Birth Matters

Stuff I've written

It's been a very long time.  For lots of reasons, I took a long sabbatical from the world of birth advocacy.  Kind of spontaneously, I (and some friends) decided to go to the recent ICAN conference this year (2016). I've discovered that there's still a spark there.  I don't know what that means, exactly - my cesarean babies will be turning 18 this year - but I do know I still think I've got something to contribute.  So, here I am again - it'll be sporadic but maybe I do still have something to write about.

This is still the place where most of what I write ends up. Hopefully it'll help you in some way - Gretchen

My Cesarean Trilogy

With my discovery of something I wrote about 4 years after my cesarean, I discover that I have a trilogy of sorts -- a look at how my feelings and understanding evolved and how I've slowly integrated my experience into the bigger whole of my life.

You Should Be Grateful  This is the first thing I wrote about my experience with a cesarean.  I wrote it in early 2001 after the birth of my daughter, at home.  It's an angry piece of writing but I haven't changed my feelings about the phrase "you should be grateful you have a healthy baby" or "all that matters is a healthy baby".  Mostly I get positive responses, from women who never knew anyone else felt the way they did.  Sometimes, people are really offended.  That's ok, sometimes being offended is the first step toward thinking about things a different way.

Where I am Now  I found this recently.  It’s always interesting to read things years later.  I guess I’d call this the middle piece between “You Should Be Grateful” and “8 Years Later” – a look at where I was about 4 years after the cesarean.  Of course, the part that makes me cringe a little is that I had such hopes that I’d learned my lesson about control…of course, that didn’t end up to be true at all, and the next 4 years have also been marked with struggles and questions, ultimately quite a few unanswered ones.   I do still struggle with not being “angry” anymore and what that means…and I still can’t say with complete honesty that it was “worth it”.

8 Years Later   I just wrote this, one month shy of the 8th anniversary of my boys' entrance into this world.  Evidently, its the third part of what is now a trilogy of sorts.  Along with Where I am Now, you can call it a companion piece to You Should Be Grateful.  I guess its a look at what's there when the anger fades a bit more.

You Should Be Grateful, 15 years later After spending several days with old ICAN friends, this essay bubbled up and out.  Read You Should Be Grateful first, if you haven't read it yet.  This is what that statement means to me now.

"Academic" Writing

These are essays that I've written that are more about teaching something, or explaining something or summarizing some research or other more factual information.  Remember that I'm not the end word on anything -- do your own research too, it isn't that hard.  Actually, that's what the first essay is about, doing your own research...

Using Research Intelligently   Many women are intimidated by scientific studies and research.  Many Obstetricians use this to their own advantage (heck, ACOG, the parent organization/OB Trade Union does it with relish and vigor) by "cherry picking" the research -- only talking about certain selected studies that support their position, while ignoring the full volume of the literature.  But, if you can read, you can read and understand scientific papers. And if you do, you'll have an advantage over most Medical Professionals, who usually rely on sound-bite summaries to form their "best professional opinion".

Electronic Fetal Monitoring First the disclaimer: I am not trained in the use or interpretation of electronic fetal heart monitor (EFM) tracings. What I have done is read a lot on the subject. This represents my own summary and interpretation of what I've read, hopefully in plain enough language that anyone can understand the terminology, and the basic aspects of fetal heart monitoring. Please don't consider yourself an expert just because you read this -- use it as a launching point to have an intelligent conversation with your caregiver about the value and interpretation of EFM data.

Cesarean Surgery Plan    I'm not much for "Birth Plans", at least not in the typical sense.  I think that if you have to write down a whole bunch of things you want (or don't want) then maybe you need to reconsider where you are planning on having your baby -- a really detailed plan tells me that the hospital isn't normally going to do any of those things...and that's not a good situation.  That said, sometimes writing out a plan helps you figure out what you really do want, and that's a good exercise.  I wrote this plan while pregnant with my daughter Ena -- my first homebirth.  I'll say right now that it is very in-your-face, because as a homebirth/VBAC transfer, I anticipated that I might not be treated as well as a planned hospital birth and I did not want to have the usual cesarean treatment.  And, truthfully, its my temperment!  The more important thing is that everything in this "plan" is possible -- most of them did happen just exactly that way with my cesarean.  That's why I've included it here -- to give women the information about what's possible, to let women know that they don't have to let hospital protocol or policy dictate the birth of their child, even if it is via cesarean surgery.

