Tuesday, August 30, 2005

A Perilous Journey from Sex to Baby

Last night, I posted some links to an article in the NY Times and the resulting blogs debating the "perilous journey from delivery room to bedroom". Many men, most who are afraid to say so, no longer find their wive's attractive after seeing her nether region used for its other great purpose. Knowing is one thing, seeing? now that's another matter entirely. This topic is near and dear to my heart and my [ahem].
Like the one blogger stated, in America, husbands weren't privy to the triumphs and perils of the birthing room until Dr. Bradley invited them in the 70s. Only the modern male doctor got to control the process that was once was the domain of women: Birthing used to be done by women, with women and the whole process was totally, completely 100% about women. The rule was empahtic: NO MEN (even male doctors, horrors!) ALLOWED.

Back in the day, women expected their bodies would do the work of birthing. It wasn't a question of if she could, but when she would. The child-birth process, like a male of the group going on his first hunt or going to war, was a rite of passage into the exclusive club of motherhood. Sheila Kitzinger has lots to say about this being a social anthropologist. That is not to say birthing was some sing-songy tra-la-la experience with no pain, no discomfort and no problems. Birthing can be messy business by it's very nature. Without the difficulty it would never have taken on such mythic status with women or men in the advisor-to-birthing-woman role. Yet, for much of history woman, as mid-wives, helped women give birth.

And then the men came.

First they came as voyeurs. This produced the "lithotomy" position--aka the flat-on-your-back-so-it-is-easier for-the-doctor(or king which is how it started)-to-see what is going on position, but nearly impossible for a woman to effectively push position.

Then they came as "helpers". And as all women and men know, a man is not a helper unless he has a really good tool. In this case it was called forceps. Back in the 1600s, when more women had disproportionate pelvises due to malnutrition, forceps could be a life-saver. But the two men who created this birth aid failed to share it with the midwives who assisted births back then nor did they share it with their fellow doctors. It was a secret that was revealed to upper-middle class women at the right time. Eventually, another doctor discovered and perfected this tool--yes, that doctor, too was a man.

Then the venue of the birth changed from the home (the woman's domain) to the hospital. Men, being men, decided it was inconvenient to go to a woman's house to help her birth. No, it would be "better" (easier for me) if she came to a hospital. This is what happened: Puerperal Fever.

In his famous essay on Puerperal Fever published in 1842 Holmes emphasized that a physician attending a midwifery case should not take an active part in an autopsy on a patient dead of puerperal fever, erysipelas, or even peritonitis. He noted that if one case of puerperal fever arises in a physician's practice there is an increased risk of a second, two cases suggest that the physician should do no obstetrics for at least a month, and three prima facie evidence that he is the source of the contagion. The time has come when the existence of a private pestilence in the sphere of a single physician should be looked upon not as a misfortune, but as a crime.

Controversy was extensive, but change began to occur. The conclusive evidence was provided by Ignaz Philip Semmelweiss (1818-1862) who qualified in Vienna in 1844, and became assistant at the Vienna Lying In Hospital soon after. At that time unmarried Viennese mothers were admitted at the sixth or seventh month of pregnancy, and discharged to the Foundling Hospital. Survivors became wards of the state, the males in due course cannon fodder for the Emperor's army.

Semmelweiss with the backing of the great morbid anatomist Rokitansky began to do autopsies on women with puerperal fever and noted that a high death rate from this disease was found only in First Clinic wards attended by students, and not in Second Clinic wards attended by midwives. Women begged to go to the latter. There were various suggestions as to cause--overcrowding, unwed maternity, but Semmelweiss showed that these were more common in Second Clinic. When his colleague Kolletschka died of a dissecting wound, Semmelweiss saw the parallel, and came to the right conclusion. He instructed his students to scrub their hands in chloride of lime before having any contact with the patient. The death-rate fell: 1846--11.4%; 1847--3.8%; 1848--1.27% cf 1.33% in Second Clinic.

