what is 'invasive birth care' to you? - Page 2

[mmaramba]

Wow, that was really interesting (to read the comments)! I guess I'm a little different from most folks here in the sense that I don't associate the word "invasive" with anything inherently negative, at least when it comes to physical actions. Maybe because my mom is a doctor, and like you said, Ms. Black, doing "invasive" procedures is both par for the course and not seen as inherently good or bad?

BTW, I am planning a very hands-off HB, and my mom is a very low-intervention doc who is very slow to prescribe drugs (FWIW, she's not an OB), so I grew up with a sort of "non-invasive" philosophy. I think it's called, "First, do no harm?"

Yet invasive procedures were also posited as sometimes helpful.

I guess I'm saying that the way I think about it semantically, whether or not something (a procedure) is physically invasive has nothing to do with whether or not it was good or warranted. But as far as being emotionally invasive... In some cases, I see it the same way as with what is physically invasive (e.g.: making a mom pay attention to you when she is in laborland can be emotionally invasive, though it can also be necessary/helpful)... and in some ways I see it as having an inherently negative connotation.

Well, that was clear as mud, LOL.

[Bekka]

This is a fascinating discussion. I'm not certain if I really have anything to add. Except I will no longer be qualifying my "highly invasive, still unmedicated, pharmaceutically induced first birth" as less invasive than someone else's. I don't know if I would have felt more invaded if I'd had CS, but I never did, but this birth (and the photographer and janitor who came in just a couple hours after birth) felt very invasive and out of control to me. So I will own my birth experience as I describe it, and allow myself the psychic, physical, emotional, and fear-mongeringly invasive birth definitions that I've always given it.

I need to go back and re read this. It really is so interesting!

[Bekka]

And, what is it with anaesthesiologists being rude? Are there any polite ones? (Actually I know one, but he doesn't work OB, and I know one nurse anesthetist, who sometimes does, but I'm sure she's not rude).

"You need to hurry up and make a decision whether you want an epidural or not."

"You need to hurry up" is an invasive phrase.

[MsBlack]

Back to the topic of the words 'invade' and 'invasive'--the root of 'invade' is the same as for 'wade' in various languages including Latin, which is the chosen language of western medicine (for med. terminology, I mean)--to enter or go in. So, like mamarramba said, being raised by a doc has impacted her understanding of the words in a positive or at least 'no harm' way: doctors 'go into' bodies for healing purposes, it's only their method and nothing else.

But when I looked in Merriam Webster for a definition, the first handful of definitions given were all essentially negative: entering with hositility/aggression--invading a country; entering with intent to possess, as in the crime of home invasion; entering with destructive/injurious power--bacteria invades the bloodstream; tending to spread out of control, as in an invasive plant/weed; to intrude upon, as invading the quiet of the birth space; to encroach or infringe upon, like invading someone's civil rights. Only the final definition was about medical practice, giving the more neutral, factual origin of the word 'invade' as used referring to going into the body with hands/tools/chemicals for diagnosis and treatment. People so rarely use the word now, as it was used several centuries back by those speaking Old English, German or Latin. Whatever the literal meaning, the connotations (implied meanings) have pretty well taken over 'invade' and 'invasive' in common use.

I mean really--if you were planning to visit your family, would you say 'I'll be invading my parent's house next week'? Maybe only if you had several kids (or one really rambunctious one! ) and you knew that you would be essentially taking over their home with your energies--and even then, you'd be saying 'invade' with humor, not rancor.

Also want to mention that it seems to me that even western medicine is starting to see the inherently negative elements of invasive procedures/diagnostics. I mean, it's becoming more widely acceptaed that even a vag exam or needle stick might cause an infection (apart from the medicine used in the needle)--even if these forms of invasion are 'small' and the risk very low. Not that med practice is becoming less invasive on the whole--but it sure seems to be they are being more careful about informed consent than in the past, making sure people understand that inherent risk of invasive care (well, maybe not so much with birthing women!). And for instance, things like laproscopic surgery are deemed 'safer' in general than fully opening the body with scalpels--there is 'less invasion' involved. Hmmm, not so much 'less invasion', but a form of invasion with lower risk than 'old fashioned' surgical invasion.

So yeah...we might agree to some invasions, either not believing it will be harmful (like u/s or VE), or agreeing the risk of harm is much smaller than the risk of not having the information or help received by the invasion. If we agree, then such things don't FEEL invasive--we don't feel hostility/agression, nor a loss of privacy nor any other bad thing (even if the invasion is not physically comfortable); instead we feel safer, well-cared-for, etc.

Also, in terms of mental/spiritual sense of invasion, one's relationship with the 'invader' matters a lot: you might really be uncomfortable with an on-call OB you never met before, walking in and doing a VE or suggesting treatment without preamble. You might really hate the nurse who just can't seem to lower her voice or wait for a contrax to end before speaking to you, getting your b/p, whatever. You might be perfectly comfortable with someone you trust doing those same things (or perhaps feel 'annoyed' if it's a friend, but not so much 'invaded'). Not just relationship--but also the way something is handled. If that OB-stranger comes in quietly, waits for the contraction to end, and gently introduces herself and her wish to do something, you might not be ruffled at all (and appreciate her manner, even if the invasion isn't exactly 'wanted'). Back to the giving of permission here--and to the respect for our birthing space that we want, that space which begins with our bodies/babies, and includes our personality and mood, preferences/beliefs; the individually created birth space that varies quite a bit from woman to woman.

nuff rambling for now I'll leave it at that for the moment.

