Rape of the Twentieth Century
-by LLM. Written in March of
1998; revised April 2000.
I have had seven children move through my body,
and I have much to tell you. Mothers who have
given birth to many children have become a rarity;
we are no longer the ones who teach the mysteries
of birth- the voices of wisdom and reason instructing
attendants in the proper care and assistance of
parturient women. Modern obstetric knowledge is
based on false hospital outcomes: doctors know
how patients give birth, but they don't know how
women give birth. We, as a society, have largely
forgotten that birth is trustworthy- it doesn't
need a lot of meddling. Birth is beautiful; it
is passionate, wild, and hormonal. And it is wounded.
Incomprehensibly intrusive, painful and humiliating
hospital procedures have injured birth; it is
bleeding, and weeping. The twentieth century has
witnessed the institutionalized rape of childbirth.
I had the privilege- and misfortune- of conceiving
my first baby at nineteen. Privilege because my
body was young and resilient; misfortune because
I was woefully ignorant of birth. The usual route
was my path- I found a doctor, read lots of books
about pregnancy written by doctors, and went to
prenatal classes that told me to always obey my
doctor.
In the last weeks of my pregnancy, I had increasingly
strong contractions- I always thought I was going
into labor, but never did. This was to be the
seed of my massive self-doubt in giving birth-
that my body couldn't perform; didn't know what
to do when it was supposed to do it. I learned
many years later that this is prodromal labor
(I wish we could get rid of the word "labor")-
one of Nature's many different ways of perfectly
easing a woman's body into birth.
My water broke at 42 weeks, and as instructed
by my books and prenatal instructor, I rushed
to the hospital. I was introduced to hospital
birthing by a giddy young doctor who had me strip
down, lie flat on my back, and put both feet together
on a bed pan. I was made to drop my knees open.
He inserted a speculum in my vagina, and came
in really, really close and had a good long look.
There were two nurses in the room, drolly looking
on. I said, "this is the most humiliating
thing that's ever happened to me." No one
else said anything.
I was hooked up to endless hours of fetal monitoring.
My contractions were cramped, irregular and spasmodic-
which happens very often with women attempting
to give birth in hospitals, inherently stressful
places to be in.
The next twenty-four hours were a maze of interventions:
a large number of pelvic exams by many different
people; being moved from room to room; blood work;
an enema; obsessive fetal monitoring; tubes; needles;
signing strange forms. I was not allowed to eat
or drink, and became very weak.
My doctor (via telephone) put me on Pitocin drip.
The contractions almost immediately became unmanageably
intense. I had an epidural, but it didn't work
(most local anesthetics don't work on me). Four
hours later, my baby was born. I was starving,
exhausted, traumatized, and thrilled at the birth
of my baby daughter. My husband wept with joy.
It is the custom in North America to induce a
woman's labor twenty-four hours after her water
has broken; in many other countries, this is extended
to over a week. The key factor in both philosophies
is that induction must happen only if birth is
not imminent within twenty-four hours of the first
pelvic exam. But if no fingers are introducing
possible contaminants, the risk of infection is
minimal. So contrary to most popular birthing
belief, after the natural rupture of her amniotic
sac the worst place a woman can go is to the hospital:
there, she is guaranteed of a contaminating pelvic
exam upon admittance.
My second child came sixteen months later. My
water broke: again I rushed to the hospital. I
had irregular contractions and lots of pelvic
exams. I was missing my baby at home so badly;
I caught my reflection in a mirror. "I look
so tragic!", I said through my tears.
Nothing was happening; my husband went out for
a burger. An obstetrician with a team of students
came in; he pushed my hospital gown up and stuck
two fingers in my vagina. "Hmmm." He
had a student do the same; "vertex (head
down) and two centimeters dilated", she said.
The obstetrician disagreed; he gave my cervix
a REAL good feel and roughly twisted my uterus
around. "You have a breech here." I
wept! I had strangers casually touching my most
secret parts; my husband was gone; I was hungry.
The student asked if she could check me again,
in the "interest of science". I annoyed
everyone in the room with more weeping. The doctor
told me the baby was in a transverse lie (lying
sideways).
My husband was back now: I felt battered; spent;
hopeless. We were told my labor and birth would
be agonizing, dangerous and slow; but with a cesarean
section the baby would be in my arms in forty
minutes. What would you say?
I was wheeled to the operating room. I shakily
climbed on top of the table. My arms were strapped
away from my body; my feet were immobilized. My
body was shaved. Needles and tubes were inserted.
I said I felt like I was being crucified. A nurse
tried to reassure me- "but with this kind
of incision, you'll still be able to wear a bikini!"
Through the thick maze of moonsuited strangers
I saw my doctor- I noticed for the first time
how much eye makeup she wore. I heard a tableful
of pagers beeping. After four attempts at an epidural,
and lots of morphine, I was given spinal anesthetic.
The baby was delivered- I felt an overwhelmingly
bizarre extracting tug from my abdomen; I said,
"oomph!" The staff looked up in alarm.
The anesthetist smiled and said, "I always
like to leave a little sensation for the mothers
at birth." It's a boy! Relief and ecstasy
flooded my body.
He was taken away to be examined. I heard his
cries; I pestered the staff to hurry up so I could
hold him. The obstetrician blandly explained that
my bladder was sitting on my belly and had to
be reinserted. I would also have to have all my
layers of muscles and fat stitched together, and
then my belly would have to be stapled shut. Oh.
I was told to be a good girl.
Finally, it was done. In the recovery room I
breastfed my baby, to the astonishment of the
hospital personnel. At least I claimed that for
myself... I learned much later that my baby wasn't
a transverse lie at all, but a Frank breech, bottom
presenting first- the easiest kind to deliver
vaginally. I wasn't told the truth; I had a cesarean
section for nothing.
