Would’ve, Could’ve, Should’ve

It’s so easy to play “Monday morning quarterback.” Take any situation, and say, “Well, if that had been me…” or, “If I had been in that situation…” And you may be right. Some people are just wired differently — are able to come up with a witty comeback, or are able to think more clearly or more quickly, or able to react faster or better than others. But you may be wrong — most likely, you would have reacted in exactly the same way as the person you are (unknowingly) criticizing.

There have been several instances on the My OB said WHAT?! blog in which comments have taken that turn — doctors making rude or nasty comments, or even downright sexual harassment, and several women have said things along the lines of, “If my husband had heard that, they’d probably have arrested him for assault, for punching the doctor’s lights out!” or “I’d’ve kicked that doctor in the face!” (for saying x, y, or z when he’s between the woman’s legs while she’s pushing.” Although I don’t think I said anything along those lines, I know I thought it, or agreed with those who did say it out loud. And yet… would I have? Sure, it’s easy enough to say when I’m reading it on a computer screen, in the comfort of my home, and the full force of the hurtful, rude, or harassing words comes through loud and clear, with no other “background noise” to drown it out. But what if I were really in that situation? How would one go about kicking someone in the face, when she’s numb from an epidural? or with her legs up in stirrups? — not exactly an easy position to get out of quickly.

Some of the women who had submitted the comments originally replied to some of the comments, saying that the “could’ve, should’ve, would’ve” comments were actually hurtful. I know that none of the commenters (or those who did not comment, but thought the same things — like me) intended for the words to hurt. For myself, I would say that when someone said, “I’d’ve kicked that guy in the face!” that she was really meaning, “that guy deserved to be kicked in the face for what he said!” Most of us probably tend towards non-violence against our fellow man, so we probably would not really have physically acted out what our immediate, visceral reaction was. Or if we were in the room when a husband did punch a doctor in the face, we might be shocked and/or horrified (even if we would have been shocked and/or horrified at the comment or action that provoked the violence).

It’s so easy to say things. It’s much harder to carry through with them. It’s easy to say, “I would never have given in to the pressure to have an unnecessary [C-section, induction, augmentation, epidural],” but much harder to actually do — especially when you’re in that particular situation, facing that particular pressure. There is an element in which it is good to hear these kinds of stories, and play through them in your mind, so that if you’re ever faced with it, you may be better prepared for a certain reaction. “Practice makes perfect.” But far better to keep these things in mind while you’re screening your midwife or doctor, or during your prenatal visits, so you can completely avoid situations like these. That’s not fool-proof by any means, unfortunately. Sometimes you can do all the “right” things and still end up on the wrong end of the stick.

If you’ve been in situations like these, please, please, please go to The Birth Survey and report the health-care provider, so that others can be forewarned and forearmed. If you’re looking for a provider, go there to see what others have said about doctors or midwives who are options for you. And if someone you know is pregnant or of childbearing age, be sure to tell her about The Birth Survey so she can get a good match for a care provider. Otherwise you or someone you care about may end up saying, “I should’ve picked a different care provider, and I would have if I only could have known.”

“Blonde Jokes” and other self-fulfilling prophecies

The other day, my Page-a-Day calendar had the following bit of trivia:

Researchers at International University Bremen in Germany monitored 80 women with different hair colors as they took intelligence tests. Before the test, half the women were told “dumb blonde” jokes. (Like: “Why do blondes open containers of yogurt while they’re still in the supermarket? Because the lid says, ‘Open here.’”) Findings: The blondes who were told dumb blonde jokes took longer to complete their tests than the blondes who weren’t told jokes. Did the dumb blonde jokes make blondes dumber? No, the researchers say: The jokes made them more self-conscious.

If hearing subtly or not-so-subtly that you’re stupid can make you take longer to take a test, I wonder what effect being told that your body is broken can have on your labor?

