I admit it, in many things, I’m a perfectionist. (Just don’t take a picture of my desk, because keeping it neat and uncluttered is not one of my perfectionistic tendencies.) Some things I do strive for perfection in are grammar, spelling and punctuation; and back in my school days, I always tried to get 100 A+ on everything. I always did my best in school, and consequently had a 4.0 in high school and college, and these were for the most part challenging courses (A Beka curriculum for Christian schools, if you’re familiar with private or home school curriculum; and taking the hardest teachers in college).

I remember one conversation I had with a classmate in history, and I still have a hard time wrapping my brain around it, now some 14 years later. He said he was aiming for a C grade in a paper, because that’s all he needed. Maybe you’re like that as well, but for me it was like fingernails on a chalkboard! He intentionally aimed for a C?? My biggest worry about doing something like that is, what if I missed? You see, when you aim for 100% and you don’t quite make it, you still get pretty darn good! But when you aim for “average” and you don’t make it, you may flunk out. Another friend I had did this — he just didn’t turn in a paper for a class, because he was going to let that be his “drop grade”; then a family friend died and he had to go to the funeral out-of-state and miss a test. He’d already used his drop grade, so ended up having a zero for a test grade. Ouch.

Some adversaries of home and/or natural birth sneer at people like me, because we aim for perfection. We question C-sections, rather than just say, “Whew, glad everyone is okay.” We decry inductions for non-medical reasons, rather than say, “Well, the baby is alive, so what were you so worried about? At least it wasn’t a fetal demise at term.” On one hand, I can see their point, because I recognize that there is no way to 100% accurately gauge what is the best course of action for every individual situation. That’s why there are large studies undertaken to look at hundred or thousands of mothers and babies, and find out on average what produces the best outcomes. But some of these mothers and babies will be hurt unnecessarily by what can help other mothers and babies. But we should still shoot for perfection, rather than merely average.

Here’s why. This post was prompted by musings on a blog post and ensuing converation about a breech birth trial. Some breech babies will die or be seriously injured by being born vaginally. Currently, the recommendation is that 100% of all breech babies be born by C-section. On average, that’s better for the babies. Still, this particular study showed that 6% of vaginally born breech babies had serious problems or died (although some people have problems with the study itself, and its conclusions, but we’ll pretend like it is 100% accurate). This means that 94% of breech babies were born vaginally without a problem. So, if 100% of breech babies are born by C-section when only 6% need to be, then 94% of mothers are having unnecessary surgery.

So, let’s let perfectionism kick in and say, “How can we more accurately determine which babies will have problems, and which will not?” Then we can offer vaginal breech birth to women and babies who are good candidates, and reduce the rate of unnecessary C-sections. Otherwise, we’ll be stuck at “average” forever. Let’s at least aim for 100%, and then if we miss the mark (which we’re human, so we’re going to), we can still come out with an “A” or a pretty high “B.”

April is Cesarean Awareness Month, so many birth people are looking at ways to reduce the rate of C-sections. Currently, breeches are born by C-section almost 100% of the time. If we could at least begin to look at ways to  increase safe vaginal breech birth, we could automatically reduce the C-section rate in those cases. Even if we only dropped the breech C-section rate to 50% — erring on the side of caution, being extra vigilant to save babies who would or might be harmed by vaginal birth — it would still result in better outcomes for more mothers, and equal or possibly better outcomes for babies as well.

What seems to be the current prevailing attitude is, “We can’t be perfect, so why try?” Frankly, I think that attitude sucks. I’d much rather see the attitude of, “Even if we can’t be perfect, why not try?”

3 Responses

  1. I agree! Why stop where we’re at? And besides, not all breech babies (for example) can be determined breech prior to birth, so we should be making sure all maternity care providers are taught how to manage such labors/births anyway!

  2. I’ll second that, and put forward another motion that they are trained in the art of “hands off the breech” birth. What is the point of hiring an ob when they don’t provide 24 hour emergency care and won’t labor sit? Why are hospitals chronically understaffed but still producing shareholder profits and massive CEO salaries, while families, insurers, and the govt. are paying for services that are overused for convenience and increase risk? How is this not being exposed and called what it is – organized, white collar crime? The Medical Mafia?

  3. In a recent online discussion, someone wrote, “Beliefs about birth are hard to shift so why do women try?” It made my jaw drop.

    Why try? Well, why not try?! Really, though, it’s not about trying to change another person’s attitude as it is about making sure that a different perspective is available so that women can make decisions that they feel good about.

    A shift in cultural attitudes toward birth will be hard to pull off. But the attitude to not even try something because it might be difficult is foreign to me.

    If we sit on our hands, we’ll easily see c-section rates of 60%, 70%, 80%…

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