Monday, August 08, 2016

Understanding an Op Ed Piece - "Get the Epidural"

Last month (July 9 2016), Jessi Klein  wrote an op-ed piece for the New York Times titled “Get the Epidural”  Here is the link to the piece - click here.

I do not normally respond to op-ed pieces because they are just that, opinions.  And I believe everyone has the right to their opinion.  This is no exception.
In her piece, Klein points out, either consciously or subconsciously, several issues that expectant women grapple with nearly every day.

In life, we are unfortunately all subject to judgement and criticism.  Is it fair?  No, especially not in the tender emotional state of pregnant women.  Strangers feel it is accepted to ask personal questions and even invade personal space by pointing at or even touching a pregnant belly.  These strangers feel that expectant women are warm and fuzzy mommies who will be accepting of a variety of social behaviors.  What strangers fail to recognize is that expectant women are still people, with emotional and physical boundaries just like anyone.  And, these same expectant women are fierce momma bears with an incredible protective instinct.  So no wonder there can be a strong push-back on invasions of personal space.

The debate continues about the names of childbirth experiences.  Words that have been tossed around include “natural”, “normal”, “unmedicated”, “unassisted”, and “physiologic”.  Most regular humans do not know the difference and often use these interchangeably.  There may only be two types of childbirth:  physiologic and intervented.  Physiologic would mean that labor begins on its own (without using any medications to begin or augment the labor progress), void of interventions of any kind including medications (such as an epidural) or instrumental assistance (forceps or vacuum).  Intervented would mean a labor and birth that required an intervention, including the previously stated interventions or even a cesarean surgery.  Both have their place in modern obstetrics. 

Birth options
Expectant women should thrive in an atmosphere of freedom to make decisions about their birth experience based on the knowledge of alternatives – such is part of the motto of the International Childbirth Education Association.  Klein implied she was doing some learning and I hope that the internet is not her sole source of information.   I hope she explores books, classes and perhaps even hires a doula who can significantly add to her personal knowledge base. Expectant women who are in a solid place informationally and who can make informed decisions, have incredible birth satisfaction and some research has shown have a reduced incidence of postpartum mood disorders.

Tokophobia & Relationship Issues
Klein’s last paragraph deals with her fear of different types of pain, including pain associated with birth and breastfeeding.  She seems unsettled about her postpartum image and unsettled about adult relationships.  These are issue that may take time to resolve and are not uncommon!  With so much information at our fingertips, it is hard to discern what information is valid and what is tainted by bias.  Finding information that is evidence-based can be more than expectant women can endure.  This may be one reason why expectant women find one source of information and remain locked on that source throughout their pregnancy.  True or biased, one source is better and less time consuming than vetting multiple sources of information.  Doing intense investigation can also facilitate the fear that may be present.

Based on what I’ve said previously, I hope Klein cultivates an environment of support.  What support looks like for expectant women is entirely up to them – whether that is family support, social support, informational support, emotional support, or physical support.  All women need to feel supported during the most challenging and exciting day of their life.  To feel unsupported during this crucial time brings about feelings of resentment and isolation.  Feeling supported can promote calm and make decision-making easier.

Each woman has the opportunity to thoroughly explore all options and information and based on that education, work together with care providers to have the birth experience that they want.  Even when some of the decisions are out of their hands, women should cultivate a trusting relationship with their care providers for just those times.  

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