Robotic Obstetrics

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.

16 thoughts on “Robotic Obstetrics

  1. This is exactly why I want to have another (fourth) baby, but this time on my own terms, either with a wonderful assistant such as Gloria, or BY MYSELF, at home… My three pregnancies were filled with self-doubt and fear as my doctor informed me of yet another “possible” complication. Seriously, the stress I went through at each of these “necessary” pre-natal visits was ridiculous. My doctor, GP, is absolutely wonderful. However, he operates within the confines of medical doctrine… he has to believe in what he is taught. Unfortunately, for most of us, that means that we are subject to statistical obstetrics. If only I can let go of the “what if” factor, and do what is right for me and my baby. Next time…

    • Gloria! I have to share this… Three years after posting the above, I had my fourth birth at home, with the two most amazing midwives, and my family attending. No interventions at all, and ZERO vaginal inspections during the entire pregnancy and birth. It was everything you inspired me to have, an experience we will never forget.

      Thank you! And special thanks to Lydia and Leslie for helping me realize how truly powerful I am. This was the very first birth where I truly felt in charge.

  2. The woman in New Zealand whom I mentioned in the above post just emailed me the good news that her 8th baby (a boy) came into the world beautifully on Sunday, Aug 16. He was caught by his Dad and the other kids woke up to greet him when their day started. I was so happy that she was able to sidestep the medical system.

  3. Pingback: What not to say « Woman to Woman Childbirth Education

  4. Hi Gloria, it’s just plain wrong. Grrr.
    An article in the Journal PAIN by Lang et al 114 (2005) 303–309 called “Can words hurt? Patient–provider interactions during invasive procedures”
    found that “Warning the patient in terms of pain or undesirable experiences resulted in greater pain (P!0.05) and greater anxiety (P!0.001) than not doing so. Sympathizing with the patient in such terms after a painful event did not increase reported pain, but resulted in greater anxiety (P!0.05). Contrary to common belief, warning or sympathizing using language that refers to negative experiences may not make patients feel better”.

    We have so much evidence that words from a ‘care’ provider is so often a hypnotic suggestion and causes the very thing that they go on about!!!

  5. I did bleed *more* following my 5th birth than my previous. However, I don’t believe it was related to being my 5th, but to the very fast birth. That said, I was at home, I did not need transport nor any intervention besides my baby and what was available at home and non-pharm.
    I cannot help but roll my eyes when I hear the hundreds of generalizations about whatever given situation an pregnant women is in 🙁

  6. When I was headed out to my little log cabin in the Alaskan wilderness to have my second baby the resounding input from people was that l was crazy. All except for my neighbor, Grandma Clara. She said, “l had my first four babies in the hospital but it was too much of a hassle so I had the next eight at home. You’ll be just fine out there.”

  7. I recently had a miscarriage at home. While losing my baby was tragic, I had great support, so it was powerful and affirming for me. The fact that my wishes for staying out of the hospital, with no interventions or scare tactics being used, were respected until I needed medical attention (lost too much blood, passed out – that’s when 911 was called) – that showed me that if I can give birth and lose a baby at home, then I can most definitely birth a full term baby at home. My miscarriage has given me the conviction and the ability to say with meaning: I am woman and birthing mom!

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