Often, when women are in labor, they are subjected to various drugs and interventions that are not necessarily necessary nor beneficial. What effect can being put into a gown for sick people have? Or being made to lie down in bed, as if you’re too frail and helpless to do things yourself? Or being given an IV as a standard practice? Or being not allowed to go to the bathroom, instead being forced to use a bedpan? What subtle messages are sent by all the poking and prodding and monitoring that women undergo on a regular basis during labor? Certainly, some women are high-risk, so they or their babies may benefit; and intermittent auscultation of the fetal heartrate is good; but when low-risk women are being told that their bodies are defective until proven otherwise… how can that be beneficial? Does it hurt?

There are so many stories I’ve read of women who felt like, as soon as they went into the hospital, or as soon as the machines were hooked up to them, that it was the machines and the drugs that took over and did the work — they were just empty vessels, non-persons, that things were done to, rather than women working to give birth to a new life, as countless other women have done before. So sad.

On the other hand, what messages does a woman hear, when her birth team encourages her, tells her that she is doing it, that she’s strong and powerful, that things are going well, and everything will be fine!

Wedding Day Disasters

I’d thought along these lines myself, comparing wedding day disasters to birth trauma, intending at some point to write a post on it. But, this woman has already done so: part one and part two.

I have seen many, many talk shows or TV court shows where a woman is very distraught –often brought to tears–when she talks about her wedding that “went wrong”. How she had planned this day for so long, it was HER MOMENT, she will NEVER get it back. Even how traumatizing it was for her.

It dawned on me–women are given more sympathy (and more air time) for their wedding day disasters, than women who a bad birth experience!

You can plan weddings, and things can still go wrong. You can plan for how you would like your labor and birth to be — or, more to the point, you can plan who you would like to be there, and how you would like for them to treat you and the baby. Occasionally, things may arise that throw your plans out the window. [Click here to read Rixa’s post on the topic, plus many interesting comments following.] Borrowing from the wedding analogy — the caterer could be in a car wreck, smashing your cake; the photographer could fall in a lake, ruining not only his camera but the pictures as well; your future father-in-law could have a heart attack on the eve of the wedding; your flower girl could pull up her dress to show her pretty panties; the ring bearer could pick his nose (and eat it) during the most solemn part of the ceremony — there are numerous things, large and small, that could happen to disrupt your plans. Some, you can laugh off (at least, with the passage of time); others, not so much. Anyone can see that if the bride is disappointed on her wedding day, that something has gone wrong (or else she has her expectations too high, possibly). We go out of our way to ensure that women have happy weddings — that everything is “just so” or “just the way she wants it,” just the same as we would try to make sure that people have happy birthdays (anybody ever get a free dessert at a restaurant on your birthday?). Common courtesy demands at least that we treat people special on their special day. A woman giving birth should be treated with even greater respect, not just because it is most certainly a special day in her life, but because of the intensely personal nature of birth. Whatever happens in birth happens to her; something bad happening during a wedding usually does not (unless her hair catches on fire from the candles or something).

What is it about this culture?? We value the woman’s right to be a “princess” for a day, “The Dress”, pictures, cake and champagne more than the woman’s right to informed consent, to be treated with dignity and respect, free of coercion and harmful, unnecessary intervention.

And that, I think, is a great deal of the problem — when women feel mistreated, disrespected, coerced, and undergoing unnecessary interventions, they have a right to complain. If the intervention is necessary, then it can be explained in a respectful, dignified way. Common courtesy.

If the wedding was a disaster, be it a torn dress or a medical emergency, does everyone tell the newlywed to just be thankful they are married? After all, even though they planned the wedding for months, invested lots of time and money into it and were anticipating it, they got the end result they wished to achieve – marriage. There should be no reason to dwell on any upsetting or traumatic events. After all, it’s just a means to an end.  The moment they got married would  – and should – erase any prior upsetting events. Right?  I doubt it.  So why are women who share with others their feelings about disappointing or traumatic births told they should just “be thankful”? Why are they told that the process of birth doesn’t matter, it’s just a means to an end?

Click over to read the rest of the posts.

