Saturday, August 24, 2013

Being "Open" about "Cesarean by Choice"

It is not easy being a cesarean by choice mom - either, you are open about your views on how you prefer your child is born or you keep them private with a very tight circle of "need to knows", with only your doctor, your husband and yourself knowing about your choice. In the worst scenario you repress doing what you really want to do and subject yourself to a process that you find, well kind of horrifying, all because a bunch of people who may not even be in the delivery room or changing the dirty diapers afterwards think it is what you "should" do.

I have come to the conclusion, that how women prefer to birth, is a part of "who" we are - and maybe women should not be so quick to hide or repress that part of ourselves - or at the very least women should should not hide it anymore than women would hide any other aspect of ourselves. That is not to say that women should not discuss the available delivery options with our care providers - along with their respective risks and benefits. That is also not to say that women should make choices based on misconceptions about the options available - if it is purely the pain of vaginal delivery that is the problem, then there might be appropriate alternatives to address that. But rather - we should be free to make a *medical decision* for ourselves, and to be comfortable with those choices, regardless of what they happen to be.

I think there is a lot of damage done, when how women prefer to birth is some kind of taboo, where only the dominant choice is seen as being socially acceptable. I think it is awful, that many women who prefer to birth by cesarean - feel the need to be ashamed of that choice. I think it is awful, that women cannot respectfully discuss their preferences with respect to birth. I believe women who prefer cesarean are just as deserving of a supportive community as those who prefer natural unmedicated childbirth, or medicated vaginal delivery. I believe women who prefer cesarean are just as deserving of access to care that respects that choice. I think that by failing to recognize cesarean by choice as valid - myths about cesarean and vaginal birth are allowed to remain, and instead of supporting each other to make the best choices for ourselves, many women either make a personally wrong choice or feel isolated by the choice that they have made.

Being cesarean by choice, is as much a part of me as being a mother, being an economist, being an agnostic, being a liberal, being a wife, being thirty-something - and I am not ashamed of that.

Thursday, August 15, 2013

What is a Good Birth?

I recently read an article interviewing a doctor who had conducted a large study "The Good Birth Project" and then had written a book A Good Birth: Finding the Positive and Profound in Your Birth Experiencewritten by a doctor, Anne Lyerly, MD. In the interview, Dr. Lyerly summarizes 5 characteristics that make. Those characteristics are described as being:

1. Agency: a good birth is one in which we have a hand in shaping, that is informed by the things we value – a birth in which we feel involved and present.

2. Personal security: a good birth is one in which we feel safe and secure, in trustworthy hands.

3. Connectedness: the degree to which we feel meaningfully connected to our loved ones, our care providers, and of course our baby.

4. Respect: a good birth is one in which we feel others respect us, our newborn, and more broadly birth as a meaningful event in our lives.

5. Knowledge: a good birth is one in which we have enough information before and during the event that we have a sense of what is happening and why; but it also depends on the wisdom we garner by virtue of going through it.

Dr. Lyerly goes on to say that

these things can all be cultivated no matter where you give birth (home, birth center, or hospital) and no matter how (vaginally or by cesarean).

What Dr. Lyerly had to say about what makes for a good birth truly resonated with me - and I feel that many women who choose cesareans are wanting "Good Births", births that meet their individual needs for agency, personal security, connectedness, respect, and knowledge. I know that my planned cesarean with my son was truly "A Good Birth" - and I can conclude that it met all of Dr. Lyerly's criterion for a good birth.

Applying the same lens to my daughter's birth, only highlights the unnecessary challenges that many cesarean by choice moms face - and in my own case highlights how big of a chasm there is between the "Good Birth" I sought and the one I was ultimately left to reconcile.

If the interview is anything to go by - I have a new book on my reading list.

Sunday, August 11, 2013

Feminism: It's About Having Choices and the Freedom to Make Them, Not the Choices Themselves

I'm an economist, as such, I have spent a lot of time in my career thinking about choices, and how people make them and trying to understand the conditions that lead to good choices - and conversely the conditions that lead to bad choices, and what can be done to get to a place where better choices are made more often. Any good economist understands that all people try to maximize their own satisfaction - but that because all people are different - with different preferences, not all people will make the same choices. And that is okay, actually, it's better than okay - it is absolutely critical!

I have come to the conclusion, that the true meaning of feminism - is about having choices and being free to make them - being free to lead a life that is most satisfying to the individual woman in her individual reality. Feminism is not, and should not be about the specific choices that individual women make - and much damage is done when biological essentialism is passed off as feminism. Much damage is done when women sit in judgement about the specific choices that other women make. Much damage is done when women fail to focus on making the best choices in their own life. Much damage is done when women fail to support other women in making their own choices.

Something wonderful happens when women shift from thinking that everyone needs to make the same choices to understanding the importance of having choice and facilitating choice. Women become more compassionate. Women become more confident in their own choices. Women become more tolerant of choices that are different from their own. Women are better able to help other women discover the choices that are best in their own individual lives, without judgement.

When the focus is on having choices, and the process of making choices - it is okay to breastfeed - it is okay to formula feed - it is okay to have children - it is okay to remain child-free - it is okay to plan a vaginal delivery - it is okay to plan a cesarean delivery - it is okay to stay at home - it is okay to work out of the home - it is okay to get a degree - it is okay not to get a degree - it is okay to get married - it is okay to stay single - it is okay to cloth diaper - it is okay to use disposables - it is okay to baby wear - it is okay to use a stroller - it is okay to send the kid to daycare - it is okay to home school - it is okay to use public schools - it is okay to use private schools - it is okay eat organic - it is okay to not eat organic - it is okay to circumcise - it is okay to not circumcise - it is okay to cry-it-out - it is okay to not cry-it-out. And none of those things make one woman a better woman than another woman who happened to make a different choice.

When the focus is on having choices and the process of making and facilitating choice - Women become empowered and empower other women - the mommy wars end and the focus shifts to what is really important - leading satisfying and fulfilling lives as individuals.

Saturday, August 10, 2013

Getting There From Here

It's too early to blog about details - but it looks like there is a way to get there from here. I'm excited. It is early days - not unlike first seeing two much wanted lines appear on a pregnancy test - there's a lot of hope and potential, but just a bit of hesitation. I'll blog about details after we are through the proverbial "First Trimester" with this project. (Note: just to avoid any confusion, the W household is not expecting a baby...)