Semmelweiss wrote: Puerperal fever is caused by conveyance to the pregnant woman of putrid particles derived from living organisms, through the agency of the examining fingers....... Consequently must I make my confession that God only knows the number of women whom I have consigned prematurely to the grave.

Besides death, along with the hospital came medicine. Women were knocked out and drugged up, gave birth and when they woke up, presented a baby. Was it hers? She didn't know. The woman had to trust the doctor that it was her child. To say she was removed from the process was an understatement. Many women found out after all this trauma, that the "baby didn't make it". But how could she be sure? She was not allowed to see the baby.

Now, to some women, the "knocked out" part was great news. Yippee! I feel no pain. I wake up and bingo! There's a baby.

Yet to other women, the whole process added up to legalized assault. The best part? As long as the baby and mother were "healthy" (a loose term because the woman was usually shaved, catheterized, given a deep episiotomy so the forceps could be used and bruised from doctors and nurses trying to push the uterus back into shape). So what if these interventions left the woman scarred, incontinent, shaken and upset and unable to enjoy sexual intercourse again?

Birth morphed from a naturally occurring proccess to a "controlled procedure". Anyone who has given birth knows that it is an uncontrolled phenomenon. In fact, when the woman feels like she is going to "loose it", around full dialation, is usually when she in fact will loose it--the baby will be born soon.

The medical establishment, being men almost entirely until this generation, sought to "help"--remove pain, keep the woman quiet and get the baby out by any means possible and quickly using scissors and knives and forceps and needles and other equipment to measure and monitor. In fact, a typical Labor and Delivery unit differs little from a good Car Dealership service shop. Sterile and white, machines whirring and everything lined up nice and neat, with tools at the ready so the broken vehicle can be fixed.

On this backdrop, Dr. Bradley invited husbands into the delivery room to "coach" their wives. Again, a woman had no clue what to do. Why she was a delicate little flower too weak and feeble to know how to do this work--she needed a Coach!

The absurdity of this situation becomes apparent daily, even thirty years later after the "coaching" movement. A man doesn't own the parts, he doesn't know what he's talking about, he is processing his own emotions about the whole thing, and if he loves the woman, he's overwhelmed with fear watching his beloved do the necessary suffering that goes with birthing. And he is supposed to Coach her? Guess what the coaching consists of, "Doctorrrrrrrrrrr, she needs drugs NOWWWW!!!!"

He has never seen her yell and scream like this. He has never seen her grunt and moan like this. He has never seen her this primal. He is FREAKED OUT! She was so classy, demure, pulled-together, sexy, confident, fill-in-the-blank. She was not what she is when she is laboring and birthing.

And then he sees the head crown. Holy !%*@! "I will never have sex with her again," he solemnly swears to himself.

All the videos, education and breathing classes fly out the window during the harrowing birth process. With the propaganda around today, both the woman and man enter the hospital with just enough knowledge to be dangerous and enough romance to fill a busty novel. We'll have candles, soft music, an epidural and poof! the baby will come. He will be her knight in shining armor (nevermind that he's an insensitive, selfish knob the rest of the time) and she will be the personification of dignified beauty making birth look elegant (nevermind she squeals at a bug skittering across the floor). She expects him to say the exact right things, be in the exact right place, meet her subtle needs at the exact right time. He expects her to follow his lead and accept his protective advice.

And we wonder why the whole process can be infused with regret, disappointment and anger?

Let's face it, in this system, both men and women are put in an impossible situation. During one of the most physically and emotionally difficult times, both partners must perform at levels they rarely achieve on days when the stars align and perfection reigns. Neither one knows what will happen during birth. Neither one knows if he or she can handle it.

But who does know? Another woman knows, that's who. She knows that unless some rare crisis occurs, the woman can do it. She knows that if the woman gets up and moves the contractions will come faster and the baby will come faster. A woman knows that women are much stronger than they are socialized to believe they are. A woman's opinion carries weight because she owns the parts, she's been there.

