Editor's note: Because of the time of year (Christmas) and the nearly unprecedented amount of mail we received in response to Nina Shapiro's story "The>"/>
Editor's note: Because of the time of year (Christmas) and the nearly unprecedented amount of mail we received in response to Nina Shapiro's story "The Birth Cult" (11/26), we're making this an allbirth letters section.
Reading Nina Shapiro's story reinforced the importance of my work in the prenatal yoga program at Seattle Holistic Center. Her burning disdain of pregnancy and fear of birthing was enough to spark a devastating fire in any unsuspecting woman or man.
Pregnancy and birth are very normal processes of being human. Only in this century have we created technocratic and medicalized births. In the early 1900s, we began to take birth away from women, midwives, and their community, and into the hospital. We subjected women and their babies to atrocities that we can barely speak of, let alone believe. We as a society created the fear that Nina writes about.
We are often not told the whole truth about tests, procedures, and especially drugs. The FDA, which officially approves the drugs, will not guarantee that any drug is safe, including those used in epidurals. Even the Committee on Drugs of the American Academy of Pediatrics cautions us that there is no drug that has been proven to be without risk for the fetus. Do you know all the risks of epidural anesthesia to you and your baby? I encourage you to find out.
The rate of cesarean sections performed is currently at 22 percent, with almost 1 million cesareans performed each year, making it the most frequently performed major operation in the US. We now know that many of our interventions of antenatal testing, labor induction, electronic monitoring, and epidural anesthesia increase cesarean rates without improving maternal and infant outcomes.
These are a few reasons we provide the highest level of education possible to our students at the Seattle Holistic Center. It has less to do with the "mom's demonstration of her power," as Ms. Shapiro wrote, and more to do with mom and her partner reclaiming their power and waking up to what is happening in our birthing practices. It is also about safety for both mother and child. It is every couple's responsibility to seek the information they need, and it is ultimately their decision what happens with their care. Hopefully they will not be strapped in by their archaic fears that keep them from making informed choices or refusals. When fear keeps us from taking responsibility, only blame is left.
In this day of seeking higher consciousness, why not begin with how we give birth?
Colette Crawford, RN
Director, Seattle Holistic Center, Inc.
A nurse, not a villain
Thank you for having the courage to challenge the "natural" birth cultists just as rigorously as they decry the "medicalization" of childbirth. I am a registered nurse working in Labor and Delivery in a teaching hospital and I am fed up with being portrayed—along with obstetricians, perinatologists, neonatologists, and other "villains"—as a sadist who seeks to rob women of their precious right to birth their babies as they choose.
I believe that women have the right to make informed choices, including the choice to give birth in a high-tech hospital with the most effective analgesia available. Omitting this information while giving the "natural" approach a hard sell is as oppressive and dishonest as the old "doctor knows best" attitudes of 50 years ago.
I'm just glad someone spoke up. I wish you, your husband, and your baby a healthy pregnancy and a safe birth. I applaud you in choosing what is best for all of you: a decision to be made in cooperation with your physician and a decision that is nobody else's damn business.
Anita Jaynes, RN
Dialing for doulas
As a mother of two, and a doula, I was deeply saddened and angered by Ms. Shapiro's tirade, which Seattle Weekly saw fit to print. Not only does Ms. Shapiro use this paper to grind her axe, but she does it with absolutely no research or fact.
Empowering women to have control over their own birthing experiences continues to be a powerful issue. As near as 50 years ago, women were routinely tied down, drugged into unconsciousness, and their babies were forcibly extracted from their bodies. The movement around the country to change this barbaric practice was pioneered by such dedicated women as Mrs. Penny Simkin, doula and author. Ms. Shapiro's slander of doulas and the "natural childbirth" community is nothing more than her personal bias.
As a doula, my first and foremost goal to the families I serve is to support them in their birth choices. If a mom wants an epidural, fine with me. I will stay by her side and help her through her labor with or without drugs. I find it very sad that Ms. Shapiro is so disillusioned with herself and her pregnancy that she must lash out at a community that has fought for decades so she could even have the choice to have an epidural.
