And until men start enduring the massive physiological stress that is carrying a pregnancy and birthing the child, partnering dads are not entitled to a say in the birthing process. I love the way you think contributing a sperm( completely effortless) somehow gives you entitlement to influence the way a woman labours.. Yuck!

By all means guys, assist your partner when she’s deciding how SHE wishes to give birth and help her in making informed choices ; but please don’t assume that your input is something you’re entitled to put across because you contributed a sperm. How a woman labours and delivers the baby is entirely up to her because it is her body that is doing the labouring.

birth is a process females have been doing for thousands of years and humans are the only species who invites the male to be present, you are there by the woman’s invitation, not because you are entitled. Until men start carrying pregnancies and birthing the child, it is entirely, 100% a woman’s decision in how that process should happen and whether her partner will be there for that matter.

In my experience(as a L&D RN), this happens because a women has felt like her choices had been stripped from her. I think this can happen with natural births as well. Not only are we expecting women to keep their emotions under control, but we are expecting them to answer questions and process information right in the middle of one of the most intense times of their lives. It really is unfair to suggest that if things don’t go as planned that they just bottle their previous plans and deal with it.

I of course feel like there are extremists out there, but I feel like a lot of these women have had horrible birth experiences. This does not mean that what happened to them was the worst thing in the world, but in their mind, they were stripped, beaten, and told to be quiet at one of the most vulnerable times of their lives. Most women I know that choose natural birth do so because 1) they are afraid of big epidural needles:) 2) they don’t like putting medications in them if they don’t have to 3) they want to be able to freely move around for birth 4) they have a hope and desire that they can do something for which they feel their bodies are made for 5) they had a bad experience previously where they felt like their choices were taken away. I don’t think these are bad reasons.

But you are right, being judgmental about other people and their choices is wrong. And just because you had a wonderful experience doesn’t mean someone else wants the same thing. All in all this is a tricky topic for women to discuss because it involves way more than just the physical, and we are all a little bit insecure anyways:)

I can only speak for me and my family when I say I’m very happy at the choices we made at the time we made them.

Great post!

My wife however already had 2 (wonderful) kids and had been married previously.

So the bottom line is this: I could have just received the Nobel Prize in Medicine for Knowing All There is to Know About Pregnancy and Childbirth and the net outcome will be that things will go exactly the way my wife says, and I will do as I am told.

Example:
Parents: “Are you going to ‘find out’?”
Me: “I want to be surprised.”
Wife: “You’ll be surprised 12 weeks. There’s planning to be done.”

There you have it folks. So far my responsibilities in the birthing room consist of “Don’t pass out.”

Got it. Check.

About your friend with the 10-pound c-section that you think was so obviously necessary: I personally know in my own social circle two women who have birthed vaginally, without medication, 11-pound baby boys, perfectly healthy, births without a hitch. One did it at home with a lay midwife. The other, who went on to have a 2nd 11-pound baby boy vaginally, was a double VBAC (i.e. she had had 2 c-sections before her 2 vaginal births and the first 11-pounder was the first baby to emerge through her vaginal canal). The human body is amazing – do not let OBs tell you that you can’t do it, because YOU CAN. As Ina May Gaskin likes to tell her moms: Your body will not grow a baby that you cannot birth. And here are her birth statistics to back it up: http://www.inamay.com/?page_id=28

I am a petite Asian 4’ 11” woman who weighs 115 pounds. I birthed a 8 pound 6 oz baby (my 2nd) without even a tear. It’s all a load of crap, Nathan. We CAN do it. Again from Ina May Gaskin: Your body is not a lemon! (Your wife’s body isn’t either.)
Have you really watched Ricki Lake’s movie? You refer to it, but you seem unaware of the important points she makes.

As for the confounding variable thing, Nathan, I take it you mean firstly that we can’t tell whether the worse outcomes from c-section come from the surgery itself or from the pre-existing conditions or emergency situation of the birth itself, and secondly, that those conditions and situations would have resulted, without a c-section, in far worse outcomes for mom and baby. Do I have that right?

I think you are wrong. Firstly, there is no doubt in even the medical community and research literature that c-sections are THEMSELVES THE CAUSE of increased risk for both baby and mother. No matter what the underlying medical condition, babies born via c-section have an increased likelihood of being cut (by a scalpel), of respiratory infection (they don’t get that last squeeze coming out of the birth canal that empties their lungs of fluid), and of prematurity (when the c-section is performed before the mother is in labor) which is a tremendous risk factor itself: http://en.wikipedia.org/wiki/Preterm_birth#Specific_risks_for_the_preterm_neonate

These are not risks that existed because the baby’s heart rate was depressing during contractions (which, as Matt says, is not even clearly abnormal or dangerous, let alone a pre-existing condition). These are complications from the surgery itself, of leap-frogging over nature’s way. This is not controversial, Nathan.
Nor is it controversial that surgery has its own risks, again, wholly unrelated to any pre-existing condition that causes the so-called “need” for c-section. It is major abdominal surgery, and that has risks that far outweigh the risks of natural childbirth. http://www.americanpregnancy.org/labornbirth/cesareanrisks.html

Even having established that c-section ITSELF presents very real and increased risks for mom and baby, I don’t think anyone (even them most ardent natural birth advocates there are) would disagree with the fact that there is some small percentage (say 5% or lower) of birth situations where a c-section is truly a necessity, without which the baby or mom would suffer harm greater than any of the above increased risks from surgery. And I don’t think that ANYONE thinks that a woman in this situation should decline a c-section.
But that still leaves the majority of c-sections in this country being medically unnecessary, in my view. Whereas you seem to think most c-sections done are medically necessary. (Like I said before, no one thinks theirs was unnecessary, right?) But how do you reconcile this with the fact that there are many other countries with fewer c-sections and yet still far better maternal and fetal outcomes than ours: the Scandinavian countries, the Nederlands, all of Europe, and Japan? http://www.icanofnj.com/usbirthstatistics.htm

