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Monday, September 27, 2010

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Brava!

You had nothing to worry about doing this post....I concur!

This is by far the best post that I have read on this topic. I find it incredible that people are allowed to act as if major surgery is no big deal, as long as it results in a healthy baby. Even when c-sections are necessary it is completely reasonable for women to wish that they did not need to be cut open!

Um, I totally could have written this post. Except I'm not eloquent or brave enough.

This is fabulous - and much of this has been swirling around in my head as I, you know, just went through all of this.

I would add that I think people need to be more vocal about the fact that breastfeeding DOES, indeed, need support. Yes, it's natural, but our bodies and our babies might need a little help or time to adjust. (I just want to say for the record: sore nipples don't mean you're doing it wrong - it means your body might not be used to having a baby suck on you many hours a day! Ha.)

Also, you wondered if others would be as passionate about childbirth and breastfeeding if they had as wonderful experiences. *I* wonder if you had such wonderful experiences because you *are* passionate about them. Because you knew/know that your birth experience would impact you for more than just the 12 hours or whatever that you were in labor.

Anyway. I could go on. But, just: YES. :)

once again you've put what I think - but can't get into words - into good writing. Thank you.

Word.

I *almost* had an unnecessary C-section, as you know, and if I hadn't been able to speak up and make the doctor give me just a few more minutes, time off of the drugs they gave me to try to make my body do something it wasn't wanting to do, I would have been forced into it. Fortunately I had a doctor willing to listen to me (albeit not exactly enthusiastically) and supportive nurses around me. Most women aren't as lucky. And I still, four years later, feel sad and guilty about my breastfeeding experience for exactly the reasons you cite. I wasn't really allowed to grieve that things didn't work out, a combination of factors involving my own PPD, returning to work six weeks after birth, and my uncooperative body. People saying "what matters is she's healthy" don't really help, and neither do people saying "but you could have breastfed if you'd REALLY TRIED." Either extreme is hurtful.

Eloquently said, Arwen!

I am not outspoken AT ALL about breastfeeding or natural birth, yet at the same time am passionate about both (still nursing the almost 2 year-old).

I didn't have a natural child birth with my 1st, but I did with my 2nd... and it was a truly incredible experience for me. HOWEVER, I really, really only think it was possible (for me) due to the extensive preparation, reading, educating I did for myself, completely OUTSIDE of our medical system. If I hadn't have done that individual research, watched films, switched to an "alternative" care provider (midwife)-- the natural child birth wouldn't have happened. And that seems a little backwards to me. Not that everyone has to choose natural childbirth, or that C-sections aren't amazing, life-saving procedures!... but that you really do have to push back so much to break out of the mold.

tending to my newborn here so the comment will be brief -- YES!!! exactly what i have attempted to say in so many conversations. i just hope i have gotten it across as well as you.

thanks for this arwen - it really articulates the frustration i feel during these sorts of conversations online - i'm not condemning anyone's choices, but there IS something more than just a healthy/living baby that deserves validation.

great post!

You've said what I've always wanted to say. I had an unnecessary c section due to a mistake made by the attending doctor. With the same baby I also had low supply. It was the most frustrating thing to hear "All that matters".

I think that the supply issues would have not happened due to the c section and its so frustrating that our system now preforms these surgeries in 1/3 births. I totally agree that the system is failing us.

Very well said. It isn't supportive at all to dismiss a woman's frustration, grief or anger as though it doesn't matter.

Awesome. Just awesome! I found your post via a twitter post and I'm so glad I took the time to read it. There were two parts in particular that really struck me.

"I understand that many (maybe most?) mothers don't feel as passionately about birth and breastfeeding as I do. That's fine. But I wonder how many of them could, or would, if they'd been lucky enough to have the experiences I've had." This is SUCH a good point and I praise God that I've had good experiences!!

Finally, this paragraph was just awesome: The women whose lives have truly been saved by c-section should have the opportunity to be grateful for the procedure, secure in the knowledge that it was vital. And the women whose c-sections were likely unnecessary should have the opportunity to be angry with the doctors instead of disappointed with their own bodies, so that we can all become more educated and more motivated to help achieve a medical system that respects women's bodies and values the natural process of birth.

