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A Healthy Baby Isn’t All That Matters

We hear all the time, “a healthy baby is all that matters.”  That’s simply not true—especially when, all too often, “healthy” means merely “surviving birth,” for both moms and babies.  That’s not nearly good enough.

The truth is that in this day and age and place, a higher standard can and should exist: a healthy baby, a healthy mom, and a positive, respectful, family-centered birth experience for everyone.

Why is that so important?  Because what we forget sometimes in merely “surviving” birth is that, for moms, giving birth isn’t just a day out of your life.  For most of us, birth is not just about having a fetus extracted from our uteruses in the most efficient way possible.

Little girl

“A Healthy Baby Isn’t All That Matters”
www.ImprovingBirth.org
Credit: TL-foto.com

Birth is a life-defining experience that sticks with you.  Ask most moms about their birth stories, and you can see and hear the emotions rush back as they share.  These are stories—good or bad—that we vividly relive over and over, whether we want to or not.  And let’s not forget that our experiences can have major, lasting, and permanent health consequences.Our birth stories affect the postpartum period (baby blues, anyone?), our relationships with our babies and families, and our attitudes about ourselves and future births.

For babies, it’s their first introduction to the world and to their primary caregivers.  We’re communicating to our babies from Day One what the world is, how threatening or safe it is, and how we relate to it.  How much better can that care be when we are launched into parenthood strengthened in birth, confident, and supported?

In the real world, of course, birth doesn’t follow a textbook pattern; there are complications and changes of plans and undesirable outcomes.  But even when these things happen, a woman can still be respected and supported.  We may not be able to control nature, but we can control how we treat women in labor and birth.  Even in the worst-case scenario (especially in the worst-case scenario!), there’s no excuse for anything less than the utmost respect for, deference to, and compassion towards the birthing woman as she is making her choices.

Because what’s really telling about the “healthy baby” phrase is that, so often, it’s used to justify a disappointing, difficult, or traumatic birth experience.  It’s said to us by our providers, our friends, and our families as we’re reeling from the shock of what just happened: trying to wrap our heads around something that seemed to go unexpectedly out of control.  And, yes, we tell it to ourselves.

So what’s the key to a new standard?  It’s us!  It’s the moms whose business drives the industry that gives us that care.  Many of us don’t realize it yet, but we are in the catbird seat.  Imagine what could happen if we, millions of moms and dads and our friends, really took hold of that power and wielded it.

We can start by educating ourselves to know what great care looks like— respectful, evidence-based care—and actively seek it out by shopping providers.  We can tune in to the red flags—things like hearing “You aren’t allowed to” from your provider—and stop ignoring our gut instincts!  In my opinion, hearing something like “A healthy baby is all that matters” during prenatal care falls into that category.  It says to me, “Whatever happens in Labor & Delivery, you have no room to complain.  If we present you with a live baby, we’ve done our job.”

Finally, and probably most important: we can exercise our power by walking away from providers who don’t offer us healthy babies, healthy moms, and a positive, respectful, family-centered birth experience.

For moms and babies, surviving birth isn’t enough.  It’s only the beginning.

Author Cristen Pascucci, a political and communications specialist, recently joined Improving Birth’s executive board.

* Also see the followup to this article, my response to an OB’s comment below: “Respect in Birth: ‘Get Over Yourselves’” * 

 

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64 Comments

  1. This is so true. I had a wonderful home birth in 1983. In 1985 I was pregnant again and planning another home birth. On my due date I woke up and thought my water had broken but when I turned on the light I was bleeding heavily. My husband rushed me to the hospital. When the on call OB saw that I had planned a home birth he turned to me and said, “Maybe this will teach you a lesson”. I ultimately ended up with a very necessary C-section but I will never forget how that awful man treated me. 28 years later and it still hurts. In hindsight I wish I had demanded another doctor right then but I was young and scared and powerless in that environment. I often wonder how many other women he abused in his career.

  2. Anne Flaherty

    I once saw this quote- “I did not die in childbirth, but I did not live either.”

    • Miriam

      “I did not die in childbirth,
      At least not for good,
      I did not die in childbirth,
      But I also did not live.”
      Marion Cohen, 1979

  3. I do agree with what you are saying, but I am not sure I take offense at the words, A healthy baby is all that matters. I am a mother of 3 and all of them came by way of c-section. The first baby was breech and to save his life he came c-section. The second child I tried but she refused to be come out after days of back labor my cervix never went past 3 she was c-section. The third wanted to push out early and premature but my cervix didn’t want to open at all c-section 3. Each time I comforted myself with the words that a healthy baby is what was important not that I missed out having a natural birth but that I had a healthy birth and that does matter. I know you are saying the same thing, I am just saying that the words you found offensive I found comforting.

