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    Find out what other moms-to-be are asking. Join in the discussion with Henci Goer, whose expertise is determining what the research tells us best promotes safe, healthy birth. If you would like to contact Henci outside of the Ask Henci forum, send an email to Goersitemail@aol.com.

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    Feb 01
    2007

    trying to help spouse understand natural childbirth

    Archived User
    Hello Ms. Goer,
    My name is Natalie Bojesen and I have read your book "The Thinking Woman's Guide..." and done plenty of other research on my own.  I actually saw you speak at Oakland University a couple years ago.  I find myself pregnant and hoping to have a natural childbirth with a CNM.  The problem is I have epilepsy and my husband has been inculcated to the medical model as his Uncle was an OB.
    -- He seems to think I read only biased material though I showed him the extensive research you obviously did for your book.  I wanted to know what a good resource would be for him as there are so many to choose from in the literature summaries and appendices.  What would seem the most objective and unbiased to someone who sincerely asked me "Well, what's wrong with a C-Section anyway?"  Everytime we discuss it, I get emotional and thus not a very good presenter of facts.  If you could help me with this I would be most appreciative.  I just want to say, also, that I really enjoy your down to earth writing style and find it easy to understand (if my husband would just read it, I'm sure he'd appreciate it as well).
    Thank you so much for your time and consideration,

    My other main issue is the epilepsy and the fact that already I've been labeled "high-risk".  If I get a high risk perinatologist (I think that's the term) to release me from that label, will a midwife assume my care?  I have great fear that I won't be able to do this the way I feel is right for me and my baby.  If anyone else has epilepsy, let me know how things went.
    thanks
    Henci Goer

    Let’s start with the question “Why not a cesarean?” The short answer is that a cesarean is major surgery with all that entails in terms of pain, recovery, and risk. What is more, cesareans are the gift that keeps on giving. The uterine scar and the high probability of dense adhesions pose threats for the rest of a woman’s reproductive life. For the long answer you cannot do better than the www.childbirthconnection.org website. Go to http://childbirthconnection.org/article.asp?ClickedLink=274&ck=10168&area=27.

     

    In some situations, of course, the potential benefits of cesarean surgery outweigh the risks, but they are not common. For the vast majority of women, the safest and best birth is a birth that unfolds at its own pace in its own way with as little medical intervention as possible. If you think about this logically, you will see why this must be so:  Every medical intervention has potential harms as well as benefits. If you apply them to a woman who either isn’t having a problem on a “just in case” basis or you use them where having patience or where no-risk remedies such as getting her up and moving would do the trick, then you expose her to the risks with no counterbalancing benefit.

     

    Childbirth Connection is also good for sound, research-based information in general on childbirth. This website, the Lamaze Normal Birth website, also has good information on what care practices best promote normal birth derived from World Health Organization recommendations. My book, The Thinking Woman’s Guide to a Better Birth, is useful for skeptical men because it lays out the research that supports what I say in a set of appendices matched to each chapter. Finally, you don’t say how far along you are, but if you aren’t due for awhile, and you are up for hard-core science, in March, Coalition for Improving Maternity Services:  Evidence Basis for the Ten Steps to Mother-Friendly Care will be published as a special issue of Lamaze International’s Journal of Perinatal Education.

     

    Because of your epilepsy, it will be even more difficult than usual to get the information you need to make an informed decision. I just returned from a conference where one of the panels was on distortion of risk. The panelists spoke about doctors telling women with nonobstetric medical conditions to stop taking medication or withholding medication in women who develop illnesses during pregnancy because we often don’t have much data on the effect of medication on the unborn baby, and the docs are afraid of malpractice suits. One case I remember them describing was a suicidal woman who was told to stop taking her antidepressants cold turkey. She ended up in a locked ward in the hospital. I am also aware of obs recommending a scheduled c/section as the solution for their own anxiety and ignorance about possible effects of a woman’s medical condition on labor. Childbirth Connection can help you there as well. Go to http://www.childbirthconnection.org/article.asp?ck=10081 to learn about the issues of informed decision making, what questions to ask, and your rights. This will help you determine, among other things, whether you are eligible for care by a midwife. Speaking of which, both the Childbirth Connection website and my book have information on how to choose a care provider who practices safe, effective care.

     

    I also feel compelled to say don’t be down on yourself because you get emotional when you try to talk about what you want and why you want it. Don’t buy into the stereotypical male idea that logic is the only valid way of knowing, and bald facts are the only basis on which to make decisions. All choices made around childbirth involve values and judgments, and there are no right answers that fit every woman’s case. You want to start with accurate, objective information, of course, but your heart and your gut trump your intellect every time, and that is how it should be.

     

    Thank you for your kind words about my writing!

     

    -- Henci


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