I had a panic stricken call from a client recently, “Gloria, do you think I might bleed after I have this baby?” Hmmmm. . . “I don’t think there’s a snowball’s hope in hell that you will bleed after you have this baby, WHY?” was my instant response. You see, she was pregnant with her 5th baby and I had followed her through her previous 3 full term pregnancies. She had had a cesarean for her first birth, she’s fit, healthy, has a great diet and her body was very efficient at giving birth. The 3 births (second, third and fourth children) that I had witnessed were at home and she was planning to have her fifth baby at home. So, I asked her “Where did you get this idea from that you might bleed with this birth?” She told me that she had been at a community event and had gone past a table for a doula group. The women at the table inquired if she was expecting her first baby. She replied “No, it’s actually my fifth” and, without any other information, one of the women blurted out “Oh, fifth babies, you always bleed with the fifth.” The other women all nodded their heads knowingly. This is what I call “robotic obstetrics” and it is rampant in the land. I probably spent an hour on the phone with that pregnant woman explaining to her that:
1. Obstetric texts list “grand multiparity” (5 or more births) as a risk factor for hemorrhage.
2. It is NOT a given.
3. Factors such as age, lifestyle, and management of the third stage of birth are far greater considerations than the number of births the woman has had.
4. Each woman is unique and you can’t make blanket diagnoses in obstetrics and, if you do, you most probably will create what you fear.
Perhaps it doesn’t occur to people that, prior to the invention of shots of pitocin and mass hospitalization, many women in North America gave birth to 15 babies in log cabins. Mother Nature wants the 12th baby to be breastfed and nurtured, too, and has provided for the safety of the grand multip woman.
Another client, who has recently moved to New Zealand and is expecting her 8th baby. is getting the same dire messages from the medical professionals she has approached in that country. She told a hospital-based midwife “I have never bled after any of my homebirths. Maybe it’s because my placenta was left alone for a long time after the birth, the cord was not cut and I didn’t have any drugs.” The midwife concurred that this could be the case; HOWEVER, it was the policy of her institution to give an intramuscular pitocin shot to all grand multiparae. Naturally, the woman is planning to bypass the whole hospital situation and just give birth at home with her family.
Another common robotic obstetric mantra that I am constantly dealing with is “Oh, you’re having your first baby at _____years old (fill in the blank with anything over 36 or anything under 19) therefore; it will be ____________________ (fill in the blank with longer/shorter, more painful/less painful, more traumatic/less traumatic, etc, etc.)
Here’s my request: “Will every “know it all” person out there, please, stop opening up your mouth and airing your personal psychic insight on how a woman’s birth will be before it has even happened? It’s really not helpful.” I’ve seen many women over 35 years old have lovely, gentle, peaceful births after pregnancies that were made miserable by professionals and acquaintances who felt duty bound to put every worry possible into that woman’s head. The mother’s age is a factor similar to the one piece of a jigsaw puzzle that fits into the bottom right hand corner—yes, it’s part of the whole but it’s not more significant than the other pieces. At the younger end of the scale, I assisted a woman who was having her first baby at 17 years old. She chose me to be her attendant because in her words “You’re the first person I’ve been to who didn’t offer to help me get an abortion.” She had planned her pregnancy and was thrilled to be having a baby but the assumptions of others were starting to get to her. The point I am making here is that people with some knowledge need to take a breath and think before they start spouting assumptions and risk factors at pregnant women. Look at the whole picture, think about what it feels like to have a precious baby under your heart, and then count to ten and ask yourself “Do I really need to say this and is it even true?” Women want to have full disclosure of all abnormal clinical findings in pregnancy but it’s not helpful to be told all the “maybe” risk factors for one’s demographic group.