Monday, February 28, 2011

Give birth with a smile… WITHOUT epidural

While browsing the Shabbat newspapers, I came across a new column in “Besheva”, by Dr. Hannah Katan. Hannah Katan is a well-known Orthodox Jewish ob\gyn and a mother of 13 children. Generally speaking, I highly esteem Dr. Katan’s opinions as expressed in various articles I have read so far, but this time I beg to humbly disagree here on the blog.

The column was titled “give birth with a smile” (translation from Hebrew) and spoke with high praise of “the invention of the century” – the epidural anesthesia, which is highly recommended by Dr. Katan to all birthing mothers “in order to stay calm and happy, and save the husband from being traumatized.”

Those who have been visiting my blog for some time know that I’ve experienced, so far, two beautiful natural births. My second birth experience was less satisfactory, but not because it lacked the miraculous epidural, but due to insensitivity on part of the medical staff. I take issue with the epidural for two main reasons: one, that it carries a host of risks but is advertised as something totally harmless. And two, that women are brainwashed into thinking they can’t give birth without it.

“Years ago,” writes Dr. Katan, “the L&D room was a place of loud voices, and sometimes screaming and crying. But since the epidural was invented, there is usually peace and quiet… which the nurses like very much.”

I would like to point out this reference to the medical staff, instead of the laboring women. Labor and birth are not about what is convenient for the doctors or midwives. Of course they have more peace and quiet thanks to epidurals. But what have epidurals done to reduce risk during birth and contribute to the health of mothers and babies?

“I tend to recommend the epidural anesthesia, which is entirely harmless (what about all the possible risks mentioned in the form of consent the women are required to sign?) and turns birth into the most natural experience in the world.” I’m sorry, but this is just backwards. Even if you are a raving fan of epidurals, surely you can’t call them “natural”?

“The woman is in full control.” No, she is not. She can’t feel the contractions, she can’t control her bladder function, she can’t get off the bed, walk around, or assume positions that will enhance the birth process. If you call this full control, I beg to differ. “Her mind isn’t occupied by the contractions or by trying to get over the pain, she can read through the book of Psalms during birth, pray for her friends and family, chat with her husband and her mother, and enjoy a truly spiritual experience.” During labor, the woman is supposed to be concentrated on the contractions, and if she is in no state for chit-chat, that is all natural. When she is in tune with her body, it helps her to do things that advance the progress of labor.

From my experience so far, it was also entirely possible to pray between and even during contractions, but if a woman can’t do that, the people who love her and are present can pray over and for her.

“The epidural anesthesia can also prevent the father’s trauma. While on duty, I was often called to take care of the laboring woman’s husband, who was lying on the floor unconscious and chalk-white.” How inconvenient. Well, it is time to remember that our sages wisely prohibited the husband from watching the birth process itself, and with good reason. Many men are not up to being present during the delivery at all, or can’t bear to see their wife throughout the contractions. It is understandable and doesn’t make them bad husbands. Does it mean the woman should consent to an epidural so that her husband can watch the birth? If the husband doesn’t feel up to being present during the delivery, a woman can get emotional support, instead, from her mother, a sister, a friend or a doula.

In the last section of her column, Dr. Katan speaks highly in praise of the custom prevalent in Charedi circles, of new mothers going to a health resort for a couple of days, to rest and recuperate. “A few days after my last birth,” she writes, “I went to a new mothers’ health resort for two days – without the baby, who was left in the expert care of his father and big sisters. My youngest was the only one who refused to nurse…as if saying, Mom, you’re too old for that.”

Logically, if a woman is young enough to give birth, she is also supposed to be young enough to produce milk for the baby. But even if nursing isn’t possible, for whatever reason, it doesn’t change one bit the newborn’s basic, all-encompassing, irresistible need to be with his mother.

So far, with both my daughters, I was told I should let my babies stay in the hospital nursery while I’m there, so that I can “rest”. I insisted on keeping them with me, and slept so much with them by my side that I was actually bored. They would wake up to nurse and slept peacefully on. If something disturbed my rest, it was the incessant crying of those babies left in the nursery, who wanted their mothers so badly. My room was right opposite the nursery and I could hardly bear hearing the babies, even though mine was right next to me. When I mentioned this crying to one of the other women during discharge, she clucked her tongue sympathetically and said, “That is why I always ask for a room as far from the nursery as possible – I can’t bear to hear the crying and think my baby might be wanting me too.” I will make no comments on that one, except to wonder why such a simple solution, of keeping the baby close, isn’t thought of by more women, as opposite to getting out of earshot.