Frank breech babies are best born vaginally,
according to a study published in the American
Journal of Obstetrics and Gynecology. It was found
elsewhere that overweight women are more likely
to be cut: when I looked at my hospital records
years later, the obstetrician repeatedly mentioned
my "obesity": curvy women are not more
likely to have difficult births, but they are
more likely to be discriminated against.
I'm grateful, thought, that the surgical staff
didn't put me under general anesthetic- it can
be lethal to the bonding and breastfeeding of
brand-new babies, and make a mother feel even
more powerless.
After a sad miscarriage eight months later, I
was pregnant again. At six months pregnant I injured
my hand in a cooking mishap. I was whisked to
the hospital, and waited two days for microsurgery;
all the while fasting and on IV drip. While in
the OR my family practitioner phoned (I was aware
of this because I refused general anesthetic-
and yes, it took several attempts to find the
right kind of local anesthetic); my one-hour glucose
tolerance test was a bit high. I said to tell
her I would get tested for gestational diabetes
right away.
I was hungry when I got home the next day: I
ate a birthday cake and several large orders of
french fries with Coke. Early the next morning
I had the three-hour glucose tolerance test. Two
of the blood glucose levels of the three that
matter most were high- a positive test result
for gestational diabetes. What a week I was having!
In learned retrospect, the diagnosis was a sham:
I have to wonder why no one asked me about what
I had eaten the previous day, and why wouldn't
it matter about the fasting, the surgery, and
stress I had been under?
So the next few months were spent largely with
doctors- in the hand clinic for occupational therapy;
in the diabetes clinic at the hospital; seeing
my own family practitioner; seeing the cursed
obstetrician who gave me the c-section and also
the go-ahead for a VBAC (vaginal birth after cesarean).
In the last weeks of the pregnancy I had been
having my usual strong contractions. And since
I was worried about my "gestational diabetes"
having a harmful effect on my baby, I went to
the hospital- I thought I should be induced; my
body didn't work for birth anyway. I was sent
home.
Then at forty-two weeks, my contractions were
picking up, and I was having show (pink mucous
or light blood from the vagina). I went to the
hospital- I was two and a half centimeters dilated,
and a bit effaced. But I was distraught at the
thought of being sent home again! I implored the
nurses to do something to help me give birth.
I was positive I was defective, certain I would
have died with my previous births if I hadn't
been in the hospital. So my membranes were ruptured.
This birth, compared to the others, came quickly
and easily. My husband was stunned- he said- "is
that it?"
My fourth baby came twenty-six months later (no
"gestational diabetes" this time). I
was fanatically fit and extremely uncomfortable
in this pregnancy- fit and uncomfortable because
I exercised like mad, even at the end, out of
fear of developing diabetes.
At forty weeks I had light contractions and a
touch of show; I phoned the hospital. On a nurse's
advice we rushed in, and my body stopped working.
I hated my body, called it stupid and useless.
They broke my water at one-half centimeter dilation.
(Segue- isn't it funny how women who have hospital
births say "they" when referring to
those who attend and badger them in labor and
delivery? Women who have homebirths say "me",
and "I".)
Still nothing much happened; just a lot of niggly,
irritating spasm-like contractions. I remember
trying to find a quiet place to "nest".
I had two obstetric nurses and a doctor (a stand-in
for my doctor, who was on a ski trip) literally
sitting and waiting for my every sensation. A
student, too: she had short fingers, and was having
difficulty finding my cervix in pelvic exams.
I placed my fists under my hips so her fingers
could reach inside my vagina more efficiently.
What a good helper! No wonder I wanted to retreat,
to get away!
Every now and then I would cry. The staff were
concerned; I said not to worry, because it seemed
to be a hormonal thing- it happened at every birth.
My uterus was palpated, and I was assessed to
have a baby in posterior presentation- "facing
pubes" (babies are normally born facing the
mother's spine). The pain soon became ferociously
intense: hysterically agonizing contractions as
I kneeled on the shower floor with a man-midwife
(male obstetric nurse) hosing my lower back with
a tepid shower nozzle. My husband held my hand.
I screamed that the baby was coming. I made it
to the bed and flopped onto my back and shrieked
him out. I vowed never to have another child.
I recently learned that my baby most likely went
into that position because my membranes were ruptured
prematurely. The most agonizing of all my births
did not have to be that way at all.
I relocated during the pregnancy of my fifth
child, a year later. I got a new doctor. Again,
no gestational diabetes. I passed the forty week
"best before date" and was advised of
a new policy that women must be induced at ten
days past their expected delivery date. I questioned
the validity of this; my doctor told me of worries
of placental insufficiency, of placental calcification-
worries that my baby would be deprived of oxygen
and nutrients. This sounded reasonable to me.
(Though not reasonable to a study published years
later that found that routine inductions at 41
weeks will increase labor complications and operative
deliveries, but will not improve infant outcomes.)
Nine days went past my due date without any excessive
uterine activity. I went to the hospital, was
monitored for an hour then had Prostin (prostaglandin
gel) smeared on my cervix. I was monitored for
an hour more. I was released, but told to come
back either in six hours or in actual labor. So
my husband and I walked around, trying to get
my labor going. I started feeling strange, shooting
pains in my cervix and down the backs of my legs.
I suggested we find a place to have illicit sex,
because the sensations I felt from the gel, it
occurred to me, were identical to those I feel
after having sex in late pregnancy.
I learned much later that the idea for the gel
itself- which is reported to have a base of pig
semen- actually came from human sperm, which is
rich in the cervix-dilating, prostaglandin hormone.