Well said, dear. Well said.

I've written this post, in a more general way, about the phrase "at least". When someone says "at least" about something, they are diminishing your feelings in an attempt to have the right answer.

Well said! Thanks for saying it.

YES.

I work. My baby had no formula until she was 9 months old. At 9 months, she went through a huge growth spurt and no matter how hard I tried, I couldn't pump enough while at work so I had to start supplementing (which led to weaning at 12 months). I didn't get over it for awhile because I didn't let myself grieve. I told MYSELF all that matters is that she's well fed and happy. I told myself at least she was exclusively breastfed until six months and didn't get formula until 9 months. And its true that's a wonderful thing, but I couldn't appreciate it until AFTER I grieved. I thought I wasn't allowed to be sad because clearly formula at 9 months is not a tragedy. But, at the time, it was a tragedy to me. Now that I've gotten over it, it doesn't make me sad at all! In fact, it ended up being the best thing for our family and I wouldn't change it even if I could.

I get that people saying "all that matters" are trying to give perspective. But perspective comes with time and it makes me so mad when people try to force it on others. That doesn't work! The sooner someone is allowed to grieve, the sooner they'll gain perspective and realize on their own what is the most important thing.

I had my first child in July via c-section. My blood pressure had been high through the pregnancy and the week before my due-date it sky-rocketed. I also had ridiculous swelling and protein in my urine and was thus diagnosed with pre-eclampsia. 4 days past my due date my doctor and I made the decision that my health was deteriorating and that the safest course of action was to induce labor. After 26 hours in active labor (I started regular contractions within 30 minutes of being administered Cytotec) including being allowed to move around freely and labor as I wanted, I had only dilated to 3.5 cm. My blood pressure at this point was higher than it had ever been and I was starting to feel the effects of it (dizzy, blurred vision, etc). The decision was then made to deliver via c-section given the serious risks to my health of continuing when I was not showing progress and my condition was getting worse.

This is the not the birth I wanted, nor my doctor wanted for me. However, it was best for my health, which ultimately benefits my son. Even though I fully understood this at the time, when the decision was made I sobbed for a good hour as they prepped me for surgery. I also cried pretty much throughout the surgery and especially as my son spent the first 30 minutes of his life with his father and not with both of us as we had dreamed for 9 months. I didn't get to hold him until he was 2 hours old (due to my negative reaction to the anesthesia which left me shaking uncontrollably for 2 hours) and only then was I able to try and breastfeed.

After spending the night as a new family (and getting precious little sleep!) I only really had time to fully process what happened the next day. I fully understand and support the decisions that I and my doctor made for my labor and delivery. However, that doesn't mean that I don't wish things happened differently. The sadness over the situation led me to spend many hours that day in tears trying to come to terms with the fact that while my doctor will let me attempt a VBAC next time, that there is a serious chance that I will never give birth vaginally - something that I hold as a sacred experience and deeply want to have for myself and my children. I'm not angry, but sad.

My mom (who delivered 5 of us by c-section due to a badly done emergency case with the first that rendered it highly unsafe for her to attempt a VBAC despite her doctor being fully supportive.... long story) said to me that what mattered most was that my son and I were ok. And what I felt then wasn't that she was telling me that my sadness (or anger if that had been the case) wasn't ok or justified; rather, her saying that enabled me to let go of the vision of the perfect birth that I had and to step back and be grateful that nothing more serious had occurred. She didn't say that I couldn't be sad, through talking with her I was able to see that if I let my sadness over that overshadow enjoying these first moments, hours, days with my son than I was doing myself the injustice.

I understand the general point of this post, and for frivolous c-sections or those not necessary, I can understand how the 'at least' comment might seem demeaning or like they're trying to brush off the emotions these women feel. But also understand that for some of us, speaking for myself, hearing those words gave me the freedom to let the sadness go and really be present to my son and husband as we began our life as a family.

