You used to be a feminist before you got pregnant
Today I’d like to rant about a pattern I’ve noticed.
Namely, I have a bunch of female friends and acquaintances that I consider feisty, informed, and argumentative sorts. People who are fun to be around and who know how to stick up for themselves, know how to spot misogyny and paternalism in all contexts, and most of all know how to dismiss such nonsense when it appears, and then get on with whatever they were doing.
And then they get pregnant and the lose most if not all of those properties. They get doctors who tell them what to eat, and how much, even though they’ve been doing quite well feeding themselves for 30 odd years without help. They get doctors who tell them how much pain killers they should have during labor, when it’s months and months before labor and we don’t even know what’s gonna happen. What gives?
Here’s a guess. Partly it’s the baby hormones that make you generally confused when you’re pregnant. The other part is that the stakes are high, and you are not an expert, so you defer to your baby doctor. Plus there’s all those ridiculous and scary pregnancy books out there which just serve to make women neurotic and should be burned. Oh and sometimes the doctors are women so they don’t seem paternalistic. But that’s what it is:
But here’s the thing, there’s not much evidence about exactly how you should eat when you’re pregnant, unless you are doing something absolutely weird. And, in spite of what a no-drugs doctor might suggest, it’s not all that dangerous to babies to have pain meds. In fact it’s super safe to have a baby now compared to the past, both for you and and your baby. And thank goodness for that.
On the flip side, a doctor has no business dictating to you that you will have an epidural either, which is what happened to my mom back in the 1970’s. It’s really your choice, and you should decide.
So if you have one of those pushy-ass doctors, fuck ’em. This is your body, you get to decide that stuff. Go get a new doctor.
And to be sure, I’m not saying you shouldn’t inform yourself about risks and signs of pre-eclampsia and other truly important stuff, but for goodness sakes don’t forget your feminist training. It’s not just your baby here, it’s also you, and yes you deserve to eat food you want to eat and to moderate pain if it gets overwhelming. You will be happier, your baby will be just fine, and she or he won’t remember a thing. Consider it training for how to be a mom later.
mathbabe 
“So if you have one of those pushy-ass doctors, fuck ’em.” Is this part of the Do onto others? 😉
Whatever happened to Turn the other cheek? Oh!
As Emily Litella would say: Never mind. (God bless Gilda Radner.)
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So if you’re not pushy and aggressive with someone you paid for their expertise you’re not a feminist? And it’s because you can’t handle the hormones? Selling women so short sounds like something who wasn’t a feminist would do.
This sounds like one gross generalization of pregnant women and most likely says more about your friends than anything else.
Women can be ardent feminists and trust their doctors. That’s what they’re paying them for.
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I trust the doctor who sews my stitches but not if the doctor says I don’t need pain relief.
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Almost all the doctors, female and male, my wife sees prescribe pain medication, but because of all the chemicals in her body from various treatments she refuses to take any. Does that make her a feminist?
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Yep.
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Speaking from personal experience the hormones are real. But it is still up to me, or should be, whether to be in overwhelming pain when there is pain medication available.
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“But here’s the thing, there’s not much evidence about exactly how you should eat when you’re pregnant, unless you are doing something absolutely weird.”
To play devil’s advocate, I’m sure 5 out of 5 people have a different opinion about what a weird diet is.
Maybe its not a terrible thing if an OBGYN shares some helpful tips on nutrition while pregnant?
as a side note, Could the example of paternalism in a sentence be any more biased?
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True!
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By the way, I just read this article on the biology of pregnancy and will never assume there are any set rules, given the biological chaos involved: http://aeon.co/magazine/nature-and-cosmos/pregnancy-is-a-battleground-between-mother-father-and-baby/
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It’s worth checking “Expecting Better” by Prof Emily Oster; it deals with the (mis)information about pregnancy.
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But she does a terrible job of validating her findings. Just because there isn’t evidence of harm doesn’t mean there isn’t harm. For drugs that cross the placenta, it is wise to be extremely cautious. And listeria is a real risk. Now, the truth is that in this era of processed foods it’s not clear that uncooked deli meat is riskier than a fruit salad, but it’s not an irrational deferral to paternalism that makes a pregnant woman wary.
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I never really felt patronized for being a woman till I became a mother so I agree on that point, but I don’t think you can primarily place the blame on the mother for responding likewise. People treat you different.
