Comments on: The Business of Being Born http://www.bellytales.com/2007/05/08/the-business-of-being-born/ The Diary of a New Midwife Tue, 02 Dec 2008 13:26:40 +0000 http://wordpress.org/?v=2.0.4 by: D_Anne http://www.bellytales.com/2007/05/08/the-business-of-being-born/#comment-20387 Thu, 17 May 2007 23:25:40 +0000 http://www.bellytales.com/2007/05/08/the-business-of-being-born/#comment-20387 I was fortunately raised with a different paradigm. A paradigm of a woman's story, not her risk--birth is a self-fulfilling prophecy--of her belief, not her doubt. Where birth was not of the male medical gaze passing test but of the feminine wisdom of process and acceptance--no that does not mean never seeking medical intervention. It is saying that this is the best my belief can do. But to say across the board--birth is unreliable in this situation--I won't and know there is no need to go there. Own our limitations, don't assign them to birth in general. For those that wonder, I was a sloppy ass,pathetic birther--not New age omming for me. And the births where I faced all those 'you shouldn't, you couldn't' is when I learned, when I grew. This is in no way a criticism of Abby Epstein. We all do the best we can believe. As a doctor's daughter I had 3 crappy hospital births of 3 beloved babes before I couldn't sell my soul again for the 'guaranteed' outcome. I was fortunately raised with a different paradigm. A paradigm of a woman’s story, not her risk–birth is a self-fulfilling prophecy–of her belief, not her doubt. Where birth was not of the male medical gaze passing test but of the feminine wisdom of process and acceptance–no that does not mean never seeking medical intervention. It is saying that this is the best my belief can do. But to say across the board–birth is unreliable in this situation–I won’t and know there is no need to go there. Own our limitations, don’t assign them to birth in general. For those that wonder, I was a sloppy ass,pathetic birther–not New age omming for me. And the births where I faced all those ‘you shouldn’t, you couldn’t’ is when I learned, when I grew. This is in no way a criticism of Abby Epstein. We all do the best we can believe. As a doctor’s daughter I had 3 crappy hospital births of 3 beloved babes before I couldn’t sell my soul again for the ‘guaranteed’ outcome.

]]> by: The Student http://www.bellytales.com/2007/05/08/the-business-of-being-born/#comment-20384 Thu, 17 May 2007 23:06:26 +0000 http://www.bellytales.com/2007/05/08/the-business-of-being-born/#comment-20384 While there are homebirth midwives who're comfortable delivering breech babies (read the homebirth breech birth story that happened in upstate NY last year in the Good Enough To Share section), many practitioners, midwives and doctors alike, are not comfortable with their breech skills. While breech delivery is still taught in school, most breech presentations are delivered through cesarean, in part because providers' skills are rusty, and in part because there are a lot more opportunities for something to go wrong with a breech presentation than a vertex presentation, and the consequences can be very serious. I also think many providers are not comfortable delivering a breech baby in a woman who has never given birth before, because her pelvis has never been "tested". In every first time mother, there's always the question of whether the head will ultimately fit through the pelvis or not, something which is usually not known for certain until the mother does indeed give birth...only, in the case of a breech delivery, when the body has already been delivered, if the head turns out to be too big to fit through the pelvis, you're in a world of trouble at that point. In any case, breech vaginal delivery is very rare these days, in both the hospital and the home, and while I am not entirely happy about this (I do think that there is a place for breech deliveries of small babies in multiparous women with tested pelves in a hospital with experienced providers, but this will probably never happen due to lack of comfort on the part of providers), because of the increased risks, I think many practitioners are not comfortable with it. However, in the case above, I think the bigger factor prompting the move to the hospital was the fact that the baby was premature, and was very small for gestational age, as it turns out, which implies that there was some kind of intrauterine growth restriction occurring. In either case, it was no longer a normal, low-risk delivery, and I certainly agree with the midwife's decision to transfer to a hospital. While there are homebirth midwives who’re comfortable delivering breech babies (read the homebirth breech birth story that happened in upstate NY last year in the Good Enough To Share section), many practitioners, midwives and doctors alike, are not comfortable with their breech skills. While breech delivery is still taught in school, most breech presentations are delivered through cesarean, in part because providers’ skills are rusty, and in part because there are a lot more opportunities for something to go wrong with a breech presentation than a vertex presentation, and the consequences can be very serious. I also think many providers are not comfortable delivering a breech baby in a woman who has never given birth before, because her pelvis has never been “tested”. In every first time mother, there’s always the question of whether the head will ultimately fit through the pelvis or not, something which is usually not known for certain until the mother does indeed give birth…only, in the case of a breech delivery, when the body has already been delivered, if the head turns out to be too big to fit through the pelvis, you’re in a world of trouble at that point. In any case, breech vaginal delivery is very rare these days, in both the hospital and the home, and while I am not entirely happy about this (I do think that there is a place for breech deliveries of small babies in multiparous women with tested pelves in a hospital with experienced providers, but this will probably never happen due to lack of comfort on the part of providers), because of the increased risks, I think many practitioners are not comfortable with it. However, in the case above, I think the bigger factor prompting the move to the hospital was the fact that the baby was premature, and was very small for gestational age, as it turns out, which implies that there was some kind of intrauterine growth restriction occurring. In either case, it was no longer a normal, low-risk delivery, and I certainly agree with the midwife’s decision to transfer to a hospital.

