Video of crowning (graphic be warned) - Page 3 - Mothering Forums

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#61 of 65 Old 08-25-2006, 06:57 PM
 
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my sig line is my birth montage- it shows crowning.

My hospital birth a nurse pushed my dh out of the way- climbed up on a stool and started to push on my stomach- hard- to get ds to come out. - no one told me why- or what- it was scary, rude and uncalled for.
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#62 of 65 Old 08-25-2006, 08:21 PM
 
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I don't know why I feel the need to jump in here since I certainly have enough aggravation IRL, but I feel the need to have a try at explaining why some folks viewing this have negative reactions to it - and why that is not necessarily the same as viewing the woman negatively, or as a victim, or as a stupid misguided consumer or whatever.

I do agree to some extent that respect and kindness are above all important. We know that women who feel respected and in control are in general happier with their birth experiences than women who feel control was taken from them and their wishes were not respected. Of course it's better to be spoken to gently, and to not have one's feelings discounted or worse.

On the other hand, it is important to pursue what is necessary and helpful in a birth, and what is not. There will always be differences of opinion on this, and gray areas where there isn't clear evidence of harm or benefit. Some people feel perineal massage is helpful - although really most comparative studies of even touching the perineum suggest that there is no benefit. (The one study I'm aware of looked at Hands on or Poised (HOOP) in which the attendant either did standard support/massage or didn't touch the baby until after delivery of the anterior shoulder. They found no difference in tearing or pain after birth to the mom.) Some studies show increased tearing with perineal massage, or increased pain. If something is a gray area like that, my personal belief is we ought to err on the side of doing less, unless we are sure it has benefit - unless it feels good to the mom (I have requests for hot compresses some for example.) Having a mom saying "Ow" or equivalent and the attendant apologizing for being mean don't suggest to me that the mom thought it felt good.

It is good that the mom is treated with respect and care - but is it enough? For example, there is an older OB at my hospital who truly believes that every 1st time mom needs an episiotomy. Now there are literally dozens of good studies that show this is absolutely wrong, but he believes it. He is a very gentle, kind man actually. If you asked him to not do one, he would "try" but he would see crowning as needing something done because that is what he believes and he would then tell you you needed that. He would even be respectful about it, and probably regretful, too, and his few mamas who even request no episiotomy (very uncommon around here) seem to feel that he was respectful and kind, and even asked their permission, and they are okay with him having done an episiotomy in the end because they "needed" it. Yet I can attend an equal number of births in the same population with a virtually zero percent episiotomy rate. So is it okay that he does so many, as long as he is kind about it?

I feel that we have to apply a critical eye to every birth intervention - from such invasive things as episiotomy, to such seemingly harmless things as asking mom to assume a certain position for birthing. Our we doing good by doing something? Are we doing good by promoting something because it is the standard and normal for our culture?

It is quite possible to think critically about interventions without thinking bad of the woman or her midwife. I am quite sure if that midwife thought she was harming her client, she wouldn't do what she does. I bet the woman felt she got great care, and she probably felt respected and cared for, and that the things her attendants did were needed. But it is important to have these kinds of discussions and keep hashing out what is good and helpful, and what is not. It is hard sometimes as a birth attendant to think critically about the things we do culturally and to step back and say - why am I doing this? Am I helping? Am I doing something necessary, or creating an unnecessary ritual? It is important as birthing women to understand also what is ritual and what is needed - or even just what you truly want versus what you feel you have to have. I don't think that is promoting snobbery or a sense of elitism in birth, it is simply seeking truth.
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#63 of 65 Old 08-25-2006, 08:47 PM
 
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But it is important to have these kinds of discussions and keep hashing out what is good and helpful, and what is not. It is hard sometimes as a birth attendant to think critically about the things we do culturally and to step back and say - why am I doing this? Am I helping? Am I doing something necessary, or creating an unnecessary ritual? It is important as birthing women to understand also what is ritual and what is needed - or even just what you truly want versus what you feel you have to have. I don't think that is promoting snobbery or a sense of elitism in birth, it is simply seeking truth.
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#64 of 65 Old 08-25-2006, 09:40 PM
 
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Originally Posted by Inca
Well lucky you for having had such a perfect birthexperience... If you think your video is much better then I will be happy to see it..
Hmmm. I'm wondering why you are coming across angry and taking this so personal? :

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#65 of 65 Old 08-25-2006, 11:42 PM
 
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First how do you know if the birthing mother finds the touching distracting? Maybe she finds it reassuring. Why do we EVER touch eachother? I dont see why she would be stretching the perineum - espcially without asking first - but the rest of it?
I was responding in the context of mwherb's post (and the context of the whole thread, really,) in which she says she doesn't see the mother reacting negatively to the midwife "moving mom's tissues". In other words, touching her genitals. I'm sorry I wasn't more clear about that. I don't remember all the rest of the touching that was going on, except for her touching her belly which I don't understand either. But at any rate, like I say, what I was referring to was specifically the touching of her genitals. And in general (personally, I don't know any exceptions,) women do not appreciate having their genitals touched by people who are not their lovers. They find it distracting, inhibiting, at the least uncomfortable, and often (as in this case) painful.

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If you have decided to begin with to see something negative going on here then ofcourse that is what you will see.
You're saying it's subjective. I'm saying it's not. It doesn't matter what I'm looking at, if it is unnecessary and has potentially negative consequences (inhibition which hinders birth, pain, etc.,) I don't see any reason to not point that out, and see plenty of reason to point it out. We don't continue to learn unless there is discourse.

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So the mom has been "led to believe" - someone has lied to her? Someone has betrayed her? Is what that MW is doing really that harmful?
No, I am not saying (and did not imply) that the midwife lied to her. I am saying that the only reason any mother would agree to such a thing would be if she believed it beneficial. She's not going to get that idea into her head out of nowhere. She was led to believe it by someone or something, and the midwife (by her actions) sanctioned that belief through her actions at least.

Speaking for myself, I believed it was necessary also. That belief did not make it any less distracting, inhibiting, emotionally unpleasant, and painful (again, as it was unnecessarily for this woman.) And yes, I regard that as harmful.

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The way she touches the lady may not be evidence based but it is part of the birthculture and is seems to be percieved that way by the woman. She is not causing any harm but believing to do good - and if both the MW and the birthing women agree that something positive is going on (that is not harmfull as far as I know - you keep talking about evidencebased - well then show me that touching the perineum - with the womans consent and accept - is harmful or dangerous) then what is the problem?
The most obvious problem is that she suffered additional pain for nothing. We can argue forever whether ignorance = bliss and not come to an agreement. I'll just say that I believe that we all have the duty to speak out against whatever we know to be untrue and/or harmful, despite what the prevailing cultural perception of it is.

As for evidence that touching the genitals with the woman's consent is harmful, I know of no studies that have looked at its effect on the woman as far as distraction, inhibition, discomfort, etc. But do we really need studies to know that those things do occur to some degree or other with the exposure and handling of genitals by those who are not the woman's lover?
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