    • Ryanne

      I think the important thing to remember is this.. “We may not be able to control nature, but we can control how we treat women in labor and birth. Even in the worst-case scenario (especially in the worst-case scenario!), there’s no excuse for anything less than the utmost respect for, deference to, and compassion towards the birthing woman as she is making her choices.” You may not feel the same as the writer because you were respected during all three births. Most of us are not. We have decisions made for us and are given the ‘dead baby’ card if we dare to make our own decision (which often in real emergencies will be nearly the same as the health care provider). I think it’s fantastic that you don’t see this phrase negatively, but please remember to not use it towards other mothers who may be feeling defeated by the birth they may have been forced or at least coerced to have.

  4. This is exactly what my female Obgyn said to me after a coercive and highly interventionist birth process which culminated in a csection that I had dreaded and feared. In the middle of her interventions, between the iv and the catheter, she told me i could get up and go home if i wanted to question her. She stopped by my room the next day to gloat and dismissed my trauma with her glib, ” I know you hated the process, but I bet you’re happy with the outcome.” I wanted to throttle her. I still do. Ten years later I am just getting to the point that I can talk about it without shaking.

    • um, why didn’t you go home then? You obviously NEEDED her and her expertise, but all you do is belittle her for it!!!

      • Cristen

        Emkay, what Linda said was that her birth process was “coercive and highly interventionist” and she felt traumatized. My hunch is that she feels that her doctor contributed to the fact that the birth ended in a C-section. We hear quite a bit from mothers who feel that their care is what caused their C-section, rather than the circumstances of their birth. Does Linda not have a right to be upset about what was done to her body or that she felt coerced in her treatment?

        • Of course she has a right to feel upset, but just because she FELT coerced doesn’t mean that was the case! It’s incredibly IRRATIONAL to say that her OB stopped by to ‘gloat’ the next day – NO, she came past on ROUNDS because that is part of her CARE. No one in a hospital has time to wander about mocking or gloating at patients?! She feared a c-section, so was obviously going to see any process leading to one as disruptive. Guess what, babies born of c-sections MATTER TOO.

          • emkay, it incredibly IRRATIONAL for you to say anything about her birth when you weren’t even there! Don’t talk like you KNOW what happened. Geez. You talk about it like you were there and belittle her when you don’t even know!

          • Wikipedia definition: Coercion /koʊˈɜrʃən/ is the practice of forcing another party to act in an involuntary manner (whether through action or inaction) by use of intimidation or threats or some other form of pressure or force, and describes a set of various different similar types of forceful actions that violate the free will of an individual to induce a desired response. These actions can include, but are not limited to, extortion, blackmail, torture, and threats to induce favors….Coercion may involve the actual infliction of physical pain/injury or psychological harm in order to enhance the credibility of a threat.

            Not to split hairs, emkay, but the definition of coercion is basically to make someone feel coerced. You challenge them physically or bully them psychologically (i.e. telling them while you are putting in a catheter– meaning the patient is already numb from the waist down– that if she doesn’t like it, ‘she can leave.’) When this thinking, feeling woman says, “I felt coerced, it means she was being coerced. Even if her care provider is so used to operating that way that she doesn’t realize that’s what she’s doing, she is coercing people. THAT’S the problem with the system. Why should we be expected to high five and thank people who treat us like garbage? Two things. First thing. 1.) it is not out of the realm of possibility that not every woman wants to make her own choices. Yep, I’ve heard the whole, “I’d rather not know… blah blah blah.” So guess what? The doctor starts telling her, and she looks at the doctor and says, “You know, I’d really just like for you to do what you think is right and I’ll trust you implicitly.” I can see that. but unfortunately, those women are not the ONLY women out there. Second thing. 2.)The doctors should come from a place of informing their patients and giving real options BY DEFAULT. They should not act like asshats when women who are aware there is actually a choice to be made walk into their offices. On the contrary, they should be doing such a good job of informing THEMSELVES and THEIR PATIENTS of best care practices, that if a woman chooses not to make choices for herself, it concerns them. That being said, if some women want to waive their choices, they have every right to do so. I am certainly not for limiting choices, or judging another woman’s choice. That, in fact, is the current problem– the ENTIRE problem.

      • Mary Anne Hunter

        @emkay…what a nasty thing to say…

      • Emkay needs therapy

        Emkay you are just being nasty, rude, thoughtless, heartless and judgmental.

      • The coldness of some people is staggering!

  5. Great post, Cristen! I am not a mom yet, but I’m a birth activist in a country with a 52% national c-section rate (reaching 90% in most urban private hospitals). In Brazil we hear this type of thinking all the time and it drives me up the wall. I have a blog myself and I would love your permission to translate your text into portuguese, citing the source and re-directing to this page, and to post it on my blog. Either way, thanks so much for this valid contribution!