Human sperm, though, is a better way of inducing
labor, because it can be compounded with natural
oxytocin. Loving and orgasmic sensations- hopefully
intrinsic in the lovemaking process- are known
to stimulate the secretion of oxytocin in a woman's
brain (and interestingly, in a man's), and oxytocin
is an integral hormone for birth. Nipple stimulation
releases it in abundance as well.
My husband passed on the quickie; it seemed that
he felt my vagina had somehow become the hospital's
property, now that it had been meddled with. We
went back to the hospital. Thinking of my fourth
child's birth, I was terrified of what was to
come.
I was confined to a fetal monitor. A strange,
haggard looking man (the staff obstetrician) examined
me, and found that my afternoon's progress amounted
to two centimeters dilation. Oh. I commented on
how tired he looked- he told me that he had been
working for the past three days. Did he sleep?-
I asked. Yes, sometimes, he said; there's a cot
in the doctor's lounge. We must speed things along,
he said, to "get this nasty business over
with".
He ruptured my membranes, and instructed me to
semi-sit for an hour, so the umbilical cord wouldn't
prolapse. Cord prolapse, often fatal for the baby,
happens when the cord drops below the baby's head
and comes out first. Artificially rupturing the
membranes is known to be a cause of this! My babies
had always been at risk, and no one even told
me how. Where was my "informed consent"?
I played some cribbage with my husband. I felt
myself drifting into a strange land I had never
been in; my terror was replaced with a wonderful
calm. I felt peaceful and introspective; sleepy
and restful with every birth sensation. The nurse-midwife
attending me was amazed. But my progress was slow
for a fifth child- it took twelve hours from my
first prostaglandin smearing until I was moved
at six centimeters dilation to the delivery room.
The table- not even a bed anymore- was my birthing
enemy. My lovely contracting became cramped and
sore. I instinctively pushed the nurse-midwife's
hands to my breasts, to stimulate the release
of oxytocin; she rigidly pulled her hands away.
After a while, my baby was born. The doctor tugged
painfully, inexplicably, on the umbilical cord.
A new nurse took over within a few minutes of
the birth. This was her last day of work, ever,
as an obstetric nurse: thirty-eight years of this
place, of countless episiotomies and shavings,
of love and death and birth and the whole damned
thing. She wanted to tell me about herself and
her husband and how the times are a'changing,
as I tried to breastfeed my brand-new baby. I
listened politely. My husband went out for a smoke
and some phone calls. The nurse reluctantly left
when I shooed her out of the room.
Then I was finally alone with my baby. There
we were, alone and entranced, hospital-tagged
and naked, when I heard the screams of the woman
giving birth in the room beside me. I said aloud,
"get me out of this chamber of horrors".
We went upstairs, and got settled into a semiprivate
room. I tried to breastfeed and sleep, but the
woman next to me had difficulty in caring for
her baby- they were both crying. I heard phones
ringing. I was hungry; I had to get my own toast
from a kitchenette on the other side of the ward.
I took my baby everywhere; I wouldn't let "them"
touch him to bathe him or weigh him or pester
him. I insisted on doing everything myself. There
were people everywhere, in my room, in the halls,
in the nursery; everyone saw my leaking breasts
hanging out, my matted hair, my tears. I crept
to the day lounge with my baby swaddled in hospital
towels. I sat with him and mourned, how I cried
over all that was lost! I wept and shook. A nurse
came in. "You should be in your room!"
I said, "I need privacy! I have to come here
to cry!" I pulled my baby under my chin.
A year and a half later, when I summoned my hospital
records through the Freedom of Information Act
(please, everyone, do this!), I saw that this
nurse wrote that I was handling my baby roughly.
(I was holding him tightly to me as I wept and
shook.) I would never hurt my babies! I was being
watched, scrutinized. Another nurse accused me
of bruising my baby when she saw a birthmark on
his leg. These cold, semi-sterile strangers believed
me to be a child abuser! Even the most kindly-faced
nurse was watching every move, every whimper,
like a malevolent hawk. I left shortly thereafter.
A few days later, at home, this thought went
through my head- a swirling black flicker of sentience
that translated into the following sentence- hospital
birth is the rape of the twentieth century.
Women are systematically, routinely, and willingly
assaulted every day by individuals and institutions
who claim to have their best interests at heart,
and most women have no concept of what is lost.
Yes, it is rape: just as a man forcing sexual
intercourse on a woman strips her of her powers,
and wounds her in sacred places, so does birth
rape. Women are left shaking, enraged and filled
with sorrow after both rapes, because the rape
is the same. And just as it would matter if our
children were conceived through rape, it matters
if they are born through rape. And in both rapes
we bleed.
~~~~
Women are made to bleed, often uncontrollably,
in hospital births. They bleed because of the
standard shot of oxytocin in the leg after birth:
a woman's natural oxytocin-making mechanisms (which
contract the uterus to its previous size) shut
down when a huge dose of the synthetic hormone
is in her bloodstream. And when the artificial
stuff wears off, a woman will suddenly feel faint
and collapse in a pool of her own blood. (The
uterus has stopped contracting, and the placental
site is nearly as large and raw as it was after
birth. Artificial hormones used to induce labor
cause excessive bleeding, too.) Hemorrhage also
happens when "fundus fiddling" is involved:
impatient birth attendants will externally manipulate
a woman's uterus to expel the placenta, and will
even tug on the cord. This is agonizing, as well
as bloody.
