Routine Interventions Aid Birth? What A Load Of Shit!

The relationship between birth and bowel movements is an obvious one to most women who have experienced normal physiological birth. Many a second stage labour has begun with a birthing woman exclaiming "I need to poo!", only to discover that the poo is in fact a baby's head.

In the immediate postpartum phase this link between these two physiological experiences was made clear to me yet again. I recall going to the toilet in those first weeks of motherhood and being struck by how much bowel movements made me feel like I was giving birth again. Both activities make my pelvis feel open.

My daughter regularly reminds me of the connection between birth and bowel movements. I've never seen anyone bear-down with such inhibition and commitment as my toddler when she's working on a number two. Even her father has been known to say "she's going to make a great birther!" during potty time.

The following is one of my favourite pieces of writing about birth. It's been available from a few online sources, though the author has been listed as unknown everywhere I have seen it so far.

BIRTH AS A BOWEL MOVEMENT

Imagine if you will, that about a hundred years ago, people began having great difficulties having bowel movements (BM for short). It al came about because of some very unhealthy lifestyles. People weren’t eating correctly because they were desperately trying to be thin and beautiful. They had malnutrition and took a lot of pills and other drugs to help them become and stay thin. People were so concerned with looking good that they put their health aside to get there.

As a result of this lifestyle, many people had a terrible time having BMs. Some people even died. Something had to be done to save these folks. So instead of changing their lifestyles, people flocked to the doctors to have their problem fixed. The problem became so prevalent that people became fearful of having BMs. Everyone dreaded going to the bathroom because of all the horror stories of pain and death. This normal, natural bodily function was labeled dangerous and hazardous and needed to be monitored and controlled to save lives.

Over time, it became the “norm” to go the hospital whenever someone had to have a BM so that doctors could monitor the process and intervene if they needed to. This continued through the years and is still practiced today. An onslaught of new life-saving technology and machinery was invented for us in aiding people to have a BM. It has become such a common practice to go to the hospital to have a BM that people have become uninformed. They don’t trust their own bodies to have a BM on their own. People are scared to have a BM that having one anywhere besides a hospital is considered irresponsible, dangerous and risky. Even though the old, unhealthy lifestyles, which caused the problem in the first place are no longer practiced, having BMs is no longer considered a normal event. Even the healthiest of people go to the hospital to have BMs out of fear that something might happen. The go “just in case”.

So, you have to have a BM and even though you are a healthy man and having a BM is a normal, natural physiological function that your body was designed to do, we go to the hospital. We grab the hospital bag and head out the door in a hurry. During the car ride you get very tense because the cramps are coming on strong and you can’t get comfortable. You try breathing through them but this only helps a little with all the stop and go traffic and bumps in the road. Not to mention that you just wish you could be at home and have privacy. Upon arrival at the hospital, you are wheeled up to a room and instructed to put on a gown with nothing else on (it has a large opening in the back which will show you rear end if you get up and walk anywhere). You are told to lie down so that a nurse can examine you. Then a strange female nurse comes in and explains that she is going to have to insert 2 fingers into your rectum to check the progress of your feces. You obviously feel humiliated because someone you don’t know has just touched a very private and personal part of you.

Then the nurse straps a monitor to your belly to measure the severity of your cramps and stick an iv in your arm. This is very distracting and makes the pain of the cramps even worse. Soon, your cramps become stronger and you are getting very uncomfortable. At this point, the nurses change shifts and new nurse comes in. She says she needs to check you again since it’s been awhile and you don’t seem to be making any progress. She inserts 2 fingers again and shakes her head from side-to-side and gives you a very disapproving look. You have not made any progress. You want to try so badly to relax so you can make progress but with the iv, the strangers, the fingers in your rectum and the negative attitudes of the staff, there are just too many distractions and you can’t. By now your cramps are very painful and it takes all you’ve got to just stay on top of them.

The hospital team decides to insert a wire up your anus to determine if, indeed, your cramps are as bad as you say they are. They again insert 2 fingers to check the dilation and fecal decent. They tell you that if you don’t make any progress in the next 30 minutes, they may have to cut the feces out. This causes you to be even more tense and you have a hard time trying to relax just knowing what may happen if you can’t push it out yourself. After another hour of laying in bed, the female doctor comes in and does yet another exam with 2 fingers because he says he wants to be sure the nurses were doing it right. He feels it is time for you to begin to push. So you are in bed, flat on your back with your feet up in stirrups trying to have a BM and pushing with all your might while the strange nurse and a doctor intently watch your anus. The feces is not coming down fast enough so the doctor decides that your anus must not be big enough for the feces to pass through so they make a large cut in your anus to make it bigger. They also need to use a vacuum extractor to help pull the feces out.