A public relations professional, mother, and “birth nut” had an insightful article about this topic called “Hitting the Right Notes.” She notes that often when people like us have conversations like this (where we, *gasp*, note the importance of being respected in birth, or talk about birth as being an empowering experience; or on the flip side, the trauma that can come from an upsetting birth experience), that people in the mainstream don’t get it. They think that we are setting up a choice between “a mountain-top experience” and “the safety of the baby,” and that’s false. Because they are not (usually) mutually exclusive. She writes,

A reporter once asked what was so bad about my cesarean. I could have talked about the painful recovery, the nearly failed breastfeeding relationship with my son, or the limits it placed on my future birthing choices. Instead, I botched my answer by talking about how emotionally disappointing it was.

None of these messages is wrong. In truth, the emotional aspect of birth is undervalued…

Talking about natural birth as a life-affirming amazing high fails to impress. Even if, on some level, women want that positive birthing experience, they don’t give themselves permission to pursue it. Too selfish. It has to be about the safety and well-being of their babies.

She then goes on to write that, rather than being opposing forces, a “one or the other” choice, a good birth experience has a great deal to do with good outcomes for mothers and babies.

By choosing our messages with care, we have the power to elevate natural birth from being a slightly hippie subculture to the safe and healthy standard that every health-care provider is obligated to uphold, and that every mother should demand.

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Are you bragging or complaining?

One of my friends recently posted on facebook that his car had just attained 200,000 miles on the odometer. Was he bragging about his high mileage and still-functional car, or complaining that his car was so old and he couldn’t afford a newer one?

Often, people make statements, and others read into them — make inferences from them, that may or may not be accurate. Sometimes, people will make back-handed statements — they will speak deprecatingly about themselves or their accomplishments, when they really want people to pat them on the back for their accomplishment. [I am reading Pride and Prejudice again, and noticed that Elisabeth, Darcy and Bingley have this conversation at Netherfield — Bingley admires Darcy’s style of letter-writing, and particularly his neatness, saying that he himself writes too fast to be neat, and also ends up forgetting to write half the words he intended. Elisabeth compliments him that he cannot write fast enough to keep up with his thoughts; but Darcy points out that Bingley is appearing to be self-deprecating, but is actually intending that Elisabeth have just that reaction — of turning a self-confessed fault into a compliment.]

Was my friend bragging or complaining? I believe he was truly bragging. In any event, several of us posted comments about our own high-mileage cars, bragging about how far we’d driven them, how good condition they were in (or not), how long we hoped to keep driving them, how many miles we’d hope to get out of them, etc. There were a few in the 200,000-mile club; my brother bested them all, with nearly 350,000 miles on his ’99 Accord (he bought it new, has maintained it well; drives it a lot in his job as a piano tuner — not to mention driving to his wife’s family in Nebraska and elsewhere [he put over 5,000 miles on it within a few weeks this summer, doing one of those trips]; and the only problem he has is that it has recently started leaking a little bit of oil).

Some of you may be cheering my friend and my brother on, in their high-mileage bragging; but I daresay that some of you may be at least nervous, if not nearly aghast at the thought of driving a car that long.

I wonder what the mood would have been, had my friends reacted negatively to this friend’s announcement. How might it have been different, had somebody responded, “200,000 miles?!?!? That’s insane! I wouldn’t feel comfortable driving a car that had over 100,000 miles on it!! You need to sell that thing before it leaves you stranded on the side of the road somewhere, or blows up on you, or something! That’s just ridiculous! I’ve never heard anything so stupid in all my life!” Or, “Why in the world would you drive a car with that many miles on it?! Can’t you afford a better car??” I think that might have dampened the cheerful aspect of the post a wee bit, don’t you?

Doesn’t the same thing happen when women gather together and the subject turns to birth?

I remember being in a conversation with several women, just a few months after I gave birth the first time. We had gathered up around a first-time pregnant mom, and the women in the group were going around telling the “MY birth was worse than YOUR birth” game, a.k.a. “let’s scare the first-time mom about labor and birth so much that she chooses an elective C-section under general anesthesia, so as to miss the whole process entirely!” I don’t even remember who all was there, nor do I remember who the pregnant woman was, but I do remember getting pretty irritated at all the women there. And as soon as I had an opening, I interrupted, “Oh, it wasn’t like that for me at all!!” And I painted a positive picture of how empowered I felt after giving birth. And what do you know — the mood changed! Suddenly all the women were trying to outdo each other in positive aspects of labor and/or birth!

