Monday, April 25, 2011

The Birth Nazi

I am continuously amazed at the way people twist my words all around.  I have a friend that said that to me the other day.  She said the comments I get on my blog are consistently 50/50 -- some supportive, some thinking I'm void of any compassion whatsoever and have totally lost my marbles.

Most of you don't know me in real life, but suffice it to say, I am very much the same sitting here at the computer as I am in person.  I will tell you what I think, and I'm OK with you telling me what you think, as long as it is kept respectful.  That's why I do not delete comments from my blog, even the ones that more or less call me a Birth Nazi.  You have the right to your opinion, just as I have the right to mine.

Before I go any further, I want to address my use of the word "Nazi" in this post.  I am using this word because I have heard myself referred to in this manner.  The "Soup Nazi" episode of Seinfeld has been laughed about for years, but when used in this manner, it's not funny.  At least I don't think it's funny.  I, personally, am quite offended by the use of the word, especially in reference to myself.  

Let's address a very interesting topic that I read several blog posts and Facebook statuses about this week:  Is it OK, even good, to expect a good birth experience?  According to most of them, no!  At least this is my interpretation:  You shouldn't get your hopes up because you might be let down.

A very fast recap of my birth experiences:  I have had 4 different births.  My first was an epidural birth where I narrowly escaped a c-section.  My second was my most emotional where I definitely experienced that "birth high." My third sucked and was my hardest (no one's fault but my own), and my fourth was the "easiest" but emotionally hard knowing it was my last and my son would never have a brother.  The only birth I cried tears of joy was my second.  The others, I was just mostly glad they were over.  Does that mean they were bad births because I didn't weep with joy?  Of course not.  They were all just different.  I learned very different things from each experience.  I hope those things I learned, I am able to pass on to my students.  Sometimes it's a case of "Do as I say, not as I did!"

There is this idea that Donna Ryan is an unforgiving natural childbirth educator.  If you have an epidural, I will make you feel awful about it.  And a c-section, forget it!  You might-as-well crawl into a hole!

OK, this is what Donna Ryan teaches.  Pay attention, Donna-haters!  I believe that there are some really awful OBs out there that are happiest when they are performing surgery.  They know nothing about natural childbirth and frankly, don't want to know.  They will scare you into an induction or make you beg for an epidural ("haha, let's keep her pit turned high and strap her to a monitor!"), or they will give you an episiotomy so long you will wish you had a c-section.  (Yes, I've heard a nurse say she heard an OB say this.) Are all OBs like this?  Of course not.  They do exist.  I think that the majority of them have not attended natural, intervention-free births enough to know what that looks like, sounds like, or how to help and encourage a couple on this journey.  Most of them will find a way to put you on their turf, where they are comfortable -- in a bed, strapped to a monitor, legs in stirrups, epidural, pitocin, etc.  See past blog post.

There are other resources in your community.  You may have to dig around to find them, but they likely exist.  Resources that support and encourage natural normal birth.  In Fort Worth, Texas there are so many resources available to families -- amazing midwives, in and out of the hospital.  With choices available, you need to use them.  These are the people who will help you have the birth you want -- or in some cases avoid the birth you don't want!  They encourage you to do the opposite of the (bad) OBs;  things like walking, intermittent monitoring, light food and drink throughout labor, choice of pushing positions, and just plain ole encouragement!  What a difference between a nurse (or midwife) saying, "You got this!  You sound wonderful.  Keep making those low, slow sounds," and "Oh, honey, if you think this is hard now, just wait till you're an 8!  Are you sure you don't want an epidural?"  Well, when you put it that way, of course I want an epidural!

I expect my couples to make the appropriate changes if necessary.  Don't ignore the red flags!  Nearly everyone that sits through my class does change their care provider and/or hospital if they see those red flags.  If you ignore them -- now, this does sound harsh, but it's true -- you have no one to blame but yourself for a "bad" birth if you do not make the necessary changes during the pregnancy.  It's not much fun to be left wondering if that c-section really was necessary. 

Your labor should be a wonderful, yet challenging, time in your life.  Your birth team is critical.  I've said that a million times here over the last three years.  Birth is probably the hardest thing you will ever do.  I never paint a rosy picture.  We don't get to pick the way your birth is going to play out, but you will have a very good idea of what normal birth looks like.  We go through lots of variations of normal too.