Just another perspective....

Wow, Arwen. YES.

Love this post! After an unnecessary induction which resulted in an epidural and a water-logged late preterm baby and an uphill breastfeeding battle with my first child, I am so thankful to have experienced an intervention-free, midwife assisted birth and breezy breastfeeding experience with my second. I am thankful to count myself among the 13.3% exclusively breastfeeding at six months, and I have every intention of breastfeeding well beyond my second daughter's first year (she's 8.5 months old at present). Even with my struggles with my first, I breastfed her until 15 months of age. I have a hard time understanding how so many women can enter into pregnancy, perhaps the most serious undertaking of a woman's life, without educating themselves about what lies ahead. It's an incredibly injustice they're doing to themselves and their babies. And, in our current over-medicalized culture, they cannot depend on the "experts" to steer guide them along the path that best suits the mother's needs.

Excellent post.

My daughter was born via c-section, and it was definitely a life saving procedure for her. They didn't know what was wrong when the decision was made to do the c-section (a continued heart rate in the 70-80 bmp range prompted it) but it turned out she had aspirated meconium and both her lungs were collapsed. She spent the next few days on oxygen and healed completely and I'm grateful everything turned out okay.

BUT. When I went back to that same doctor for my next pregnancy, things weren't so good. He said he would let me "try" a VBAC but that he would want an epidural in place (even if I didn't want one) "just in case" I would need a c-section again. He said he wouldn't induce labor (I wasn't induced the first time either) but that I also shouldn't go past my due date or I'd need a c-section. After that appointment I was pretty sure I wanted to switch doctors, so when we ended up moving I was glad I could shop around for a pro VBAC doctor. I had a VBAC and definitely want to do it again next time.

It amazes me though, how many doctors tell women they "can't" have a VBAC for whatever reason, and many women just accept that because they trust doctors. That is definitely the medical system failing women.

And yes, I definitely got a lot of the "all that matters is a healthy baby" after the c-section. I also got a lot of "at least you're pregnant now" when the due date of a pregnancy I lost came around. Like somehow being pregnant made the miscarriage not matter anymore. So thank you for pointing out that the most important thing is not the only important thing.

I know this will be long, and I almost feel like I should have my own blog, but I have a lot to say on this subject, so bear with me, please.

I have heard “all that matters” SO many times in the last 2-3 years. When my son was born (he’ll be 3 in Jan), it was a beautiful, natural, friendly, home/water birth. It was perfect, IMO. Since I had breastfed my daughter (now 10) for 3+ years, without any major problems, I felt no need for preparation or support for the planned breastfeeding of my son. I figured, I’ve done it once, I can do it again. WRONG!

First, the Dr said he had jaundice, so his heel got pricked, and 5 days later, got pricked again. I cried just as much as he did at these traumatic events. Then a nurse showed up with a “baby tanning bed”, where I had to leave my son for 24 hours, no matter how much he screamed or cried. Then the nurse pricked his heel again. I was done with it all at that point, so thankfully, his bilirubin level was declared low enough to be done.

Next, at approximately 1 month, I caved to pressure from my then-husband, and we had my son circumcised. I nursed him just after, and he whimpered, but latched on, for a few minutes, until he peed, at which point he jerked back off my breast and screamed bloody murder! Every time he peed, every diaper change for the next 2 weeks was screaming and crying (I cried as much as he did!). I will NEVER subject ANY of my children to that procedure, that torture, again!

I had (mostly) quit smoking while I was pregnant, but stupidly, I started back up again when my son was only 2 months old. I had no idea that it would dry up my milk, like it did. I was the only car/driver for all the adults in my household, driving my mom to and from work, my brother to and from work, my husband to and from work, running all the errands, etc. I never got time to just sit and nurse and be a mom. I had NO support, as all of them, my family and his, couldn’t care less whether I breastfed or not, some even thought it was disgusting. I wasn’t in LLL, and all of my friends live out of town (I wasn’t connected to them through Facebook yet). I was alone and drowning.

