and it is SO not my call.  But I know plenty of people who have delivered 10 pounders vaginally and lived to tell about it.  If you're pregnant and you're being told that you have to schedule a C because your baby is too big, it is my opinion that you should get a second opinion.  Of course, you're probably going to be told that you're going to kill your baby...  but they'll tell you that for eating tuna fish, too, so tell them I said to piss off.

I love how Meredith, medical expert that she is, says, "Clearly Mom made the right decision, scheduling a c-section..." when she's told how much the baby weighs...  That quote is inexact because I've somehow killed the sound on my computer, but I remember getting all fired up about it several days ago when I saw this originally, and it's close enough.

It just annoys the crap out of me that the Today show is going so far to normalize surgical childbirth...  It seems to me that if 30+% of births are already C's, it's pretty normal.  I've heard anecdotally that a lot of labor and delivery nurses have never seen an unmedicated natural childbirth, because they've become so rare.  Maybe, considering the complications that are possible in any surgery (much less one with two patients!), we should be trying to normalize the old fashioned sort of birth.

I know my next birth is going to be induced (Claire's was, too, and I did it unmedicated after that - unless you count the Tylenol they gave me for the headache I got from pregnancy-induced-hypertension) because I would never make it to the hospital if I waited until I went into labor naturally - I have extremely fast labors.  Scary fast.  Maybe the Today show should send a camera crew, and they can normalize natural childbirth a little.  I would love the opportunity to show other women that it IS possible and you CAN do it (believing that is half the battle, actually).  I'd love the opportunity to show women that natural childbirth isn't anything like what you see in movies - it's not all screaming and "You'll never touch me again!" and bumbling doctors and fainting husbands. 

I promise I'll try not to break the cameraman's nose.

PS - I fully believe that C-sections should be available to those who truly need them in emergency situations.  A very old friend of mine just had an emergency C-section, actually, and both she and baby are doing fine, thank goodness.  Edited to add:  The FRIEND's not old, but I've known her forever.  She's only 29.  LOL


amywoodbeck said...

I am sure the big baby excuse is used as just that: an excuse. But my best friend pushed for 2.5 hours before they finally decided to do a section. Poor baby came out with a ridge on her forehead from where she was stuck on her mommy's pelvic bone. So it can be a legitimate reason too. I have PCOS and other medical issues, I was induced and 8.5 hours later I still hadn't dilated past a 2 and my baby's heartbeat wasn't reacting well to the contractions anymore, so off to the operating room we went. My 2nd was a scheduled c-section based on my reactions to the pitocin the 1st time. From time to time I have felt slighted and cheated a little from not being able to push and try natrually. But my body just didn't allow it and they still came out beautiful and wonderful and adorable. I am glad to hear that just because you had a natural birth you don't look down on us 'unnatural birthers' (actually overheard phrase, I almost punched the lady).
Back to the big baby thing.. I wonder as we moms get more educated on what to eat while pregnant and the nutrition if our babies will just keep getting bigger and bigger and bigger over time. Mine were 8 8 and 8 13; none of my friends have had a baby under 8 pounds in the past 4 years. We are growing them big these days and I wonder if our bodies can handle it? That may sound silly, but it is a conversation that me and lots of my mommy friends have had lately.
Great Post!

DORI said...

I was 110lbs when I got pregnant, my husband, 130, both of us under 5'4". The doctor estimated that the little guy will be tiny. He was almost 9lbs and guess who had to have an emergency C? Just goes to show you how off their estimations on the weight can really be.

Melisa with one S said...

Nice; I agree completely with you that there are way too many C-sections goin' on, and many patients (and doctors) too often schedule them unnecessarily only because it's easier, quicker, or works better with their schedule.

I had a C-section w/ my first one because he "failed to progress" and, being a first-time soon-to-be mom, I listened to my doctor's recommendation that the C-section be performed without considering that maybe I should have waited a little longer. I think she had somewhere to go that night or something.

My second one? Natural birth, no drugs, 9 pounds 11 ounces. (I have a large frame though; a petite person would have probably had to have the C)

Anyway, regarding the Today Show, I'm certain that the only reason they showed a C on tv was because they wanted to do it live, and the unpredictability of natural birth isn't really "friendly" for a three hour morning show. Still, as I watched, I wondered "Now, WHY are we having a live birth on tv?"

Cate said...

Great post, Amy! I've been meaning to comment but things like grant proposals were taking up my time...

I really love how you get a the crux of this argument -- OF COURSE we want the option available in case of emergency! But why is it that normal birth is so often classified as "emergency"?

I bore an 11 pound 9 oz child without a C section. I am a surgery-phobe, and even the idea of a needle in my spine freaked me out. My entire pregnancy I told every provider, every helper, that I would do anything not to be cut open. I prepared mentally and through classes.

While I was in labor, after transferring to the hospital from the birth center because there was meconium in the waters, the doctor sized her up as 7 pounds and they couldn't figure out why it was so much work for me to push her out. But they respected my desire to keep trying; they monitored her well and she was always fine, and she came out fine too. The whole room hushed -- at the time I won the biggest-baby-by-vajayjay award at the University of Washington Hospital. I don't know if I still hold the title or not.