  6. With my first baby, I “fired” my original OB in my first trimester. I was experiencing severe cramps during the night and didn’t know what was happening; when I paged her, she called back to say she wasn’t in the mood to deal with an overreaction and if I had a problem I could take it to the ER. There’s nothing wrong and everything right with making sure you have a caregiver who’s on the same page as you. Trust is crucial to a good birth experience. I had a great relationship with my second OB and it was a relief being able to jut focus on birthing, and not worry about what she might do or say.

  7. I was told this over and over after my homebirth ended in a cesarean 21 months ago. It was necessary, but it still left a wound in my spirit and shattered my self-confidence. The treatment I received from my homebirth midwife was so different than the way I was treated after transfer. People touching me without my permission, bullying me. It was all why I wanted a homebirth in the first place.

    It wasn’t until I found this project that I found other moms who understood that it isn’t just a healthy baby that matters.

    http://igg.me/p/300723

    It’s a project by, about, and for homebirth cesarean mothers and their midwives. Awesome stuff that will do a lot to improve birth!

  8. You can have a great birth and take some control. When I had my first child there was an IV, an episiotomy, there was demerol and my baby was often in the nursery, even though I was there less than twenty four hours I wanted her with me. I had my next baby almost four years later. Same hospital, same doctors. I went in when I was in labor and I told them what I DIDN’T want. No IV, no episiotomy, no drugs and that my baby would stay in my room. At first they thought I was nuts, but before I knew it, the staff and doctors were rooting me on. With my second birth I lost a lot of blood, but it isn’t what I remember primarily, I remember that it was the birth I wanted to have.

  9. Brilliant post. Such a great reminder as to why we are all here supporting and encouraging the effort to demand Evidenced Based Birth and Family Centered Births. The birth I had, although drug free, was not without major frustrations because I had to fight the nurses nearly to the end. I did have an episiotomy and after studying to be a doula, it could have been avoided with spontaneous pushing and a position other than laying down. It was horrible to recover from and my experience in the ‘triage’ before I got to labor delivery was horrific. I will NOT have my next baby in a hospital. . . and as a doula I cringe every time I serve a mother and she says she is birthing at the hospital I did. It takes all the fiber of my being to not say “RUN, GO THE OTHER WAY!! THEY DO NOT SUPPORT EVIDENCE BASED BIRTH!!!”. . . but IO instead encourage, support and educate them so they are prepared.

    Thank you for all you do. . . it helps us mothers who have had pretty good birth stories keeping going. . . knowing that our efforts to make sure other women to not have the stories we have. . . my birth story propelled me into making sure all women know how awesome a drug free birth feels, that they can do it . . . and make sure that all women knows their options when pregnant and giving birth — WE MUST START DEMANDING CHANGE!!

    Blessings to you!!

  10. Thanks to all for commenting. These are all good and legitimate points. Something I didn’t mention in this post is that, in the U.S., we have the research, knowledge, resources, and technology to produce the best health outcomes in the world. Prioritizing the “whole” well-being of women and babies is not a safety or health compromise–it’s actually an essential factor in elevating safety and health.

  11. Both of my children were born via C-section. The first went fine, but the second had severe breathing problems, and was not expected to live ( he’s now 22and healthy). I had not been told that not going through labor and the birth stress can cause the baby to have problems since it may not make the autonomic changes from the in utero environment to “outside air,” which is what happened in my son’s case. Fortunately, we were at an excellent facility, and had a good outcome. Had this occurred even two years prior, according to the neonatologist, Dan would not have survived. Labor, even with a planned C-section, is necessary for the well being of the baby. I was fortunate enough to have an excellent doctor, who was respectful of me throughout both of my pregnancies and considered the well being of of both me and my baby well ahead of any other factor. I knew he was good when he treated all of the hospital staff with respect and courtesy, as peers and professionals- not as his “handmaidens,” as some physicians do.

  12. I enjoyed your post and the thoughtful points you make but wanted to add a bit about how it feels to have a great birth and an “unhealthy” baby. Many babies are born with disease and disorder. Hear the standard well at least you had a healthy baby is heartbreaking to these moms, even moreso if the birth was interfered with.

  13. I wanted a drug-free birth with my first baby, and I ended up being induced because of high blood pressure. Except for the induction medication, I was able to go drug-free up to 1/2 hour before the baby was born, when it was discovered that the baby’s heart rate was dropping and no matter what was done (including flipping me from side to side), the heart rate was not going up so I ended up with an emergency c-section, and I was given a spinal 1/2 hour before the baby was born. After birth, I discovered that the umbilical cord had been wrapped tightly around my baby’s neck and his heart rate had been dropping because every time there was a contraction, he was already low enough that he had begun to descend through the cervix and the cord was tightening around his neck. The surgeon had never seen a c-section baby that low into the cervix before. While it was not the birth I wanted, I had the best surgeon I could have gotten, and I had minimal pain and scarring during recovery. My second baby, I insisted on a drug-free birth again, and I wanted a VBAC. I wanted to have her at home, but hubby was afraid that what happened with Baby #1 could happen again so he did not want to risk having baby #2 at home. I was able to go into labour spontaneously with Baby #2, and while it was a long labour, I did do it all drug-free, and I ended up giving birth on all fours (I could not lay on my back, it hurt too much) – no epistomy (which I did NOT want) and while I was disappointed not to have a midwife, the head nurse in charge of me had been a midwife for about twelve years herself, so she really respected my natural birth plan, and she helped me tremendously. The doctor actually missed the baby’s birth, it happened so fast, but the head nurse was with me and used her midwife experience to help me through it. Excellent birth experience the second time around! I’ll try to convince hubby to have a home birth if we ever have Baby #3.