]]> by: D_Anne http://www.bellytales.com/2007/05/08/the-business-of-being-born/#comment-20340 Thu, 17 May 2007 14:52:30 +0000 http://www.bellytales.com/2007/05/08/the-business-of-being-born/#comment-20340 You had me until "because her baby was breech, she needed a cesarean." Why? Is this what is taught now? Or was it because of the restrictions put on birth in the place where Epstein chose to birth? At what point has breeches at home become a "stupid risk?" You had me until “because her baby was breech, she needed a cesarean.” Why? Is this what is taught now? Or was it because of the restrictions put on birth in the place where Epstein chose to birth? At what point has breeches at home become a “stupid risk?”

]]> by: Rachel http://www.bellytales.com/2007/05/08/the-business-of-being-born/#comment-18676 Wed, 09 May 2007 14:02:45 +0000 http://www.bellytales.com/2007/05/08/the-business-of-being-born/#comment-18676 Thanks for posting this review - I really hope I get a chance to see this film. Thanks for posting this review - I really hope I get a chance to see this film.

]]> by: Jaws http://www.bellytales.com/2007/05/08/the-business-of-being-born/#comment-18570 Wed, 09 May 2007 02:19:21 +0000 http://www.bellytales.com/2007/05/08/the-business-of-being-born/#comment-18570 This looks fascinating! I'll keep an eye out for it in SF...or is there a way to keep track of where it might show up? The official website (very sparse, by the way) only mentions Tribeca. This looks fascinating! I’ll keep an eye out for it in SF…or is there a way to keep track of where it might show up? The official website (very sparse, by the way) only mentions Tribeca.

]]> by: Bebunu http://www.bellytales.com/2007/05/08/the-business-of-being-born/#comment-18565 Wed, 09 May 2007 01:33:11 +0000 http://www.bellytales.com/2007/05/08/the-business-of-being-born/#comment-18565 That movie seems really interesting. I have a really hard time trying to explain to my husband why I am so impressed and amazed by midwifery and why I think that it's the way to go, bu it seems like this movie would do the job for me. Thanks for the review. How did you do on your comprehensive exam by the way?? That movie seems really interesting. I have a really hard time trying to explain to my husband why I am so impressed and amazed by midwifery and why I think that it’s the way to go, bu it seems like this movie would do the job for me.

Thanks for the review.

How did you do on your comprehensive exam by the way??

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