21 Marzo 2013

Should the intense feeling of birth be considered or avoided?

By Beatrice Benfenati
Tags: Birth

There has been great talking lately about the epidural anesthesia and Livia Turco’s bill proposal recently approved, in order to include “painless delivery under epidural anesthesia” at normal level of assistance (LEA).
Many groups of doctors, obstetricians, birth operators and parents, have written to Minister Turco to express their doubts about consequences of the epidural anesthesia diffusion for every woman who lives labor pains; even if they agree that in case of real necessity they must have the possibility to choose this free assistance.
Inspired by all the letters sent by these groups, which are downloadable from Internet, I would like to integrate them with my consideration.
The way culture looks upon birth and death indicates the values on which it is founded.
What does it mean for the Western world to be born and die in the right way?
How is the intense feeling associated with both these experiences considered?
Should it be considered or avoided?
The routine medicalization of both these two occasions seems to tell us that, according to our culture,  it should always be avoided.
Dealing with “birth” for 25 years and personally delivering three babies at home, I know that pain definitely belongs to the physiology of birth and that it should not always be seen as pathological. So, what is the point of asking this shallow question: “Do you want to suffer or not?”. Or answering to a pregnant woman, who has already declared she does not want epidural anesthesia, “As you like, but everyone ends up asking for it”, as many mothers experienced in hospital when they were asked whether they wanted epidural anesthesia or not.
Why should they immediately cause in women a sense of inadequacy and the subsequent reliance on medical care?
Why should they offend women deciding in advance that they will not be able to face delivery experience?
Why should the tradition be interrupted? Once, at home, we were accompanied by someone expert in the delivery and death experiences, considered as sacred moments.
How would it be possible for a woman who has delivered under epidural anesthesia to help another woman who has decided for natural birth? She wouldn’t know the sapient words to say, nor the gestures, because she had never heard or seen them.
This interruption in traditions has already had its negative effects on breast-feeding. Almost no young mother can find any good piece of advice about breast-feeding from her own mother, who has been herself influenced at her time by whom was not convinced about breast-feeding.
The message brought at home, must be submitted to experts today; they can be the obstetrician, or in the worse (and unfortunately largely) case, the pediatrician, who is an expert in pathology, when breast-feeding is purely physiological.
A pediatrician from Pescara, dealing with the newborn, wrote, as a joke: "It is just as if they would call the pediatrician instead of the baby-sitter, to take care of their baby, when they have to go out".
It is strange that the word "birth" is now associated to "health" (which means "doctor") instead of "experience" that involves the priceless presence of someone who has lived this experience before and can be the best guide.
The question is: "Is the epidural anesthesia a conquest or a constriction for women?"
Can they choose anesthesia or are they forced into it, in order to hide unfortunate, sometimes, violent practices in birth structures?
Why is so little invested in natural means to reduce pain through guide-to-birth courses, right information and sustain in finding motivation, determination and confidence into being able to face the situation? The atmosphere is also quite important for delivery when a woman gets into labor: the same midwife who guided her during pregnancy should be present for birth and the mother should have the possibility to choose the best position, or to deliver in water.
Delivery, in Italy, is painful, so why, instead of bettering the quality of assistance, which could ease contractions, do they just leave the situation as it is and practice anesthesia?
Which kind of thought there is? And which one is lacking to make this attention arise?
Certainly the consequences of separating the mind, which remains vigilant, from a body that becomes “silent” are not considered as important.
Body language is no longer a value, neither dealing with their own feelings, which is evidently considered as meaningless.
It is commonly thought that delivery and feelings are separate.
Nobody thinks about the results of such division between the mother and what is happening: her baby's birth.
It has not been considered either that there could be a link between the mother's separation from her child, as a result of anesthesia, and the problems that follow delivery. The relationship between mother and newborn baby is of prime importance, but discomfort is cured through medicine, when medicine itself has caused discomfort.
Is not that cycle completely absurd?

Extract from the article “Il sentire intenso che accompagna la nascita è da ascoltare o da evitare?” (Should the intense feeling of birth be considered or avoided?) by B. Benfenati on "Antiche e moderne vie d'illuminazione" (Antique and modern ways towards illumination), ASIA Association - periodical review, December 27, 2006.

Translated from the original Italian version by Elena Poletti 

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