  14. good ideas, yet next to impossible to implement. with lackluster maternity coverage as is, how many people can shop around and drop providers? for the most part, women stick with providers that accept their coverage, be that someone good or bad.

    • Lindsay

      You do have time to shop around, you have 9 months! :) I started asking probing questions right away with my OB and about halfway through my pregnancy realized that I did not trust her to leave me alone during the birth. I got recommendations on other practices from my Bradley Method instructor and found a midwifery where I had a water birth with no medical interventions.

      Although in more rural areas there may not be a lot of choices, if you live anywhere near a city you are sure to find a midwifery or natural-birth friendly OB practice if you ask around. :)

    • Ina, I am SO glad you pointed this out!! I have never had the ability to shop around because I had to go with the provider who would accept my insurance. That SEVERELY limits who you can choose and how demanding you can be.

  15. Hi, Ina. Not impossible at all! :) It’s true that many women stick with their providers, good or bad. But what we’ve found is that for women who truly want more options, they often have more than they realize. We see it happen all the time. Sometimes, it’s a matter of getting more deeply connected to a local network (as opposed to just asking around to friends and family), and sometimes it takes thinking outside the box (traveling further away than originally planned, or considering birth outside of a hospital). We’ve also had moms talk their insurance companies into covering alternatives that they wouldn’t have otherwise! You are right that coverage can be a huge limitation. That won’t change if we continue to accept the status quo, go to the providers we’re told to go to, and stay silent about it.

  16. Get over yourselves. I am an ob/gyn and mother. I have seen and delivered many patients. I am comforting and open with my patients. You all act as if ALL ob gyns have no heart. Get off you high horse

    • Hi, Angrel. I’m not sure what you take issue with in this article. I recommended that women seek out providers who offer them the very best care, and that certainly includes OBs. Also, if you do choose to leave another comment on our site, we ask that you are respectful. This is a forum for discussion.

      Followup to this comment is here: http://www.improvingbirth.org/2013/02/respect-in-birth-get-over-yourselves-2/

    • Angrel,
      As the founder of ImprovingBirth, I want to be clear that some of my very good friends are fantastic, kind, caring, big hearted ObGyn’s. I would have them deliver my children and refer clients to them regularly. They also support this cause and sit on our board of advisers. I’m sorry that you were given the impression that this organization is against OB care. Let’s not pretend, though, that there aren’t significantly more doctors that are not practicing evidence-based care nor are they giving fully informed consent and allowing women to make their own choices about their care. As an OB, I know you know the personalities of your colleagues. I also know it’s difficult to know how the doctors around you actually practice when you aren’t able to see them in action. It’s a serious disconnect within the system. If you would like to continue this discussion, please feel free to contact me directly. Warmly, Dawn Thompson

    • Hillary Dana-Rumi

      Angrel,
      First in no way did the writer say or imply that all ob/gyn’s have no heart. Your post proves that choosing the correct provider is crucial. Clearly you have never had a traumatic or disappointing birth of your own. Furthermore, the number of patients you have seen and delivered is meaningless if you have yet to interpret and understand how important it is for most women to have the birth they wanted. I feel sorry for you and your patients. Your attitude is exactly why more and more women are turning to midwives, home birth, and birthing center births.

  17. Jess boodhoo

    Bravo!!!!! Thank you for saying what I have felt and voiced repeatedly. I had a battle to have my triplets naturally, I knew it was best for us, and all the way through my pregnancy I heard this! We stood our ground, I took back the power and made my decision to have them vb. we were all so healthy after birth that we were all released from hospital on day five and are now still exclusively breast feeding. It is in our hands to make a change.

  18. Jessica Angel

    My three were all successful, happy, healthy homebirths. I felt strongly that without any indications of risk my births had no business taking place in a hospital. I read to prepare and selected a wonderful midwife. I could not have had the awesome experiences that I did under other circumstances. I pray that my daughter will love and trust herself and her body enough to consider keeping away from the hospital (if there are no risk factors). I think many women do not prepare themselves enough and don’t know many (or any) people who have had a birth without interference and how it can be. Doctors are often doing exactly what we pay them for and even taking all the pain and work out of the labor process. Insurance covered the first birth completely, the second nearly completely, and the third not at all. I had 9 months to scrimp and self-fund my birth and the experience and care (for my physical, mental, and emotional well being) was totally worth it. If I do have another I know what direction I’ll go and it’s worth it to me to pay full price to stay away from a potential unnecesarean. I think sometimes it is necessary, but more often than not, they can be avoided…

  19. Great blog post and so important that women understand that they have choice and should exercise it. Birth is so, so important and is the start of a parents journey. It matters.

