Tuesday, March 24, 2009

My Thoughts on the New York Magazine Article Profiling Cara Muhlhahn

I have been stewing ever since I read the story, and I have held off posting my thoughts while I calmed down and got my thoughts together. Here are some of my impressions:

First, I totally resent the title of the article: "Extreme Birth."

As my friend (who also had a home birth) quipped with me, "what, are they talking about giving birth on the side of a cliff or something?" Kidding aside, how backwards is it that people (like Cara Muhlhahn) who believe in and support the process of physiologically normal birth are the ones who's work is branded "extreme." Meanwhile, Doctors are currently seeing to it that one in three American women are cut open to have their babies extracted via cesarean section.

To me, the great tragedy here is that something as physically radical (and truly extreme) for mother and baby as cesarean section has become incredibly routine. Why don't more people in the mainstream media/medical establishment look at c-section (not to mention the myriad of typical medical protocol and hospital interventions that interrupt the natural process and often result in c-sections) as "extreme"? Why is the burden of proof of safety usually placed so heavily on the process that nature intended and designed over the course of millennia as opposed to the relatively recent modern inventions, drugs, and technology that interrupt that process? Anyway, that's a whole other soapbox I could go off on.

Now I would like to talk a little bit about my experience of being interviewed by Andrew Goldman for this article, because I think it sheds a bit of light on what I believe to be his true bias against home birth.

A couple of months ago, I had a phone conversation with Mr. Goldman that lasted for over an hour. Throughout the interview I thought it was incredibly obvious that Mr. Goldman had an agenda that sought to establish me and other people who have home births as stereotypically hippie-dippy, anti-establishment, Birkenstock-wearing flakes. Here are some of the questions that he asked me:

Are you a vegetarian?
Do you only buy organic food?
Is your child being vaccinated?

I have tried without success to imagine how any of these questions relate to the stated topic of our conversation, home birth, and specifically my relationship with Cara Muhlhahn. At at the time they left me feeling baffled, and since then my emotions have grown into feeling downright offended. One of the most upsetting points in the interview was after I went to great lengths to tell Mr. Goldman about my personal experience with home birth, which gets into my family history and the fact that both my mother and mother-in law had home births. My mother's influence on my choice of where to give birth has been enormous. She gave birth to me (her first child) in a hospital with all the technological bells and whistles of the day -- She was laying down and hooked up to all the requisite monitors, I was pulled out with forceps, she was immediately separated from me, and hours later when a nurse returned with a baby...it was not me! The whole experience was downright traumatic for both of us and it began the journey that led my mom to stay at home and use a midwife by the time my sister (her third child) was born nine years later.

I went into great detail sharing this personal background and carefully setting up the premise that it was her negative firsthand experience with the medical establishment that led my mom to discover the alternative path of home birth, which she pursued only after yet another negative hospital experience (with the birth of my brother) and much research, reading, and education on the issue. The midwife-assisted home birth proved to be a far more positive and healthy experience for the entire family. Mr. Goldman seemed to be listening intently, but when I reached the end of the story, he simply asked, "and would you say that your parents were hippies?"

Even if that question was remotely relevant, my parents most definitely were not hippies. And while I have nothing against hippies, I deeply resent the implication of his question and all of Andrew Goldman's overriding attempts to pigeonhole me and my family into an easily discounted stereotypical, "fringe" minority.

As for the article's s attacks on the character, credibility, and professionalism of Cara Muhlhahn, I can only express my profound outrage. My personal experience with Cara was good, I trusted her ability and expertise a hundred percent, and I have the utmost respect for her and her work. She is incredibly well respected in her field and I think she adeptly provides a much-needed service to pregnant women who have precious few options in our confoundedly broken-down health care system. Andrew Goldman's story was one-sided and unfair because it put sensationalism above the facts.

Note: I would encourage you to check out the interesting conversation and debate that is unfolding over on the article's comment thread. It sheds some light on aspects of the story that were glossed over or not covered at all.