This is what I teach about an epidural:  You know what normal birth looks like.  You know what to do, what not to do, you have prepared in every way possible (birth team, relaxation, exercise, nutrition, hired a doula), and you know when you are out of the "normal" range, which can mean a lot of different things.  You have the education to know when you are on the path to a c-section.  Many an epidural has saved a mom from a c-section.  We all hope that an epidural is not a part of the birth equation, but sometimes it is, and sometimes it's even a good thing, a necessary intervention that saves a mom from a c-section.

I have never -- not even once -- told a mom that she failed when she had that epidural.  Or a c-section.  I would never do that.  In many instances, I've put myself in their shoes, and have no doubt that I would have made the exact same decision.  Now, I can't say that a mom won't beat herself up over it, but it's not because I made her feel bad. 

Here's the reality:  When people sit through my class and do all the "right" things and their birth does not go as they had hoped (epidural, transfer, c-section), rarely do I have someone seem to dwell on it and have a hard time getting over it.  Most people know that there are things in birth that are not within our control, but you do your part, roll with the punches, understand why those things became necessary in your birth, and move on!  Learn from them.  Don't become a victim of your birth!  I am seeing this all the time.  It's exhausting.  Your birth does not define who you are as a person.  How you deal with things that happen in your life is more important than the actual things that happen. 

There are some midwives that have told me that the reason they refer to my classes is not necessarily because they love The Bradley Method®, but because my couples seem to bounce back easier when things go differently from their original plans.  My couples also know that they can trust them to help them on this road and if they say they need intervention or medication, it's OK to trust them.  Attitude is everything.

I simply want to see women believe in themselves enough to give birth their all.  Sometimes, that may not mean an unmedicated birth.  It might even mean a c-section in the end.  But if you do your part -- not just become a victim of a very broken maternity system -- you will have a good birth!  Does that make me a Birth Nazi?  Then so be it.


Patsnights said...

Damn straight ... good for you speaking truthfuly and defending your honor

Jolee Burger said...

Donna, you are amazing! You know if people use the term Birth Nazi in a negative way, it is just coming from a place of insecurity. Your class sizes speak for themselves - you are a much-needed voice in Tarrant County.

Danie Nicole said...

I love this post!
I am one of those women who was a victim of her first birth. I did not properly prepare myself and I ignored some red flags. My medical induction (pitocin, constant monitoring, internal fetal monitor, not allowed out of bed except to pee in one of those chairs by my bed) and eventually epidural after threatened with a c-section was not at all what I wanted.
Still, I am not at all offended by anything you said. In fact I want to say thank you for this post!

Cynthia said...

This is a wonderful discussion of your teaching philosophy and your own perspective toward birth. I love the way you support women and families to look realistically and positively at their experiences, no matter how things turn out in the end. Yes, we can be super prepared for birth. Yes, things can go very differently from what we hope. Yes, we can still tell ourselves a very positive story about our birth experiences (without being polyanna about it)! Thanks for writing.

Joy@WhenDoesDaddyComeHome said...

Hmmm - I don't think you've ever misconstrued your words. I think people hear what they want to hear and attack out of their own insecurities. People want to reason and validate their bad birth decisions and still pat their doctors (and even some med-wives) on the back.

The birth system here is so corrupt and I commend you for sharing with women and men in your classes alternative CHOICES! Because without hearing it most people don't even KNOW there are choices.

Macha said...

I think that's always the best approach, to never say that everyone needs to do the same thing (whether it's all-natural or full of medications and interventions), so that when things don't go according to plan, you're not feeling like crap because you didn't do it "right." Because there is no "right," there is only what is right for each individual.

Mrs. Obie said...

I find that whenever people attack you for your beliefs, its because they are insecure or disappointed with their own beliefs or choices. I discovered this first hand recently and you just have to brush it off.

You keep doing you...because you're doing a great job!

Regina said...

Great post Donna! I feel like birth needs to be added to religion and politics.....things that you can't talk about without causing controversy! Keep doing what you're doing though, because you are the reason I decided to have a natural birth.
But you are scaring me with talk of Abby's birth! I want my 3rd to be as easy as my 2nd! Is that possible? ;)

Gloria said...