No one wants a laboring woman to suffer, but there are alternatives to drugs. There are volumes of research (pick up Henci Goer's book Obstetrical Myths vs. Research Realities) showing that drugs can and do have negative side effects. That is still not to say that a woman can't choose drugs during labor and be supported in that choice. With the birth of my second child, I hired two doulas to support me in my labor. Originally, I wanted an unmedicated birth but opted for an epidural when labor got harder than I could handle. I had a great birth, with my epidural and my doulas, but when I give birth again you bet that I will do my best to avoid drugs. If I could give Ms. Shapiro one piece of advice it would be to seek out that which frightens her so. She would be pleasantly surprised at the warm welcome she would receive from the "birth culture" she so publicly disdains.
Lynelle Hofman, CD, CLE
Birth cult? Just wait
I applaud Nina Shapiro in her expos頯f the True Motherhood. She has just hit the tip of the iceberg, unfortunately. If you really want to feel like a wimp try a subscription to Mothering Magazine.
I am the mother of a 10-year-old girl and 6-year-old twin girls. I did everything wrong in my births. I barfed for six months (three months for each pregnancy). My girls were all cesarean. I had wonderful doctors who let me hang myself until it was apparent that the only way to deliver was to go in and get them.
Just wait until you pick the wrong preschool, dress your baby in anything other than a natural fiber, and God forbid, supplement with formula! Never use that pacifier in public or you'll be shunned for life.
Hang in there, Nina. Good luck and have a healthy, beautiful baby with lots of love.
Go with the flow
I agree that the "birth culture" is out of balance. I've been attracted to the teachings of that community and work as a pregnancy massage therapist, so I was very disappointed when my first son was born by cesarean. I was planning for a natural childbirth and was left with a gnawing feeling that I had failed somehow. I consulted a midwife who planted great seeds of doubt and mistrust about that birth, questioning my OB's every decision. With my next pregnancy, I did switch to a different (and less critical) certified nurse midwife for an alternative experience. I read books, took workshops, and tried to sort out what kind of birth I "should" have.
During labor, my entire birth plan flew out the window due to reasons outside anyone's control. I did get my natural vaginal birth, but by then I couldn't have cared less. It was far from the empowering experience I had hoped for. And then the real nightmare started: Our baby was born with a congenital defect and died three and a half weeks later. What good is a natural childbirth if you don't have the baby? Suddenly, all my concerns for the quality of the birth experience seemed misguided.
I wish the birthing community would put more emphasis on "flow and flexibility" in labor. Labor is like a freight train that cannot be stopped or truly controlled. A written birth plan is no guarantee of how it will go nor is the desire for an "enlightened birth experience." Some lucky women do get to follow their plans. For those who don't, it is too bad that guilt and shame often accompany the experience when in fact there are often valid reasons for the usual suspects (pitocin induction, continuous fetal monitoring and IV drips, epidurals, and even C-sections). The birth culture loves to blame the intervention-happy, overpowering OB.
I wish judgment could be left out of the conversation entirely. Natural childbirth is not groovier or worthy of more praise. There are sound physiological reasons for an easier recovery, but that woman is not better or more spiritually aware than one who receives an epidural or has a C-section. And she certainly isn't more prepared to be a good parent.
laura stusser, lmp
Birthing, Down Under
I read with interest "The "Birth Cult." It is a pity that such polarization has to occur on such a fundamental subject. The birthing movement has, not surprisingly, been a reaction to the gross overmedicalization of what really is a natural process that (unfortunately not always) is a matter of choice.
The "American Way of Birth" has for too long created an illness out of a normal event, something to be medically controlled, and the psychology of that topic would fill large books. More than 80 percent of all pregnancies do not require significant medical intervention. Antenatal care needs a team approach. I would refer anyone seeking more information to Henci Goer's excellent Obstetric Myths vs. Research Realities.
Everyone is entitled to choice in childbirth, and I agree that guilt is a poor way of manipulating people. Where do we learn to be guilty? I would ask Nina where did she learn to be fearful of childbirth . . . someone/thing must have taught her.
I spend the seven or so months of antenatal care trying to motivate women to feel supremely confident in their bodies natural or innate abilities. Epidurals are available but less of my mothers need them, and less of any other drug. It is a matter of leaving all options open. Fear almost always magnifies pain, and because pain is among the most subjective of human experiences, no one else can tell you what yours is/will be like. Feeling "in control" is also a very good way to reduce perception of pain. Avoid birth attendants who control everything, often with the best of intentions but leading to more interference. I hope I have added some perspective to the debate.
