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Thursday, January 18, 2018

Push Back: Guilt in the Age of Natural Parenting

As a friend commented, "That's one controversial lady." Amy Tuteur, MD, is an OB/GYN by training who now runs a blog dedicated to decimating the natural parenting industry. She takes her work to this collection, Push Back: Guilt in the Age of Natural Parenting. Another friend of mine saw me reading it and groaned, and commented about how I shouldn't feel guilty. I will be the first to tell you that I have no guilt in my parenting, which I will get to in a bit. I picked this book up because it was mentioned in a long-form article on breastfeeding (along with Lactivism from a couple of weeks ago), so I picked it up as more reading into this mommy wars issue that I'm now so interested in.

Dr. Tuteur focuses on three areas that make her angry, the first of which is natural childbirth. She argues not just that women should not feel bad that the didn't have a natural birth, but that women in the 21st century should avoid natural childbirth altogether because we have pain relief and the medical establishment for a reason. Breastfeeding is her second issue, and she wants women to not feel guilty if they can't or don't want to breastfeed. Finally, attachment parenting really gets Dr. Tuteur up in arms. Kids have turned out fine for centuries, and there's no reason for women (because let's face it, it's mostly women) to feel guilty if they can't hold their child 24/7.

I pretty much summed up the breastfeeding argument in my post on Lactivism a couple of weeks ago (link in the first paragraph), so I won't go too much into detail here. I can sum up my position, which I think is a little less militant than Dr. Tuteur's, as "do it if you can but don't cry about it if you can't, and it's no one's business why you choose what you choose." I agree with the author when I say that I think that the argument goes beyond just those who can't and needs to include those who don't want to. It doesn't matter the reason why -- if you don't want to, you are the boss of your body and you get to make that decision.

I'm also in the "I don't really care so much" zone on attachment parenting. I thought I was attachment parenting when I told people that what I was doing was "lazy parenting," but Dr. Tuteur describes it here as something much more rigid and crunchy than anything I'm into. Now, that being said, I have yet to read the Dr. Sears book, so I'm withholding thoughts on this since I haven't quite done my research well enough to have an opinion. After reading Dr. Tuteur's thoughts on these three subjects, I'm hesitant to jump in and completely believe her description of attachment parenting. She may be right (again, I'll do my own investigation), but she is just as militantly dictating her agenda as those she rails against in this book. Which brings to me to the biggest beef I have with this book.

Natural childbirth. I haven't made any bones about my goal for my own birth was natural childbirth with the understanding that I would have the kid however I ended up having the kid. A quick side note here so that you can understand why I think Dr. Tuteur's claim that these views come from her being a feminist is a little , and the short answer is because of her dismissal of any argument about patient-centered care in treating women giving birth. As I said, the goal was natural childbirth, and I labored for 12 hours on Pitocin after an induction via balloon catheter with no epidural. I'm damned proud of that, and I'm glad I experienced it. I ended up with an epidural and a Cesarean not because of any emergency or concern about the baby -- the hospital puts laboring patients on a time clock, and after six hours, if there's no movement to transition, you move into surgery. I have yet to meet someone who isn't horrified when I tell them this.

That being said, I don't regret getting my kiddo out the way he came. I don't feel guilty about a c-section or an epidural (honestly, it felt like rainbows and unicorns), and it is what it is. What I hated about my birth, and what still sits with me, is how I was treated as a patient. I was treated by the hospital staff (namely the nurses) and the doctor on duty when I was inducted (who, by the way, was not my OB -- she was absolutely amazing, patient-centered, collaborative, and awesome) as just another case to move through labor and delivery. I had to literally argue to be treated as a human being. It was disgusting, and especially as someone who only wanted to be an autonomous being. (Side note -- the surgery staff were also great, although the ped on duty should be slapped.)

Dr. Tuteur is so anti-natural childbirth that she never stops to consider the women who are choosing it and why. I wondered as I read this book if she had ever had a conversation with someone who chose this route about her reasons for doing so. There are many things I agree with her about -- for instance, pain meds are awesome, and giving birth is dangerous, and we have increased the ability for women to live after giving birth wildly in the past centuries with modern medical advancements. She is 100% correct about that. Additionally, I would never argue medicinal procedures or implications with her, as she is clearly the expert here. I am, however, pushing back (if you will) on the notion that women don't need to be a part of their birth experience. Dr. Tuteur completely and deliberately ignores the patients at the center of this dangerous process, and their feelings. It is precisely because birth is traumatizing that women should be involved in why things are happening and how to be a part of the team with their doctors.

In what I feel is the most egregious violation of bodily autonomy in women, Dr. Tuteur only mentions one single time in the entire sections on natural childbirth about women who have experienced sexual assault needing to discuss this with their providers. One, single, solitary time. She says you need to talk to your provider about it and they can help you. Oh boy howdy, how wrong she is about this. I have seen plenty of OB/GYN's myself who were not understanding of this. So no, it's not as simple as being like, "Hey, I was assaulted, be careful!" I can't even begin to describe to you how absolutely morally wrong I believe this is in an argument about giving birth, one of the most physically and emotionally difficult experiences a human goes through. All of this to say, some women want to be a part of their birth experience through natural childbirth because it's how they feel they can be in control of the situation, even if in reality they aren't.

There are a ton of reasons why a person might choose a natural childbirth, and there are many ways to go about it (not just a home birth -- it can happen in a birthing center or a hospital), and to dismiss them all in turn without thinking that some women might choose this course of action not because they are hippies who think they know best, but because they are real reasons that affect and are affected by the fact that they are humans with feelings and bringing life into the world is scary, is unkind at best. 

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