Man, that was Totally Badass, that discussion. Many thanks to participants. So cool, and so necessary to talk about this stuff.
I wanted to make a couple of points before moving onward and downward; a few things always get brought up in discussions about childbirth, and they're pretty much red herrings. The first concerns maternal mortality rates in the present as compared to the past. (Here is where I would ordinarily include a lot of statistics, but you will forgive me for not wishing to research relative maternal mortality and morbidity rates, at this point in pregnancy.)
Things have improved over time, largely due to our growing but still incomplete understanding of things like hypertensive disorders of pregnancy, and -- here's a huge one -- infection control. This doesn't have anything to do with the moving of birth location to the hospital; in fact infection rates went up at first, before good Dr. Semmelweis figured out that it's a bad idea to handle a corpse and then insert one's doctorly hands into a laboring mother. Improvements have been made, and hospitals are now a safer place to deliver than they once were.
And so is home. Birth in general is safer today (here I'm speaking about the U.S., Canada, most of Europe), regardless of where it takes place, thanks to a growing understanding of the body and how it works. This isn't strictly the purview of "modern medicine" -- a huge amount of birth knowledge comes from midwifery, and then later can be demonstrated scientifically in studies. Medicine and midwifery work best in tandem, learning from and honoring each other. So a present-day midwifery practice -- and likewise an obstetrical practice -- has the possibility of presenting the best of both worlds: say, the option to give birth at home or in a birth center, with a shot of pitocin available to prevent hemorrhage if it's needed, along with the handed-down knowledge of how NOT to cause a hemorrhage (by pulling on the umbilical cord, for example). Unfortunately medicine is often very slow to learn from midwifery.
Anyway there's no point arguing the safety and relative merits of homebirth in general. It's been demonstrated pretty conclusively.
En fin: nobody's saying that medical advances are a bad thing, or that they shouldn't be used when necessary. Nobody's asking for a return to seventeenth-century standards of medical care.
I'm having little bitty contractions, which is killing my concentration. On to the next thing.
Somebody pointed out in the comments that hey, they used to amputate legs without anesthesia. I've also heard the argument that you wouldn't get a root canal without anesthesia, so why go through childbirth without?
While I believe that pain medication has its place in childbirth, and that its availability is in general a very good thing, the above arguments are flawed. Amputation and root canals are not analagous to childbirth -- yeah, they both hurt, but that's where the comparison stops. Surgery is -- well, it's surgery! Anesthesia is necessary because otherwise people simply die from shock during surgery. Childbirth is a natural process -- not that that means it doesn't hurt. It does mean that we have a system set up to provide us with means to cope with the pain, not to the point of being comfortable, but to the point where we don't die just from the pain. It means humans are, by and large, designed to do it. Again, this doesn't mean that I think any woman should be denied painkillers if she wants or needs them -- it just means that the two -- childbirth and surgery -- are not comparable.
Okay, one more thing, this one just about me.
I appreciate all the good wishes for the coming, um, global superstorm. I have to admit I'm a bit frustrated by the frequent exhortations to remember that things don't always go as planned -- only because I've spent so much time and energy making sure that I -- we -- will be okay no matter what happens, physically and mentally. I don't go into childbirth imagining that it'll be a psychedelic party (although wouldn't that be cool?), and I'm not fool enough to think you can plan a thing like childbirth. It's like trying to plan a hurricane: it'll do its thing, and the best you can do is work with it. If we transfer, we transfer. If I feel like I can't go on without medication, that won't represent a perceived failure on my part, not at all. In all likelihood these things won't happen, but if they do, that's okay with me -- deeply okay. I'm not afraid to go to the hospital, and I'm not afraid to stay home. It makes me sad to hear women talk about having "failed homebirths," because there's no such thing as failure there. You respond to the situation to the best of your ability, and that means different things.
I have a deep faith in the process of childbirth, in my birth attendants, and in myself. What will happen will happen.
I know those of you who offered that suggestion -- to bear in mind that things change -- do so with the utmost love and good intent, and I'm guessing you speak from your own experiences of things changing, fast, in a way you hadn't anticipated. So thank you for wanting to spare me that same thing, and know that I'm okay -- whatever happens.
I'm just glad to be here, you know? Never thought I'd get to.