An Ass-Backward View of the World

I had a long conversation with a friend last night. She is in her final month of pregnancy, with her first baby, who is in breech position, with her doc talking cesarean. If attempts to turn the baby are unsuccessful, she will consider a homebirth in order to avoid the surgery. I urged her to let her doctor know her thinking. Woman are often unwilling to have a frank discussion with their caregiver about their wants and desires. I reminded my friend that she selected this person (or group) and that she is paying them to be trusted partners in this process. Don't start doing things behind their backs but tell them exactly what you plan to do and why and listen to their feedback (but take it with a grain of salt- they don't have the final say- you do). I think this approach is important because it preserves the integrity of the relationship. Doctors and midwives are not mind readers. They need to know and understand what type of care clients desire, or what they don't want and why. Otherwise they'll just continue to think women are happy with the care they are getting. I also urged my friend to look at all her options. Its not just cesarean or homebirth. There are options between those two extremes. Homebirth should be the result of a move toward something you want, rather than a move away from something you don't want. I don't envy my friend's choices. The fact is, the med schools no longer teach docs how to deliver vaginal breeches. Why should they? Cesareans are the new cure for every maternal ill, and so easy (for everyone but mother and baby that it). Its absolutely unprecedented, the number of young healthy women getting cesareans. We have an entire generation of women who won't know what vaginal birth is like. This is a tragedy on a massive scale. Young women have been robbed of their births. What's so special about this generation that they can't give birth? Nothing. Its not the women that have changed- its the system. Active management of labor, manages labor right into the ground. Bogus research and outdated beliefs have set unrealistic expectations of birth. New technology has hindered and not helped the process. Litigation fears rule the birth place. Nature is not seen as kind and benevolent but cruel and deadly- a force to be thwarted at every turn. So who's really ass-backward here?