Also in the spirit of being feisty and informed I was surprised to see the rates of complications of an epidural are much higher than I would assume. (http://www.rxlist.com/naropin-drug/side-effects-interactions.htm — go to page 3 to see a chart) They have hypotension listed at 32 percent of patients and fetal bradycardia (baby heart rate drop) at 12 percent in this particular study. Granted it is hard to say what the percentage of these events are for a control group, thus it would seem prudent to prepare for a birth without (my personal experience being that preparation is possible and useful). Also I think doctors who advocate for no-drugs are pretty rare, it is far more common for women to be told they have to have drugs or that they are naive to assume they won’t want drugs, I would assume this is because a mother who has had pain relief is easier to care for, and in general I think it is hard to watch a person in pain when you could do something to help them.
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Following on Marcos’ suggestion, another good read for before starting out on trying to conceive is The Thinking Woman’s Guide to a Better Birth. (Disclosure: the author is my aunt. But I have on at least three different occasions had conversations with female friends who either had already gone through the process of having kids, or were embarking on the process, mentioned the book, and gotten a reaction along the lines of, “Whoa, she’s your aunt? I have that book and it’s great!”)
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Ok on the pushy doctors, some are just pushing but now a days they are on pay for performance and get graded on making sure you understand everything that you need to know and it makes some MDs pushier probably, the P4P is real thing and if they are a member of an HMO, they get it with audits.
There’s this “scoring” thing now called a Patient Activation score that is done to assure you have been educated and have all the knowledge you need to have a baby and guess what the doctors get graded on how well they grade you..augh..let people be people. Yes a risk assessment is completed and this is not just for pregnant women, it’s all through healthcare.
http://ducknetweb.blogspot.com/2014/04/patient-activation-scores-quantitate.html
So by the time you are done you are either a 1, 2, 3 or 4. Frankly I said noting in a patient chart is a lot better than being a number by all means. This might explain part of the rhetoric and when doctors get audited the HMO folks come in and dig through charts and poke around and normally their data is flawed as they come in ready to ding the doctor for missing mammograms on patients that have died, etc. or for 10 year old, in other words, the data’s all scrambled and in medical charts at HMOs, you live in the after life:) So when the auditors come in they dig and make sure the MDs are giving you ever bit of information you can possibly digest.
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I was lucky to have talked to a reasonable doctor, have support from my reasonable husband and reasonable doula, and have a pushy-ass nurse when I went into the hospital and met the unreasonable doctor who wanted to hook me up immediately to an epidural and pitocin … the pushy-ass nurse in particular saved me from that crazy-ass doctor. She also told me not to ask the doctor whether or not I could eat, so that the doctor didn’t declare me disallowed to have food. And also, the second time it was a hell of a lot easier to deal with the system, semi-knowing what to expect from labor. The first time was not what I was expecting.
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I second your vote — thank the good lord for pushy-ass nurses. Those women rule. And they DO know what to expect and they deal with the whole labor process every single day, while the doctor frequently rides in like the Lone Ranger right at the end. And boy, do they know the good, bad, and ugly in the doctors. I didn’t have to contend with some stranger for a doctor, though, because I had a high risk pregnancy and a perinatologist. He was committed to doing my delivery except for a short list of disasters — in which case i would get one of two other people in his practice.
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“And, in spite of what a no-drugs doctor might suggest, it’s not all that dangerous to babies to have pain meds.”
I’ve seen some absolute disasters with drugs during pregnancies (it wasn’t pain meds). I think the current trend to let women take whatever they want in the name of feminism is deeply misguided and unjust for the child.
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I feel very lucky to have had a doctor who didn’t see himself as an expert talking to a little ol’ patient, but a person talking to a person. I’ve been appalled at what I’ve heard from other women about their experiences. Doctors of all sorts can be good or bad, but this feels different enough from being “sick” that some people can’t see the problem when it is happening. And nothing can prepare you for the enormous hassle of “the entire universe up in your business” and extreme judginess involved in being a mother, but pushing back and staying sensible and engaged during pregnancy can’t hurt. Most everything else in pregnancy WILL hurt, at one time or another, LOL.
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If anything, my wife became much more feminist when she became pregnant. After we read some books comparing hospital births supervised by doctors to those in birthing centers and at home supervised by midwives and chatted with a nurse-midwife (Ruth Wilf, wife of mathematician Herb Wilf), we were determined to avoid a hospital birth. To my shock, my wife opted to have both of our sons born at home.
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mathbabe,
I generally agree with your posts but here I find I must disagree. Strongly. The reason why your female friends who become pregnant suddenly change their attitudes is because another life is now their responsibility and it’s time to put the BS aside. It’s time to listen to the experts on what is good diet and what isn’t. Most food out there is shit, we all know it is. So, yes, having a doctor tell you what not to eat is a good idea. Having a doctor who knows far more about that pain medication than you do saying not to take too much of it is a good idea. Doctors dictate the epidural because too many women go all Rambo about having a natural birth only to scream for the epidural WHEN IT’S TO LATE TO GET IT. My wife’s doctor pulled me to aside and practically begged me not to let my wife make the same mistake and today we are both glad we didn’t.