A bigger cause of bleeding is episiotomy. Most
blood loss in a typical birth will actually come
from an episiotomy wound; so much so that a woman
can even become anemic. Episiotomy is a foul,
malevolent invention- created out of the incredible
logic of trying to prevent a perineal injury by
inflicting one. When vaginas are cut open, women
suffer: episiotomies can rip through a woman's
perineal tissues, causing extensive tearing; they
hurt intensely- doctors will often not even wait
for the local anesthetic to kick in before cutting
(or even bother administering one); women will
cry when they pee for a month. Scar tissue can
make sex painful or difficult, often for a woman's
lifetime; and sexual sensation can be diminished
because episiotomy permanently severs the nerves
that flow far into the perineum from the clitoris.
The wound often becomes painfully infected- in
which case the sutures need to be removed to drain
the wound, and the perineum needs to be painfully
restitched. Deathly gangrenous infections- necrotizing
fasciitis and clostridial myonecrosis- are caused
by episiotomy. Cancer, endometriosis, and brain
abscesses are known to be seeded from the episiotomy
site, too.
Episiotomies permanently weaken the pelvic floor
muscles and can cause hidden injuries to the anal
sphincter. This is the reason that 6% of women
have anal and fecal incontinence after childbirth.
And sometimes after severe tearing, a rectovaginal
fistula (a gap in the wall between the rectum
and the vagina) will develop- and women will pass
feces through their vaginas. These women are left
feeling abused, mutilated, dirty- and are often
told to consult a psychiatrist. They will need
more surgery to repair the initial injury, and
future babies will have to be delivered by cesarean
section.
Babies can get cut in episiotomies too. There
have been reports of eyelid lacerations, and even
castration in breech-borne babies. Episiotomies
cause the need for hazardous and painful suctioning:
when a woman's vagina has been cut open, it cannot
tightly squeeze the baby's shoulders as they pass
through the birth canal. Nature has her own way
of "suctioning"- the pressure of the
walls of an uncut vagina squeezes the baby's shoulders
and chest, making fluids burp out of the baby's
nose and mouth, easily and naturally.
Natural tears are easier on the body- they heal
far more quickly, and are less painful than razor-sharp,
deep scissor cuts. Despite this- and the fact
that there is no scientific support, whatsoever,
in favor of routine episiotomy- over 60% of hospital-birthing
women will still get one. Many doctors (and even
nurse-midwives) are loathe to give up the old
ways, and resist eradicating this most unfair
cut.
Forceps, created through the unbelievable reasoning
that babies' heads will be protected from birth
by clamping metal tongs, are often used in conjunction
with episiotomy. Forceps (and to a lesser degree
vacuum extractors) cause rectal injuries, and
anal difficulties- such as chronic, painful hemorrhoids:
the veins inside pregnant women's rectums are
naturally very thin. And when artificial extraction
equipment is used- especially in association with
coerced, forced "purple pushing" births-
these delicate veins become engorged, distended,
weakened and bruised. Any existing hemorrhoids
become fiercely painful, and often manifest themselves
into lifetimes of drugstore analgesics and sitting
on rubber rings at movie theaters.
Use of forceps can permanently disfigure women's
genitals, and cause bladder injuries- sometimes
women's bladders are so badly bruised that lifelong
urinary stress incontinence problems result. For
babies, forceps use can cause cerebral and Bell's
palsies, cephalhematomas (pools of blood forming
under the scalp), skull fractures, and great pain-
and painful birth brings an increased risk of
violent suicide later in life.
In 1920, the article "The Prophylactic Forceps
Operation" by Joseph B. DeLee became the
touchstone for physician-managed vaginal deliveries.
It detailed DeLee's ideal birth: first cutting
a large episiotomy on an etherized, unconscious,
bound woman, then pulling her baby out with forceps.
Then manually removing the placenta, and giving
large doses of ergot to curtail postpartum hemorrhage.
Then pulling the cervix down with forceps to examine
it, and stitch up any tears. Then carefully reconstructing
the vagina to restore "virginal conditions".
Scopolamine and morphine are given in the birth,
and then for the lengthy post-delivery work to
"prolong narcosis for many hours postpartum
and to abolish the memory of labor." This
one man's torturous birth ideal became the standard
for women's births for the bulk of the twentieth
century. Incredibly, there is a prestigious award
given in his name… the "DeLee Humanitarian
Award". It is awarded to doctors who have
made outstanding contributions to the health of
women and infants.
Epidural anesthetic has replaced scopolamine
as the birth drug of "choice"- in some
centers over 90% of birthing women will have an
epidural- and it can lead to terrible consequences
(none of which women are routinely told about
when they ask- "is it safe?"). 70% of
women will experience side effects- such as low
blood pressure, fecal and urinary incontinence,
paralysis of the lower extremities, allergic reactions,
respiratory depression, headache, vomiting, and
seizures. 20% will develop fever for which the
baby will need to be treated too. 15-35% will
have to be catheterized because they can't pee.
30-40% will have severe backache for hours or
days after birth, and 20% will have severe backache
one year later.
Epidurals cause one in ten babies to be born
"blue" (severe fetal hypoxia- lack of
oxygen; induction drugs cause it too). The Caine-derivative
anesthetics used in epidurals rapidly cross the
placenta and can harm both a baby's central nervous
system and cardiac function. Epidural drugs- especially
when given with a cocktail of other drugs- cause
jaundice, as newborns try to metabolize the powerful
drugs with their immature livers. Epidurals lead
to a decrease in muscle tone and strength in the
newborn, affecting the baby's ability to breastfeed
properly. And since dose is calibrated to maternal
weight, babies can easily get an overdose (a baby
is about one-twentieth the size of the mother).
