Many recent events have all been pointing towards how women in labour are “monitored”. Many midwives do not do vaginal examinations because they are intrusive and painful and there are other ways of monitoring progress. This is all a very good thing, but I would suggest it doesn’t go far enough. The whole concept of labour progress is assessed using a male mindset. What I mean by this is that men and women think differently. It is scientifically proven our brains function differently and there are different connecting pathways between right and left hemispheres for men and women. Now all of this I say to point out that we are different – in no way do I imply one is better than the other – just different. And nothing is black and white; there are variations and scales within male and female. I am also not saying that science is purely a male domain – I love science, but how it is applied is usually different for males and females.
Since medicine first took over birth as their domain, it has looked at the whole issue with a male-mind. Progress of labour was assessed and monitored, categorised and boxed and put on a time line with a clear beginning, clear progression and clear end. And then they told women how it should be done according to their understanding. And women tried their hardest to ‘fit’ their models. One look at our atrocious birth statistics and trauma will tell you that women cannot fit into these boxes no matter how hard they try.
In reality, birth is purely a feminine phenomenon and we cannot understand it with a male mind. We have the body – the equipment so to speak – and the innate wisdom – to birth. And it does not involve monitoring and fitting into neat little categories. So as midwives avoid the actual physical measurement (VE's) to monitor progress, and come up with lots of external ways to know how a woman is progressing, we give no thought to the fact that we are still using a male-minded yard stick for alternate ways of measuring as if it is the valid way of thinking about birth. It is not just the how of measuring it is the measuring itself.
As women we are all very well aware that life is not like a straight line progression - relationships are not like that and birth is certainly not like that. A women telling a story will leave the progression of her story line for a bit and go back and tell you a side bit, or a piece of history that will make your appreciation of the story more comprehensive - progress is not definitely a straight line. Birth is a beautiful dance where a woman is mostly telling her life story. Let her do it her way, and progress as she feels she needs to - completely unhindered. If she feels she needs to check her “progress” on the male minded scale than something has happened to hinder her self expression and she is doubting herself. What she really wants to know is “am I ok?” Even though she may ask how far dilated she is, she is only verbalising like this because it is set in our cultural concrete that dilation measures progress in labour. What she really needs to hear is “Yes you are fine. You are getting closer. You can do this. YES – you do have the strength. Dig deep – the power to do this is within you.”
Don't get me wrong - all of these external signs are interesting and fascinating - and I watch and observe women, but I do not let the expectations of my observations change my assessment of where she is. I care about how she is and how the baby is. What matters is - how is she? How can I support her best? What does she need? Not "how far is she along the path?" she is either moving toward pushing her baby out or she is pushing her baby out. Who cares how close she is so long as she is listening to her body?
So my aim is to re-educate women into believing instead of the 3 medical (male minded) stages of labour there are really 5. (Well, I think I might reassess this and make it 6 to include the pre-labour stage as a valid stage of labour, because often what women are feeling during this stage is completely invalidated and dismissed with a “well you’re not really IN labour”. Don’t forget – the definite “beginning of labour” at 3-4cm is also a male mindset.) But once a woman is in labour, there are only 5 stages that matter. . .
1.baby coming soon
2.baby coming now
3.baby out and needs to be left alone.
4. ohh look there's the placenta
5. don't you dare disturb mum and bub or I'll rip your arm off
Wednesday, March 31, 2010
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Fabulous!!! (Insert sound of wild applause here)
ReplyDeleteClaire--this post is a gem--and so are YOU!
Great article, Claire, I'm going to post it far and wide. One of the tricks I was taught by Nancy Wainer Cohen: go to the dollar store and buy a plastic spaghetti measurer--you know, a plastic thing-y with holes for different serving sizes. Pull out the measurer every chance you get and ask people if they know what it is. Let them know it's a "Penis Measurer", specially made for measuring a man's progress with his penis. Everyone can see that you'd never do that to a man so why do we permit it with child bearing women?
ReplyDeleteThanks for writing this. Gloria Lemay
I'm so glad you posted this! It was such a pleasure to sit in on you session at the Trust Birth Conference! Glad to reread soem of what you said. :-)
ReplyDeleteRegina Rich
Claire you are a TREASURE and I am so incredibly happy to know you and be your friend. We would not think of ever having another Trust Birth Conference without you. See you in 2012, if I don't make it to OZ before that! You know if there is an AAMI MSL I will be there! Keep Telling the TRUTH!!!!!!! If WE don't WHO will????????