As my milk dried up, my son began showing signs of dehydration and malnutrition, but NOBODY caught on, not the ER Dr who saw his rust-colored pee or his Pediatrician, who noticed his weight loss. Nobody realized what was going on, even with all the signs, until it was too late. After (basically) starving him for TWO MONTHS, my mother yelled at me, I cried and cried, my sister-in-law went to the store and brought home formula and bottles, and I switched to the bottle. The need to fill his belly, ASAP, outweighed my need to re-build my supply and continue our breastfeeding relationship. I had no LLL Leader or Lactation Consultant to suggest or provide a supplemental feeding system – which could have done both at the same time! My family, my body, my “support system”, the medical establishment, everyone and everything let me down, and in turn, I let my son down. I was too lazy, too selfish, too busy, too stressed, too whatever to do what I KNEW was right! I had done right with my daughter; I had done the research, and had made up my mind. Suddenly, I had no strength, no conviction, no resolve. I caved to pressure, to whim, to other people’s desires rather than my own.

Not breastfeeding my son changed everything about the way I parented him. It didn’t change how much I love him, just how much I held him, co-slept with him, made eye contact with him, talked to him, responded to his needs. Now, nearly 3 years later, he’s developmentally delayed in his speech, and I wonder if that’s my fault too!

I feel SO guilty, like SUCH a failure, but when I try to discuss my feelings, I get “all that matters” and “at least” and “you did what was best”. I want someone to recognize my feelings as real and valid, someone to sympathize and empathize with me, someone to let me cry, and get angry, and kick and scream so I can work through it all. I want someone to realize that I set standards of “good mom” for myself, and that I fell SO VERY short of them with my son… and it ALL could have been prevented. Instead of letting that first nurse prick my son’s heel, I could have taken him home and sat near a window nursing him. I could have loaned my car to my sister-in-law for a month or two and asked her to drive everyone around so I could be a mom to my new son. I could have said NO to the circumcision, and NO to the cigarettes. I could have gone to LLL meetings, gotten to know a leader, and had someone to call when questions came up. I could have pushed harder to be the mom I know I should have been to him, to tell everyone else to BACK OFF!!!

Maybe I need therapy. LOL

Will being a good mom again to the next baby (due in Dec) resolve my feelings of guilt, or make them worse? Can I make up for lost time by encouraging him to nurse again (he is VERY interested in my boobs)? I feel a little better having fought for him recently, pushing the system to recognize that he was delayed, that SOMETHING was wrong. However, they still have no cause for his delay – he can hear just fine, his ears look clear, he doesn’t have autism – so until he gets a little older, the diagnosis is on hold. But a service plan is in place, and we are working with him to teach him how to communicate with us, even without words. Now we’re potty training too, at his pace, and I’m trying to bond with him. Sometimes I feel better, and other times I feel like it’s too little too late.

Leave the “all that matters” at home when trying to make a mom feel better. It SO doesn’t help!

Distinctio! I think the best part of this post is how you make the fine distinction between saying "all that matters" and "the most important thing," which makes the difference between validating someone's feelings and over-valuing mother-centered births and the breastfeeding relationship and simply valuing it, appropriately, in good order. I love subtle distinctions, it's the sign of intelligence and good argument.

Otherwise I would have been tempted to remind everyone reading this that before medical births the maternal death rate (forget about infant mortality) was 1 in 100 and now it is something like 1 in 100,000 or roughly four orders of magnitude difference.

If you read into the study on the high number of c-sections it is because of two things--one is an earlier medical invasion through ART. Older mothers, mother's with health challenges, and high order multiples are all going to need more NECESSARY c-sections. There is also the issue of higher rates of gestational diabetes and maternal obesity. The curse of prosperity. So an increase in c-sections doesn't mean that there are more unnecessary procedures, necessarily. It means that there are also more high-risk births.

The article also makes the central point to what has happened to obstetrics which is over-litigiousness. Not to go all dystopic, in the very, very near future of public health and no tort-reform, we may be grieving over not being able to get an OB at all, and find that to be far more appropriate than spending precious time resenting medical invasions.