Babies receiving epidural drugs, as well as any
other kind of painkilling drug in their births,
are more likely to be addicted to drugs later
in life- and have learning disabilities and violent
behavior. Epidurals make women four times more
likely to have forceps or vacuum extractor deliveries,
and twice as likely to get cesarean sections.
Cesarean sections are done for many reasons,
mostly relating to impatience in the hospital
staff. "Failure to progress" being the
most common and infuriating reason: this is when
a woman's cervix is not dilating according to
the hospital's preset idea of how a labor should
unfold, and she is literally stood over and told
to dilate. She is threatened with surgery if she
doesn't. Of course her body won't open for birth
in such a dangerous and stressful scenario; and
if the baby can't be blasted out by artificial
oxytocin or dragged out by forceps, it will be
cut out by an obstetrician.
A c-section may also performed due to the observance
of normal fluctuations of a baby's heart rate
(as noted on a fetal monitor, often the first
intervention in the classic cascade of interventions);
these fluctuations may sometimes lead medical
personnel to erroneously believe that the baby
is in "distress", and needs to be removed
immediately. Activities like thumb-sucking, sleeping
and even maternal thirst will cause dramatic differences
in fetal heart rates. (Though sometimes the baby
will be put in genuine distress through drugs
or hormones given to the mother.)
Cephalopelvic disproportion is another common
excuse for a cesarean section: it is often claimed
that many women's pelvic outlets are too small
for babies to pass through. This is nonsense!
If so many women had such useless pelvises for
birthing, their ancestors would not have survived-
and the only women alive today would have enormously
wide pelvises! Modern women's bodies aren't broken-
they know how to give birth, if only left alone;
women who are said to be incapable of birthing
without modern obstetrics are very likely to be
supremely able to give birth without intervention-
as long as they are nowhere near the institution
that is so quick to intervene.
In most hospitals, one in five women will have
a cesarean section; in some centers the number
is as high as one in three. This statistic should
not be any higher than three in one hundred! And
the cruelty of cesarean section must not be diminished
because of its frequency: women should be focusing
on babies, love and breastfeeding in the first
weeks after birth; not staples, catheters and
weeping incisions!
After my section (as in cross-section;
vivisection) I understood misery: trying to care
for my new baby while recovering from major abdominal
surgery on a hard hospital bed was the most heartbreaking
thing in my life. Every move was agony; gas pains
ripped sickly through my savaged abdomen; my catheter
hurt me when it was inside my urethra, and left
sharp pains when it was out. I could barely move
to change my baby's diaper, and the hospital staff
were too busy to help me care for my baby. The
tape that held the IV tube in my arm constantly
had to be repositioned, and each time it ripped
at my skin and hair.
I wasn't allowed to eat: first the liquids on
Day One after surgery, then the gruel on Day Two,
then the mash on Day Three was not the sustenance
I needed to fuel my breasts for milk-making, nor
to feed my healing, ravaged body. I was a patient,
a sickly invalid, a twenty-one year-old woman
who had to pee in a bag, and hold her belly together
before rolling over in bed. I was helpless to
care for my new baby, and I will always remember
his first days of life as grotesquely uncomfortable,
and full of sorrow. I couldn't even get up to
brush my teeth.
And why are the significant risks of cesarean
section not discussed? I didn't even know of the
danger I was in. Women are up to sixteen times
more likely to die after a cesarean delivery than
a vaginal birth. Cesareans cause hemorrhage; women
during cesareans are ten times more likely to
lose their uteruses because of unstoppable bleeding,
and hemorrhage is actually the leading cause of
all maternal deaths. Cesarean sections cause ileus
(intestinal paralysis associated with abdominal
injury), intestinal obstructions and adhesions,
pulmonary embolism, and Mendelson's syndrome (acid
pulmonary aspiration). There is a 20% chance of
a dangerous infection developing after the birth-
a big problem with the proliferation of antibiotic-resistant
hospital microbes.
After a cesarean, women suffer more from postpartum
depression. And birth trauma, a much misunderstood
condition that most doctors haven't even heard
of, which stems directly from feelings of powerlessness
and worthlessness that come from violent hospital
births.
Women can develop lifelong urinary stress incontinence
when the bladder is peeled away from the uterus,
and bladder and uterus injuries happen, as well
accidental injuries to other organs, tissues and
vessels. Cesareans cause respiratory distress
syndrome in newborns- a leading killer of babies,
and between 2-6% of babies will be accidentally
cut by the scalpel.
After cesareans, women are more likely to develop
ectopic pregnancies (if they even manage to get
pregnant at all); and future babies are at risk
of poor outcomes. Women are also more likely to
grow placentas that either block their vaginal
outlets (placenta previa), or detach themselves
while a woman is still in her pregnancy (abruptio
placentae)- and both conditions can kill the mother
and baby.
Future births will be considered high risk because
of the slight chance of the cesarean scar rupturing,
and a ruptured uterus can cause death for the
baby and a lost uterus for the mother. VBAC women
being administered induction drugs are at particular
risk of uterine rupture, especially with the drugs
Prostin (I was blissfully unaware of the danger
I was in during the birth of my fifth), and Cytotec-
an ulcer drug not even approved for obstetrical
use by the FDA or its manufacturer: it makes women
up to 28 times more likely to have their uteruses
rupture in childbirth (despite this, its use has
spread like wildfire in the medical and nurse-midwifery
communities). The pain of cesareans just goes
on and on.
In a cesarean section, a private, secret, and
sensual event becomes a sterile crucifixion in
a room full of slicing, staring strangers. And
the ultimate rape is that we are told we need
to be cut. The sanctity and power of birth becomes
a meek "yes, doctor" and we become spectators
to our own violation; we even thank the doctors
as they scurry on their way out of the operating
room.