  20. I had two miscarriages before getting pregnant with my son, both of which were under the care of an OB/GYN. With my son, I went with a birth center that had a midwife and an OB on staff. I had a natural birth with minimal tearing and no interventions. I learned the invaluable lesson that I COULD actually trust my body, and am now planning for a homebirth with our second.

    To Angrel, from your post, I get less open and comfortable, and more defensive and closed off. Perhaps your communication with patients is quite different than your comments on blog posts??

  21. A healthy baby and healthy mommy isn’t all that matters, but it is certainly the priority. The assumption in this post is that the healthy living baby is a given. It is going to happen regardless. Unfortunately, that is not always true. There is no excuse for disrespect and bullying, but sometimes even fully explaining risks is treated as “pulling the dead baby card” and bullying.

    • How is pulling the dead baby card ever beneficial? You risk sending a laboring woman into a panic (she’s in an extremely vulnerable psychological and physical state, arguably the most vulnerable in all of nature)– which could actually be dangerous as well as counterproductive to your joint goal of a healthy baby and expedient process in the case of a real emergency. What makes more sense, is to act with purpose and urgency, so that everyone involved feels they are in capable hands. There are plenty of ways to describe the seriousness of the situation quickly without saying something like that to the mother. There are also other ways to communicate that very thing, if it actually has to be said– we’re having trouble hearing your baby’s heart rate. Or, “your baby isn’t responding well.” Or, “we can see now that if we don’t do this thing, there’s the potential that it could have a very serious impact on your baby.” Or, “we need take you to the O.R. immediately, your baby is in danger.” There are a variety of choices there. Any of those would be more eloquent and appropriate than using the “D” word. I’m sure if I sat around and thought about it, I could even come up with more choices. Especially if I did it for a living. Just sayin’.

  22. Hi, Becky–I actually did say that “In the real world, of course, birth doesn’t follow a textbook pattern; there are complications and changes of plans and undesirable outcomes. But even when these things happen, a woman can still be respected and supported. We may not be able to control nature, but we can control how we treat women in labor and birth. Even in the worst-case scenario (especially in the worst-case scenario!), there’s no excuse for anything less than the utmost respect for, deference to, and compassion towards the birthing woman as she is making her choices.”

    I don’t think it’s very often that full information is considered bullying. I’m sure there’s someone out there who fits that bill, but it’s not most women.

  23. Thank you, thank you for the work you do. I was a woman who trusted her doctor, hospital and all the medical support that went with it. But the on-call doctor who delivered my child, Dr. Joseph Hazan at Barnes-Jewish St. Peters Hospital in St. Louis, performed numerous interventions without my knowledge or consent. The experience left me with PTSD and a lot of negative feelings about what should have been a joyous memory. I now have to devote at least part of my time to healing from my treatment during birth instead of mothering my firstborn. I really thought a healthy baby was all that mattered. I was wrong, and my family has suffered for it.

  24. Annie Bourgault

    “we can exercise our power by walking away from providers”

    Well, I did and I was punished for it. I am a mother of twins born at home in Australia. I made that choice because I didn’t have the choice to have a natural birth at the hospital. I was told to have a c-section or to at least have an epidural in. I was refused the possibility to labor in water.

    I lost my second twin at home. I was sent for respite at the hospital where I didn’t want to give birth in the first place. While I was crying holding my dead son, the OB who wanted me to have a c-section came and told me she had called the coroner and the police.

    There will be a coronial inquest in the death of my son Sam. When? I don’t know. It’s part of the very public torturial process.

    I lost Sam to a complete abruption. Being part of a few grieving support group I have come to realize I am not alone in this situation. The difference is that the other women have lost their second twin or baby in hospital. No police interrogations for hours after the birth, no searching of your house and none of your belongings will be taken away from you. Full abruption is still rare 1-2%. I do understand that most people might question why a mother would give birth at home with twins.

    First of all may I just say that there are women out there who also lose their life going for the elective c-section? May I say that not all babies survive their c-section? May I add that c-section babies have more chance NOT to survive their first year? May I say that c-section mothers are less likely to be able to breastfeed their babies. It goes on and on. So why would I want an elective c-section? There are risks on both sides of the fence and I was not willing to live with the risks that come with an elective c-section.

    I’m totally supportive of elective c-section if you are willing to live with the risks that come with it. Had I found a caregiver/OB who would have been TOTALLY supportive of my choice for a natural vaginal birth of twins (with my first being breech) I would have considered it. Seriously. But I was met with contempt. My breech was born just fine.

