pregnancy
Mamas on Bedrest: Is Your Provider “Thinking” Like a Man Or a Woman?
January 9th, 2012Men and women think differently.
Well that’s no news flash! Yet I have been thinking a lot about the differences in thought patterns since writing the last post and considering how the differences in thought, speech and behavior will affect how men and women provide health care, in particular, prenatal and peripartum care.
The more I consider the war waging between OB’s and midwives, the more I am inclined to ask,
Is the obstetrical approach truly “Misogenistic” as some midwives accuse, or is it more a function of how men think versus how women think?
I think cases can be made for both, but having been trained in a very “male” model of health care delivery (the Duke University Physician Assistant Program), I firmly believe that this more masculine/left brained model is more a function of mental organization as opposed to deliberate cruelty.
Millions of dollars and countless hours have spent trying to determine just why men and women think differently. In my hunt for answers, a short surf of the internet yielded a very interesting website by Renato Sabbatini, PhD, a neurophysiologists in Brazil who has done considerable research on the subject. Dr. Sabbatini, citing studies by numerous researchers on the subject presents many anatomical reasons as well as evoutionary reasons for differences in the ways that men and women think. Anatomically, (and I’m grossly generalizing here, do read the citation for more precise characterizations of the differences) the left brain in men (the side of the brain linkied to independence, dominance, spatial and mathematical skills, rank-related aggression), is larger than in women. Conversely, the right brain in women (human relations, recognizing emotional overtones in others and in language, emotional and artistic expressiveness, esthetic appreciation, verbal language and carrying out detailed and pre-planned tasks) is larger than in men. Additionally, the corpus callosum, the think band of neurons that runs between the two sides of the brain is thicker and more developed in females than in males. What does this mean? It means that women are more adept at sending messages back and forth across the brain than me. In simple terms, we multi-task while men focus on one or two tasks at a time.
A simple illustration: Send your husband to the grocery store with a list. He’ll most likely come home with exactly what is on that list and little if anything else. But when you go to the grocery store, you’ll get what’s on your list, but if there is a sale on some item you use a lot, you’ll likely pick up a few. Likewise, if you have forgotten an item and see it on the shelf, something will trigger your memory and you will remember that you’re running low and pick the item up. Is one mode of shopping better than the other? Not really, just different. (Sabbatini and his colleagues note that if roles are reversed, then habits and behaviors often reverse. So if your husband does most of the grocery shopping, he may be more likely to spot necessary not on the shopping list before you do!)
Sabbatini also cited some evolutionary reasons for these differences.
“In ancient times, each sex had a very defined role that helped ensure the survival of the species. Cave men hunted. Cave women gathered food near the home and cared for the children. Brain areas may have been sharpened to enable each sex to carry out their jobs”.
As a mama on bed rest reading this, you may be thinking, “Well that doesn’t help me. I’m worried, I have no one to help me care for my children at home and I may end up losing my job over this. ” All this is entirely true, but your OB (especially if male) isn’t even thinking about these “ancillary” issues. The practice of obstetrics trains physicians to “ensure as healthy a pregnancy as possible so that a healthy, live baby results.” The motivation behind this is, “By any means necessary. ” Steroids making you sick, suck it up, and you’ll get your baby. Preterm labor, go on bed rest. You can rehab your body later and get another job after you clear bankruptcy.
Now I have made this seem callous, cut and dry, but the “life factors” that come into play when a pregnancy has complications are not mentioned or intended to be treated by physicians. (Interesting to note that most of these issues are handled by hospital social workers. How many of them are male??) That’s not what physicians are taught in medical school nor are they trained to consider these issues. To that end, don’t be surprised when your female OB is as cut and dried as her male counterparts. Medical School is a tough road to trod and while there are many women in obstetrics, the rule of thumb is “If you want to make it with ‘the boys’ you have to play by their rules.” Many women physicians go on to develop more caring “feminine” practices, but a large majority continue in their “produce, produce, produce or perish” mode of operation.
How do we blend the two approaches? How can we utilize the scientific, “management” model of obstetrics when needed while maintaining a softer, more collaborative and fully encompassing approach at the same time?
It’s called working together and we’ll discuss how this can be done in our next post.
What are your thoughts on the male and female brain approaches to pregnancy care? Share your comments below. You can also follow and discuss with us on Twitter (@mamasonbedrest) or on our Page. To keep up with this feed, be sure to sign up for our RSS feed in the upper right hand corner of this page.
Mamas on Bedrest: Is childbirth really OB vs Midwife or Men vs. Women?
January 6th, 2012We are 6 days into 2012 and the battle over “who is the better birth provider” and “Where is the best place to give birth” continues.
On December 30, 2011, The Feministing blog posted an interesting interview with Ina May Gaskin as part of a series on birth professionals. Ina May Gaskin is one of the world’s most recognized midwives, authors and teachers of childbirth. For those of you unfamiliar with Ina May’s work, here is a very brief summary, shortened from the biography provided in the blog post.