In the hospital, an overwhelming, poisonous complacency
overtakes us as we are stripped of our privacy,
our dignity, and even our clothing. We hold our
doctors in a position of utmost trust; we believe
in their good intentions, and their upholding
of the Hippocratic Oath (do no harm). But they
do do harm- they do harm every day. And
they are given societal sanction to do as they
please with us.
This reminds me of children being abused by trusted
people in positions of power: the abuse, committed
selfishly and without regard for the children's
future, is insidious and generational, and the
children always believe they deserve what happens
to them. The abuse of women's bodies in birth
is committed for the selfish convenience of medicine,
with little regard for women's immediate and future
health. Generations of women have been told their
abuse is necessary, that bloody birth is universal,
and unavoidable- due to the frail malfunctioning
of their own bodies. Women and children are told
to put up, and shut up. This is no longer tolerable.
Just as abusive authority figures are being increasingly
held accountable for the suffering of children,
exploitive medical practitioners must be held
accountable for every stitch, every stab, every
scalpel slice that is inflicted on women's bodies-
even decades after the cut.
The underlying motive for every hospital birth
is the safety of the baby (as if the hospital
environment is salve to new life). A woman is
told that her healthy baby is all that matters,
that the end justifies the means- if she's sliced
and diced in birth, then so be it; that the baby
in her arms at the end is all that matters.
But a woman matters. Her vagina matters, her
belly matters, her intact veins and perineum matters,
feces emerging from her vagina matters, her self-esteem
matters, her love of birth matters, she
matters! Not allowing a woman a powerful birth
is like never letting her achieve orgasm; sort
of like saying "orgasms don't matter, dear,
as long as you conceive!"
I call the whole ritual of sacrificing the integrity,
power, and sexuality of birth "puerperal
infibulation". Just as women in some cultures
have their clitorises clipped and their vulvas
shaved of flesh and sewn shut (infibulation),
women in our culture quite often have their vaginas,
perinea, and bellies cut open by doctors, then
have their bodies sutured or stapled shut after
it all. In both cases, women are either held tightly
or strapped down to restrain them when the knives
or scissors come out- and have little say regarding
the outcome of the knife.
Interestingly, the underlying purposes are the
same: to rigidly control female sexuality (yes,
childbirth is an inherently sexual event), and
to protect children as they are being born. Many
cultures practicing routine female genital mutilation
(FGM) are insistent in their belief that in birth,
if an infant touches its mother's sexual tissues,
it may well die (hence the removal of external
genitalia). On average, one out of four North
American women are told that unless their babies
are delivered by cesarean section, their babies
may well die (and of course, babies don't even
come close to their mothers' vaginal tissues).
Or unless our vaginas are cut open, our babies
may be injured in the tight passage of birth.
("Crushed against a tight pelvic floor",
as Joseph B. DeLee said.) Vaginas are very threatening
things to some people!
Westerners hearing of FGM are adamant in believing
in the sinister backwardness of practicing cultures.
But how can we call the former culture barbaric
when our own actions are so monstrous? Whether
a woman has her vagina cut open in an isolated
hut or in a world class teaching hospital is irrelevant:
she's still having her vagina cut open, her suffering
is still severe, and will inevitably endure.
Another reason women's vaginas are mutilated
is to ensure a tight fit for their male partners.
In some societies, models are made of betrothed
men's penises- these models are inserted into
the vaginas of the brides-to-be; then the women's
vaginas are cut and sewn to fit the models' dimensions.
In our society, I hear of doctors who tell women
before their cesarean sections- "Your husband
will thank me"; or asking the fathers, before
episiotomy stitch-ups: "Do you want me to
put a couple of extra stitches in for you?"
Yes, this is happening now- not twenty years ago.
Puerperal infibulation is as deeply rooted in
our culture as FGM is in the cultures that practice
it. Here, women are myopically coerced into giving
their birthing bodies to intervention-eager practitioners;
there, women are vehemently encouraged to have
themselves made surgically chaste. And we are
both made to believe in the purposefulness of
such mutilation, compelled to succumb to the sublime
wisdom of those who profess to be more learned,
more wise, more virtuous in mind and in practice
than the simple women we appear to be- we are
taught to trust in the righteousness of authority,
and to disdain our most basic urges to flee.
And overwhelmingly, resistance is futile- because
sadly, in both cultures, our own mothers and grandmothers-
the ones who claim to love us most- usher us the
most eagerly into the hands of the practitioners
waiting to perform the cruelest cuts; mother-cutting
is generational, and insidious. The elder generation
can rarely see the pointlessness of this painful
cycle- their own suffering seemingly will not
go unfelt by the younger generations.
And birthing bloodshed isn't about to end- Western
women are reluctant to give up their beloved doctors,
and their worship at the altar of Modern Medicine.
Exasperatingly, I have found that most women don't
even come close to believing me when I tell them
they don't need to go to the hospital to give
birth; they especially refuse to believe that
childbirth is trustworthy, and doesn't need gloved
fingers, neurotic monitoring nor surgical scissors
to perform its inevitable, evolutionary task.
There is a fantasy bond that develops between
those involved in the high drama of Western medical
birth deliverance. The anxiety created in the
birth process is relieved by the emergence of
a live baby and the ultimate survival of the mother.
The stressed family believes that they were saved,
and they love their violators- returning time
and again to the scene of violence unless they
wake up, and begin to question the whole structure.
Puerperally infibulated women strive to find
reason in their pain, a utilitarian purpose for
every poke, every cut, and every scalpel slice.