34 comments:

  1. wow! that is so disheartening. it seems as though he was a bit misleading about his interest and intentions for writing the article. I'm just wondering how Cara feels.

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  2. i was surprised by the article too. it started off well, i thought it was showing how positive home birth can be. but then, BAM! home birth is always dangerous! the midwife is always crazy! the parents don't know anything! ugh, what a let down of an article.
    i'm not planning on having babies any time soon, i'm only 23, newly wed, still in school, having adventures, etc etc. but the more i read about it, the more home birth really appeals to me. i used to be in the "omg when i have a kid i want to be on so many drugs that i dont remember anything, knock! me! out!". but by reading blogs such as yours i'm really coming around the the idea of a present birth. i want to BE there. i want to take my time. i want it to be safe and comforting and a positive experience for everyone. so THANK YOU and all the other brave women who are so candid about their birth experiences for opening my eyes to different possibilities! now i will just have to convince my husband.... :P

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  3. Leigh, I am so happy you expressed your opinion about the article and shed some light onto what the interviewer was like...It makes sense now why the article was so disheartening to those of us who support home birth practices. I was so excited to read the article and I was hoping to gain more insight to the beauty of natural home birth but instead it was a scary realism that people always manipulate what they don't understand (especially one minded reporters). I will definitely have to check out the thread under the article to see what others are saying!

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  4. I just quickly read the article's comments...it stayed cordial overall :). Yeah, as I mentioned in my comment in your previous post, I thought it was pretty negative. Hearing the questions he asked, it all makes sense now. That's too bad! Reading the comments, it's so sad that many people still don't see the importance of the birth experience...they think that as long as the baby is healthy that's ALL that matters...obviously that's the most important thing, but nearly as important is the overall experience - for the mom and baby. A beautiful, natural, uninterrupted, and positive experience that honors a woman's body is pretty much impossible in a hospital, which is why we had our baby at a small birth center and we wouldn't have changed ANYTHING. Women that have elective c-sections I just don't undertand. Sorry, I just don't. WHY would you NOT want to experience all the beauty that natural birth entails and why would you want to have the recovery that c-sections require? If allowed to birth naturally, our bodies know how to heal and do so very quickly...Anyway, I could go on and on but should stop :). TU for letting us hear your thoughts Leigh!

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  5. thanks for this. Going to read the comments section with Cole when she gets home.

    The title is the tell-tale of an overall "fear" agenda. It's ridiculous.

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  6. thanks for your comments. i have to say it did freak me out a bit, i started to question my decision and then i stopped myself and realized that his article was totally one sided. i quickly opened up my inay may's book and i was all good.

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  7. The article was obviously biased and very disheartening. I'm glad you're telling your side of the story.

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  8. the article frustrated me, too. i'm sorry that the interviewer was such a jerk. it seems as though he really used you (and others!) to build up his own cause-tearing down the growing home birth community. i am thankful you've told your side of the story.
    people still look at me like a freak when i tell them that my son was delivered by my mom in my parents home (the home i grew up in). what they don't understand is that my son was brought into this world in the most loving place by all the people who love him most. i always get misty eyed when i think of the day he was born.
    i can't wait to have another home birth!!!

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  9. Leigh -- I am offended on your behalf at the attitude of the interviewer/writer. He honestly should be ashamed of himself. I respect and applaud your decision to have your kiddos at home, and admire your body's ability to go through the birthing process the way it was created to.

    I do have to respond to "Our Green Nests" comments though. I had a fabulous experience giving birth in a hospital, and I did have a c-section. Sadly, my body (and my son's) were unable to handle the natural birthing process. Being that our bodies are so far from perfection, this does happen on occasion, and some women -- while completely respecting themseleves and having the respect of the professionals around them -- decide that it is in the best interests of mother and child to have a c-section. I will also elect to have a c-section if and when I have another child given the serious nature of the issues that occurred at my last birth.