ReplyDeleteI LOVE the 5 stages you outlined!!!!
ReplyDeleteThank you Charis! I agree entirely. I have been so fortunate to have birthed my two first sons at home with Gloria Lemay in attendance, who never bugged me with any interventions--including the measurement of anything. My 3rd son was born unassisted at home, and my 4th will be arriving at the end of August. I wonder a little bit when freebirthing women themselves get caught up in timing their own sensations or become fixated on someone measuring their cervix, etc. Sometimes we have to try to turn off our culture to get into our lizard brain and birth peacefully...
ReplyDeleteGloria - your comment about the spaghetti measure made me laugh so hard I nearly peed myself!
ReplyDeleteBeautiful Claire! Numbers lie anyway...
ReplyDeleteI agree that you should add the pre-labor stage. Mom's walking that path really need assurance that their body knows what to do. Maybe it could be something like "don't pressure me, I'm gearing up to have a baby"
Claire, this is wonderful! Thanks so much for writing it out. Gloria has such great ideas for visual teaching aids. People can talk all day, but once you see that visual, it sticks in your mind forever.
ReplyDeleteI love it, love it, love it!! Can I translate it to spanish?
ReplyDeleteWell said!!! LOVE the stages.
ReplyDeleteIts true that so many women are judged and subjected to CS because of the curve and 'lack of progress'. It breaks my heart. I am VERY tempted to get a penis measurer as an antidote to my hospitals policies......
How true. Thank you so much for posting it! Can we get it circulated in the UK Birth Centres - midwife led but male mindset!
ReplyDeleteOH this article is simply fabulous! We really must get away from all this "measuring" and just let birth happen. I always think of the way a mare births a foal. The reason thorough bred stables have elaborate cameras to monitor births for horses is that the mare does not want anyone around. If a human happens on her while she is in labor the labor will often stop. She does not feel safe. So she stops birthing and waits for privacy. We are fight of flight animals just like horses. No wonder so many women suffer from "failure to progress" when they are assaulted by so many strangers in a hospital setting. Until I saw my own daughter give birth at home I never really understood what a true natural birth was. I want more than anything to help women understand their power and the wonder of a birth when they do it themselves. Thank you for this wonderful article. I am posting it on my childbirthsolutions facebook page right NOW.
ReplyDeletego ahead Agustina - so long as it is referenced I would be honoured!!!
ReplyDeleteall I need to say is I love you girl! And I miss you like crazy!!! One week together was simply NOT ENOUGH!!!! 2012 will not be here fast enough for me! I want this session!
ReplyDeleteVery interesting, Claire! From the work of my teacher, Ray Castellino, Castellino Prenatal and Birth Therapy, healing birth trauma, we have FIVE STAGES OF BIRTH FROM THE BABY'S PERSPECTIVE. I will match yours with ours and see how close they are. It would ALSO be from the MOTHER'S BODY'S perspective ... when mother and baby are in sync with each during labor. Throughout the five stages, labor and birth, everything that happens is being imprinted on the baby's brain, and is defining his or her relationship with mother and with the world.
ReplyDeletewww.castellinotraining.com, www.myrnamartin.net, and www.healyourearlyimprints (two colleagues who did this work as well.
My therapy site is down. www.infantparenthealing.com but my film site is up. www.theothersideoftheglass.com.
This is exciting, Claire. I'll get back to you next week after I match them up!!
Beautiful, Claire - LOVE the 5 steps, and you!!
ReplyDeletewhat a blessing you are. i'm so sorry i missed you at the trust birth !~ but i won't next time around! and you can rest reassured that this blog is going to be referenced to in my neck of the wood (rural vermont, if you mind...)
ReplyDeleteand gloria ~ what a giggle. you make us smile all around...
blessings
paule
You just roxorz my soxorz. (You are great)
ReplyDeleteThat sounds fascinating Louann - can't wait myself. Birth is anintricate dance and communication between mother and baby that people on the outside are just not a part of. Off to check out those websites!
ReplyDeletebeautiful, Claire, and so true! My babies and I thank you for being the midwife you are oxox
ReplyDeleteLovely!
ReplyDelete