The New Yorker article by Gawande was really shocking to me, not because of the explanations of the multiple ways that childbirth can go wrong, but the cultural implications of childbirth. I was most shocked by the priorities established during early childbirth, where it seems like the life of the mother was put as a higher priority than the life of the child. The mother always putting her life second to her children defines childbirth and motherhood in our western culture. You always hear stories about mother’s, or fathers for that matter, risking their lives to save their children. I know that my own mother almost died giving birth to me, but she always said that that she would have chosen my life over hers. I thought the idea of crushing a baby’s skull in order to save the mother was absolutely horrible, but is that just because we’ve been socialized to believe that once a baby is born that their life is more important?
I was also really interested in the medicinal aspect of the article. I just did a presentation in another class about western medicine practices vs eastern medical practices. When Elizabeth Rourke’s doctor arrived in her room and started administering one medicine it seemed to cause a domino effect where only more chemicals would help cure the problem. I think that we’ve taken childbirth to be this situation where only one way is the correct way for it to be done and every other way is incorrect. It seems to me that western medicine, and this article, has made childbirth seem much more precarious and dangerous than it actually is.
In the deconstruction article, Goer suggest that planning caesarian sections for women may be the answer. I think that both of these articles are dramatizing childbirth. Is it something that I actively want to go through as a female? No. But I think that most women who do choose to have a baby understand the risk involved and the actual process that they are going to go through. I know that if I were giving birth I would want every drug under the sun to make it not hurt, and I may choose to have a caesarian section, but I don’t think that standardizing it is the answer because not everyone is the “worst case scenario” as these articles make it seem.
I enjoyed reading the Atul Gawande article. I thought the combination of an actual birth story and the investigative journalistic approach worked very well. This article reminded me of the Brown Bag lunch topic on Tuesday: “Masculinist Obstetrical and Childcare Practices in the Time of Henry VIII” given by Professor Eric Lunch. Professor Lunch used King Henry the VIII as an example of the shift from childbirth being in the feminine midwife realm to it being a process that included surgeons and doctors, who at that time were mainly male. King Henry VIII so desperately wanted a male heir that he took special precautions when his third wife was giving birth to their son, Edward. Instead of only midwives, King Henry VIII made sure there were male surgeons in case anything in the birth went wrong. Jane Seymour died of childbirth complications ten days after giving birth, and some believe it was because the male surgeons, not having a lot of childbirth experience, did not remove all of the afterbirth. After this time, it became increasingly more common for childbirth to be viewed as a medical process, and more surgeons and doctors were present for childbirth. Eventually, this led to more rigid guidelines about who was allowed to be in charge of the birthing process. Tests and training were required, which was easily passable by a man coming from medical school, but not a midwife without official training. This is an example of the trend that Gawande explores: how childbirth moved from an individualistic process to a standardized one. I think it is important that women realize that there are options when it comes to childbirth, and what may be right for one woman may not be right for another.
ReplyDeleteIn related news, a recent New York Times atrticle about the rising rate of caesarean births in the United States: http://www.nytimes.com/2010/03/24/health/24birth.html?scp=1&sq=c%20section&st=cse
One of the issues I had with the Gawande article was that women choose to get pregnant, and unless it is an emergency, they choose what type of childbirth they want whether it be water, natural, cesarean section, etc. The articles seemed to demonize doctors, who are under so much pressure, especially with the constantly looming threat of malpractice hanging over their heads. While it may not be ideal, you are placing yours and your baby's life in the hands of trained skilled doctors and personally I would want what is best for me and my baby and I don't think that I am educated in medicine well enough to think I know more than the doctor. Additionally, perhaps if the threat of malpractice didn't loom over doctors' every single move, they might be apt to trying more "natural" methods of childbirth and working more closely with midwives, but again, while it is not ideal, it makes a lot of sense that doctors do what they feel most comfortable with and what they consider themselves to be better at.
ReplyDeleteDo I think standardization is necessarily a good thing? No. I think an individualistic approach sounds much better, but doctors do make the effort to discuss what kind of birth plan a woman wants and they do their best to stick to that unless a medical emergency or complication arises that would jeopardize the original plans.
What I did find interesting was relating these articles to the Muscio article from last class. Muscio discussed how she advocated for more inward looking help/medicine which seemed to tie into the criticism of more western obstetric practices that this article discussed. I personally think a combination of both is the best course of action.
Great posts, all! Between the three of you, you've raised a number of really important points. First, as you point out, there's this question of our blind trust in Western medicine, and what other possibilities are available to women giving birth (and in other medical situations); how do we balance a healthy skepticism with acknowledgment of the value of Western medicine? Second, how can we enable women to make decisions that are best for them? What needs to change not only with doctors, but with the medical establishment, from insurance companies to hospital regulations, etc.? And finally, Emily does a great job of pointing out the ways in which Muscio and other writers from Tuesday who are concerned with women being empowered to make health decisions jives nicely with both Gawande and Goer's goals in writing these articles.
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