Updated: Feb 20
Birth. Yup totally was...I heard the stories, I saw the movies. All the people portraying pain and fear. It was easy to fear birth seeing all that shit. I can't blame people, look how it's portrayed!
It's not to say years of being in the birth realm has made it so I'm completely free of fears of birth. That would be untrue. I am generally afraid of how families are treated within the medical model. The over-medicalization of birth is a pretty scary thing. Yes, we are evolving and things are better about birth in a sense. I mean we are not having "Twilight Births" with forceps and straight jackets anymore so there's that. But the "coercion through love" thing is certainly still very much alive and well.
What do I mean by this? "Coercion through love"
It's when a provider sets you up for a pre-determined intervention (usually makes it easier for them ) as a ways of "saving you and your baby." Typically the provider uses an "I care about you" tone and may even infantilize the birthing person to convince them this is what they need. Fear happens, low-key coercion happens. They pulled rank on you, convince you to do things their way, then praise you for following their direction and then leave you alone until it's "time to push". Manipulative much? YUP!
When Birth is managed it disempowers the birther and that's what I fear about birth. When trusted providers pull a bait and switch and suddenly you're on the board with "pit", "epi" or my least favorite term "section" next to your name. You didn't want that, so how did it happen?
Read on to learn how to prevent this form of low key coercion.
"Shoulder dystocia is an OB's worst nightmare and your baby is measuring big"
What they don't tell you:
a. Ultrasounds are not accurate at measuring baby's weight. (off by 2 lbs either way)
b. Shoulder dystocia can happen to a baby at any size.
c. Babies typically don't grow bigger than the space they are provided unless there is true gestational diabetes and cephalopelvic disproportion which is rare.
"Your blood pressure is high so you need to be induced to avoid pre-eclampsia"
What they don't tell you:
A. Your blood volume increases to 50 % by 28 weeks and naturally your blood pressure will increase due to the excess work your body has to do to pump the excess blood.
B. They won't tell you, that you should actually get your blood pressure read at the end of the appointment, not the beginning especially if you have white coat syndrome, driving fears, or when you're running late and rushing in.
C. It's a variation of normal to have pre-hypertensive numbers especially in labor because your body is under stress. Pre-hypertensive numbers are 140/90. When numbers get up to 160/110 then you worry and take immediate action to calm your mind and body and see what kind of help you need either with homeopathy, herbs or medicine.
D. Blood pressure can be affected by the wrong cuff size. Plus sized? Make sure they use the larger cuff.
E. Blood Pressure is positional and ever changing even while you sleep. It's higher when you sit vs when you lie down. Technically you should be lying down with arm fully supported while getting your blood pressure read. Reading should be checked on left side and in a darkened room to reduce neocortical stimulation.
F. Not all high blood pressure reads turn into pre-eclampsia. You need to look at all of the factors. What are your protein levels? (+2 and above should raise eyebrows) They should do a 24 hour catch to get an accurate view of protein levels. Trace amounts of protein and glucose are a variation of normal due to the extra blood volume so there's a natural spillage that occurs especially in later pregnancy so we are looking for high numbers here.
Are you getting sharp headaches. Have upper epigastric pain? Swelling of the upper body? (Lower body edema is a variation of normal) Are you seeing sparkles, spots or having blurred vision? Is your blood pressure incredibly high (160/110 or over) ? Have you had sudden weight gain? (10 lbs in 1 week for instance) Do you feel off, and anxious along with all of the above? Then you should get checked and an induction is an appropriate next step as pre-eclampsia is nothing to mess with.
That is a very good reason for induction, but the early induction scheduled to avoid the possibility of pre-pre eclampsia with a whole lot of dead baby talk is a form of coercion. The stress of these talks also raises blood pressure and anyone with a cuff in hand will signal to the nervous system that you are not safe and bad news is to come. Then poof, your blood pressure rises. I've seen it time and time again.
Here's a tip:
It's not about how high your blood pressure gets but how LOW you can get it. A good provider will nourish this need for another reading. To get an accurate reading of true pre-hypertension it's about taking a series of blood pressure readings every thirty minutes over the course of 4 hours or 2 readings 6 hours apart and both remain high despite position, calm environment etc...
36 Week appointment: You baby is done growing and is safe to come out next week. Let's schedule your babies birthday! If you go "over your due date" there is a higher risk of stillbirth so this is safer option for your baby. Don't you want your baby in your arms?
What they don't tell you....
A. Inductions can be upwards to 5 days. I have attended a few. Average is about 2/3 days and most inductions done super early (37-39 weeks ) with a low Bishops score end in long inductions or cesarean because the body and baby were just not ready. Failure to progress is typically the diagnosis code stamped on peoples medical charts. Like you failed? No, they failed YOU. If you needed an induction, that's one thing but this is not what I'm talking about. I'm talking about unnecessary inductions leading to unnecessary cesareans. and stories I hear like this...
"I'm so lucky I was at the hospital when my babies heart rate dipped! I had an emergency cesarean and I'm so grateful to my Dr! If I was at home, we wouldn't have lived!"
It's really more like, "When the interventions and drugs that my doctor convinced me to do, which then lead to my babies system to become hyperstimulated, which then caused fetal distress which then my doctor was able to save us from." (Face-smack )
If you were at home, you wouldn't have had any of those interventions so that journey likely would not have happened. Transfers happen, yes but it's not as common as you may think. I hope you sense my tone here. I'm not anti-hospital btw, big fan of good ones but I'm talking about those providers and hospital systems that set you up to fail for a profit.
B. Speaking of which, doctors make more money when you use induction drugs, get an epidural and have a cesarean.
C. This topic will be another post coming up....You need continuous monitoring while on Cytotec, Cervidil and Pitocin and any other medication.
Plus sized? You may be forced to remain in one spot due to the monitors not reading the heart monitor for the baby well enough. My advise, moving your body is best, let them chase you. You need to move. Another option is an internal fetal monitor but that comes with breaking your waters, (also another post) and risk of infection since they have to put a tiny spiral thread into babies scalp to get their heart rate. It will allow you to move so if waters are already broken, go for it if it feels right to you.
You can also just put your foot down, say f*#% your policies and if you are not on any medications say "No thank you, I will only have intermittent monitoring please".
You can also just stay home if you're healthy. That's what I am doing next baby!
D. They may not let you eat even though that is outdated advice. Do you know that they don't want you to eat in case you need a cesarean, but "failure to progress" the biggest reason for cesarean birth. Why do some people get "failure to progress"?
Something food and rest can help you with. Here's some more food for thought, "Rates of aspiration during general anesthesia for cesarean delivery have been estimated to be 0.1%, 0.7% with observed regurgitation. Aspiration during cesarean delivery has evolved from being a leading cause of anesthetic-related maternal mortality several decades ago to a very rare cause today." Read More Here
These are just a few of the more common "coercion through love" tactics I hear about from my clients. These were used on me too! I have more to share so stay tuned!
That's what happens. Time and time again, my well-educated, brilliant, open-minded, self-directed clients are getting coerced due to these common scare tactics without getting the full picture, the whole story, the truth.
So ya, I'm not afraid of birth itself. Birth unfolds as it needs to especially when it's supported properly and takes the journey it is meant to take. It can be short and intense. It can be long and exhausting. It can be calm and supported, it can be primal and alive, it can be unexpected, it can be disappointing, it can be orgasmic, it can be joyful, it can be unassisted, empowering and free.