That conversation has replayed in my mind numerous times in the nearly 5 years since it happened, but it has only been recently that I realized that probably many of the women were trying to be like Bingley — they were wanting… confirmation?… a compliment? … somebody to tell them, “Oh, that does sound bad, you must be a strong woman to make it through all that!”? They were complaining in pretense. What they were actually doing, was bragging. Sure, there was room for complaint, undoubtedly — but I think they were wanting that pat on the back for having given birth under such adverse circumstances, but couldn’t just say it as honestly as that. It rather reminds of the old grandpa telling his grandkids about how he had to walk to school when he was a boy, five miles, through the snow, uphill both ways!

Michelle Duggar, home-birther (and daughter-in-law, too!)

You learn something new every day.

Not having a TV, I only keep up with the Duggars by proxy, or occasionally watching something my mom has taped. I knew that Michelle had had three C-sections (her first set of twins, and two transverse singletons, I think #15 & 17 — two of the youngest ones). But what I did not know was that she had had two home births! Here’s the link. Babies #6 and 7 were born at home, and she said it was wonderful. Interesting.

Update — I just found out that the oldest Duggar just became the proud father of the first Duggar grand-baby! And they had a home birth! How cool is that?! [Yes, I will get my mom to save the episode which includes the baby’s birth!!] Here’s a short clip from the Today show, which mentioned it, along with a snippet of video.

But it was just…

NavelGazing Midwife has written a thought-provoking post on birth trauma and birth rape.

One thing that stood out to me (probably because of the recent posts “At least you have a healthy baby” and “You should be grateful“) was the discussion of trauma in the setting of societal norms. In part,

Is Postpartum Post-Traumatic Stress Disorder (PPPTSD) an illness of luxury? If we were huddled in a migrant camp, would we really be concerned that the doctor pushed our legs apart to do a vaginal exam? Or would the multi-rape experiences overshadow the minimal intrusion the roaming doctor or midwife does.

Is PPPTSD judged by societal norms?

When I was in sexual assault self-help groups (almost always led by therapists), there was a tendency among the women to rate the abuse, almost always minimizing their own. “Well, I was just sexually abused at twelve from the guy next door. She was six and it was her brother. She had it much worse than I did.” Over and over, we had to remind each other (and be reminded) that rating the abuse discounted our own.

This is one of the angles I was searching for — maybe I hit on it well, maybe not — in those posts. If we compare outcomes, results, feelings, failings, etc., we will probably find that we are both better off and worse off than others — comparatively speaking. But should we compare ourselves with ourselves? That’s not wise. If we compare ourselves and our situations with how good they could be, we can always find something lacking. If we compare ourselves and our situations with how bad they could be, we can always see that it could be worse. But does the fact that we are not the lowest of the low mitigate the fact that we are in some way suffering and/or in pain? Why should we compare the level of violation we feel to what someone else “must feel” from having been violated in a different way? Is that helpful? If it is, then perhaps we should; but I don’t think that it really is helpful.

In one way, it is this “comparative way of thinking” that may embolden some people to continue acting in a hurtful way. “Well, sure, I did X, but at least it wasn’t as bad as what this guy over here did!” Using that criteria and logic (or illogic), a mass murderer could justify himself by saying, “At least I didn’t murder millions of people, like Hitler and Stalin did — I only raped and murdered 50 women!” ?!?!?!? “Well I may have raped 10 women, but at least I didn’t molest any children!” ?!?!?!? Are comparisons really even valid, when you’re comparing a rotten apple to a rotten orange? They’re both rotten fruit! — why try to make it sound like either one is acceptable?!

One of the first comments on NGM’s post was from Rixa:

Pain (or suffering) is like a gas: it fills the available space, no matter how small or big.