Obstetrician & Gynecologist Hobart, Tasmania, Australia
It's about choice
I would hope that any women preparing for childbirth would take Nina Shapiro's article for what it is, a soliloquy of one women's experience, and not as valid medical information. In the same vein, I would hope a reader would not be influenced by Shapiro's extreme opinion of the Seattle Holistic Center, a place where I, mother of one healthy baby boy, received much support and assistance during preparation for my chosen hospital birth and planned epidural use: an experience in direct contrast to Shapiro's personal musings.
The director of the center even allowed me to call her at home in trying to assist me in finding a doula support person who would work well with my personal choice of hospital and pain medicated birth.
Shapiro makes a few good points, but lacks an intelligent understanding of the issues surrounding current pain relief measures for childbirth. Women interested in educating themselves about pain relief options should consult many resources and health professionals, and consider implementing both old and new approaches when birth time comes. Newer methods include an "epidural light," which is offered at some hospitals. The amount of pain medication administered is less than normal amount, with less chance of numbing a women's lower extremities (so that she will be able to push during the end stage of labor).
It is good to not feel "guilty" about a medicated labor and delivery, but not very smart to think of it as an easy solution to the reality of pain during childbirth. Using drugs during labor can lead to unwanted consequences for both mother and baby.
I hope I have counteracted the "all pervasive cult" perception Shapiro alleges of the Holistic Center. All methods of child birth, both natural and medical, have pros and cons, and I found the center to be supportive of each women's personal birth choice.
Birthin', Southern style
I think Nina Shapiro is on the right track by dumping the attitudes and information that she does not need ("The Birth Cult," 11/26). I am from Mississippi and I seem to be in the opposite position from her. Here, there are so few midwives, I can count them on my fingers. With my first birth I saw an obstetrician. When I asked for natural birth he said, "OK, we will plan an epidural." My labor was three hours long and there was no time for the epidural so I had my son "naturally." Yes, it was painful, but it was not the overwhelming pain I thought it would be. Seconds after my baby was born the nurse put medication in my IV drip and I was out. I got a glimpse of my son before I went out and it was several hours before I awoke. It made getting to know my son harder but I did not realize that at the time.
With my second pregnancy I found a midwife, and she was not "new agey" nor did she want me to give birth in the cotton fields as one of my friends put it. I labored four hours and had a girl. It was not the labor I cherish but the moment she came out in a beautiful ball and laid on my stomach. At that moment I felt no pain. And I loved her and I have loved her since. I didn't know that instant love with my son (though I cherish him just as much). It was a trade-off to me. I feel the pain but I get to feel the pleasure equally unadulterated.
I could care less what anyone chooses when it comes to prenatal care and birth, but I do care about what choices are available, and am damn glad that there is a large and vocal birth community in Seattle. I have yet to meet any midwife in Seattle who would tell me how to have a baby—but I have definitely met a few ob-gyns who have.
Perhaps your readers would be better served by a story investigating how the medical community still hounds the midwifery community. Just last year a very experienced and successful Seattle midwife had her license suspended on charges not brought by any client but by the medical community (a very common tactic to put a midwife out of business—as they can rarely come up with the funds to defend themselves). This midwife, with the support of friends, clients, and associates, raised $30,000 for her legal defense and won—she fought because at issue was the availability of choices. I think that is where Shapiro misses the boat—the birth community is not about what you choose, but that you can choose, and if Seattle is "one of the best places to give birth," it is because of that community.
We are part of the birth conspiracy Nina Shapiro writes about. My wife attends prenatal yoga, and we're taking the Bradley method classes, a popular alternative to Lamaze. In month seven of our pregnancy, we ditched our OB, found a midwife, and switched hospitals, because we decided that OBs intervene and midwives let nature take its course.
Were we coerced? I don't think so. Mainly, our Bradley teacher crams us with information in the belief that wise consumers make wise choices, and the more we learn the better our chances of having the birth we want, whether at-home natural with candles, patchouli oil, and Tibetan birth CD or a high-tech birth with OB pager and catcher's mitt.
I wish Ms. Shapiro a wonderful birth and a healthy, happy baby—the greatest joy. I agree women should do what's right for them. I just side with the folks who say learn all you can before deciding what's "right."
Stop the insanity!
Oy, would you like some cheese with that whine?
Nina's pregnancy plight is an easy one to solve. In most of these United States, the word "doula" is evidence of some sort of black magic; suggest midwifery and your right to birth without intervention, and they set up the faggots (kindling) to burn you alive.
