Two maternity "gurus" on cesareans and "fairytale births"

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Recent interviews with Sheila Kitzinger and Ina May Gaskin have raised interesting points about mother’s expectations for birth and birth outcomes.

As quoted in the Telegraph,

Sheila Kitzinger, the pioneer of the natural birth movement, says heavy marketing of a “perfect birth” has left countless women feeling like failures when their own experiences fall short of expectations.

Sheila further asserts that consumerism and pressure to perform or achieve fuel this disappointment:

“Childbirth experts are often blamed for raising women’s expectations but I think you have to look further. I think the problem is a consumerist agenda. We are geared up to competition, to test everything; nowadays, we see birth as a performance,” she said.

Mrs Kitzinger said many modern women, accustomed to taking control of their careers, made a mistake in applying the same thinking to childbirth.

“There is a heavy emphasis on performance and achievement today. Women increasingly think they should keep control of childbirth, that they should manage it, rather than surrender to the experience. One mother said to me: ‘I am a teacher, I can control a class of 25, I’m not frightened of taking charge, why couldn’t I be in control of the most important experience of my life?'”

How does this relate to cesareans? Sheila continues,

“Caesareans are heavily promoted, as safe, as having no adverse consequences, as resulting in birth without pain. The medical system has a great focus on control and surveillance, and all the monitoring contributes to increased interventions,” she said.

“Women end up under emotional blackmail; mothers do not want to do anything that could harm their baby, so are likely to agree to whatever is being proposed. As a result, many end up feeling cheated”.

Similarly, Ina May Gaskin, interviewed on Babble by Jennifer Block, asserts that too many women are afraid of giving birth vaginally:

Don’t listen to people’s frightening birth stories while you’re pregnant. The pathological levels of fear of labor pain have definitely helped to drive up national cesarean rates in most countries. Now we have the ridiculous situation in which an entire generation of women of childbearing age have been trained to believe that major surgery (the cesarean) isn’t painful or potentially harmful. Too often, women aren’t shown that the pain of cesarean is felt after the surgery, so this aspect of the operation often comes as a big surprise. On the other hand, until fairly recently, there was little or no general knowledge of the fact that some women experience labor and birth as pleasurable — even orgasmic — experiences.

When asked if this might set some women up to be disappointed if they don’t achieve a perfect birth, Ina May responds,

The view that women who have had positive experiences giving birth vaginally should be quiet about them, lest they make a woman who had (or chooses) a cesarean feel bad or guilty, this doesn’t seem a good idea. If we make ourselves mute in order to make sure that no one ever feels bad, we are likely contributing to ever higher levels of cesarean section and lower rates of initiation of breastfeeding.

Part of promoting better births for women includes lowering stress during labor:

What happens too often in our maternity wards in this country is that women are so stressed and frightened in labor that they have high adrenaline levels. These same women, if they had had proper preparation for labor and birth and if they had doulas or midwives with them throughout labor, would have adrenaline levels so low as to permit their own oxytocin to flow freely, thus helping them to progress well in labor and to give birth vaginally.One of the reasons that we in the US have such high rates of cesarean section is that we fail to make it possible for women to have high levels of their own oxytocin during labor, because we don’t understand why and how we should create relaxing atmospheres in which women can give birth.

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