No woman should every give birth without another woman. Period. Whether a midwife, doula, mother, sister, friend, a woman NEEDS a woman during this time.

The woman who mid-wives with the birthing mother (mid-wife means "with woman"), doesn't interfere. She instills. She meets the woman's eyes. Her presence is a comfort because if the mid-wife (or mom or sister or friend or doula) did it, so can I.

And here is another thing a woman helper can do for the birthing mother: She can help the husband. She can direct him to hold his wife in a way that helps her. She can tell him to go get water for his wife because she's thirsty. He can use his strength to rub her shoulders. In short, the woman helper helps the man become USEFUL. Rather than an appendage, he is part of his wife's journey to motherhood.

Even more important, if the husband realizes, as some do at the end of this ordeal, "Hey, I am not cut out for this. I don't want to see it." The birthing mother won't be left alone. She still has support. She is still emotionally cared for.

Societally, birth is so medicalized and removed from everyday living, that both men and women have distorted expectations. Men no longer farm and birth calves. If they did that messy business, being with their wife wouldn't be such a big deal. Instead, the woman's vagina exists for one purpose: to give him sexual pleasure. Seeing the birth is a gory side-effect he never wanted to know about. He's not desensitized to the process because he's seen it over and over. No, her private parts are just that--secret places to be enjoyed in the dark and should be kept that way.

Same way with breastfeeding. Ack! Breasts are for fun not for food! I know men who refused to have their wives breastfeed for a variety of nefarious reasons: her boobs will get droopy, I'm jealous because she spends more time with the baby than me, I'm jealous because it is something only she can do.

In fact, being pregnant and giving birth is the MOST FEMINIST ACT. A man simply cannot do it. I believe this helplessness, this outsider status, plays on the secret insecurities of many men which may in part explain why a woman is much more likely to be abused when pregnant by her spouse.

To mitigate these shaky feelings, men have systematically "intervened". Birthing as a medical procedure becomes one more way to dominate and control women all in the guise of "helping". (A note on the women OB/GYNs: I have had a good one. I have had a bad one. I know from experience, even as a chiropractor, that the medical school process, too is male-dominated and heirarchical lending to rely only on "reason" and "facts". To succeed in this milieu, almost like bootcamp, a depersonalization occurs. Read more about this through Dr. Christiane Northrup's experience. Women, in order to be accepted in the medical world, often give up their unique gifts as women to succeed and be part of the "fraternity".)

Women have bought into the weakness crap. Terrified by the scary stories, horrified by gruesome pictures, they willingly and eagerly submit to de-humanizing protocols and nonsensical procedures. I.V.'s "just in case", forced to work without food and drink "just in case", monitors "just in case", staying in bed so that all these wires don't get messed up, watched like a clock to "make sure you're progressing", poked and prodded and inspected by strangers and when she freaks out and the baby refuses to come, it all becomes a self-fulfilling prophecy. Oh, thank God for the forceps, the caesarean, the spinal block, and especially THE DOCTOR.

I want to be clear here: all this being said, I am not saying that these interventions are not life-saving at times. These interventions save lives in emergency cases. But with a 25-33% caesarean rate around here, you would think that women over the centuries grew babies on trees the birthing process is so fraught with doom.

Birthing needs to be returned to the woman's domain. Women will do better health-wise. Their babies will do better. More babies will be nursed which will reduce SIDs, asthma and even some cancers. The women will be emotionally supported through this primal process as only other women can do.

And if the husband is invited into this process by his wife, then he is a lucky man, indeed. Birthing a baby is one of the most magical, empowering, unbelievably life-affirming passages a woman experiences.

If he can't handle seeing what her body was made to do, if he can't see her in that complex transition from woman to mother, he belongs where the men of old belonged--outside. He can see the baby later.
More blogs about the woodlands rita.