We need to believe in the righteousness of what's
done to us- the sadness and horror of it all would
be too much too bear, otherwise. Perhaps some
women's worship of doctors is stemmed in a history
of dysfunctional "enabling" relationships-
it seems that the women who are the most abused
at their doctors' hands are the ones who are the
most unlikely to move away from their doctors'
control (I know I was- I was always desperate
to be a good girl, to please my doctors; I was
always effusive in my forgiving of their errors).
Disabling birth responses are based in our collective
cultural birth hysteria, and women's fear and
distrust of birth are so ingrained that someone
who speaks of birth as an intimate, sensual event
is likely to be feared and reviled.
But telling a puerperally infibulated woman about
the beauty of birth must be like telling a woman
with her clitoris snipped off that sex can be
erotic and orgasmic. They will both think you
don't know what you are talking about. But I have
had my clitoris reattached, so to speak, and I
must tell the world about what is lost.
It is only logical that childbirth should take
place where a women feels most secure and comfortable-
in her own home. Homebirth is safe: the countries
with the highest incidence of midwife-attended
homebirths have the lowest infant mortality rates,
and women have much better overall outcomes. In
a homebirth, interventions are taken very seriously,
and are considered and reconsidered before resorting
to (at hospitals, the very ease with which interventions
occur lead to their phenomenal commonplaceness).
Homebirth would only be dangerous if the common
obstetric interventions were brought from hospital
to home.
Home waterbirth in particular encourages excellent
outcomes. Immersion in a birthing pool soothes
away fear and discomfort; mothers need no artificial
pain relief; labors are quicker and easier; big
babies come more easily, and, due to how relaxed
and supple perineal tissues remain, women rarely
tear. Women can easily move their bodies for the
smooth passage of their babies, and find optimal
birthing positions without the cumbersome effects
of gravity, as "on land". Women with
knee or back problem can find comfortable birthing
positions more comfortably.
And after giving birth in their own homes, in
water or on a firm surface, women have joyful
memories of their births and recover quickly.
So why don't more women have homebirths, when
the cost and trauma involved are so minimal? Whose
interests are served by the women's enforced ignorance,
and the ritualized invasion of childbirth? Not
any mother's, nor any baby's.
If women and children are to thrive, they must
be left alone in the genuinely trustworthy passage
of birth. And choosing to stay home, far away
from the equipment and practitioners that so easily
and routinely foul birth, is the best way to ensure
a healthy outcome.
So why are we mostly told to give birth in hospitals?
There is a deep cultural fear of natural processes,
especially of women's sexuality; and our medical
establishment is a reflection of our society.
It is "safer" to medicalize birth than
it is to understand the true power of women, and
the trustworthy functioning of female bodies.
As long as we think rape only involves sexual
intercourse, sensual can only mean erotic, and
bottlefeeding is a healthy alternative to breastfeeding,
we are not realizing the magnificence of our own
existence: orgasmic lovemaking, being pregnant,
giving birth, breastfeeding, and feeling goofy
baby love all come from the same hormones; are
all the same sensual swoon. And all must be left
alone: we need privacy and dignity to explore
our most secret and loving places.
Of course, there are exceptions to homebirth.
Certain women have health conditions that may
need advanced obstetrical care, and these women
should never be condemned for not being able to
give birth without intervention. Each obstetrical
intervention benefits a small number of women.
But when interventions are applied to women as
a rule, the risk/benefit ratio reverses, and more
harm is caused than good.
~~~~
Thirteen months after my fifth child was born,
I was pregnant again. I did not want another hospital
birth.
I began searching for a better way to give birth.
I read the helpful and powerful "Homebirth",
by Sheila Kitzinger. I contacted various midwives
registered with the College of Midwives of British
Columbia, but understood that they would medicalize
my pregnancy too much; would give me too many
tests and interfere unnecessarily with my birth.
I heard of midwife Gloria Lemay through friends.
I spoke to her of my experiences on the phone.
I asked her how many babies she delivered- "Oh,
I don't deliver babies, the Moms do that! I've
attended over six hundred births, though."
I asked her if she would touch my breasts for
me if I needed that done in my birthing time.
"I'd stand on my head naked in Mundy Park
if it would help you get your baby out."
We talked for hours. My husband and I went to
meet her; she would attend my birth.
I got enormous amounts of hostility and concern
from my extended family regarding my choice, and
after hearing their experiences with forceps,
rectal exams and stirrups, I understood their
paralyzing fears. I summoned all of my medical
records, and found the many inconsistencies, half-truths
and outright lies that had occurred in my colorful
obstetric history.
Forty weeks came quickly. My due date! Four liters
of Labor Aide waited for me in the fridge, my
mattress was covered in a painter's drop sheet-
I was ready. But nothing was happening! The old
dread came back. My body's busted! I can't give
birth without intervention!
As the days crawled by uneventfully, I would
call Gloria, crying. "I'm not like other
women! I can't give birth by myself!" And
she would say, "Of course you can, and of
course you will. Your body will give birth whether
you believe it or not. Your body knew how to conceive
your babies, it knew how to breastfeed your babies,
and it knows how to give birth to your babies."
"You trust my body?" "Yes, I trust
your body. Your birth will be beautiful."
For a little while, I would believe her. She would
give me these pep talks as I would need them.
At forty-two weeks my mother became very concerned;
I myself was born almost a month late: my mother
attributed my eye troubles as a child to her lengthy
pregnancy with me. I called Gloria. "My baby
will be born half-dead and blind!" "No!
You're baby's fine!"
He was very active, and had a consistently strong
heartbeat. I was healthy- my blood pressure was
fantastic, and my diet was great. She said, "I
can't think of any environment healthier for your
baby than inside your uterus." Yet I knew
that I would have been induced with almost any
other midwife, and certainly with any doctor.
