On (not always joyful) Birth Stories
Complications from giving birth are still taboo, in part because of social media narratives about natural births. Thoughts on this and what "a good birth" means.
Community events round-up
We started this newsletter because we believe kids need to be raised in strong communities placing the public good at the center of their work - public schools, libraries, parks and playgrounds, third spaces, museums. The ongoing coup is also an attack on these values.
What can we do? Some suggestions: call your representative, join a protest, volunteer with Food not Bombs, join or start your neighborhood mutual aid group, learn how you can help edit and protect Wikipedia. Here are more volunteer programs. Consider also joining a political club. There are many options in San Francisco, such as the Harvey Milk Club, Westside Families Democratic Club, or the League of Women Voters, as well as topic-specific advocacy groups and groups who share an ethnic background.
Our regular events below:
As always, SFPL has a great rosters of free community events for families
A reminder about the Children’s Council play date, and that we listed organizations offering recurring community events for families here and there
Birth stories
We were struck by this article about how women these days aren't familiar with common birth complications such as prolapse and other pelvic floor issues. Dr Jocelyn Fitzgerald, a urogynecologist, explains:
“We have this idea that birth is no big deal, everyone does it and it’s a natural thing your body was made to do. When it goes “wrong”, so to speak, women think they’re the only one and they don’t want to give the impression that their body couldn’t do it. [...] Postpartum incontinence happens to roughly 30% of women. Pain is probably the next biggest one.”
In other words, long term impairments due to birth injuries are extremely common. And yet, they are scarcely addressed in birth preparation classes or materials about maternal birth outcomes (which tend to only focus on deaths). Part of the reason, as is suggested in the interview, is that talking about them is perceived as scaremongering. Part of it likely is that there’s relatively little that can be done to prevent issues, which may give a sense of powerlessness that birth professionals would rather avoid conveying. Pelvic floor exercises and whole body workouts are already recommended in preparation for pregnancy and birth. But while they may improve outcomes, they won’t prevent the issues. Evidence on practices reducing tearing tends to be poor at best.
There are cultural differences in how pain meds are presented as impeding or facilitating birth and their impact on birth injuries. It’s common in France to place an epidural to let labor proceed for longer without active pushing so the vagina has more time to stretch. The social media wisdom about natural birth tends to say the contrary. It’s difficult to compare the impact of different interventions during births given all the factors at play, and understandable that we rely on individual stories that makes us feel good instead.
No such study seems to exist on how birth and its consequences are perceived in the longer run. We do know that birth injuries and trauma tend to negatively impact the their relationship with the baby. Many will also never recover fully from birth injuries, and the dearth of conversation and support likely impacts their parenthood journey.
Well, this is not very joyful. But we’re glad this issue is being addressed in the mainstream media and in recent research. Unfortunately, recent attempted cuts to medical research funding may set us back on this and other health topics.
So we read A Good Birth by Anne Lyerly. This book is about what makes women feel like they have had a good birth, based on a study of 100 women. And it's not about whether the birth happened at home or in hospital or whether it was vaginal or cesarean – women feel like they have a good birth when they have agency, personal security, connectedness with loved ones (feeling supported by and connected to friends and family and caregivers), respect, and knowledge (clear, timely, and accurate info about what is happening during birth, including potential interventions and their rationale).
Birth remains one of life's most profound transformations. We will remember about what it was like to give birth for years and years. Our wish is for all of us to go through the process with open eyes, together, rather than alone. We will leave the comments open in case you want to share about birth complications you or your loved ones have experienced.