Granted, I am a young mother still and there might be countless situations I haven’t observed, but the chief of my experience so far has taught me that caring for a newborn, although time-consuming, is not very complicated, and generally includes nursing and changing diapers, which can both be done without leaving one’s bed. If a woman were given the opportunity to sleep all the while her newborn sleeps, she could be very well-rested.

What really puts a strain on the mother is having, in addition to the newborn, her other children, if she has any, and her household duties to attend to. The natural solution is not to break up the family and have the mother go away, certainly not to leave the baby behind – but to obtain household help. The husband can take some days off work, Granny or a sister or a friend can come and stay a few days. If nobody is available, household help can be rented for a while, and thus enable the woman to recover in the privacy and comfort of her home, and still be with her children and allow them to see the baby and get used to this new addition to the family.

I can’t help but feel that such attitudes as expressed in Dr. Katan’s article promote detachment – detachment of a woman from her body and from her newborn baby, and detachment between the children. It doesn’t feel right, and I hope that I was able to show, in some small measure, that there might be another option.


Rightthinker-Andrea said...

Excellent post! We have six, and there is nothing more rewarding than doing the hard work to usher in new life!

In September, I birthed our 10 lb 9 oz baby boy at just shy of 42 weeks, quickly and without any medication in my bedroom with a midwife. It was a great birth!

No meddling..just birth and safety and peace..

God Bless!

Kimberly said...

What I find interesting is that as a culture we seem to want to be disconnected and unattached when our babies are being born or very small, but once they become toddlers and actually begin to naturally desire some freedom and independence we become overly attached and hover. It's like we've got it completely backwards-or we're making up for being disconnected and detached when they were tiny by over parenting as they grow.

Shorty said...

I found this post super interesting, because i am interested in natural child birth. the one thing that i have been finding with some doctors, is that they see birth as a clinic process. Something that needs to be treated, not a normal physiological function, like sweating or breathing. Granted, its a BIG function, but its still NORMAL. and that's how i wanted to be treated, NORMAL.

Kate said...

I had am emergency D&C when I started to bleed to death during my 2nd miscarriage. Since I had a large meal before the miscarriage happened, I had to have an epidural for the procedure. I recovered quickly, but experienced a quick drop in blood pressure that caused me to completely pass out. Then, I had a horrible migraine for a week because they poked a hole in my spinal column and I was leaking spinal fluid into my body. The doctor told me, "You're lacking in spinal fluid which surrounds your brain, so you're brain is bumping against your skull. You'll be fine once the hole heals up in a week or so. If not, we'll have to do a patch surgery."

Epidurals harmless?

The whole husband passing out thing is ridiculous. I was blessed with the ability to sit at the doctor's end of my sister in law's delivery of her 2nd child. Her husband, my brother was there with me. He watched ALL his children being born and never even flinched or thought less of his wife sexually. My husband didn't want to have a doctor's view, but stayed with me at my head for all 3 of my births and was the epitome of masculine, husbandly support. He doesn't find me any less attractive for having seen me in such a state.

Also, laboring with a smile is possible. I was just about 10 cm dilated with my previous labor and delivery, and right after a HUGE contraction, I looked up at the nurse and just beamed at her. She couldn't believe it. I'm not saying this to be all braggy, but one's personal mindset does help.

That being said, so far, I've been blessed with easy and quick labors and deliveries. I can't imagine having back labor, vomiting with every contraction, having big babies (mine were all small), stalled progress, or whatever else could happen.

Lena Michalev said...

Interesting post! The hospital that I am currently doing my OB rotations at are now heavily promoting that the infants stay with the mothers. In fact, they closed down the entire nursery, so now babies stay with the mother at all times. However, 95% are still getting epidurals (and many are getting C-sections). This hospital is in a poor area, and predominantly a different culture, and many girls who come in are 14-22 years old and not married.

Anonymous said...

I didnt like my epidural. After I'd been given it I had a bad feeling. They kept telling me to sleep while I could (it was an induction) but this very loud voice in my head said no, so I didn't. aybe I was just being silly / paranoid like they said I was but I wasnt chancing it.