    We are all entitled to give birth, in whatever way we feel is right; however I also believe that we should respect others' decisions, recognizing that we may not always understand everything behind those choices.

    xoxo,
    allegra

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  10. I really like what allegra wrote above and I think it is something all of us should keep in mind when discussing this topic.

    I'm sorry to hear that you had such a bad experience being interviewed by a reporter; that was very unprofessional of him. Believe it or not, good reporters exist out there.

    Thank you for continuing to write about a topic that isn't discussed enough that is so near and dear to your heart. I have learned a lot.

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  11. Leigh, I love how articulate you are when you're angry!! (you're also articulate when you're happy ... & all shades of emotions in between!) Your dear readers needed to hear your thoughts, including your interview experience, to gain a broader perspective into the biased article he wrote. It was gentle, kind & thoughtful of you to wait & let others express their views before airing yours.
    This "extreme" article aroused a real fury in me. Thank you so much, dear, fierce daughter-in-law for telling it like it is!

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  12. I didn't want to say anything that was really negative in my comment on your last post, so I didn't. But I agree with you. The maternity care system in this country is very broken. Very broken. Women don't have homebirths because they are trying to be trendy or granola, they just know what's up in the hospital scene. Usually, sadly, from experience. I have had two babies, both in the hospital. And without going into detail: I will never go back.

    Erin

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  13. Leigh, I just wanted to add how heartwarming it is to me when I read the comments from your mother and mother-in-law. It's so sweet that they are both so dedicated to your blog, and their comments frequently bring tears to my eyes.

    xoxo,
    allegra

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  14. Ugh, I hate how birth has turned into such a business, a money making business. This was a really excellent post!

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  15. I wanted to thank Allegra and Rach for mentioning that some of us end up with C-sections whether we like it or not. And because of the increased risks that come with how we're made, we, with conflicted hearts, will elect to have C-sections again if we have children.
    That being said:
    It's so typical that a loaded topic like this has to be presented in a biased way. Why someone presenting to a large audience can't give equal time to differing viewpints and not paint either side as a lunatic is beyond me.
    sigh.
    It's obvious that he spent the most time on the quotes and stories that were most likely to alienate people and portray Cara in a negative light.
    He paid lip service to the pro side by giving them a paragraph or two.
    Your response is justified and very articulate, send it on in to them! Let them know how you felt home births were portrayed!

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  16. Ha! So much for my first impressions. In all seriousness though, the fact that you felt that the writer had an agenda AND that he managed to offend you in the process of asking you to share a very personal experience says a lot. I would certainly hate for anyone I interviewed to feel that way.

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  17. I appreciate all of your thoughtful, insightful comments so much. A huge "thank you" to everyone for following this story and taking the time to participate in the conversation.

    I wanted to address Allegra's first comment in particular, and just state clearly that I never intend for my disgust with our culture of c-section to be interpreted as a personal judgement on all women who get c-sections. I know that there is a time and a place for sections, they just shouldn't be the result in 30% of births! The skyrocketing rates mean that many more women are getting cut than have to be, and I think that is a deeply unfair violation that needs to be spoken out against. I totally respect you personally, and I appreciate you adding your perspective here.

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  18. thank you thank you thank you for your response to my comments. i agree 100% that the increase in c-sections (especially those elected prior to any complications) is alarming, unnecessary, and inappropriate. i just also want to share the other side as well. thank you for allowing me to do so, for respecting me for doing so, and for being such an open-minded and refreshing voice!

    love you and your blog,
    allegra

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  19. Hi, i´m a shy follower from southamerica. The topics of your blog are allways warming to me. My english is not perfect but the feeling this article generated on me is a mix of fear, confusion and rage. Instead when I saw the film BOBB the sensation was powerfull, joy, happiness that there is still something that humanity has to be real, raw, and happy. In my country homebirths are not usual at all. Till I was a mother and found specific information (too late though) nobody talks about it. It´s like natural birth and attaching parenting are secrets. Here is not also considered hippie but "low class" and for people with no education or resources. Poor people who live far away from hospitals usually have homebirths, there is allways a midwife near, and thats it. Here this topic is not even under discussion. What I would like to know is what make people so negative and reluctant to this, breastfeeding, sleeping with small kids, babywearing. Why is the wonder of life so scary to us?