Ina May is the famed “midwife of modern midwifery” and has revolutionized the way the world views this ancient practice since the emergence of her seminal book “Spiritual Midwifery.” …A pioneer in the natural birth movement, Ina May firmly places control back into women’s hands from what she calls “male-centered, misogynistic birthing processes” which views women’s bodies as defective designs and allows for profit to be made from women’s fears of their own bodies….
She and her husband Stephen Gaskin established The Farm, a 1,750-acre commune in Tennessee, with a population once at its highest of 1500 residents, where Ina May runs The Farm Midwifery Center. The cesarean rate at The Farm’s clinic is less than 2% and people from all over the world come to receive their home birth services.
The post continues on with the inteview of Ms. Gaskin. As with any blog post, there will be those who like the information provided and those who oppose it. I personally am for opposing viewpoints as we’re all entitled to our opinions, it makes for interesting conversation and I tend to learn something from the other person’s viewpoint-even if I’ll never agree with them. But when the viewpoints become venomous and attack the author and/or the content of the blog rather than convey a viewpoint backed by solid evidence, then the conversation degenerates. I think that the commentors on this blog post did fairly well in that many cited specific articles and studies to back their opinions.
I had no sooner read this back and forth on “the dangers of home births” when I received an e-mail notifying me that there was a comment on a post I had written for Science and Sensibility, the Lamaze International Blog, back in November. While my post was addressing racial disparities in health care delivery, in maternity care in particular, the comment was coming from a mother/grandmother who lost both her daughter and granddaughter during childbirth following (an unwanted) labor induction. While all the details of the birth were not provided, I am gathering (and again, I don’t have all the facts) that the induction was not medically necessary. The delivering mama tried to refuse the induction but in the end succumbed. The events that transpired are unknown to us, but the end result was tragic-a mother and a baby both lost their lives.
I am always struck by physicians who scream from the mountain tops, “Home births are unsafe!”. Who do you think delivered your grand parents? And their parents? And their parents and so on??? Midwifery is mentioned way back in the book of Exodus (The second book of the bible) and existed well before that. Yet we also know that throughout time, millions of women have died during childbirth. Those of us in the childbirth arena well know, childbirth is risky business. As one of my mentor’s Dr. Linda Burke Galloway says, “Obstetrics is the specialty of the unexpected”.
But I’d like to think that we’ve come a long time since the bondage of the Israelites in Egypt, and truly we have. An article that I found in the Postgraduate Medical Journal gives a historical recount of the genesis of obstetrics. From this article and several others that I have read, obstetrics originally came to pass as a way to deal with breech birth presentations and save the mother’s life (if not the baby’s as well). Instrumentation was orginally frowned upon in childbirth and was typicaly only used for stillbirths. Interestingly, forceps, anesthesia and antisepsis, all were introduced by men and increasingly used when “accoucheurs” (male midwives)” became fashionable in the 17th century in France. Modern obstetrics as we know it became a medical specialty, taught in medical schools, in the 19th century in Europe and later towards the end of the 19th century in the United States.
As I look at the history of childbirth attendance, there is an interesting shift that takes place. When you look at the early records, the bible, documents from early civilizations, and up until about the 16th century in western civilizations women were the birth attendants. Women cared for women and did the best that they could, with information handed down from generation to generation, to take care of themselves and eachother (Remember, women weren’t allowed to be educated in many cultures-they could not read or write or conduct any sort of scientific experiment.). Child bearing and childrearing was considered “women’s work” and men took no part.
But in other areas of medicine and science, men were studying and discovering ways to ward off disease and improve longevity. However, they were not attending births and women were not allowed to be educated so these advances were slow to reach childbirth and women continued to die. As men began to slowly infiltrate and attend childbirths, they brought with them instrumentation, anesthetics and techniques of antisepsis which we know improved outcomes. Midwives, female attendants, began to be marginalized. Regarded as ignorant, their services were increasingly less sought after for childbirth delivery.
During the 19th century in Europe and most certainly by the 20th century in the United States, childbirth increasingly took place in hospitals, mortality rates improved and midwifery (by women attendants) was relegated to poor women unable to afford the services of a doctor or hospital .The modern obstetrical model of the male educated and authorative figure dictating what and how things will take place during childbirth had been widely accepted and was the primary model of childbirth and healthcare delivery-until very recently.
From my perspective, this is the origin, the very core of this “OB vs. Midwife” debate. While both sides are very adept at going tit for tat as to who has the most untoward outcomes, the core argument stems from these simple facts,
- Women used to care for women and babies before, during and after childbirth.
- Men began studying ways to improve outcomes and prevent death during childbirth.
- When men began implementing what they learned, they pushed the women attendants aside, labeled them as igorant and uneducated (which they were because they were not allowed to attend medical school!) and ousted them from the birth arena.
- Childbirth and women’s health went from an intimate community (I’m thinking of the book The Red Tent by Anita Diamante) in which women cared for one another and shared wisdom from one woman to another to an austere, more academic environment in which little beyond the immediate health issue was considered.