[soso-lynn]

It seems that invasion here is very much tied in to unneccessary procedures and/or lack of respect. I would also like to point out that even the most respectful, communicative and evidence-based care giving midwife can invade someone's birth. If a woman is labouring and dealing with it all inwardly, in her head or is "in the zone", a simple, loving word of encouragement can draw her out and bring her back to reality. That, to me, is invasive.

If a woman is feeling very protective of her infant immediately after birth, even her partner's eagerness to see or touch the baby can be perceived as invasive.

On the other hand, some women may want some comfort and encouragement but be unable to verbalize it so I think that, for homebirth midwives, the key to providing all around non-invasive care is to know when interacting with the mother is going to be welcomed and helpful and when to truly step back.

[erin_brycesmom]

Originally Posted by soso-lynn

It seems that invasion here is very much tied in to unneccessary procedures and/or lack of respect. I would also like to point out that even the most respectful, communicative and evidence-based care giving midwife can invade someone's birth. If a woman is labouring and dealing with it all inwardly, in her head or is "in the zone", a simple, loving word of encouragement can draw her out and bring her back to reality. That, to me, is invasive.

If a woman is feeling very protective of her infant immediately after birth, even her partner's eagerness to see or touch the baby can be perceived as invasive.

On the other hand, some women may want some comfort and encouragement but be unable to verbalize it so I think that, for homebirth midwives, the key to providing all around non-invasive care is to know when interacting with the mother is going to be welcomed and helpful and when to truly step back.

This is beautifully stated! I agree on all points!

[MsBlack]

Yes, good point, so-so lynn--I agree

[phathui5]

And, what is it with anaesthesiologists being rude? Are there any polite ones? (Actually I know one, but he doesn't work OB, and I know one nurse anesthetist, who sometimes does, but I'm sure she's not rude).

I met a great one at a birth I attended. I'm pretty sure the nurse had sent him in hoping that he would talk my client into an epidural but he asked her what she wanted to do then told her that she was doing great and left.

[Lady Lilya]

My mother had 2 natural births in the 80s. The anesthesiologist was hanging around, on the order of the OB who wanted him available. But he had nothing to do, so my father put him to work taking pictures.

[Storm Bride]

Originally Posted by Bekka

And, what is it with anaesthesiologists being rude? Are there any polite ones?

Originally Posted by phathui5

I met a great one at a birth I attended.

My case may be different, because mine have all been c-sections, and there was no issue of anyone trying to talk me into anesthesia (I hate being numb to the point that I seriously considered asking them to do surgery without it...but there's no way they would, and I know I'd risk getting badly injured, as it would be impossible not to move). However, the anesthesiologist I had last time was a gem - quite...brusque, but she was still awesome (I'll admit that she mostly won my heart by making a point of saying "this is major abdominal surgery, even though we like to pretend it's not"). The one I saw when I had Aaron was pretty good, as far as I can remember...that whole night is pretty foggy in a lot of ways. I mostly remember him talking to me in L&D, then having him fold my hand over the oxygen mask and tell me to hold it steady while he did whatever he had to do to get me under so fast.

The one I had for both dd1 was pretty good. The only one that bugged me was the one who handled ds2, because he gave me the freaking morphine, which I'd planned to decline, without telling me he was giving it to me. I hate that stuff. I accepted it with dd1, and hated it.

[MegBoz]

Originally Posted by soso-lynn

On the other hand, some women may want some comfort and encouragement but be unable to verbalize it so I think that, for homebirth midwives, the key to providing all around non-invasive care is to know when interacting with the mother is going to be welcomed and helpful and when to truly step back.

Excellent point & I totally agree. But how on earth do they actually do that? Really, I"m baffled. I'd have no clue!!

I'm actually concerned now about my HB MW - she's cool with being hands off, but I'm not 100% confident that she really, truly will just stay quiet - do only the bare minimum necessary (check FHT) & leave me alone. (It's nothing against her personally! I just have trouble trusting.)

I read birth stories on her website & the mamas mention the MW & her apprentice suggesting position changes. When does a MW know when to just let mama labor or push as she's doing vs. go ahead & speak up & suggest a position change??? How do you make that call?

[Magali]

Originally Posted by Bekka

And, what is it with anaesthesiologists being rude? Are there any polite ones? (Actually I know one, but he doesn't work OB, and I know one nurse anesthetist, who sometimes does, but I'm sure she's not rude).

"You need to hurry up and make a decision whether you want an epidural or not."

"You need to hurry up" is an invasive phrase.

I had epidurals with both my kids. I was never pressured into them. With my fisrt the anaesthesiologist asked me if I was sure I really wanted the epidural because I was so close to delivery. And with my dd, born 2 weeks ago, there was no pressure either. I got the feeling both times that they would have rather not given me the epidural.

My thoughts on what is invasive and what isn't, have really been rocked since delivering my dd in a hospital. It was such a fantastic, respectful, non invasive experience for me. I haven't read all the replies, and am looking forward to going through this thread.