Great post. I personally believe that when a woman has done everything she an to achieve a natural birth through dieting, taking childbirth classes, maintaining good health ect., that she will be okay even if she ends up needing an intervention, because she'll know that she did everything possible to facilitate in a natural birth, therefore understand that it wasn't her fault. Also, thinking positively and expecting a natural birth helps to achieve on as well. It's much more difficult for a woman to birth naturally if she's taught to prepare for a c-section.

polley said...

OK, Donna, my friend. I am one of the people who knows you in person.

This post is the first time I have heard you say epidurals have a place and doctors can do well in births. It may be because I haven't attended your classes.
When birth comes up in a conversation, you jump into the middle of others' sentences, dismiss others opinions, and push hard for your passionate beliefs about birth and pretty much all western medical care.
Your behavior leaves many, including me who enjoys you so much, feeling bad after talking to you.

When its your behavior making others uncomfortable, it is your responsibility when others feel badly.

You can be passionate without pressuring. You can be respectful without giving up any of that passion.

Keep up the good work, you are a great force for good.
See you soon,
:) love, Polley

Donna Ryan said...

Wow. Not sure what to say after that comment. I'm totally good with people expressing their opinions here, but that was more of a character assassin.

Mama Birth said...

Well- I think Donna rocks! I love you. You have inspired me, taught me, given me advice, and helped me start on the path of natural birth and teaching myself.
I like you the way you are. I guess you could decide not to be passionate, not to care, not to be somebody that people know they can talk to about this. But where would the fun be in that? You are fantastic the way you ARE. What makes you different is what makes you great. Don't change. (Unless it is something really awful that you need to.)
There will alway be people who will be offended, no matter how nice or in your face you are.
I refuse to believe that I or you or ANYBODY can MAKE anybody FEEL anything. My feelings are MY thing and only I get to control them. The same is true for everybody.
Many people like to pass the buck and blame their guilt, feelings, or inadequacies on others, but it is a sign of character weakness. They simply don't want to own their reactions. You will find these people everywhere- and if we listened to them nobody would ever speak.
Keep talking. Let people own their choices and their guilt. You can't make anybody feel that.
I must also say that I was in a class with one mama who had an epidural and one who had a c-section- Donna never put down those women or made them feel anything. In fact they are all still good friends- 7 years later. (And one VBACd and the other had two more natural births.)

Anonymous said...

Being one of your former Bradley students who had an epidural, I consider myself "qualified" to speak to this.
1) You are not a "Birth Nazi"... You are a "Birth Advocate."
2) [For the benefit of everyone else] I was with the UNT midwives and after three days of labor, a chiropractic visit, acupressure and a diagnosis of high blood pressure, I had an epidural. I was the only one beating myself after my birth. It was actually Donna who called me and helped me feel better about my birth and feel like I wasn't a failure.
3) I am eagerly anticipating my next birth. I am not afraid of what might happen because I know what can happen, thanks to Donna... and experience. I fully expect to have a non-medicated birth the next time around. : )

polley said...

Donna does rock! It is no small thing to see a need for change and then make it happen. Tarrant county is lucky she landed here!

You have helped probably a hundred families through your classes, thousands with TCBN and its Birth Fair. Your knowledge and passion are the fuel for all those hugely successful services.

Many you teach are those who were already seeking what you teach. Your commitment to informed choice and your compassion for expectant motherhood can‘t be seen when the undecided and uninformed are overwhelmed by your passion for natural childbirth. So many more could be reached and helped if that commitment to informed choice was shown sooner.

Hope the procedure went well and you got that lunch you've been dreaming of and a long nap!

TheArtsyEclectic said...

I think that there are women out there who simply aren't ready to accept where they're at or experience the full range of that potential (potentially awesome!) roller coaster ride that is an intervention-free birth. It makes me sad for those women who would rather take the illusion of control that a medicalized birth gives, than surrender to such an amazing, powerful process. But then, if they're not ready to hear it, I can't really communicate it to them without a fair potential of upsetting them. That said, I don't think you're at all "too pushy" or anything remotely resembling a "nazi". FWIW, at least =) I say keep up the good work!

Karen Joy said...

I don't know you IRL, but have enjoyed your blog for... about a year now. I have learned a lot, and have been encouraged many times. I agree with virtually everything you've written, that I've read in the past.