As for men in the delivery room ... I have heard from several men that once they saw the whole birth process they never could look at that region again without remembering, thus impacting the couple's intimate life. I think men belong, as they did before, in another room waiting for news.

This woman sounds very silly and selfish. I envision her as having a nanny to do all the real work of childrearing.

Kay said...

yes, yes, yes! I'm an old mom with my babies all grown adults now. But I have believed this from day one. Natural birth (wishing I had been mature enough to insist on a few things when I had my children) and keeping baby with me and then help at home.
You, my dear, are wise beyond your years.

leah Brand-Burks said...

There is no way in the WORLD I would ever leave my just-born baby so I could go to some ridiculous 'mother's resort.' That sounds more like torture, for mother and baby! And I will feel that way whether I have 2 children or 15! said...

Great post! But I do *not* agree with: "our sages wisely prohibited the husband from watching the birth process itself..."

Not all men are incapable of watching a birth (just look on YouTube for videos). In fact, most are and some are even touched by it.

Analytical Adam said...

She sounds like a feminist to me that worships the women and her body like God. Sounds like a feminist to me.

Just because someone has a lot of children doesn't mean they are not
a feminist.

One in my family has 9 kids but they support women in combat and they openly couldn't care less if others have 0 children. I have been reading the very imbalanced situation with birth rates.
In the movie the sound of music their 10 children had 28 grandchildren but 26 of the children came from 4 of the 10 children as one had two children and the other 5 had ZERO.
Very unevenly distributed.

I wish you would care how boys are treated. They are treated like garbage and their needs and concerns are ignored

Her first priority is to make as much money as an OBGYN for equality purposes.

Does her husband work?

This idea that women think women will be nicer to women over men is also feminism.

Orthodoxy today is nothing but a man hating feminist cult and they love lawyers which hurts the doctor-patient relationship.

Analytical Adam said...

Why should a male doctor trust a so called religious women who is part of Rabbinic Judaism. There are known to thing very low of men and have a sense of entitlement so if things go wrong they will sue. They never give credit to men except for the male religious leaders on top. They know they are full of hatred of men more so then so called secular people.

Anonymous said...

This is just outragous, a DOCTOR, who advocates that you leave your newborn child and go for a little vacation. I just can´t believe it. It goes against erverything that every mother learn when expecting in Sweden, and in every other country I have ever heard of. I´m so upset that I´m stuttering while I´m trying to write this. The damages this does to the newborn child AND mother are countless. Besides the disturbed brestfeeding and bonding process the absence of a nursing baby delays the contraction of the uterus and makes the bleeding stop faster. The first days are for just looking in the newborns eyes and rest. Not going on little trips. OMG!!! And it´s a mother who is writing this!! Where is her natural love and campassion for the child?

Regarding the epidural it´s already been discussed in several different posts, so let me just say one more time that I fully approve of it. I don´t get why you always say that it´s impossible to move etc. when you´r having an epidural. The standard procedure is to give a stand-up epidural wich allows every mobility that you usually have, including control of bladder and feeling the contractions. It doesn´t allow you to give birth with a smile either, the pushing process is not affected and very painful. But you don´t have to go through days with horrendous pains during the opening stages.

And Anna, lucky for you that your births were reasonably free from pain. But most women have other experiences, to say the least.
Dont´t dismiss what they have experienced. Life is not fair, and giving birth can be everything between a fulfilling expirience and a cruel and slow death. The epidural have saved lifes and made giving birth much easier for many women. I am one of them.


Elle said...

YIKES!! so what is it that she has said in the past that you have liked? Because she clearly seems anti-natural birth and put the emphasis on "convenience" instead of "long term well-being". MY biggest concern is a mother of THIRTEEN advising mothers to go to a rehab without their baby. WHAT!?!?! Oh my word I just wanna scream. What will that do to first time mother's (and mothers will lesser experiences who mistakenly put trust into their doctor thinking she knows a thing or two) breastfeeding relationship. Everyone with common sense knows how much delaying breastfeeding in the first hours/days is a recipe for nursing complications.

This article seems very disappointing and pretty much like the drivel that's sold over here in the states. how

Anonymous said...

Excellent article...I fully agree with everything you've said (as always!) I can't imagine being separated from my precious newborn babies at such a critical time in their lives! - Jeni from Canada

Engels=English said...

Wohaa! Though I don't always agree with your Intervention at Absolute Minimum attitude, this woman is certainly on the complete other side of the spectrum!

