Tag Archives: birth

Nurse-Midwives are With Women, Walking a Middle Path to a Safe and Rewarding Birth

In childbirth politics as in all politics, extreme viewpoints make the news, and sensible centrists are ignored. A couple of years ago, Ricki Lake provoked a firestorm of debate about home birth with her film, The Business of Being Born, which showcased gloriously crunchy New York City home births, and made the case for the home birth option. Obstetricians responded with censorious anger, shouting at Lake via condescending statements from the American College of Obstetrics and Gynecology. Recently, obstetrician and blogger Amy Tuteur published Push Back: Guilt in the Age of Natural Parenting, in which she made fun of women stupid enough to believe that they might have a better birth experience without an epidural, and excoriated anyone who would refuse any of the bells and whistles of modern obstetrics. Her title was a response to journalist Jennifer Block’s, Pushed: The Painful Truth about Childbirth and Modern Maternity Care, an exposé of callous obstetricians who damaged women and their babies with the thoughtless overuse of standard obstetric interventions such as the induction agent cytotec and the drastic overuse of major abdominal surgery (cesarean section).

All this shouting. Is it getting us anywhere? Mightn’t there be some middle path for women who see the appeal of “natural” birth, or who at least would like to minimize their chances of cesarean section, but who are not confident about giving birth without immediate medical back-up?1 Could there possibly be a way to combine the emergency backstop of modern medicine with the caring values of home-birth midwifery?…

Read the rest at Nursing Clio

Sportscasters Apologize, But Do They Miss the Point?

On Friday, April 4, sportscasters Boomer and Carton apologized for their remarks criticizing baseball player Daniel Murphy’s decision to miss two games to be with his wife after the birth of their child.  Boomer and Carton seemed to be shocked to have been taken seriously, and truly sorry that they had caused an annoyance and distraction for Murphy.  So how did the apology measure up to my hopes for where this conversation, now started, might proceed?  Boomer did most of the talking.  It started well: “I was not telling women what to do with their bodies. I would never do that. That’s their decision, that’s their life and they know their bodies better than I do.”  Well, actually, he originally said that if he were in Murphy’s situation, he would have demanded a pre-season cesarean.  But I’ll call this a reasonable clarification.  But then, ““That is my fault for uttering the word ‘C-section’ on this radio station. And it all of a sudden put their lives under a spotlight, and for that I truly apologize.”  Well, yes, it is kind of obnoxious to second-guess someone’s family and medical decisions on air.  But on the other hand, it would be too bad to go back to censoring the words “c-section.”  He then thanked the March of Dimes for reaching out to him to “patiently re-educate” him, and reminded the public that he was a longtime supporter of the organization.  But he didn’t explain to his listenership why the March of Dimes had called: the organization has an active campaign to discourage early induction of birth, because it can have long term bad effects on children.  It would have been a great moment for Boomer to actually say something useful, but he failed to take it.  And then he closed by defending Carton’s remarks about Murphy taking more than a few hours away from baseball.  He reiterated that seeing the baby being born is a really important moment, and that Boomer and Carton had themselves been present for their babies’ births.  Clearly, this brouhaha did not lead them to rethink their notion of the father’s responsibilities when his baby is born.  They still see it as, “baby comes out, I cut the cord, job done.”  An apology is a start, but clearly, there are plenty of further conversations to be had.

Sportscasters Advocate Elective Cesarean Section

Yesterday, Momsrising.org and others excoriated sportscasters Boomer Esiason and Craig Carton for obnoxiously opining that baseball player Daniel Murphy should have told his wife to have an elective cesarean section, so that the birth would be done before the season started.  Boomer and Carton were annoyed that Murphy missed two games to take 3 days’ paternity leave, to be with his wife after the birth of their child.

As an advocate of evidence-based birth practices, I of course find this suggestion alarming.  Cesarean section is major abdominal surgery, and can come with complications.  It also increases the chance of problems in future pregnancies and births.  And premature birth can cause long-term problems for the child.  Pre-term convenience cesareans are clearly a bad idea.

But even more, as a historian, I find this story really striking. 

First, the most obvious: Sportscasters casually opining about cesarean sections? Wow.  Even a decade ago, this would have been shocking.  But in recent years, celebrity pregnancy and birth have become staples of tabloid news, and we casually discuss who has a “baby bump,” who gave birth when, and who is breastfeeding.  We used to focus on stars’ sex lives, but now we talk about the aftermath too.  Sportscasters discussing cesareans and paternity leave is perhaps a natural next step, giving some public attention to men’s reproductive lives.  While I didn’t like what Boomer and Carton had to say, my inclination is to feel that this is probably a positive development.

Second, it is clear from this incident that cesarean section has become as normalized and taken-for-granted in our society as vaginal birth.  Murphy’s wife in fact, in the end, gave birth by emergency cesarean.  Boomer and Carton, and other commentators, called it a “normal birth,” without complications.  They thought Murphy should have spent at most 24 hours with his wife during her recovery.  In 1965, the first year statistics on cesareans were compiled, they accounted for 4.5% of births in the United States.  Rates began rising in the 1970s, and now stand at about 33% of births.  In 1965, a surgical birth would certainly have been treated as “complicated,” by all involved.  Now, it’s routine.  The fact that surgical births often come with postpartum complications, such as incision infections, and typically come with much longer and tougher recoveries, disappears into the “normalcy” of the practice.

Third, I am struck in various commentaries, such as one by Mike Golic and Mike Greenberg, that the father’s role in birth is typically considered very important, but also very narrow.  He is supposed to be there for the birth.  It is not always clear whether it’s for his sake, to have the experience of seeing the baby newly-born, or for his wife’s sake.  As long as he’s there for that moment, and his wife isn’t hemorrhaging afterwards, his official, ceremonial role is done.  Murphy clearly did not experience his wife’s birth this way; he was quoted as saying, “I can only speak from my experience — a father seeing his wife — she was completely finished. I mean, she was done. She had surgery, and she was wiped. Having me there helped a lot, and vice versa, to take some of the load off. … It felt, for us, like the right decision to make.”  But even sympathetic commentators from the sports world tended to view the emergence of the infant as the crucial moment, and the rest as optional.  For most of Western history, of course, husbands were not welcome at their wives’ births; it has only been in the last 50 years that we have cultivated a new role for them as partners and supporters of their wives.  But it appears that at least for some Americans, this new role is defined incredibly narrowly, as a ceremonial moment, kind of like wedding vows.  See the baby come out, cut the cord, done.  It seems to me that the narrow definition serves busy husbands better than it serves laboring and recovering wives.

While Boomer and Carton’s commentary was obnoxious, and their harsh criticism of Murphy for taking three days’ paternity leave infuriating, I am pleased to see these issues addressed in the hyper-masculine world of professional sports.  I just hope Boomer and Carton don’t have the last word.