My second birth, my circumstances were different, and I made the choice to use a regular OB and have the baby in a hospital (in fact the same hospital where I was born), because I was just focused on the baby, and not so much on the process this time. And I knew from my first birth that no matter what plans and preparation I did, things in labor would go the way they would go. And when labor started, it was a typical second birth -- fast and intense -- but really, really NORMAL. I wanted to go without pain meds because having lived through 25 hours of labor the first time without, I thought I could do it again. However, during this very normal birth, I was constantly criticized and questioned by the nurses - not so much the OB -- why wasn't I accepting pain meds? Why did I have to be so loud? Why did I want to stand up and walk? Why couldn't I just hold still and let them insert the IV? The heart is doing wierd de-cells for a minute, wouldn't I just prefer the epidural and surgical birth? My baby was born in under 5 hours completely healthy and 9 pounds 7 oz., a totally normal birth and baby.

Point being: In my first birth, with a supportive team, I was able to birth an extraordinary baby without a cesarean, even though there were many times when it seemed possible that we were heading down that road. In my second birth, under normal circumstances and a normal baby and a very normal birth were constantly questioned and I was constantly told I was abnormal in some way.

I believe THIS is what you are talking about, Amy, that the hospital world gets so used to the "orderly" and "routine" that true, messy, intense labor seems aberrant and wrong. They get so used to taking care of every discomfort that they are upset by loud laboring moms, moms who want to move and flop around, and they think that it's no longer part of the process to do that during labor. And it's THIS attitude that leads to unnecessary cesareans.

Amy said...

Great comment, Cate! You're exactly right. A mother who wants a natural labor (because she's afraid of the side-effects of interventions - like the spinal headache that is possible with an epidural, for example) should NEVER be made to feel like she's inconveniencing the nurses. For cryin' out loud!!

I've heard plenty of bad things about the hospital where you had your second birth - it's the same hospital that drove my mom to have homebirths 30 years ago with Chuck and Megan - so I'm not all that surprised that they gave you a hard time. Still sad for you, but not surprised.

Thanks for finishing all the thoughts I left dangling! :)

Amy said...

Sorry - I just woke up - a mother who wants a natural labor for ANY reason shouldn't be made to feel like she's inconveniencing anyone.

Fear of the interventions and their side effects was a big part of it for me, too.

I need some coffee... Yes, it's 3:30 pm. :)

Crunchy Domestic Goddess said...

Thanks for sharing this on BlogHer. I was just as frustrated with the commentary as you were and wrote about it on my blog. Surprisingly, the TODAY show asked me to write a post for their blog. So I did. :) It was edited a bit (they took out the part where I said it was irreverent and irresponsible journalism :P), but I think I still got the point across. ;)
Learn more about cesarean births

Anna said...

I know this blog entry is almost a month old, but I'm reading through your blog backwards! I completely agree with everything you said about vaginal birth vs. cesarean births. I don't really get the point of showing a birth on television either. The reason I'm commenting is that I want to know why the nurses seem to be so rough with the baby? They're practically winging him through the air and lifting him up by his arms and quickly plunging the nasal aspirator into him. Poor little guy just went from being all cozy in his mom to a bright, cold place where he's being manhandled. Are they not being gentle because they're trying to stimulate him to breathe properly or what? This is probably obvious since their treatment of the baby surprised me, but I've never had a child or witnessed a birth. When I do have a baby, I really hope the nurses will be more gentle with the little thing.

Amy said...

Anna - thanks for reading and commenting!

The nurses can be a little rough with brand new babies - but it turns out that brand new babies aren't as fragile as we think they are. They're actually pretty tough, if rather slippery, creatures.

When Claire was born she was the most unholy color of lavender I have ever seen. My first words to her were, "She's purple and covered with mayonnaise!" The nurse rubbed her really vigorously (while she was laying on my chest - the baby, that is, not the nurse) to help stimulate her breathing.

If you look at nature, dogs will lick their puppies to get them breathing. Something about being rubbed stimulates mammals to breathe.

I'm not sure if it's rubbing specifically that you're referring to in the video, though. Some of the procedures (like suctioning out the mouth and nose) look pretty brutal. I was astonished at how far down the suction bulb goes in their little throats. I didn't see the doctor do it until I looked at some (highly graphic and unbloggable) pictures from Claire's birth, actually.

When you have a baby, assuming that everyone is healthy and there aren't emergency things to be done, you can request that they lay the baby right on your chest, and that they allow the baby to be with you for the first little while - leaving all the medical stuff for later. You can also request that the baby be held by her father first. A lot of it is up to you. Part of the process of being pregnant involves finding a doctor whose practices match with your values - so if you want your baby to be treated differently from what you saw, that's a good starting point for a discussion with your doctor, when you're eventually pregnant, about what you want done with and to your child.

Always remember that you have the right to ask people to treat your baby the way you want him to be treated - even in the hospital.

Nice to "meet" you!