You finally manage (with the help of a large cut and vacuum) to push the feces out. You are in a lot of pain, you’re bleeding, exhausted, spent and humiliated. You feel like something in your body is broken and didn’t work correctly. This must be true since you needed all this help for a normally natural bodily function right? The nurse then pushes on your abdomen to make sure all of the feces has been expelled. This is VERY painful but thank God you were in a hospital or else something bad might have happened. Someone stitches you up and are given instructions on how to aid your healing.

So, you made it through. You’re alive and that’s what really matters right? Is it though? What about your pain? What about the humiliation? What about the violation of privacy? What about the anger you feel towards the whole damn thing because your experience could have been completely normal and uncomplicated at home?

Now, this scenario is absolutely and utterly ridiculous right? It seems absurd to go to the hospital for something that could have easily, and much less painfully, been done at home. The same is true of birth. This scenario is exactly what happened to birth (the “unhealthy” habits were obviously a bit different) and many women are suffering, needlessly, as a result. I can attest to the fact that this scenario is VERY common in hospitals today—I have even experienced it with my own hospital birth.

People have been raised to fear birth and to think that it needs the medical community to make it happen. Birth interventions have become so common that people accept them, and every side effect that comes with them, as necessary for a good outcome. And most don’t believe it when someone tells them that it can be so much better if those things weren’t done routinely.

A healthy, informed woman who is knowledgeable in birth had just as slim a chance of dying in birth as someone does while having a BM. All you need to have a safe birth is to be informed and to listen to your instincts (something that is very difficult to do with people watching you—just like it is difficult to have a BM with people watching you!). Birth is safe and simple. Just like having a BM is safe and simple. I need as much assistance while birthing our children as you do while having a bowel movement!

This piece has been described by a birth activist I know as "a great one for Dads". I completely agree! If you know a Dad or Dad-to-be who likes the idea of interventions at birth, ask him how he would feel about time limits, anal examinations, a roomful of strangers watching, (and possibly chanting "push! Push! Push!" or "don't push!" or "pant!") and being hooked up to monitors etc. while he is trying to take a crap. Just the thought of it will probably cause his sphincter to close up!

This analogy is also useful when reading or listening to opinions that show a lack of trust in birth and women's bodies' ability to birth. Next time you hear someone say "birth is dangerous", repeat back "pooing is dangerous", or "your baby is too big for your pelvis"; "your poo is too big for your colon". Purebirth creator, Lisa Schuring applies routine interventions in childbirth to going to the toilet in The Purebirth Pages: The Australian Freebirth Newsletter:

1. Pain relief to poop out of the poop hole
2. Coached pooping - being told when, where and how to poop
3. Poopistomy - a small incision in the anus to allow your poop to come out
4. Poopidural - Why be a martyr? Get your poopidural today and have a poop without FEELING A THING! (don't bother reading the small print of the adverse effects on you and your poop because lots of people get poopidurals and they're safe!)
5. AROP - artificial rupture of poop
6. Laxative aid - wonderful drugs to force that pesky poo to come out quick smart. So what if its not all whole? ...(Issue 3, October 2006 p.4)

It seems completely ridiculous that such interventions would be used during toilet time. This is because our society has trust in the human body to eliminate, but does not extend this trust the normal physiological experience of childbirth. But the two activities share similarities, as Gloria Lemay suggests:

I also find it valuable to view birth as an "elimination process" like other elimination processes-coughing, pooping, peeing, crying and sweating. All are valuable (like giving birth is) for maintaining the health of the body. They all require removing the thinking mind and changing one's "state." My friend Leilah is fond of saying, "Birth is a no brainer." After all "elimination processes" are finished, we feel a lot better until the next time. Each individual is competent to handle her bodily elimination functions without a lot of input from others. Birth complications, especially in the first-time mother, are often the result of helpful tampering with something that simply needs time and privacy to unfold as intended. (From Pushing For First Time Moms)

Who knows where the future of birth and poo might lead? Once upon a time everyone birthed at home, perhaps one day we will all be cathertised? Maybe one day I'll be supporting people through pooing, helping them to relax and trust that their colon's know what to do? Maybe one day the majority of us will birth at home again, and laugh at the dark ages of obstetric distrust of something so everyday as pushing a person out a vagina?