- Women (those giving birth and those women who attend births) are rallying against the academic environments and are demanding that they be given equal access in women’s health, bringing in the more intimate interpersonal relationship between provider and patient/client and allowing women patients more authority in the treatment process. Those that can, opt out and choose birthing centers or home births with (female) midwives.
For me, the question isn’t OB vs Midwife (especially now that there are female OB’s and male midwives). It really isn’t entirely about mode of care, more interventional (obstetrics) vs. more attendant (midwifery). At its core, the fight being waged over childbearing is between men and women and who (should) call the shots. From this perspective, it’s a completely different argument, one I’ll continue in the next post.
Who do you think should direct a woman’s care before and during childbirth? What is your experience? Share your thoughts below. We’ll be chatting about this on Twitter (@mamasonbedrest) and on our Facebook Page. To follow this topic, sign up for our RSS Feed at the upper right hand corner of this page.
Mamas on Bedrest: “2011 A Horrible, Wonderful Year” A Mama’s Triumph Over Adversity
January 4th, 2012Mamas are the most resilient people that I know!
After going through fertility treatments, Paige, @babydust on Twitter and the author of this post, is a mama to a 3 year old little girl and darling twin baby boys. Now a SAHM (stay at home mama), many would think that Paige “lives the life”. But her journey was anything but easy. Paige’s story epitomizes an all too common scenario for Mamas on Bedrest. Yet, despite its troughs and pitfalls, Paige prevailed.
For those of you “going through” I share Paige’s story with you (with her permission) to show you that you are not alone in your trials and to show you that there can be a happy ending. Paige has an awesome blog called Baby Dust Diaries. I highly recommend you take a look. Thank you so much Paige for sharing your story!
2011 A Horrible, Wonderful Year
Ah 2011. What can I say about you? My first reaction is that 2011 SUCKED BIG TIME. I mean at least 70% of the days of this year were some of the hardest of my life. And yet, in all the ways that really matter, you know those ways that will matter in 5, 10, 20 years, 2011 was full of life-changing blessings. I mean I welcomed two baby boys into my family AND I became (at last) a stay at home mom.
I guess the problem was, as will most things, my blessings came with much blood, sweat and tears. I started the year with an extended hospital stay to keep my babies from being born too early. Hospital bedrest is misery. Seriously.
Yet, it was a blessing because it kept my boys a-baking for a crucial extra month!
Even though my eventual goal was to be a SAHM it would probably have taken a few years for my hubby and I to get to that point. And then Psycho Boss (PB) entered the picture. I can’t even describe the continuous harassment I endured at this person’s hands. The examples would be endless and cause me stress just in the remembering. Worse yet, the process that is supposed to protect employees from Pregnancy discrimination failed me miserably. At every turn I had people shocked at the treatment I endured and agreeing that it had to end. Then when I finally sought formal relief it is like the “machine” that was my agency responded by getting its hackles up. Talking about an issue is one thing – actually filing a complaint? In hindsight, the minute I formalized my complaint my career was over. Even if I had won (or especially if I had won) I would have been blacklisted. It became a witch hunt. No one denied the discrimination but everything else became a problem. In the end, a job that I loved and had always been family friendly, ended because I couldn’t attend a 6PM meeting with 3 hours notice. They actually laughed (yes, LAUGHED) when I said I’d need a days notice to change my child care arrangements. It wasn’t about that meeting it was about punishing me for complaining.
Ugh! Enough of that! Just talking about it is going to give me nightmares tonight (luckily the daily nightmares are now just weekly, they’ll go away, right?) My point is that it was demoralizing in the extreme. I couldn’t sleep or eat I had a constant headche and stomach ache. I had no energy to parent. I considered hurting myself although I don’t think I was suicidal. It certainly combined/exacerbated/triggered severe post-partum depression. It was the second worst thing that has ever happened to me.
Yet, I had asked God to help me stay home with my kids and he sure did. The circumstances were less than ideal but I got my wish. I’m sure that 5 years from now I’ll be so glad I quit my job. Maybe I’ll even be thankful for PB? Nah.
An added problem was that I couldn’t talk about any of this on the blog. I get even angrier at PB when I think about him taking away my voice, my outlet. Holding back what was really going on in my life made any writing impossible. You can’t build a partial dam, know what I mean? THEN I got hacked and it felt like a punch in the stomach. Here my one solace – my blog – was being taken away.
Sob. Sob. I know it might sound pathetic but it was a very difficult year. I’m glad it is over and I look forward to looking back on it as a huge transitional point in my life for the better. I also hope to NEVER relive it!
Mamas, you can make it! Our roads are not typically easy, but as Paige shows, they are often well worth the struggle. Congratulations to Paige for her beautiful children and for finally becoming the SAHM she wanted to be.
Would you like to share your Bedrest story with other mamas? We’d love to hear it and share it! Share your story or a link to it at info@mamasonbedrest.com and give us the full attribution so we can credit you. Your stories are what keep other mamas who are still “on the road” trodding.
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