Sunday, November 15, 2009

Unitarian Universalist Sermon on Birth Part 5: Sermon


Let’s start with a survey. Raise your hand if you:

* Have given birth?
* Been there when your partner gave birth?
* Seen another person besides your partner give birth?
* Seen an animal being born?

Many of you are ahead of me on this journey. The only birth I have ever witnessed was our class pet Carmel the Guinea Pig during a math test in fifth grade.

Now let me give you the results of some surveys. But before I do that, I wanted to give a little disclaimer. Birth is messy and bloody and often painful. So in this sermon about birth I’m going to talk quite a bit about medical conditions and women’s body parts and maybe even touch on how babies are made in the first place. So you might not hear the paralyzed “paralyzed bowel” in a typical sermon, but this is not your typical sermon.

Back to the first survey. According to the Listening to Mothers survey conducted by the advocacy group Citizens for Midwifery in 2006 (1):

* Electronic fetal monitoring, what Monty Python called “the machine that goes ‘Ping!’” in the movie The Meaning of Life, is used in almost all (94%) births, despite being classified as having “a trade-off between beneficial and adverse effects” in a review of medical literature. (2)
* Epidural anesthesia is used in three-fourths (76%) of all births, despite also being classified as having “a trade-off between beneficial and adverse effects” by the same study. (2)
* Hooking the mother up to an intravenous drip (IV) for delivery of nutrients is used in 83% of all births, despite being classified by the same study as being “unlikely to be beneficial”. (2)
* Episiotomy is used in one-third (33%) of births, despite being classified as “likely to be ineffective or harmful” when used routinely. (2)
* And the mother of all birth interventions, the cesarean section, is used in 31% of all births. (3)

Here are the results of another survey. (My husband wanted me to include this statistic because it’s so powerful.) According to the Centers for Disease Control, babies are more than half again (1.6 times) more likely to be born on a weekday than a weekend. The CDC even has a name for this phenomenon. They call it “the weekend deficit” (4) as in "the weekend deficit keeps going up" or "the weekend deficit is more pronounced for c-sections than vaginal births".

So what does this survey tell us? That, in this country at this time, a lot of women are having highly medicalized births even though the medical evidence says that it might not be the best for their health or the health of their babies.

Now for some women, “highly medicalized” is exactly what they need. In fact, CDC data analyzed by the advocacy group Childbirth Connection (5) say that nearly one a fifth (17%) of women fall into the “high risk” category and need these interventions.

For other women, these interventions are not what they need, but they’re what they want. I don’t know if you’ve heard this, but childbirth can be quite painful. And for the benefit of pain relief that an epidural brings, many women will happily make the trade-off.

But for other women, the consequences of these interventions can be disastrous.

Take, for example, cesarean sections. And I don’t mean to pick on cesarean sections, but there are a lot of data on their risks, yet often these data are not presented to women when they are making their choices.

Oh, and all of the numbers that I’m giving you today come from either government vital statistics data or peer-reviewed articles published in medical journals. So I have a more rigorous standard than “I read it on the Internet. It must be true!” And you can look up these studies yourself because I’ve included all the references for all these numbers in the written version of my sermon, which will be posted on the church website and on my own blog.

Where was I? Ah, yes, caesarean sections, which is how nearly one-third of babies in the U.S. enter the world. Yet with c-sections, there is a 4.5% rate of major complications for the mother, which include severe hemorrhage, need for another surgery to find out what’s causing the severe hemorrhage, pelvic infection, pneumonia, blood poisoning, blood clotting too much and blood clotting too little. In addition, there is a nearly one-third rate of minor complications for the mother, which include fever, hemorrhage, blood-filled swelling, urinary infection, uterine infection, leg clots, and paralyzed bowel or bladder. (I don’t know why paralyzed bowel or bladder is classified as a minor complication. It seems pretty major to me.) There is even a 1% rate of the baby being cut by the surgeon’s scalpel. (6)

In addition to physical wounds from this type of intervention, psychological wounds can be just as profound, if not more so. Problems include difficulty caring for the newborn; difficulty caring for older siblings; disappointment, anger, frustration and sadness at the missed opportunity for a vaginal birth; a feeling of being disfigured; and painful intercourse or a lack of interest in sex that often contributes to marital stress. For some women, the psychological problems are so bad that they experience post-traumatic stress disorder (PTSD) with symptoms of nightmares, flashbacks, a deep fear of getting pregnant again, and difficulty forming an attachment to the new baby.

Plus, many women who have these problems experience a trivialization of their physical and psychological pain by medical professionals and well-meaning family and friends. One woman writes in the book Caesarean Voices (7): “They all think you are just lucky to have a healthy baby and you should count your blessings.” So in addition to all these other negative feelings, you can add guilt to the list.

Our country’s over-medicalization of birth is one of many factors in another alarming statistic: maternal death. More women are dying in childbirth in the U.S. than they used to. Let me say that again, because most people don’t believe it because they think it cannot possibly be true. But this is what the data show: both the rate and the absolute number of women dying in childbirth in this country has doubled over the past decade. (8)

The alarming rise in maternal deaths prompted Ina May Gaskin, who wrote the mediation from Spiritual Midwifery that I read earlier, to launch the Safe Motherhood Quilt Project. Similar to the AIDS Quilt, the Safe Motherhood Quilt is comprised of panels, each commemorating a woman who died of pregnancy-related causes in the U.S. since 1982. The quilt now has almost 200 panels online and even more as part of the physical quilt. (9)

So why should we, as Unitarian Unviersalists, care about these births? Why should you care? Especially if you have no children and have no plans to, or are done having your babies? Because respect for birth is yet one more way to manifest the Seven Principles. And lack of respect for birth is yet one more way that the Seven Principles are violated.