Sometimes, overweening guilt, fixation on things not going according to plan, and an inappropriate value on things like natural birth and breastfeeding, which are valuable in proportion to other goals, can be a form of self-obsession that people need to either be gently prodded from or, maybe even snapped out of. I suppose I'm highly unpopular here if my preference would be sometimes to say: "get over it." LOL. Feeling somewhat more entitled toward a little bit of tough love, perhaps, because I had a crash c-section and a baby near death, after chorioamnionitis, and felt a little grief in the moment of the c-section decision so understand it but also understand when it's gone beyond meaningful emotional experience into something less productive.

Grief that lasts beyond a short period and begins to interfere with the present day is rationally out of proportion to what has happened to most women. We don't always do a person a service by indulging it.

I don't doubt that some women are victims of unnecessary c-sections--but more, much more, they are not "victims" of truly unnecessary c-sections as much as they are of a doctor's conservative choice to eliminate unnecessary risks when a lower-risk option is available. Again--distinctio! A subtle shift but an important one in having a proportional response to the current state of obstetric medicine. Can a cultural value on natural birth weigh into those distinctions a little more? Sure. How much more? I daresay few women here are qualified to make that call. There is also simply something more pragmatic than a misogynistic system at play here--would you rather an OB be able to survive the pitfalls of malpractice in their career so that woman who truly need OBs have one? Unfortunately, the reality is most doctors have to self-protect in order to live to fight another placental abruption and save a mother and child another day.

And could there possibly be a reactionary over-valuation of natural birth and breastfeeding that contributes to the disproportional grief and guilt a woman feels when she is the recipient of the advantages of medical culture? Where a woman feels if she has trouble breastfeeding and fails to give birth naturally that somehow her ability to attach and bond with her child is somehow inextricably damaged? Is there something there that needs adjustment and perhaps a confrontation with the very real fact that they are alive and so is their baby, might be in order?

First, Katie, I think it's important that your mom told you that "what matters MOST" (not "all that matters"). As Blog Nerd says, it's an important distinction.

Lynnalu, I'm so sorry for your pain in the experience. Yes, it matters that your son was fed and it also matter that he has delays. BUT do not keep beating yourself up over it. There are many children with delays who never had nutritional issues. I do think you need to talk to someone for YOUR own peace and to help you get past it. You need to be able to approach the rest of your pregnancy and your new baby -- and help your other children -- without the heavy burden of guilt you are putting on yourself still.

Now -- my own reactions to this post. I agree too Arwen!

I had an emergency C-section with my first birth, but it was to save my son's life, not mine. I labored all night, got to 9 cm, and his heart rate was decelerating with every contraction. My OB watched carefully, tried different approaches and finally the rate was dropping too much -- so it was a rush to the OR. Yes, I was disappointed, but scared at that point. After a couple hours in NICU, he recovered and was fine. It really was a situation in which what mattered MOST was that he was safe and healthy. But it did matter that I was sad, that I got sick from the meds, that I didn't hold him for several hours, that he slept almost all day and had trouble nursing, and that I had a slow C-section recovery. BUT none of that mattered as much to me as his safety. After a SLOW start breastfeeding, he was breastfed until he was 17 months old.

I was glad that my doctor supported VBAC. When I was pregnant again 3 years later, I read up and even took a childbirth class again. My OB was on vacation, but her partner (another woman) and the nurses were incredibly supportive and encouraging. Having a natural birth was so empowering (and I am NOT one to normally use that word since it's been so overused in unpleasant ways). It was wonderful to be alert and have an alert newborn and have her take to breastfeeding easily. I was thrilled with the difference in the birth, the recovery, and the experience of that first day of her life. She also nursed until 19 months.

So I've experienced both the full-intervention lots of monitoring and meds birth and a fully natural birth. (Interesting to note -- both in the same hospital from the same OB practice, just different medical situations.) I had a hard struggle with breastfeeding and an easy start. But my experience with my daughter did not undo my past experience, nor did it "best" it. My feelings about both are real.

