Pushed.
It’s a book about birth. A book about “The Painful Truth about Childbirth and Modern Maternity Care.” So why review it for an erotica site?
Because here at O&C, where we champion women’s sexuality and everything involved in that freedom. We sometimes have to look at other areas that are directly related to a woman’s rights over her body.
In Pushed, the author, Jennifer Block, discusses the obvious but somehow overlooked point that a woman’s rights over her own body do not begin and end with the right to choose. In other words, a woman’s rights over her own body begin with her sexual rights, continue through her family planning rights, and are just as important and should be just as legitimized through the entirety of her birthing experience.
It started harmlessly enough over drinks with a friend. Talk turned to the women we knew who were pregnant – and what their plans were for giving birth. Some of the women we discussed were having planned cesareans, and we both agreed that we wouldn’t do the same. I had vague notions that something “unnatural” like a cesarean couldn’t be a good way to go, and my friend had similar, vague impressions. But then we both looked at each other and wondered, “What’s so bad about a C-section?”
Fast-forward to a visit with a talented midwife, who happens to be my cousin and dear friend. I told her about the conversation and she replied, “The question is, what’s not bad about a C-section.” Enter my copy of Pushed.
Block’s book is a thoughtful, well-researched text about the way modern medicine deals with pregnant women. Block chronicles the journey of obstetrics in the U.S., weaving a highly readable tale that is sometimes sad, sometimes absurdly funny, often scary, and unfortunately infuriating. Pushed is also the story of midwives and dulas, how they have been subjugated as legitimate birth attendants in the last century, and what their rolls are today.
Ladies and gentlemen – if you are considering becoming a parent, or a parent again, don’t do it without reading this book first. And ladies, this is a must-read for all of us -- we should be aware of what is going on in the medical and legal fields in direct regard to women's bodies.
There is an intensive amount of health information in Pushed, as well as several studies and medical statistics, and this is all interwoven through poignant personal stories. Block spends a lot of time interviewing and witnessing the work of midwives, including an "underground” midwife practicing with no licensure, and a well-respected midwife who was at the forefront of her field before being put through the ringer of the legal field. There is also a wide range of personal stories from mothers, on what they wanted, how they were treated, and how they've been scarred by their birthing experiences in hospitals.
An important point that Block makes is that much of the medical field treats birth as if it is an emergency situation, a medical procedure to be controlled at every step, rather than a natural human condition during which the mother's body and the fetus dance together, both following a sequence of physical and chemical events in order to healthily deliver a baby. In many of today’s delivery rooms, a woman is strapped down, connected to machines, monitored, poked, prodded and medicated – when research shows that the healthiest way for a woman to deliver a baby is to have an active labor where she’s moving around going through the process with her own body's chemicals signaling the way. Because so many obstetricians want to control birth as a medical procedure, Block argues, too many births end up as cesareans.
The research suggests that cesareans are necessary in a rate of between 10 and 15% of births – because this is the number of births that occur in which something is actually medically going wrong and an M.D. needs to step in. Above this rate, cesareans begin to have adverse affects in comparison to natural birth.
The answer to my original question, "What's so bad about a C-section?" is indeed best answered with "What's not bad about a C-section?" A few important and not-readily available points that Block discusses (all backed by documented research, pp. 114-115):
1. A cesarean section is a wound that impedes normal digestive function; function that must resume following surgery
2. Breast milk is delayed
3. Seven layers of tissue and muscle are severed
4. There is always significant blood loss
5. Recovery from a cesarean is typically much longer and more painful than recovery from a vaginal birth
6. Infant death rates are higher when cesareans are done with low-risk babies
7. Serious infection can result in unnecessary cesareans
8. Women are more likely to die during a cesarean birth than women giving birth vaginally
What’s more, risks increase many times over after just one cesarean. The surgery causes scars and adhesions within the woman’s abdomen, which can cause complications in the uterus during a future pregnancy. These complications include eptopic pregnancies, detachment of the placenta before birth, or situations where the placenta rips the uterus along the scar-lines and can also impact the bladder (pp 116 – 117).
And these points are cumulatively only the tip of the iceberg when it comes to learning the facts about modern-day birth. The information that Block provides is complex and thorough, and deserves attention.
Block's text is not anti modern-medicine. Instead, she works hard to paint a well-informed picture of the politics, policies and personal beliefs that go into shaping the state of modern obstetrics. Many of the M.D.s and nurses she interviews are pro-midwife, and all of the midwives she interviews have positive partnerships with M.D.s. The midwives who Block interview concur about the importance of having a doctor's services available should they become necessary in the event of an actual medical emergency.
While reading Pushed, one does not come to the conclusion that the doctor is the epitome of evil and we should boycott the obstetrician at all costs. But one does question whether the state of modern obstetrics truly does support and provide the highest quality care and safety for mother and child.
One sad element to the story is the lack of interest from women's groups such as NARAL and NOW to involve themselves in a serious way in the issue of birth and choice. It appears that these groups have chosen the issue of choice and abortion as the most important aspect of women's rights, while not concerning themselves so much with women in labor who are being stripped of their rights.
Some readers might shy away from a book like this out of fear of adding stress to pregnancy and impending birth. To this I would say, if we truly believe that we have the right to choose for ourselves and our body, we have an obligation to educate ourselves and make decisions based on what's best for us.
Pushed, by Jennifer Block. Da Capo Press, 2008. Pushedbirth.com.
Originally published December 2008