The women who tell their stories in Cesarean Voices, for example, were not treated with inherent worth and dignity of every human being (the First Principle). They did not have a voice in their own care (the Fifth Principle). Because of the lack of information or misinformation they were given, they were denied their right to search for their own truth and decide what option was right for them (the Fourth Principle).

We should care about these women because they are in the interdependent web of which we all are a part (the Seventh Principle). That’s why I asked John to give his perspective on our son’s birth. Because the birth experience is important not just to the mom, but to per partner, the children she gives birth to, her family and her entire community.

Now at this point, I want to stop and make something very clear. If you had a highly medicalized birth (whether by medical necessity or your own choice or both) and you have no physical or psychological wounds, consider yourself blessed. The last thing I want to do in this sermon is to cause anyone to feel bad because of the choices they’ve made.

But what I do want to communicate to you is that other women are not as blessed. These women are wounded, and they need your help.

But don’t despair, because help is on the way.

One form of help is a group called Birth Options Alliance, which was founded six years ago in nearby Takoma Park by playwright Karen Brody and has now grown to over 600 members. The group educates expectant parents on their choices, provides support to expectant parents through monthly meetings and an active e-mail group, fights against threats to birth options in the DC area, and works to expand options. You can join Birth Options Alliance, anyone can, for free, simply by signing up for the Yahoo group. (10)

Another form of help is the effort to start a birth center in Takoma Park on the campus of Washington Adventist Hospital, which will be relocating in 2013. And, as many of you know from my relentless e-mail campaign, I am leading this effort. (11)

Believe me, when I was giving birth to my babies on those warm summer nights in 2002 and 2005, I never expected that that this would become, as I described in my e-mails, “my new mission in life”.

But I feel that I have been called to do this. Most women who become birth activists do so because of a horrible birth experience (like those described in Caesarean Voices). But not me. I had two great births at the Maternity Center.

But the Maternity Center closed in May 2007. And, that same month, a midwife practice in Takoma Park that delivered babies at Sibley Hospital, called Takoma Midwives, also closed.

So the option that I had for my babies’ births has been taken away. So I feel that I have been called to restore that option to women here in this area.

But I’m not the only one at UUCSS working on this issue. Our Youth Coordinator Dawn Star Borchelt teaches childbirth preparation classes. Former UUCSS member Carolyn Dutcher was a midwife at Takoma Midwives, and delivered quite a few children of this congregation who are downstairs in RE right now. Church members Meredith Massey, Kathryn Leete, Alexa Fraser and Sarah Torrell have all pledged some combination of their time and their talent and their money to support the new birth center.

I even got the idea for the name “Seasons of Life Women’s Health and Birth Center” from the quilts that you’re looking at right now in this sanctuary. I wanted a name that would reflect the breadth of the center’s mission, that it would provide care for all phases of a woman’s life: from the onset of menstruation (including teen sexuality issues), through the childbearing years (including birth, birth control and fertility assistance), to elder years (including menopause).

This church and this congregation have supported me in my “new mission in life”. So I just wanted to say thank you. But, you know, from the eight years that I’ve been a part of this church and the eight years that I’ve been a Unitarian Universalist, I’m actually not surprised. Making the world a better place is what we UUs do. It is the Sixth Principle, after all.

Ina May Gaskin wrote in our meditation that “each and every birth is the birth of the Christ child”. And Mary McAnally, in our poem of opening words, equated each laboring woman to the Great Mother Goddess.

So let us embrace the sacredness of each and every birth. Do it for yourself, for your wife, for your partner, for your daughters and sisters and neighbors and co-workers and friends. Do it for the woman who gave birth to the child you adopted, even if you never met her, even if you never even knew her name.

Ina May Gaskin also wrote in our meditation that “Each birth is holy.” and that those who attend births have a “daily acquaintance with miracles”.

So miracles really do happen every day: 11,000 miracles every day in the U.S. on average. Some are empowering and life-changing. Some are terrible. Some are tragic. But they all are miraculous.

So let us all try to be more reverent of those miracles. The Great Mother Goddess within us all deserves no less.

-Amy Polk

Endnotes:

(1) Listening to Mothers II Survey (Citizens for Midwifery, 2006) http://www.cfmidwifery.org/
(2) A Guide to Effective Care in Pregnancy and Childbirth, Third Edition (Oxford University Press, 2000) http://www.childbirthconnection.org/article.asp?ClickedLink=194&ck=10218&area=2
(3) 2006 data. Centers for Disease Control and Prevention, National Vital Statistics System http://www.cdc.gov/nchs/births.htm.
(4) National Vital Statistics Report, Volume 65, Number 6 (Centers for Disease Control and Prevention, December 5, 2007) http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_06.pdf.
(5) 2006 data compiled by Childbirth Connection. Presentation at the American Association of Birth Centers (AABC) 2007 Annual Meeting.
(6) The Thinking Woman’s Guide to a Better Birth by Henci Goer (Penguin Putnam, 1999), p. 23.
(7) Caesarean Voices (International Caesarean Awareness Network, 2007), p. 56. http://www.ican-online.org/.
(8) Maternal Mortality and Related Concepts, Series 3, Number 33 (Centers for Disease Control and Prevention, National Center for Health Statistics, February 2007) http://www.cdc.gov/nchs/data/series/sr_03/sr03_033.pdf
(9) Safe Motherhood Quilt Project http://rememberthemothers.net/.
(10) Birth Options Alliance http://www.birthoptionsalliance.org/.
(11) Seasons of Life Women’s Health and Birth Center http://www.seasonsoflifebirthcenter.org/.

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