Sometimes I had deep doubts about what I was doing-
I knew that almost no one would agree with our
waiting it out.
But I learned that forty weeks is just an average
length of gestation- different women will give
birth at different lengths of pregnancy, in the
same way that every birth and every person is
unique. We are born, learn to crawl, walk and
talk at our own special pace; we can only learn
and grow according to our own unique developmental
schedule. No one has the right to intrude with
preset notions of how a birth or life should unfold.
I grew afraid of my impending birth. I was afraid
of the pain. I read a book written by another
woman whose sixth child's pregnancy also went
beyond forty weeks (Chris Griscom's "Ocean
Born- Birth as Initiation"). She said, "Don't
be afraid! Birth is yours to give! Claim
it for yourself!" I would repeat this
to myself in times of fear.
Forty-three weeks of pregnancy went by; I started
a debate about midwifery in a local newspaper.
It kept my mind occupied. I learned how to check
my own cervix; I was more than three centimeters
dilated already, really soft and beautifully open-
thanks to my lovely, ongoing prodromal labor.
I passed my mucus plug; Gloria said she had never
seen a woman lose it and go more than four days
without giving birth.
One week later: stumbling sad in the snow, feeling
as though my pregnancy was a straightjacket I
couldn't get out of. Why hadn't I given birth
yet? There was no confusion about my dates; I
had done a home pregnancy test two days after
I expected my last period. This was a time of
intense fear for me; I was terrified by all the
medical documentation that said my baby would
be unhealthy, that my placenta was dying. How
could I trust in this one woman when so many others
would have had me induced almost three weeks ago?
Then one night, at forty-four weeks pregnant,
I woke up to pee. As I sat down, I felt a little
pop!- my water had broken! I called Gloria.
We quietly chatted, and she was on her way. My
children were nearby; I touched their hair as
they slept. I prepared a warm bath for myself.
I caught my reflection in the mirror- I was radiant,
joyful, beautiful.
My birthing sensations felt like squeezing hugs
across my belly. Bill helped me out of the tub,
then put some African music on. We kissed and
danced. For the first time ever, I was joyful
in birth, and left alone- no needles, knives,
fingers, hooks, scissors, staples, drugs, tubes,
synthetic hormones, medical students, nonsense.
And no crying! The tears I had always had in
labors before were not hormonal, but environmental...
My body worked beautifully: each birth sensation
was elegant, and forceful. After three hours,
the time had come. I kneeled on our couch, and
panted, sighed and screamed my baby out. He was
ten and a half pounds and adorable! My husband
caught him in his big, warm hands, and I laid
back to receive him onto my body. I have never
felt such bliss.
Every woman deserves such bliss! Interfering
with this bliss must be recognized as the criminal
act that it is! Blissful birth is the birthright
of every woman; a gift from her body to her soul!
My placenta was perfect. An induction would have
been brutally unnecessary. I buried my placenta
on day four. I never knew how much my placentas
mattered to me; some cultures say they are the
bodies of children's guardian angels. I still
cry for all that has been lost.
We are living in strange and savage times. This
century will be remembered as one of war and genocide;
and violent, coercive childbirth. Birth is weeping,
and bleeding. We are made to believe we must give
birth in sometimes hostile and mostly indifferent
hospitals, where interference with a woman's natural
birthing rhythms is the norm. Our vaginas can
be stared at and cut by strangers, and abnormal
emotional and physical behaviors- such as excessive
fear, crying, and stress-induced stoppage of labor-
have become normal and expected. Babies are routinely
harmed; and the perpetrators are exalted as life
savers, instead of reviled as child abusers. A
birth without unnecessary intervention is now
unusual, even though we all have the potential
to birth beautifully- if only left alone.
One hundred years ago, hospital birth was considered
to be the radical and dangerous alternative to
a midwife-assisted homebirth. Women avoided doctors
and hospitals for many reasons: they didn't want
to be experimented on (and many still are- especially
poor, minority, very young, and/or non English-speaking
women); highly contagious puerperal fever was
a deadly reality; disease ran rampant (and still
does); the of idea having men (almost all doctors
were male) in the "lying-in chamber"
seemed dangerously immodest. Hospitals and doctors
were expensive. But quite quickly, doctors became
the accepted providers of maternity care; and
after a century long, worldwide smear campaign
by the medical establishment, midwives and their
wisdom have almost become extinct.
But women are becoming unwilling to be pawns
that are moved, positioned and sacrificed by the
medical "profession". We are increasingly,
and passionately, healing birth for ourselves;
and women who have borne many children can be
instrumental in helping other women understand
the mysteries and myriad variances of pregnancy
and childbirth.
Hospital birth must once again be considered
the radical alternative to a planned homebirth.
If women still insist on having hospital births,
they must consider having experienced labor support
people, such as strong doulas, with them at all
times- to vociferously and passionately "guard
the normal". Homebirth is the obvious way
to avoid unnecessary interventions altogether.
Midwives have the potential to be our greatest
allies in this; but they, too, must resist the
temptation to try to "hurry things along",
or interfere unnecessarily.
Most importantly, women must remember that childbirth
is sacred- it is the most primal and hormonal
event of our lives. And it is the most beautiful-
it is when we meet our babyloves for the first
time.
But we cannot expect others to respect and love
our births and our bodies when we do not ourselves
believe them to be sacred. I find it most heartbreaking
that women still need to be convinced that being
cut and stabbed at in birth is an inherently bad
thing.
Please, women. Claim birth for yourselves. It
belongs to you.
Medical References
for Rape of the Twentieth Century
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