The Labor Politic

Business Suits and Handshakes

So, we’ve gone and turned the wonder of childbirth into big business.  What’s new?  We’ve done worse with our wonders:  Love, death, sex, religion, art, war.  If it can be sold, we’ll sell it.  If it could be sold, we’ll invent it–then we’ll sell it.

Now that I’m snug inside month number eight, I turn my eyes towards the inevitable:  child labor.  My interest in the event has grown exponentially.  Before pregnancy, the topic bored me.  Sure, the blood and guts “war stories” sustained my interest, but how could they not, with all that horror, body fluid, and out-of-this-world pain?  No wonder women love to linger on their suffering–I imagine my attention span is not that dissimilar to others.

Things are different, now.  I am pregnant.   I am facing that unavoidable conjecture of events (baby inside becomes baby outside). I am interested in more than just the details that cause my stomach to curdle and my mind to pop.

I watched Ricky Lake’s much talked about (in the pregnancy world, at least) documentary, The Business of Being Born.  While the film’s examination of the medical world, women’s experience, and the scientific facts encompassing them both assuaged my fears regarding labor (i.e. the natural process my body will undertake, expelling this little guy from my innards),  the movie obliterated that complacent and soothing adage:  Doctor knows best.

We would be naive to think money was not a formidable player in our experience as a hospital patient–or in anything requiring money, for that matter.   The money motivation and influence creates a web and suddenly, we’re no longer alone in our hospital room–we’ve got the insurance companies, the drug manufacturers, knife happy surgeons (our own OBGYNs in disguise!) crowded around our beds, dictating what happens to our urgent and exposed bodies.

The Necessary Euphemisms (and Untruths)

Then there are the drugs.  Ina May Gaskin’s Guide to Childbirth clearly and carefully lists the various technologies, treatments, and drugs currently popular inside the obstetric practice.  Included, is Epidural Anesthesia.  Simply put, epidural labor is more likely to result in a cesarean section.  Cesarean sections, no matter how common, are major surgeries.  Half of cesarean women suffer complications (ranging from minor to major) (www.ICAN-online.org).

Last week, at my hospital’s “birthing class,” the instructor, a bright eyed (and childless) nurse told us about Cytotec, a cunning little drug used to ripen the cervix and jump start labor.

“It was actually meant to heal ulcers,” she said, her eyes wide and nodding, “But obstetricians have used it to help induce labor for years!”  She paused.  I half expected her to ask us to applaud the drug’s innovative use outside of its approved indication.  “I’m pretty sure the FDA approved it recently…”  She added quickly.

When I returned home, I looked up what the FDA had to say about Cytotec.  Not only does the FDA not approve the drug’s obstetretic use, it warns against its use in an FDA Alert (http://www.fda.gov/Cder/drug/infopage/misoprostol/default.htm).  Cytotec can lead to hyperstimulation of the uterus which can cause the uterus to tear, and according to the FDA, “A torn uterus may result in severe bleeding, having the uterus removed (hysterectomy), and death of the mother or baby” (See above link).  Hooray for Cytotec!

I still see red when I think about it.  The drug is explicitly intended for the oral administration of patients suffering from ulcers.  Who was the first doctor to shove one of those pills up a woman’s vagina?  And how is it that the entire medical community cheerfully continues to administer the drug while the FDA clearly states they are putting these women at serious risk?

These statistics lead me to conclude that all and any unnecessary medical intervention increases the risk and danger to both baby and mother.  Armed (and burdened) with this knowledge, I naturally want to avoid unnecessary medical intervention.

The Battle of the Sexes

Much childbirth media likes to position the wounded female against the white clad, mask donning male.  The sterile, self centered doctors ran the midwives out of town, scaring the mothers into believing their bodies weren’t sufficient, that they needed the hero doctor, that they needed to sterilize, lay down, place their feet into stirrups and push with all their might against gravity so that good old doc can better see that baby’s head crown.

My own experiences have led me to see things differently.  While fact is fact–the medical industry (made up mostly of men) did run a scare campaign against midwives in the early 20th century, and male dominated businesses (and labs) have directed much of the industry’s evolution; to solely blame the guys for our current birthing model, is to give the guys too much credit.

Nine times out of ten, when I’ve mentioned that maybe, I was thinking about, (shrug) maybe I would try to do my best to (smile) maybe have a pain killer free labor, I’ve been met with a certain degree of scorn and scoffing.

“Good luck with that!”

“When I had mine, I couldn’t have enough drugs.”

“Drug me up.”

“Remember:  you don’t have to be a hero.”

At first, these sometimes hostile reactions puzzled me.  I am not trying to be a hero.  I’m only trying to limit possible (unnecessary) complications.

Women’s reactions to my quiet attempt at remaining un-drugged have made it clear to me that to blame men for dominating women’s birth experiences is simple minded.  Most women don’t want to feel the pain.  They want the drugs, and I pity the man who stands in between a woman and what she wants, especially when she is in the throes of labor.

Besides, most of the time, with or without drugs, everything ends happily:  healthy baby, healthy mama.  Check and check.

As women, we are the consumers.  We vote with our money.  We speak with our mouths.  We instigate the law suits.  No one can force us to take, do, or not do anything.  Not even a doctor.

The Wonder Perseveres

The labor topic arose at my baby shower this weekend.  One of my family members has three children.  She had her first without much medical intervention (pain killers included).  When speaking about the birth of her last daughter, she looked tired.  “I know what it feels like.  I didn’t need to feel it again.”  She wanted pain relief, and I couldn’t blame her.  I can’t help but wonder if my risk paranoia will wane after I, too, know what it feels like.

Like it or not, when we speak about our labor experiences, we speak about something more.  Labor speak is political speak.  It’s political, but it’s also very personal, and these different aspects collide, often mid sentence, mid emotion.  Women half-way apologize (via justification) for their decisions (to take drugs, what drugs, to be induced, to vaccinate, etc.).  And yet, at my baby shower, as the women in my family surrounded me, alive with the electricity of their shared experiences, I listened for that common moment, when the wonder of it all broke through, no matter how the baby arrived.  That common wonder sparkled and popped wordlessly.  We all reacted to it individually, uniquely.  We all struggled to articulate the experience using different, inadequate words.

I left my baby shower savoring one triumphent truth:  there exists an unutterable core to this wonder (and all wonders) that cannot be sold, commercialized or made political.

As a writer, it is these things, these things that evade language that stop me the most–and I am ultimately humbled silent.