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  20. On a happier note, have you seen THIS???

    http://aervilhacorderosa.com/blog/2009/03/babywearing_4.html

    reminded me of you. Such a beautiful site, even though I can't understand a word.

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  21. Allegra -- love right back at you, babe!

    Timoteoscrapbook -- thank you so much for joining in, it's so nice to "meet" you :) Your comment proves the importance of freely speaking out about this issue lest it become shoved even further towards the margins of society. I commend you for finding your own path to truth about how to raise your kids with compassion and a wide-eyed embrace of the wonder and beauty in life.

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  22. P,
    Thanks for the link :) Yes, I know and love Rosa Pomar's site. It is inspirational to me so I am incredibly flattered to know that it reminded you of me. xoxo.

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  23. I have spent the last few days stewing on the article, trying to calm down, trying to put my thoughts into words. I've gone through some paper girl!

    Of my three birthing experiences the two in the hospital were the "Extreme" ones. The redeeming factor of those two births, were the beautiful, intelligent and passionate children that came into this world as a result.

    P.S. Some books that helped in my education: "The Silent Knife", "Male Practice", anything by Ina Mae Gaskin.

    P.S.S. I hate to burst Mr. Goldman's bubble but I DO NOT fit his mold of home birth women. I am just a woman who wants and wanted the very best for her children and her body.

    LOVE YOU SO MUCH!

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  24. I wouldn't want to second guess the vibe you felt you were getting from the reporter, but it sounds like he may well have been trying to set up a negative. It's a lot easier to write that "these people are not the hippies you are expecting," when you have a quote from someone saying "heck no, my mom was a lawyer and an avowed Republican!" or "sure, I buy organic food sometimes, but I also have a weakness for Big Macs and an embarrassing reality tv addiction."

    Anyway, it's a minor point, but I thought I would mention ...

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  25. Daphne, it's not a minor point at all. In fact, I thought the same thing before the article came out -- I think I was trying to stay positive and tell myself that the negative vibe I got with those questions was not for real. But as soon as I read the article my worst fears about where the reporter was coming from were confirmed. I mean, he didn't exactly go out of his way to clear up any of the hippie-homebirther cliches, did he? Only to the extent that he quoted a doctor saying that before BOBB “Nobody in Manhattan other than the real crunchy, hair-underneath-the-arm granola types knew anything about home birth,” before proceeding to propagate the newest cliche on the block, which is that all home birth people are caught up in the movement because it's now perceived as chic or trendy or because it was written about in Vogue -- a way to achieve a birth with "perfect aesthetics." I guess I just have a problem with the fact that Goldman seemed resistant to digging deeper than these two (admittedly opposite) stereotypes.

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  26. ... and would you say that your parents are hippies?

    Oh my goodness!

    Thank you so much for sending me this link to your blog.

    I wasn't sure if I was just reading the Cara article wrong. I do have to say that when I read articles that lean toward supporting midwifery, I smile and I don't complain about bias in that case. I'm human. The problem is that I can only think of a handful of articles in major publications that aren't dripping with the usual fear! fear! fear!

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  27. Thank you for this. I am a nurse and have spent the 3 years I have been a nurse feeling so frustrated by the lack of evidence based care being used in labor & birth. Home births are supported by data, by large trials and have been shown to be safe, so I will continue to be baffled by the medical community that views them as irresponsible. Is it really so irresponsible to want the best possible outcome for your baby? I am particularly disappointed in my fellow nurses who too often fall into the role of chastising those who choose to give birth at home. I am so inspired by you and by your desire to set the story straight.