    Yes I could have refused all this but the pressure is there and when I give birth I just want to DO that. Birth. This was my second birth. I know I can birth.

    Would my son had survive in hospital? I don’t think so. But I wouldn’t have to go through a Coronial inquest. I could just grieve. I think both sides of the birth was midwifery/medical have failed in one simple thing. The midwives told me: “your babies are just going to fall out.” without talking about the possible risks.” We both knew there were risks but didn’t really discuss it even when I brought it up. The medical system failed by not listening to my needs for a natural birth and supporting me. What I would really have liked: To birth in a hospital with my midwife by my side. Nobody to bother us. And we press the red button if something happens. But THAT choice was also refused to me. I’m not angry just very sad.

    I find it incredibly difficult to understand that everyday women accept all kinds of interventions, epidurals, inductions, c-sections. They accept interventions that come with their own sets of risks. When they fail to push their babies out and even the forceps and an emergency c-section fails to save the baby or the baby is brain damage do we say: “did you know the risks of your choice?” No we let the woman grieve. Because she made a choice and she made it (I hope) knowing she could live or die with it.

    That’s what I did and I live with my choice.

    I was told to find a lawyer-but for what? What do I have to defend myself against?

    • Alison

      Your story is so important. I am sorry that it happened. I am sorry for your suffering. But mostly I am sorry that the system that women give birth in is not respectful and leads to these terrible choices and sacrifices for women and families. I know many women who have birthed at home despite having risks that might have precluded them from doing so had they known they would have been respected in their choices in the hospital setting. I have also known women who chose elective cesarean section because they believed that this “choice” saved them from a riskier proposition— trying to achieve a good vaginal birth outcome in the hospital setting. They didn’t even want to risk trying! We are caught between a rock and a hard place. None of us asked for that. You and your babies deserved better. We all deserve better.

    • I just wanted to let you know that your story touched me and I’m so very sorry and angry on your behalf that the “care” providers entirely failed to care for you or your children. And how disgusting that a woman’s choice for a healthy, happy birth her way (in this day and age) is met with suspicion, ridicule and then blame!

      The fact that a criminal investigation is required for a homebirth like yours when the same outcome in a hospital would have resulted in nothing makes me sick. So much faith is put into the hands of doctors that many people forget (possibly because the politics of healthcare and justice system reaffirms) that they aren’t all knowing, don’t have all the answers and aren’t the only practitioners that birth healthy babies.

      Anyway, I wish you healing and strength through this difficult time Annie. My thoughts are with you and your family for the loss of Sam <3

  25. To say a “healthy baby is all that matters” is to disregard the mother and father’s experience and feelings around their birth experience. When my obgyn said that to me, it made me feel like I didn’t matter at all and that I was just the vessel for our son. And after his birth, I had several friends and family members that kept saying that phrase over and over again and it felt like a complete dismissal of how I felt or what I was going through. The bottom line is even if YOU think that a “healthy baby is all that matters”…that may not be the case for the mother. Another lesson in choosing your words carefully when comforting a mother that may have not gotten the birth experience she had hoped for.

    • Seriously, though… would you rather have a sick/injured/stillborn baby with a perfect birth? Obviously the lovely candle-lit experience + healthy baby is ideal, but when it boils down to it, all said and done, REALLY, the healthy baby is the goal. I even know mothers who in DIC have said things along the lines of ‘concentrate on my baby’ because that was their main concern.

      • Cristen

        Emkay, who said anything about candles? :) We are talking about safe, supported births. Healthy babies and healthy mothers. I think you are reading what you think we are saying and not what we are actually saying here.

        • Emkay, if that is truly the way you feel, what happens when the baby survives the C-section and the mother does not? I believe the statistic is that a woman is 5 times more likely to die after a C-section than a vaginal delivery. My husband expressly communicated to me that he would always choose the option that most favored MY survival because he can always have another baby, as long as he has me. Not every choice is black and white. A woman isn’t being selfish to choose VBAC or vaginal, when she knows that the risks to her are as great or greater with C-section. Every family should be able to make their own choices. The risks should be accurately portrayed so that women know there is actually a choice. Most women care about the health of their babies. That argument is flawed because it implies there is just one way to skin a cat. There might be a variety of paths a woman can travel in an effort to have a healthy baby. Most women who choose a particular way of birthing have their very own, very personal reasons why. Those reasons are not invalid, and they are often deeply rooted in the overarching desire to have a healthy baby. It is time we stopped mocking women for wanting to have a (insert kind of birth here.) That’s why this ridiculousness is still allowed to continue.