A house divided will fall. As long as they keep us divided, we have no chance or choice. What a shame. . . .
ceo, ism. corp.
I'm writing in regard to Nina Shapiro's "The Birth Cult." I am the mother of a beautiful 9-month-old daughter, and also a neonatal nurse practitioner. This article so closely mirrored my own experience with pregnancy and birth that I felt I could have written it. Pregnancy was the most political thing I've ever done. I took the yoga classes, and while much of my experience there was very valuable, I finally had to stop going—the dissonance between their philosophy and my own was too great. I had little use for What to Expect When You're Expecting, because I found reading it only increased my stress level by giving me more to worry about. Our childbirth "education" class was so biased that my husband feared I'd seriously injure my tongue trying to keep my mouth shut—or get expelled when I couldn't. I found the whole thing vaguely anti-woman, as if despite (or because of) all our progress, women should now be made to feel every pain of childbirth as punishment for our own independence as well as for Eve's sin.
I also deeply resented the demonization of Western medical care providers, doctors and nurses—"they" who try to somehow ruin a woman's birth experience by controlling it with drugs and technology. In my
experience, the goal has always been a comfortable and safe delivery for both mom and baby. Women in labor are given choices based on the immediate circumstance, not asked to plan for every possible contingency before events occur and efforts are made to respect the families wishes whenever possible.
The instructor of our childbirth education class said she thought 80 percent of laboring women in Seattle had had epidurals, implying that was a bad thing. I wanted to ask her if she really thought 80 percent of the women in Seattle were stupid. I don't think so. I think that women who are preparing for delivery should arm themselves with as much information as possible and should be given choices based on their unique situation, but that a more comfortable delivery is not a less-than-valid experience. Birth is an overwhelmingly joyful experience, and the guilty baggage I found tied to it was really unfortunate. Thank you, Ms. Shapiro, for expressing so well what I'd been thinking about for much of the last year.
Amy Dunn Caldwell, NNP ARNP
I'm due in April with my first, and I'm just starting to get "the pressure." Initially I wanted to try a natural birth. I do have a high pain tolerance and wanted to see what all the fuss was about, after all, women have been doing this for a while. But the more pressure I get, as to the right way to have a baby, the more inclined I am to roll into the delivery room with a bottle of vodka screaming for an epidural. And even though I want to try a natural labor, I'm not an idiot. I won't say never to anything, even, god forbid, drugs during labor. I have never had a baby before. I have no idea what it's going to be like. And frankly, while other women's experiences are interesting, I'm not sure they are entirely relevant. Every woman is different, every body is different, every labor is different and every baby is different. Just because one woman chose one option, that doesn't mean it's good for everyone. I won't be "disappointed" in myself if I can't "tough it out." This is not a contest. If it is, it's a race where everyone starts at a different point on a different mountain with a different load. Sure, historically women have done this for thousands of years, but you think if you gave the cave woman the option of an epidural she wouldn't have jumped at it? As for the baby, anyone who can tell me that they were damaged, annoyed or can even remember their mother's use of drugs, please stand up. There is a possibility that the child is a bit groggy, can't initially nurse as well, etc. with some drugs. But it's a rough world out there, and I don't believe whatever educated choice I make for my delivery (short of possibly the bottle of vodka,) will harm my baby.
I laughed till it hurt with your article. It came at the perfect time for me. It is odd that people not only want input on is one the most personal decision you can make, but are also then offended if you do not make the same choices. In addition comes the implication that you are a bad mother. Someone told me once that this is all just preparing us for motherhood, the only profession in which, there seems to be no correct choices, no end to the amount of advice you will get and no end to the amount of criticism.
I also have to thank you for letting me know I'm not the only one to be annoyed by all that sappy crap about seeing fuzzy ducks and thinking with joy of the as-yet unborn life inside of me. The first time I felt my little person kick wasn't a huge bonding experience, it didn't make me "connect with the un-born joy growing inside," it scared the shit out of me. Don't get me wrong, my husband and I chose to do this crazy, insane thing, but the intrusions about the right decisions and the wrong decisions really annoy me.
And the belly rubs? Don't even get me started. What am I, Budda? Thanks again.
Jennifer Steiner Merrill
I had not yet read Nina Shapiro's article "Birth Control[sic]" when my husband and I and our new baby went into a Seattle bookstore that displays a digital world population counter in their window. Below it is a message that reads something like, "All you breeders out there knock it off already." Despite our shameless act of procreation, the bookstore seemed happy to take our money.