As moms, we all deal with guilt and second-guessing and blame (from ourselves and others) FAR, far too often.

Arwen, I so appreciate your post. Especially in matters so heartfelt (and sadly too often guilt-inducing) as birth and feeding our beloved babies. We have to find a way to better support each other, and ourselves.

Yes, what matters MOST is the health, happiness, and well-being of mom, baby, and the family.

But we have to let ourselves (and each other) know that our feelings about disappointments or surprises or unpopular choices are valid.

Sorry to be so long. Guess I need to get a blog one of these days....

Thank you, Arwen! As a mother of a baby born by "emergency" csection where I was put under general anesthesia and my husband was not allowed into the operating room. Neither of us saw our baby be born, and I didn't even meet him or hold him until he was more than 4 hours old. I was often handed that phrase, and told that I should be grateful for a healthy baby. Well, obviously I would have a completely different depth of devastation, had either of us not left the hospital healthy, but we did, and I still felt robbed and broken-hearted. Friends and family couldn't really figure out how to deal with me. ,.lp,m

I think there is so little public space to deal with birth trauma. People don't understand what it is, let alone how to be supportive of someone who has experienced it - especially someone who had birth trauma but still had a healthy baby.

Loved this post. You very fabulously articulated my feelings! Thanks. Will be sharing with some friends.

I haven't read all of the comments, but I had a birth experience that was traumatic and had to have two surgeries to recover physically. The emotional recovery was something else entirely. I got the most help from a book called "I Can't Get Over It", about recovery from PTSD. I'm certain I had PTSD as a result. I think it's different from the baby blues or even PPD.

The book gave me a really great understanding of how the things that people say ("all that matters" is a great example) may re-traumatize a person by invalidating their experience. I think people are so uncomfortable with the dark, the difficult, and the painful, that they immediately reach for some verbal bandaid to apply to make themselves feel better. They hurt with their words.

I'm glad you brought this topic up. I've finally come to understand that a benefit of my bad birth and nursing experience is that I can stand in solidarity and be appropriately supportive of those who were unlucky in the same ways as me. It's not any of our faults how these natural processes work out in most cases, and we have to find a way to integrate them into our total life experiences. Most people will do this most effectively by talking with another person and being validated. I think if you can't offering that validation that they so need is love in action.

Whoops, got my last line wrong...meant to say that if you can offer that validation, it's love in action. EDIT FAIL. ;o)))

Your post really touched me because I am the mother that you write about on both counts: unplanned c-section (despite one successful intervention-free birth) and unable to breastfeed my children without supplementing (and I've tried everything). Despite my less-than-ideal situations working out in pretty much the best way possible otherwise, it has been difficult emotionally. I could say so much more on this topic, but ultimately: it is wonderful to have my feelings validated in such a loving way. Thank you.

Thank you! I'm about to have a baby, and because the women in my husband's family have not been able to breastfeed, I am constantly surrounded by "don't expect to be able to do it, all these people couldn't." Even though I know that I have to think positively and be confident to be able to stand up to that sort of negative pressure, I'm still terrified that as soon as one thing goes wrong (and what breastfeeding mom doesn't have even one thing go wrong?) I'll be talked into believing that I just *couldn't* do it. Not only that, but if I can succeed at breastfeeding, I'll be the one who makes them feel guilty for not being able to do it themselves. I don't know all of their circumstances, but I can't help feeling bitter that because they were victimized by a system that says (and again, I don't know all their circumstances, but I know this is common), "oops, you got the flu, so we have to put you on antibiotics, so you're not allowed to nurse, and by the time you're off the antibiotics your milk will have dried up so here's some formula, have a nice day," I have massive amounts of pressure on me to fail. And I haven't even been able to give it a try yet!