  26. Great article. This was sent to me by our doula as my wife has JUST finished going through this very challenging experience. I practice as a physician assistant in primary care, and have been incredibly surprised by the attitude taken up by both practitioners and non-medical people when you present the possibility of a “medication free natural child birth”. It’s as if this concept is more foreign than the thought of carelessly extracting a baby from a person for reasons of convenience etc. In our case, labor went very nicely reaching 9 cm dilation naturally. Cervix did not complete dilating and baby’s head didn’t drop. Had a decceleration and doc recommended c-section. While this was likely the necessary outcome, throughout the entire pregnancy and labor, he seemed to be pressing in this direction and it seemed as if the outcome was inevitable. Incredibly disheartening for my wife (and myself) as we had done a great deal to prepare for a natural delivery. Over the last 4 or 5 days, this “healthy baby” phrase has been very popular. While my wife agrees, it doesn’t take away the heartbreak and disappointment she feels that things seemed to be out of her hands from the word go. There is a huge need to shift the thinking on labor and delivery in the US as the outcomes are not better with the ever-increasing rate of cesarean section. I could go on, but I at least wanted to add a guy’s voice to the discussion. I will be printing this article and sharing it with family so they can better understand what my wife is going thru currently.

  27. I am a nurse in a labor & delivery unit and take care of a lot of the patient that come in requesting a natural, medication-free delivery. I enjoy taking care of these patients and supporting them during their labors. But because I work here, I can and do see the other side. It is unfortunate but true that a majority of physicians make the decisions that they do because of the litigious nature of their business. Childbirth can be risky and so many women have sued their physicians and been awarded outrageous sums of money that doctors are now very conservative with their decisions. As one physician that I work with has written, “I don’t know of any doctor that gets sued for performing a c-section. It’s always for not performing a c-section.”

  28. “A healthy baby is all that matters” is one of the most belittling phrases I can think of. It implies that the mother doesn’t matter at all. She is just a vessel to be emptied. Having had two CS for failed inductions I remember (40 years ago) how bad I felt when I got served up with that phrase. It never goes away. I stopped at two babies, I could not risk that again.

  29. I had my son at home with an amazingly patient support team including a fully trained midwife and on call doctor to support her over the phone. The birth took 60 hours with lots of start stops and about 9 hours hovering on 9 cm. the second stage then took about 3 hours. I was acknowledged that there may have been emotional and mental reasons that it was taking so long, and with carful checking of his heart rates and ensuring infection was avoided I still had him at home.. I am so greatful for this as I was a young mum and I felt like the doctors I had seen before were a bit judgmental because i was 17 and had no partner. I was so blessed in having someone who believed in my ability to trust the process in an educated and supported environment, surrounded by a community of caring women. I think it prevented me from suffering PND more than I may have due to my situation. I value all forms of birth and my second was in hospital and was ok yet the chance to home birth with my first gave me so much faith in myself and the connections to the community of support I had created for myself and my son.

  30. Shannon

    I love the sentiment of this post, it is one I find myself explaining often. I continue to be frustrated at the way this phrase dismisses whatever has happened to the mother in the process.

    I wanted to say though, that the experience matters even when the baby is not healthy. It matters very, very much because if something happens and the baby does not survive, the birth experience itself will be the only time the parents have had with that child. My best friend’s baby died unexpectedly at birth. It was, of course, shocking and traumatic beyond words. Sadly, the hospital staff had only been mediocre at best during the labor and then got even worse after the baby died. If my friend had at least had a good birth experience, she would have that to look back on to help her heal.

    Saying “all that matters is that you have a healthy baby” really is just a way to justify an “anything goes” mentality during the labor and birth. But how do you justify those things when the mother leaves the hospital with empty arms?

  31. Mechelle

    My daughter just left her doctor to go to a birthing center. She talked with the doctor and staff several times about a natural birth and was met with “if we see that your decisions are not in the best interest of the child, then we will intervene” ( this was after she said she would not be induced). She was literally treated like she had no say so or they were just coddling her til she went into labor so they could brow beat her into making decisions spur of the moment. I could not understand how having a baby naturally had become so foreign to them. I fully understand that in some circumstances that c-section is needed but not as the only option for every birth coming through the door. I’m very proud that my daughter is fighting to have her baby her way :)

    • Cristen

      Mechelle, that is seriously scary, and, unfortunately, a story we hear all too often. I’m so glad your daughter exercised her rights as a consumer and an individual and took her business and her body elsewhere. Wishing her and her baby the best!

  32. My wife and I switched doctors at 38 1/2 weeks because our original group told us that our only option if our baby, who was frank breech, didn’t turn was to have a c-section. We did not want that! At 42 weeks, my amazing wife vaginally delivered a healthy, 9pd, baby with no epidural and absolutely no complications. If we weren’t well-educated about our options and willing to fight for what we believed in, then we would not have gotten to experience the beauty of our delivery.

