Sometimes when I teach my semianrs to Dcs about birth trauma, they say it's not really like that anymore. According to many of our patients and those of others, i know that the many interventions during birth are affecting the labors of women and resulting in birth trauma. This of course leads to undue spinal and nervous system stress. Here is the story of a recent birth (sounds like a case of constraint combined with fear, not a pelvis too small) The Birth Love Column by Leilah McCracken leilah@birthlove.com Linda's Birth The pregnant model in my midwifery study group gave birth nine days ago. Linda had come to study group in the last weeks of her pregnancy as a favor to her doula, who had once been a student of Gloria's (Lemay, the private birth attendant who conducts the study group). Linda also came because she found the atmosphere very enriching and supportive. This woman was planning to give birth in the hospital, and had a doctor who was sure of her "disproportionate" pelvis. She started getting sensations Saturday evening, and called her doula, Sue. Sue came over, and helped her as long as she could, but soon Linda was asking to go to the hospital- Gloria had warned that Linda's going to the hospital too soon would be a disastrous mistake, because with her absurd labeling of "small" pelvis, she would be almost certain to get a C-section if her labor should stall or be less than ideal in any way. So Sue called Gloria, and she came to the house; she helped Linda settle as much as she could. She sent Linda's husband to a quiet corner to get some rest. Linda was able to get through her labor a lot more peacefully with Gloria there: whenever she found the sensations more powerful than she could bear, she would ask to go to the hospital; but then Gloria would take her vital signs, and listen to the baby's heart. This would calm Linda right down, enabling her to stay home longer. She would then sleep very deeply between the intensifying sensations. Gloria says she finds this to be the case with women who view birth as an exclusively medical event- they are best able to relax into birth when they can see some medical busywork going on. But this is understandable... the rituals of medical birth are very comforting to many people; birth becomes predictable and manipulable, logical and controllable. And by following the rituals Linda expected, Gloria was able to keep her home until she was assessed to be 8 cm (as found by the hospital staff upon admittance). This is what pleases Gloria most about this birth- that Linda was able to stay away from the hospital for that long, avoiding the induction drugs and surgical births that are so common in this area. But once Linda did get to the hospital, the interventions began. She was strapped into bed with a fetal monitoring device, and the fetal heart rate was found to be much higher in the hospital than it was at home (though the monitors used in local hospitals are quite archaic, and are known to cause inaccurate readings). Then she got an amniotomy, and her waters had meconium in them. Her doctor decided to give the baby internal monitoring. (Gloria showed us an internal monitoring device- which is twisted into the baby's scalp- at the following study group. She invited any one of us to screw it into our fingertip. Not one of us could bear to...) The baby's heart rate was normal. It was difficult for Gloria to be in the hospital with Linda- she found that every suggestion she made, everything she did was counteracted by the medical people, as if to show her who was "boss". When she praised Linda for doing such a good job getting through contractions without any drugs, the nurses offered nitrous oxide. When the baby was coming, Gloria said, "push slowly, slowly, pant, pant, pant..." But then everyone else started yelling at Linda to push. After the baby was born (and suctioned very vigorously), Gloria tried to say, "don't cut the cord yet," but the doctor cut it as soon as he could (Gloria said the only remotely positive thing about the cord being cut this early was that she was able to see how much rich placental blood actually does go into babies' bodies under ideal birthing conditions- she said at least two cups' worth spilled uselessly onto the sheets). Then Gloria tried to have the baby put on her mother's chest- but the doctor said "no way!" and passed her off to the pediatrician for inspection. The baby was put in a "crash cart"- and was very, very unhappy to be there; she was crying in fitful terror. Gloria and the baby's father went to her, to try to settle her- they held her little hands and spoke softly. The pediatrician grew angry at them- said they were stimulating her, and interfering with the examination! All they could do was back away. After a brief cuddle with Mom, the baby was taken to the special care nursery. (The pediatrician noticed signs of distress when the baby was in the crash cart.) Gloria gave Linda a hug, and went home to her own daughters. Sue, who had been very helpful to Linda throughout the labor, stayed with Linda for several hours to help her settle into the hospital. Linda was very, very tired... The baby's father was delighted at the birth of his new little daughter. Gloria went to visit Linda at her home a few days ago- Mom is still very tired, and baby is having difficulties latching on to the breast. But she has lots of support, and all should go well. Would it have been better for Gloria not to go in with Linda, and let the hospital routines unfold unfettered? This Gloria will always wonder about. If a birthing woman isn't committed to homebirth or midwifery, is she served best by being in the hospital only with people accustomed to working within hospital routines and protocols? Does someone who is a powerful advocate of natural birth pose more of a hindrance to a positive hospital birth than a boon? Is there a compromise? And why do women perpetually insist they feel safest to give birth in the places that interfere so egregiously?