There is a minor thing with which I disagree in this post. It is this: Communication is a two-way street. If someone doesn't understand you, the fault doesn't lie entirely with them and it's not necessarily that they are misconstruing your words, either accidentally or on purpose. When we communicate with others, we have a responsibility to speak in a manner that is able to be received by others.

I'm reminded of my husband, who, early in our marriage would get upset when something he did or said upset me, even though it wasn't his intention to upset me. He thought I should just get over it, because it was on accident, not intentional. My response to him was, "Well, it only partially matters what your intentions are. What also matters is how I'm perceiving it! So, if you're consistently doing 'x' and it's hurting me, even though it's not your intention to hurt me, you should stop doing that, because you love me."

In other words, you have to INTEND to communicate well. Not just say what you wanna say and expect others to understand you all the time, especially when they are likely coming from a different paradigm than you are.

Similarly, I used to pat myself on the back for my huge, working vocabulary. In college, a friend with an even greater vocabulary cautioned me that if I'm speaking to someone who clearly doesn't understand what I'm saying, the fault is MINE if I continue to use my polysyllabic words and ignore the confusion on the other's face.

I think that's where the communication breakdown may happen with others. You're speaking YOUR language (one that I speak, and one with which I agree), but not everyone else has the same vocabulary, experience, or values... and what you're saying often just doesn't compute.

That said, I'm glad for this post!! I think it's extremely important to not ignore red flags -- I once changed my OB at 30 weeks because of a number of red flags. Having the knowledge to make informed decisions is SO important!! And, having someone who tells you, "YOU CAN DO IT!!" during birth is incredibly, incredibly valuable and important. We're vulnerable when birthing, and we need to give ourselves the best possible chance -- by making decisions beforehand -- in order to have the best possible outcome. And, yes, I do believe in expecting a good birth experience!! I think it's one of the SADDEST things about the hospital birth culture in the US, that expectant mothers dread birthing. I *LOVE* birthing, and I want more women to have LESS fear, MORE excited expectation, and I think that will positively impact birth outcomes.

Sorry for such a long comment. I hope I've communicated it in a way that's not offensive. Truly.

Carolyn Hastie said...

Weird the way some folk call those who care deeply about and advocate for good health and wellbeing 'nazis'. According to that name calling group of people, there are breastfeeding nazis, natural birth nazis, attachment parenting nazis, health food nazis, ecofriendly nazis.

I suspect that the name calling is a classic case of projection. Perhaps it would be wise for those who attribute negative attributes to others to spend some time in reflection. They might find they have more in common with what they think they are criticising than they are aware.

Rosemarie said...

I loved your post. I had a Bradley birth and my instructor was pretty much the same - if we needed the epi or the birth turned out differently than we hoped, it was okay. "You get the birth you're given." And never once did any of her students feel let down (at our reunion). I birthed in a hospital with a natural un-friendly OB (the guy on duty) but the nurses were there for me all the way. They were so excited about this natural birth (once they realized, "hey, she's gonna do it for real!"). My husband learned so much in class one of the nurses told me after, "he was best coach we've even seen." Because my h2o broke I had to get put on pit, but the lowest dose possible and I did it (also had access to a shower and mobile monitor). Despite all the "medical", I had my natural birth (and no episiotomy either). Take that Doctor!

Samantha said...

It is always hard to convey such a passion for something as controversial as natural childbirth in a way that helps people to understand. I certainly don't see anything offensive in any of your posts that I've devoured today, but I also 100% agree with non-medicated deliveries!

There is a very tender line that many mediated mama's and much of the medical field vigorously fight to keep anyone from touching, crossing or even coming close to. I do think some of it comes from a fear of being "attacked" and feeling bad about their choices or their profession. These are the one's that need to understand the MOST!

Since the unmedicated birth of my second child, I have developed a very sincere passion for natural childbirth and have a hard time restraining myself from shouting to the world that I think it's the best thing EVER. That I want the world to know about it and do it all is such a wonderful thing that EVERY mom should have an opportunity to experience it if possible.

My best ally in this little dilemma is to "let them come to YOU". I know it sounds silly, but in conversation I may drop a subtle hint about my experience, and if they want to talk about it...great!! If not, there's always another time.

I will never stop advocating for natural birth. Keep up your passion and thank you for sharing what you love!