  33. Marion

    This thoughtful article brings to mind a video about the rights of the birthing mother. Please feel free to check it out!

    http://www.youtube.com/watch?v=tJRzBpFjJS8

  34. Momof3

    “A healthy baby isn’t all that matters”….you might feel differently if you ever had to go into labor with a baby you knew was already dead. After pushing my daughter’s lifeless body into the world, the ONLY thing that mattered to me with future children was that they were healthy. I was induced with my 2 subsequent children, and thankfully both were born completely healthy. I have zero complaints about my birth experiences with them, because they were born *alive.*

    I don’t disagree with all that you say; I just ask that you keep some perspective. A few months of baby blues are nothing compared to a lifetime of grief.

  35. Amanda

    A lot of people who take issue with the assertion that “A Healthy Baby Isn’t All That Matters” seem to be reading it as “A Healthy Baby Doesn’t Matter”. The author isn’t saying that the health of the baby should not be considered, but that it isn’t the ONLY thing that should be considered.

    My first son was diagnosed with brain and heart deformities, and wouldn’t survive the stress of birth. I was initially devastated when I found out in the second trimester that not only might my baby die, I would not even be allowed to go into labor. I felt like a failure, but I turned it around because my team of specialists respected me and balanced my needs with the needs of my son.

    Thanks to their work, I not only had a live (if unhealthy) baby, but I also had an empowering and positive C-Section and post-partum experience. My son lived for 14 months, and I got to fully enjoy every day of his life.

    His little brother was perfectly healthy, but his birth was a horrible experience and I was miserable. I was bullied, sneered at, called a liar when I answered questions, and was accused of “stealing” my baby from the nursery since I got tired of telling nurses not to take him away and just went and brought him back to my room. I was treated terribly at every step of the way, and spent the first few weeks angry, with all those awful experiences replaying themselves over and over in my head. Five years later, I still feel tense and angry when I remember his birth.

    • Cristen

      Amanda, that’s it exactly. That EITHER the baby OR the mom matters. That ONLY a healthy baby matters, or ONLY a healthy mom matters. That’s a huge fallacy we’ve got to correct. What’s disturbing about it is that it’s a phrase often used to justify poor treatment of mom, not better treatment of baby. That’s a big difference. I’m sorry to hear about your experience with your second birth (and happy you had a good birth and that time with your first son). I hope you will consider participating in the Rally to Improve Birth to call for more respectful treatment of mothers in birth.

  36. Forensicgirl

    Thank you for this very informative and well-written post! I agree that treating the mother with respect and compassion is vital and that dismissing genuine trauma with “At least your baby survived” is horribly cruel. The care the mother receives makes a huge difference to how she feels and recovers, and can support her if things go wrong. It’s like the pro-circumcision advocates that say “I’m circumcised/my son is circumcised and is fine!”. I certainly want more for myself than just to be the manner in which a healthy baby is born, just like I want more for my sons than to be “fine”.

  37. I had a wonderful OBGYN who had supported me the entire 9 months. Unfortunatly he was out of town for the delivery so I got the dr. that was on call. He was old and rough and wouldn’t talk to me. He would walk into the room….not look at or address me…and shove his hand up to check things. The nurses made comments about how horrible he was. After a long horrible 18 hrs in delivery with a nurse who randomly brought in students to “see” without asking me, I had to go for an emergency C-section. This dr…again not addressing me at all…sliced my daughter’s shoulder, sliced through some nerves in my stomach and then proceeded to stitch me with latex stitches (which I’m allergic to). This resulted in a week later having to go to the er and having them cut open my incision to remove the infected stitches and re-staple my incision. 6 yrs later I still have stabbing pain all over my stomach from nerve damage. The part that upset me the most was that I didn’t have any idea what was going on. It took almost 10 hour after recovery before I could see my baby, and I had 4 different nurses all telling my that I was breast feeding wrong…but none would give me instructions. As a first time, fairly young mother, I was medicated, in pain, emotional and clueless. A little instruction or even details of what was supposed to be happening would have been nice. I strongly beleive that if I ever have another child it will not be in a hospital. I would like someone to actually tell me what they are doing before performing intrusive checks!

  38. I’m tired of hearing the old “at least you have a healthy baby” junk. That’s what the hospital said when I made a complaint. So her fractured collar bone didn’t matter? The complete disregard for my wishes and the resulting trauma symptoms I’ve had, the crying all the way home (and every other time I’ve thought about that day) don’t matter? I failed to protect my baby and I have to live with the regret of not standing up for my rights. Some docs think they are bigger than God. Yes I am very happy my baby is alive. I am happy ALL my kids are alive but that is not ALL that matters. I also want them to be safe and loved and protected and to thrive, and not to have their rights violated. I do not feel it is wrong of me to hope for all that for my baby at birth also. PS my home birth was wonderful.

  39. Any manner of the “healthy” baby is all that matters comment stems from ignorance, callousness, and a disregard for humanity. It’s the equivalent of telling a rape victim that she should get over it and just be happy she survived. Same sentiment, different words, yet somehow rape is still illegal and horrific even when the victim survives. The only real difference between the two circumstances is social acceptability and a lack of accountability for criminal behavior in guilty birth caregivers.

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