Drugs in Birth One of the areas where there is little true informed consent is the use of drugs during labor.  So I decided to discuss a common side effect -- itching -- and illustrate why there isn't good informed consent and why routine use of drugs might not be such a great idea.

Opinion Pieces

This is the other stuff -- stuff that comes to me late at night or in the shower or while driving.  Stuff that I write in response to other women and their stories or questions or the dilemmas they find themselves in.  It spans about 7 years, at least some of it found in earlier versions elsewhere.  All of it has been updated and/or revised, as I saw fit.  Here's where you really get to find out what I think about birth and cesareans, about VBAC and how women and their babies are treated.  About what I think of "modern medicine" and the fear it engenders in all of us.  You may or may not agree with me in everything but I hope you at least agree that this is important and we need to be talking about it more.

Feelings: Can't live with 'em, can't live without 'em?  This was written in response to several conversations I've had recently about healing and pain and how one even begins to navigate emotions that are so powerful and frightening.  Needless to say, I'm no expert but I have been working on it.  This is what I've come up with so far, with a lot of help from wiser people than myself.

Automechanics and Obstetricians My husband and I just got back from a long weekend in San Francisco -- the first time we've been away without the kids since, well, long before we had kids!  This essay came out of a conversation he and I had over breakfast one morning (at a very cute little diner on Lombard St. if you are interested).  Its kind of fun when my husband participates in my birth obsession.  Plus, when I get him talking, it is very interesting to see his perspective on the whole thing.

How I got from There to Here: My Path to a Homebirth   I’ve written this sort of explanation several times, in several forums.  My journey to planning a homebirth started about a month before my cesarean, when it began to look more and more like I was going to have that cesarean I would “never have”.  I think that in some ways, I’m a surprising person to be a homebirth advocate – at least I do know that I’ve been asked how I came to choose homebirth a number times. So, if that’s something you’ve ever wondered, here’s the explanation.

What's in a Name?   What a cesarean should be called is a very common conversation in my community.  I think we sometimes miss the point -- sometimes the name isn't what's important, rather its who's doing the naming that is important.

Do You Want to Have a VBAC?  Things have changed a lot in the last 10 years.  It used to be relatively easy to plan a VBAC.  Now it is ridiculously difficult, for ridiculous reasons.  Why should you care?

Birth Dreams   How do we keep well-meaning (and not so well-meaning) people from criticizing our dreams and plans for a birth?  The first step is to take birth back into the realm of intimacy and realize we really don't have to tell everyone what we are doing.

About Hospital Birth I've heavily revised this from its original form.  It was a response I wrote to an email I received about whether or not the support email list affiliated with ICAN supported women who were planning hospital births (specifically VBACs).  My response was "yes, we do but it doesn't look like most women expect".  Now, this is an explanation of why I think hospital birth is a lot more complicated and difficult to negotiate than most women believe and why it is absolutely necessary to look at the hospital system with a critical eye when planning where to give birth.

Cesarean Surgery: Lessons, Purpose and Reasons  This is another essay that I'm not clear on exactly when I wrote it but I think it was later in the period of time when I was writing so much.  It is a part of how I'm learning to integrate my experience into the whole of my life.  I hope it provokes some thought in others.

Three Things to be Afraid Of?   This is a revised version of something I wrote awhile ago.  I'll admit -- I get SO frustrated when I hear the same lies and misrepresentations repeated over and over and over by women who really want to believe that their OB has their "best interest" at heart...I don't know which is scarier -- that OBs don't know what their own research actually says or that they deliberately tell their patients lies about risks.

Planning for Birth: Unconscious Assumptions and Compromise  As women in this time and place, we have a tendency (for the most part) to worry about what "other people think".  The "nice/good girl" syndrome is a very real thing, even in women like me who usually aren't particularly concerned about what most people think (pregnancy can make the most assertive woman do and say things she is shocked about later).  The problem is, being a "nice girl" when it comes to planning a birth often leads to plans that aren't in the best interest of the woman or her baby.

How to write a VBAC Birth Plan  Here are my suggestions on how to go about planning your VBAC.

VBAC isn't as safe as we thought?  Recently, I'm hearing this from women who've been told this by their obstetrician, who is trying to dissuade them from even considering VBAC.  But is it true?

Set My Children Free  This is another heavily revised version of something I wrote several years ago.  I'm sure it seems quite over-the-top to some but I do believe how we give birth sets the stage for more than just how any given woman deals with a bad birth experience.