As a medical student, I appreciate reading Arwen's post, and all of the comments left here. I feel that reading these has given me greater insight and understanding for my future in the medical community, and as a male unable to experience these things first-hand.
Just last week, in my Growth & Development class, we had a lecture on breastfeeding and how important it is to the mother and child on many different levels. There is a trend moving back towards breastfeeding, and we were instructed to encourage and support the mother in breastfeeding as she is able, and refer to lactation consultants if necessary.
My mother was involved with LLL, breastfed my siblings and myself, and had my five younger siblings at home. Maybe this is one reason why I feel more supportive of these issues, but I honestly believe that the medical community is realizing the importance and health of the natural processes of birth and breastfeeding.
This got to be longer than I had intended, but I wanted to let you all know that you are understood. I also want to ask that you not give up on the entire medical community. We are human, we make mistakes, and we need to be educated too. There are good doctors out there. Please pray that I may become one. Thank you all.

--Dan G.

Thank you for this post! I totally agree, even being one of those who has had 2 births (almost) like what I wanted and 2 successful breastfeeding experiences. I can think of a couple times when I have said "well, at least..." and can certainly see how it was harmful rather than helpful. Thanks for your wise words!

Very well said! I hear what blog nerd says, but I don't think the high risk statistics are quite as high as the intervention statistics. Even if you don't count c-secs, there's an awful lot of pitocin going on out there. I've personally known very few high-risk women, but I've known numerous who've had interventions and c-secs for "failure to progress". If I'd been in a hospital with my first, I'd have been cut, too, no doubt, but he came out just fine at home (it just took a LONG time). With my second, they'd never have let me birth a baby in a face presentation, but with the help an experienced midwife, he came out, too! The medical system is SO broken.

There is a reason that it's so common for women to feel disappointed after a medicalized birth. The people who expect them to "just get over it" don't realize that we instinctively feel that there is more to birth than "getting the baby out".

I agree with Blog Nerd that prolonged grief over childbirth and breastfeeding disappointments can become a form of self-absorption, even a form of narcissism. I certainly don't dispute that women have the right to grieve these disappointments. And in the case where a childbirth or breastfeeding disappointment is truly the result of a flawed medical culture (some common theories: bored, impatient techno-happy OBs who live in fear of lawsuits), then women have every right to pursue change within the system. But this can be done without allowing their grief to linger beyond the point where it overshadows the joy of having a healthy baby, something that should not be taken for granted. And it can also be done without insulting other mothers, something which happens far too often. As Arwen pointed out, this distracts from the real issue.

"All that matters" is a loaded phrase and always sets jaw in a clench. As the mom of 4 c/s babies (my first were preemie twins and my uterus wasn't in shape for vaginal delivers after that) I was always ok with my c/s deliveries. It was about what was best. I never felt guilt about it, but I do know lots of mommies who do. I'm also the type to tell a person who is trying to make me feel badly to "go fly a kite" but with stronger language.
I wish people who think before they spoke about most things, but sensitive matters definitely. I have a very close friend who lost her son in a late term pregnancy loss and people said the most awful things to her. Things like "at least you'll be able to more kids" and "at least he didn't have to live with his condition" (he had a genetic problem that would have made his life very difficult) and worst of all "all that matters is that you have your health." Ugh. People should think before they speak and worry about how their comments may be perceived.

I didn't manage to get very far into this post - partly because little miss almost one kept being a pickle but also because it made me cry.

I understand the points that you were making, and if i manage to go back and read them again I think i'd agree with them, but what made me cry was when you talked about the need to grieve, and i realised that yes, that's what I had done when at about 10 days old we had to start giving Sophia formula as well as breastmilk because I just wasn't producing enough. Thank you for understanding that need to grieve when situations conspire to make us make choices we don't really want to make.

I am very thankful that Sophia never gave up rooting for the breast and actually at almost 1, she's still breastfeeding, and neither of us are likely to be wanting to give that up any time soon.

I have six friends who had babies after me. All low-risk, uncomplicated pregnancies, all under the care of physicians and gave birth in hospitals. Four of them ended up with c-sections, and the other two were threatened with c-sections. One of the four sections was a breech, but the others were all some version of FTP. Both of the vaginal births involved pitocin. All the mothers wanted to breastfeed and were committed to doing so, but only one ended up exclusively breastfeeding. I'm sorry, but that is not normal, and it is not a product of older mothers and gestational diabetes. (All but one of these women were in their early 30s or late 20s).