And as Ina May Gaskin writes, were are probably losing even more mothers than we think we are to complications from surgical child birth because we don’t report maternal deaths properly. If a woman hemorrhages to death or dies of infection a month or even a week after her baby is born, it wouldn’t be recorded as pregnancy-related! See http://www.inamay.com/?page_id=12

In Europe and Japan, midwives attend over 75% of the births, and OBs are called in where there are high-risk situations like multiples, breech, maternal health factors, etc. Why do we need midwives? Ina May Gaskin again: “To start a pregnancy, you need a woman and a man; their functions are different, but everybody will hope that they will love one another, respect and admire one another. To care for pregnancy and childbirth, you need a midwife and a doctor. I hope that they will love one another, respect and admire one another and will know that they are both needed and complementary.” http://www.inamay.com/?page_id=249

Finally, Nathan, why is elective c-section for a woman’s convenience a poor choice? Is that not judging moms who have simply made a different choice than you have? If you can say that, I don’t know why you have a problem with the natural birth advocates who you so despise saying that starting down the slippery slope of hospital interventions is a poor choice that often ends unnecessarily in c-section. Which is it?

Nathan, can you say more about the uniform standard of care? You make it sound so simple and so obviously right, and as if no one would ever disagree with that. But what if those who care about a uniform standard of care (OBs) provide care that is entirely more risky than those who don’t care (lay midwives)? What if treating birth as a medical event (in hospitals) leads to standardization that actually has worse outcomes than when birth is handled as a family event (as in homebirth)? And if you read Atul Gawande’s piece about why c-sections are necessary, it’s not because they’re safer. It’s because they’re the safest way to have babies *in hospitals*, where things need to be uniform (like no one leaves a scalpel inside your wife) in order to be safe. But if you avoid the hospital (and their uniform standard of care) entirely, your wife and baby have better odds. How’s that for radical?
This probably sounds crazy to you but I no longer consider my births to be medical affairs. For me they are mostly spiritual events, and to that end, I don’t want standardization and shift changes, I want someone who connects deeply with me and believes in my body. Yes, my midwife brings sutures and oxygen tanks and pitocin in case I hemorrhage, and yes, it is important there is a hospital nearby in case we need it. (And if I ever go into surgery, just for you I will smile at the anesthesiologist, okay?) But really there is this entire element of a woman’s spirit during birth that is entirely overlooked here. It’s not that women who have c-sections couldn’t birth or that they or their babies were in any danger. It’s that they put themselves into a situation (hospital) that greatly impeded their innate ability to birth their babies and created in them the false sensation of danger or worse yet circumstances that actually created real danger (pitocin leading to hemorrhage or rupture), and that they were (and continue to be) ignorant of what those impediments were. You think your wife would have died without the hospital OBs. Whereas I think that most women in her situation would never have hemorrhaged had they not gone to the hospital and been given pitocin for augmenting a labor that would have proceeded just fine on its own if we were patient and supportive and didn’t have a system that tries to cram as many paying patients into beds as quickly as they can. Read that book I recommended to you! (As a teaser, I will tell you that one of the chapters is titled, Sphinter Law. It is the most basic tenet natural childbirth and yet you’ve never heard of it, right?)

@L-A: I personally find the balance between advocacy and non-judgment really tricky. The crucial difference seems to be whether we are talking about public health or talking about a person’s choices. In terms of public health, there is no question that natural birth is safer for all concerned, and to that end, routine use of labor-augmenting drugs and pain-killers is to the detriment not just to us, but to our unborn children. (And the same goes for breastfeeding – in public health terms, all babies benefit tremendously from being breastfed for at least a year.) There is a time for sympathy – no one would say that in response to a friend’s c-section story it would be helpful to start sharing European statistics. But without advocacy there is no education, and without education there is no change. It’s a timeless conundrum, I’m afraid, how to advocate for change without stepping on others’ toes. Perhaps mothers should stop confusing public health advocacy with attacks on their choices. (Do we get upset with anti-smoking or bike-helmet-wearing campaigns?) Perhaps mothers should stop putting responsibility for their feelings of guilt and inadequacy on others. It can be disturbing to learn things that make us question our choices, or that we were ignorant or misinformed – but is it sensible, fair, or productive to attack the source of the information? Is it so important to avoid bad feelings that we should muzzle ourselves or others from improving things for those who come behind us? And furthermore, isn’t it rather puzzling that feelings of guilt can be blamed on others at all? If in fact natural birth and breastfeeding advocates are wrong, then those mothers shouldn’t feel bad at all. And if in fact they’re right, those bad feelings are productive ones – they can inspire each of us to educate ourselves and choose better the next time around.

@Emily: You GO GIRL!

Which is why, when my wife and I were getting ready to go through all of this, we asked the hospital what it’s C-section rate was. I don’t remember the actual figure, but it was lower than average, or at least low enough not to be worrying. I think I may even have learned to ask that question at birthing class!

(FWIW, we also checked episiotomy rates, which is less of a big deal here, but in Jean’s home country of Taiwan, the rate is nearly 100% — which, ick.)

It’s funny, the birth ed classes actually leave out the worst parts–post-partum effects on mom, and I’m not talking depression. Google mastitis, diastasis and prolapse, preferably via google image. That kind of stuff happens, at higher rates than anyone wants to talk about, no matter how they come out. If they talked about it ahead of time, who knows what would happen to our replacement rate.