The last reasons ppl should have epidurals is to make life easier for the nurses, and to prevent the husband from fainting. That's just RIDIC!

Screaming etc. is NORMAL during birth...

Anonymous said...

it is sad to me that you seem to have such a terrible view of hospitals and doctors. i really wonder why you continue to even use their services when you always seem to know better? maybe it is just your local hospitals and doctors but i have never come close to any of the "forced treatments" that you mention repeatedly. i was in full control of my birthing preferences and i PREFERRED an epidural. i have had a baby with and one without and i will take the with anytime. i am tired of the attitude that "natural birth" mothers place on those of us who chose to use epidurals...we are no less mothers, our babies are no less babies and our birth experiences are no less wonderful and happy.

i COULD feel contractions with my epidural. i COULD control my bladder and i DID NOT want to walk.

no one has ever tried to force me to not have my baby in the room with me.

i'm just a little afraid for pregnant women who come to your sight and think that this is the norm. what you describe post in and post out is not how it always is. and if someone is weak enough to let medical professionals choose for them...well that is no fault of the professional. again i wonder...if you seem to know so much more than the professionals whose help YOU have employed...why do you continue to employ them?

crystal in the USA.

Anonymous said...

Yes, by all means the main goal should be to protect the husband from trauma. WHAT??? I would be so ashamed if my husband needed to be "protected" from the trauma of his children being born - what kind of man is that? I've never heard of such a thing. Anna, I've never heard of such nonsense - removing the focus from the mother and child, and putting them at risk to secure the comfort and convenience of the (high-strung) husband and the nurses??? Unbelievable.

Anonymous said...

Mrs Anna T, you've got that right!

Marah said...

With all the pains meds available today for birth, you hippy trippy mothers are just ASININE and STUPID to go the "natural way". If I ever have kids, I WILL use all pain meds avaliable, epis AND a spinal!

Rightthinker-Andrea said...


That is your right, and one that should be available to you.

I'm just hugely in favor of self-education..meaning, understanding the risks, the pro's, the con's of all treatments and all methods of obstetrical care BEFORE you enter into it...

Therefore, informed consent and available choice-ie: hospital with an OB, with a midwife, or a birth center or a homebirth can be available.

Much of it is a state of mind and preparedness. If you expect to nearly die because of pain, then it will be hard to handle. The body is powerful, and women need to describe birth accurately. It is often (I only say often as opposed to an always statement, because many say there is little to no pain) the most painful experience you will ever have.

However, the benefits of health for mama, baby and for nursing relationships, as well as a desire to "do it again" for more children, have been well-proven.

I don't fault any woman for choosing a hospital and long as she knows what it's all about, it's her right...unfortunately, many don't view natural birthing and homebirthing the same...

In a hospital, everything is "the doctor's fault" or "the mean nurse" or "hospital policy that lead to..."

At home, it's all mama's responsibility..and that's the same stigma you just attached by calling us "hippie trippy". In fact, I'm an ultra-conservative Christian woman, who has gone through "pain with a purpose" over and over and over again to birth my beloved children.

However, the word "hippie" does not define me whatsoever. No, I'm more a natural living as the bible prescribed kind of mama...hippie? Nope, don't worship the planet-in fact, I'm totally against the new green movement as a religion.

Please understand who you are talking about, and how the manner in which you do so can cause you to sound a bit bitter an un-educated.

God Bless you and if you decide to have children, I pray you get the birth you desire.

Kat said...

Why does Not-So-Analytical
Adam continue to post on this blog? I realize that he is a bitter, woman-hating man...but I do not know what draws him to this lovely blog. He never has anything the least bit enlightening to say.

Rightthinker-Andrea said...

Much agreed, Kat.

Anonymous said...

I would just like to tell that in the recent weeks (in Sweden) there have been a discussion about the health issues for midwifes/nurses regarding their hearing. Problems with tinnitus and other related issues have proved to be a far bigger risk than discovered before. The reason for this is the screamings of the women giving birth. Nurses risk to pay with their health to be by the labouring womans side. Now, obviously the answer to this problem is not to give unwanted medication, and an epidural will not take away the pains of pushing, where a woman is most likely to scream at the top of her lungs. But the problem needs to be solved, perhaps a pair of special designed earplugs wuld do the trick? Please, I´m being seriuos, this is no joke!