Bravo for this post, Arwen. I am too angry at the medical system to be able to be this articulate and sensitive to people's feelings while still getting the message across. The way birth and breastfeeding are treated in this culture is broken. Blog nerd, you are dead wrong. Natural birth is not "mother-centered" birth -- it is the birth that, barring medical complications that necessitate intervention, is SAFER for the baby and the mother. That is why women want it and will fight to get it. Maternal mortality rates are a tricky subject, and I think your numbers are exaggerated, but no one disputes that some c-sections are necessary. I think a 5-7% c-section rate would probably be appropriate, perhaps as high as 10% in higher-risk populations. But 33% and higher? No way. A rate that high is not attributable to high-risk pregnancies.

Okay, I'll watch my wording, because you have a point. "Most important" isn't the same as "all that matters" but I feel like some people take it TOO far. My dear friend just had a (more) risky, VBAC homebirth because she no longer trusted doctors in hospitals after they encouraged her to have c-section when her first child wasn't holding up the the contractions. (he was very tiny at birth, despite his being born at term, so it makes sense that he wasn't holding up to the contractions real well - he wasn't strong).

I fully agree w/ you on the breastfeeding thing - I feel like way too many people don't get they support they need to keep trying, even if it's hard in the beginning. Be it from their families or the OBs or the child's pediatrician (which is where I'm having troubles - I'm getting ready to dump mine if they mention supplementing w/ formula one more time!)

What a fantastic post! The birth of my first child two weeks ago was nothing like I thought it would be. I (narrowly) escaped a c-section and breastfeeding is going great, but I still feel disappointed that my son's birth was surrounded by chaos and fear, rather than strength and confidence. You're right-- there's a HUGE difference between "all that matters" and "the most important thing"... Our birth experiences matter to us!!!

I exclusively pumped milk for Rowena for 8 months because she just wouldn't latch. It was really devastating for me, and I got so much flak from others about it! I would tell myself "all that matters" to comfort myself. I really enjoyed this post!

Four weeks ago today I had my daughter after 33 hours of labor, during which I progressed extremely slowly. Ultimately, I was put on pitocin and given a narcotic to help me "relax," both with my consent, but only because I felt I had little choice - my water had broken and hospital policy wouldn't have allowed me to labor much longer. Fortunately, these interventions worked to help me finish dialating, and I was able to deliver vaginally. I still cried about my experience every day for a week afterward. It could have easily ended in a c-section, and though the hospital staff was great overall in allowing me to labor as naturally as possible within their rules, I had to lie down and be monitored for 20 minutes of every hour - and every time I did, my contractions would slow down. I'm convinced the monitoring policy kept me from progressing, even though my midwife tried at least twice to blame it on my body's inability to relax during contractions. I left the hospital feeling doubt about my ability to deliver a child naturally, even though I know intellectally that this is ridiculous. My daughter was extremely healthy at birth despite the long labor, and I suspect she would have been even without the interventions. I feel very lucky that we established a decent BF relationship right off the bat, because any problems there probably would have made me feel even worse.

Thank you, Arwen, for articulating so well that a mother's feelings about this issue really do matter.

Yes.

But.

To a mother who has actually lost a child at birth or to starvation or malnutrition, the (real) grief that comes with a medicalized birth or formula feeding probably doesn't seem to belong to the same world.

It's tricky to maintain the right balance between pushing back against the modern medical model that shortchanges a lot of us and remembering to be grateful that we are some of the very, VERY few women (when you look at the whole of the world and the whole of history) who can reasonably hope that we will not have to bury any of our children.

noooooooooooooooooooooooooooooooo!!!!!!!!! TOTALLY not talking about you!!!!!!!!!! it's not like you're like, not insanely busy, you know, what with a 4 year old and a 2 year old. :)

i read you, too! just barely ever comment!

i was being silly and snarky.

love you, friend!!!!!

I am so totally with you on this. So glad I am not the only one who feels this way.

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