Every pregnant woman, and mother (and father!) has felt the sting of judgment. It is without question hurtful. Sometimes the guilt trips seem to come from everywhere. But as a mother, it is most disheartening when I see women do this to each other.
When I returned home from the bookstore to read your article, I fully understood this aspect. Beyond that, however, I could hardly keep up with the tangle of backlashes and confused information. Birth rooted in feminism? Feminism was a political rights movement that began in this century. Birth has been around since, well since the birth of the first baby. Turning down the lights is a radical idea? How does this compare to the idea of sticking a needle in your spine? And who needs to be taken down a notch, the world that created my first OB who yawned as I was pushing out my baby and later drove home in his red sports car or the world who created Penny Simpkin who, despite being a well-known published author, taught my birth class in her home and shared her yo-yo with my kids? The farther I read into this article, the more I started to wonder if it wasn't being underwritten by some big pharmaceutical company. If anyone stands to gain from the glorification labor pain it's drug manufacturers and insurance companies, certainly not childbirth educators.
No woman can have a baby the wrong way. This is the premise of every good midwife, doula and childbirth educator reguardless of their personal biases and preferences. And, if you feel giving birth is up for judgment, wait until you become a mom. Second only to salt water, unsolicited parenting advice (usually from people without kids) is the most abundant resource on the planet.
Jana Trueblood Hannigan
The Weekly's human interest stories generally don't impress me. In fact, those written by Kathryn Robinson (who is about as much a progressivist feminist as Camille Paglia is) usually piss me off. But Nina Shapiro's article on au courant birthing philosophy and practice deserves a hearty "Tell it, sister!"
I know, personally, of two women who've had disasatrous experiences with midwife-assisted homebirths. One had a history of problem pregnancies, yet even after she went into labor and was obviously once again in trouble, the midwife still insisted it would be a moral failure on her part to go to the hospital. Eventually, she and her husband went anyway. Her baby was born half-strangled by its umbilical cord, and may be brain-damaged for life. The other instance I happened to be on hand for (as errand runner and general morale support). My friend went into hard labor—and stayed there, for hours, with no results, except that her cervix began to reclose. Her husband and I listened incredulously as the midwife insisted that everything was fine, the mother-to-be just had to relax, and if we took her to a hospital, they'd attach monitors to her, and give her drugs, and probably (gasp) perform a C-section! Her husband realized he was listening to potentially lethal bullshit, and hauled her off to a hospital. Where—after indeed giving her drugs, mostly to get her cervix to relax and reopen—they learned that the baby was stuck behind the pelvic bone. In with the forceps, out with the baby: mother and child returned home doing just fine, thank you very much.
I used to be an advocate of midwife-assisted home births. No longer. Too many midwives are too high on that weirdly anti-woman, anti-child pregnancy cultism Ms. Shapiro describes so well. Hospitals do a damn fine job these days of providing comfortable, supportive birth environments. You can have low lighting and soft music, you can have your friends and family present, you can give birth lying down or squatting or standing up or, for all I know, hanging from the ceiling, if you want. You can even have a midwife attend you. But at a hospital you also have personnel and facilities ready to hand if something goes wrong. And no one will call you evil or a failure if you decide to have an epidural.
Thank you, Nina Shapiro and Seattle Weekly for an important story well told.
Travails of Childbirth
In response to Nina Shapiro's article about proponents of informed birth being a "guilt-laden cult," it seems that Ms. Shapiro has mistaken a minority opinion (that birth should be natural and women feel empowered by it) for the opinion of the majority of women in this country. An overwhelming majority of women in this country believe in the same concept of pregnancy and birth as Ms. Shapiro does, planning to make it through the "travails" of childbirth armed with epidurals and all the latest medical technology and striving to integrate children into their lives without sacrificing too much of themselves in the process.
Ms. Shapiro seems to have inadvertently placed herself in the hotbed of a radical approach to pregnancy, childbirth, and mothering, yet instead of simply avoiding this view that differs so vastly from the majority or instead of making an attempt to understand it, she merely withdraws into a defensive posture of ridicule. Like a person who has taken a tram to the top of a mountain and then derides the mountain climber who has exerted so much effort to get to the same place, she has missed the point entirely. Every mountain