Links - how important is birth? problems with research, VBAC questions, and more

Enjoy Birth and Stand and Deliver and Talk Birth all meditate on the importance of birth - how it shapes women, how it shaped them - and whether or not it is important in shaping women as mothers. All provoked by this post at Sweet Salty. Excellent food for thought.

No Fat Talk Week - I personally celebrate this 52 weeks a year, and invite you to join!

Winning entries from the National Advocates for Pregnant Women writing contest. How's this for a title: “In the Manner Prescribed By the State”: Potential Challenges to State-Enforced Hospital Limitations on Childbirth Options. I like!

Melissa lists questions to ask a VBAC provider.

Amy at Science & Sensibility asks Do We Need a Cochrane Review to Tell Us That Women Should Move in Labor?. She says, "Somehow, things have gotten turned around, and the normal condition is now the “experiment” and the intervention is the “control”. In addition to being irrational, this is a set-up to perpetuate conventional obstetric care, which imposes unhealthy and unfounded restrictions on women in labor. This is because in “intervention versus control” research, you have to show that the intervention performs significantly better, otherwise the control condition remains standard practice." Read the rest on how this is a bass-ackwards way to go about things. It's alerted my eyes to look for the same issues in breastfeeding research.

Aaaand a new favorite (via, as so often, The Unnecesarean), Arwyn explores the analogy between athletics and childbirth:

"Everyone has heard of and no one doubts the existence of “runner’s high”, so why do we start plugging our ears and rolling our eyes and flapping our tongues when we speak of “birthing high”? ... Even discounting that, or in its absence, there is potential for pride and a sense of accomplishment: something we value so much in athletics, yet scoff at in childbirth, where our effort benefits both us and another. We deny women that pride in accomplishment (for which support of athletics is so vital to girls’ sense of self and women’s equality), that boost in self-esteem and feeling of competency, right when we need it most: at the start of parenting, one of the most demanding journeys a person can undertake."

And that's enough for tonight!

Don't count on your epidural

I used to work with a great midwife who gave a presentation of research on women's satisfaction with pain relief in labor. She said "If women are expecting pain relief and don't get it, they are not satisfied. If they are expecting unmedicated labor and end up with medications, they are not satisfied."

I thought of that when I read Reality Rounds' great post on expecting an epidural...and not getting one.

This is something I wish more women understood. Just because you expect to get pain relief in labor, you may not get it. You may never get it: you may have a fast labor, or show up too late, or have to wait too long for the anesthesiologist and by the time he shows up the baby is crowning. (If he ever shows up.) You also might have to wait for hours. When you get one, your epidural may not work, or only work partially. (My least favorite kinds of epidurals.) And most women do seem to feel a baby emerging from the vagina, regardless of the epidural.

I agree with RR: every woman should take a class that teaches them non-medical forms of pain relief. If your expectations for pain relief are met and you never needed those techniques - great. But if you need them, they could come in pretty handy. Above all, of course, keep your expectations flexible - then it's harder to be disappointed.