Citation:
Block, Jennifer. Pushed: The Painful Truth About Childbirth And Modern Maternity Care. 1st. Philadelphia, PA: De Capo Press, 2007. Print.
Pushed and the “Business of Being Born” have similar arguments, which are that hospitalized birth is horrible, industrialized, traumatic, and in some ways more dangerous than a different kind of birth. They both argue that maternity care is in crisis, and that birthing decisions are made for monetary and legal reasons and not for women. The two also contrast regarding their arguments about birth. Both argue that midwives are a healthy, safe, and happier alternative to OBGYNs. However, Pushed describes the struggle of finding and being a competent midwife without overstepping a given state’s birthing laws. If everyone suddenly turned to midwives for their births, which is what the “Business of Being Born” seems to encourage, the demand for midwives would be far too high. Additionally, the Business of Being Born portrays births that were difficult, but ultimately were driven by inherent physiological desires of the woman: push, end the pain, surrender to the pain, and bring the baby into the world. Pushed explores the fact that women do not always feel these inherent desires: “Labor felt more endless and unrelenting to Jessica than she had expected. The act was also less intuitive than she had expected. ‘I never felt the urge to push,’ she says. ‘It was hard for me to figure out how to push’” (Block, 209). Jessica’s lack of inherent feelings during labor somewhat refuted the point of the Business of Being Born; sometimes women need professional or medical direction and don’t know how to facilitate their births.
2. I think the second 100 pages of Pushed communicate that many women feel pressure from doctors, family, and society in general to comply with the “norms” of childbirth, and thereby often go to hospitals, undergo subsequent administration of drugs and surgeries, suffer Post-Traumatic Stress Disorder, experience a long recovery and maternal morbidity, bear an unhealthy baby, and lack the ability to have future children in manners dominantly viewed as safe. It is mentioned on page 134 that “Normal is customary and usual but that may not be necessarily what evidence shows to be best.” Pushed recommends that low-risk women should not go to the hospital unless they want a (possibly violently and highly) medicated birth.
The assertion of Pushed that the hospital is an inappropriate place for a baby to be born makes sense to me, simply because the hospital is a business for the ill to be healed; Doctors have been trained by their schooling and experience to heal, but also to think in terms of what is best for the hospital as a business and they, the doctors. In the doctor’s mind, I visualize a scale. On one side of the scale is the mother’s and baby’s well-being, and the value of physiologically natural births. On the other side is the pressure to make the mother’s bed available as soon as possible and to remove any risks that would result in a lawsuit, and to treat the birthing woman like other people in the hospital: someone who requires fixing. I wish that midwives had more legal opportunities in more states, as well as more recognition as a substitute for OB-GYNs.
3.
It struck me that even with the option of utilizing a midwife, it is extremely difficult and even impossible to have a baby how one wants. “I was really upset, I thought why is this so damn hard–to have a baby the way I want to have a baby?” This, I think, is the fundamental horror of birth. This natural and necessary part of life is hindered by society. Clearly the act of reproducing (which entails sex) is not being hindered by society to an extent that threatens life, since the population of the world is growing. Ridding oneself of waste has become a relatively easy process due to the obsessively sanitary norms of society.
I found it interesting that “Today…the proportion of women suffering morbidity (“an adverse impact on a woman’s physical health during childbirth, beyond what is expected in a normal delivery”) is probably well over half” (Block, 115). According to this quote, the majority of women are suffering unnecessary and invasive procedures that they probably do not want and of which they do not understand the risks. Why have we let this become the norm? Perhaps this could be reversed by training more midwives, transferring nurses in hospitals to the profession of midwifery, and decreasing the legal shenanigans that keeps midwives from practicing legally or advertising themselves, so that more women have the opportunity of escaping morbidities.
An irony of Pushed that deserves attention is in the discussion of animalistic vs. humanistic nature in birthing women of society. "Historically, women have sought support. It's part of what separates us from animals: our babies are helpless, neonatal" (Block, 104). By going to other humans (such as midwives or doctors) for emotional and physical support, women are embracing their human nature. However, they have done so to such an extent that their flight from animalistic living has, perhaps, reversed. "...Let us tether them to machines so that they cannot move. Let us make them stay silent and make no noise in their pains. Let us expose their most private parts and threaten them with cold steel. Let us make them push their babies upwards, against the pull of the earth...This is not the natural cry of a woman in labour bringing a child to birth, although if you have ever witnessed childbirth in a medicalized setting you might be forgiven for thinking so. This is the screaming plea of a tethered animal in pain" (Block, 174-175). Women are buying into the idea of optimal support in hospitals, and have inadvertently fled from any animalistic nature. In doing so, they have (also inadvertently) allowed themselves to be treated like animals.
Pushed described in a particularly simple and strong way how women should fundamentally be helped to give birth. "For caregivers, the best thing to realize is to sit on your hands if you don't need to intervene - to be vigilant, not hyper vigilant. That's the art of obstetrics: learning to do nothing" (Block, 105). I think that if more doctors understood to do nothing unless necessary for the well-being of the mother and child, then there would be less effecting trauma and harmful procedures.
Another concept of Pushed that struck with me was that, by enforcing various procedures, surgeries, and drug use in the birth, doctors are forgoing natural, physiological needs of both mother and baby. “The value of spontaneous vaginal birth–the conditioning of the fetal lungs, the priming of the breastfeeding relationship, the infusion of the ‘love hormone’, the physical proximity of mother and baby–is a radical notion among some obstetric leaders” (Block, 142). When a doctor offers the option of a C-section, Pitocin, epidural, etc., they should not knowingly disclose information from the mother at the doctor’s convenience. The mother may be in pain, exhausted, angry, overly stubborn, and hungry, but she has a right to deciding what happens to her body, of which her baby is a part.
4.
Jennifer Block claims that women don’t remember horrible, oppressive birth experiences accurately because of “birth amnesia and part psychological coping–Maria blocked out the treatment so it wouldn’t manifest as depression or worse” (Block, 153). Some women later report their birth experiences as positive and say that they’d go to the same hospital and doctor that actually caused their maternal morbidity. “The gap between reality and perception leaves a ringing dissonance” (Block, 154). Her claim is indeed valid; birth amnesia has an easily explained physiological cause. Oxytocin, a hormone that functions in the mother’s body throughout the birth, hinders memory. “Oxytocin significantly impaired recall performance… and selectively influences memory performance” (http://www.ncbi.nlm.nih.gov/pubmed/15501488). Forgetting an event to protect the mind from depression or worse is common among mothers. “Postnatal cognitive processing included retrospective appraisal of birth, such as taking a fatalistic view and focusing on the present, for example, concentrating on the baby. Memories of birth included not remembering parts of the birth and forgetting how bad it was. Women with posttraumatic stress symptoms reported more panic, anger, thoughts of death, mental defeat, and dissociation during birth; after birth, they reported fewer strategies that focused on the present, more painful memories, intrusive memories, and rumination, than women without symptoms” (http://www.ncbi.nlm.nih.gov/pubmed/17718876). Women who had traumatic memories associated with their births also focused on the present and forgot how “bad” the birth was. Block’s claim that women cope with traumatic births with amnesia and selective memory is reputable, according to the sources above.
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