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  28. So many wonderful comments here have inspired me to want to add a little about my own home birth story.

    When I decided to give birth at home, almost 37 years ago, it was not at all popular; no one I knew had done it. Yet it seemed so basic to me, as in why would I go to the hospital for a non-medical event? When people asked, "aren't you afraid?" I would respond that I was actually much more afraid of hospitals.

    I found one OB-GYN who supported home births; there were not even any midwives then! I saw this doctor throughout my pregnancy. Truth is I didn't love his personality and decided near-term that I would rather not have him attend the birth. I asked how he'd feel if one of his assistants attended instead. He agreed that would be fine.

    My son was born at home after a long, somewhat erratic labor. He was a few weeks early & small AND he was perfectly healthy!

    So many times, I've thought about what this experience would have been like in a hospital: There is no way I would have been allowed to labor the way I did. I would definitely have been given pitocin to speed up contractions when they slowed & almost came to a halt. An epidural would have likely followed because the pain from the pitocin would have been too much to bear. And who knows after that?

    For certain, my son would have been whisked away and into an incubator because he would have been labeled "premature" and jaundiced. We would have been separated and missed out on the important early bonding of those first hours and days.

    A very different picture ... and yes, he would still be the wonderful & amazing person he is today!

    But I am so grateful he was able to arrive in the world in this way - peacefully, calmly, surrounded & bathed in love.

    I wouldn't trade that experience for anything in the world. And I do believe, deep in my heart & soul, that he is, at least in part, who he is today because of coming into the world in this way.

    This is not a statement by a selfish mother only thinking of herself & her own experience. It is the statement of a mother who wanted a natural, unhurried welcome for her baby into this world, one as free of hardship & trauma as possible.

    And that is exactly what happened.

    Thank you for letting me share the miracle of this birth with your lovely readers, Leigh, and thank you, dearest daughter-in-law, for your constant & continual inspiration.

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  29. I just wanted to let Abby know (comment above),a very good friend of our family (back in the old days when I was having babies) encouraged me to have a home birth without ever saying I should have a home birth. She just happened to be a delivery room nurse who actually had first hand knowledge of what really goes on. She gave birth at home to her four children because of that knowledge. That was powerful to me. Kudo's to you for questioning.

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  30. Allegra, I was speaking directly about women that choose c-sections for non-health reasons...the ones that choose them to get it "out of the way and done with". I thought that was clear, but apologize if it wasn't. There are some c-sections that are warranted of course, but it's pretty slim and oftentimes due to the landslide of medical interventions that were allowed anyway. Obviously we are all very defensive about our personal choices, especially when it comes to something as major as the birth of our babies, but I'm sorry if you were offended.

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  31. Leigh, you ARE articulate. And intelligent. And I love that you chose to address this topic with such respect and care.

    I'd have to read the article again to be sure, but I actually thought the author did a fairly good job of being objective. After all, he listed a lot of "positives" about home birth too.

    That said, I agree with you about the title of the article and its implications. If any form of birth is "extreme," then certainly it is ones that involve IVs, pitocin, vacuum extractions, c-sections, etc.

    My first birth was in a hospital with an OB. My second birth was in a birth center with a midwife (2 weeks ago). The two experiences were quite different - and the latter was a hundred times better.

    I really appreciated Our Green Nest's honesty when she said, "it's so sad that many people still don't see the importance of the birth experience...they think that as long as the baby is healthy that's ALL that matters...obviously that's the most important thing, but nearly as important is the overall experience - for the mom and baby." I couldn't agree more. I'd like to see more women/moms having these kind of open conversations with each other.

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  32. i'm so glad you wrote this. thank you, leigh. xo

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  33. Hi Leigh. The author is defending his article in the comments on HuffPo... http://tinyurl.com/d3dn82

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  34. Thank you so much for that link, Jill. What a great back-and-forth on the HuffPo thread! I am heartened to see the intensity and intelligence of the arguments being offered (on both sides of the issue).

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