Yes, I agree, doctors can be pushy. But then again, look at many of the patients they have to deal with – people just like the women/friends you describe. People who think their way is the best way despite their not having one single year of experience since this is, you know, their FIRST PREGNANCY. And then when their child is sick, they want to SUE, SUE, SUE.
Again, I agree with most of your posts, truly I do. But it may be time to really look at all four sides of the square on this one and realize there is more to this situation than may at first appear.
Today, it’s super safe to have a baby because we have all those very same doctors pushing us to make good choices instead of letting bone-headed people do what they want.
JamesNT
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That’s OK, you don’t have to agree with me about stuff! As long as the conversation remains respectful I welcome disagreement.
In this case we will agree to disagree. I think more problems are caused by women being treated like idiots than are being caused by women changing their mind about wanted pain relief.
I have this discussion a lot with my friend who is training to become a midwife. She’s adamant that the more stuff you do, the more likely you are to end up with a C-section. I agree and still think women should be in charge.
And it goes without saying that I don’t think women should be doing crazy hard drugs while they’re pregnant, or drinking a lot of booze, or other things that endanger their kids excessively.
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In a lot of areas of life women ARE treated unfairly and there ARE times they need to step up to bat and swing as hard as they can and aim for that home run. And I’ve been blessed with a wife who is very assertive and very intelligent (she has her bachelors in textile chemistry and her bachelors in accounting) and knows when to call the BS alarm. Why do you think I married her? Today, we have a beautiful 8 year old little girl who is going to kick some serious a$$ when she grows up.
The problem with life is that none of us can be experts in everything. And when it comes to having a child and raising said child to the age of 18, you’ve pretty much got one shot at it. After that shot, one of 5 things will happen. Your child will either:
join the military, <— My kid if she wants to
go to college, <— My kid
get a job at McDonalds, <— Not my kid
continue to live with you, <–Seriously, not my kid
or go to jail. <— HELL NO
I think your comment that many feminist females back off when they are pregnant because the stakes are so high is spot on. The stakes are high.
Please do continue to help your friends. But please, all things in moderation. 🙂
I have, and continue, to look forward to your posts.
Jamesnt
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As both a doctor and a mother, I’ve been on both sides.
Medicine as a whole has come a long way in the past 50 years, from a completely paternalistic field in which patients were not necessarily even told of cancer diagnoses, to one in which the doctrine of informed consent is the norm (if not always the reality). In addition, over the 20 years that I’ve been an anesthesiologist, I have seen obstetrics shift from predominantly male to mostly women–which helps (though may not eliminate) the paternalism.
I won’t quibble about dietary advice during pregnancy– though some of it has basis in research, much is opinion. I generally question the rationale for advice that I am given, and would certainly switch from any doctor who I felt was overbearing. (Informed is good–I’m not sure feisty and argumentative are productive ways to approach the conversation.) I would also switch from any lawyer or financial advisor who was overbearing.
I do want to address the pain question, as that is my field. I believe that anyone in pain has the right to request–or refuse– pain relief. That is the case whether you are in labor or have a broken arm. As long as labor epidurals have been around, it has been claimed that they cause more women to need cesareans–this is a correlation/causation issue. More women who request epidurals end up with cesareans because they are the ones who had the most pain in the first place– a dysfunctional labor pattern causes greater pain as well as not effectively delivering the baby. (Those with easy, quick labors seldom need either cesareans or epidurals.) Because this correlation is mistakenly thought to be causative, women in great pain may be denied or delayed epidurals to keep them from needing cesareans.
The other problem I have related to pain relief comes from women who may call themselves feminist– those who militantly believe that childbirth is natural, and should not be treated as a medical procedure. They try to make women feel guilty about asking for pain relief, and suggest they are giving into the medical establishment if they do so (or if they go to the hospital to deliver). I’m all in favor of women delivering without pain medication if they are motivated and able to do so, but I’ve put labor epidurals into many women who felt that they had “failed” as women by asking for it. There should be no shame in asking for pain relief. (I ask them whether they would feel compelled to be “natural” in terms of pain relief if they broke their arms.)
And the idea that a real feminist would deliver at home makes me angry. If you had ever seen a mother hemorrhaging after delivery, or a blue baby that needed resuscitation, you would think twice about delivering at home because “it’s a natural process.” There is a reason that old cemeteries are full of young women and old men.
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Thanks so much for this!!
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Hmm. Having been the mom-to-be with pre-enclampsia that flew into full-fledged trauma, and landed me and my preemie son in intensive care, with all manner of drugs and medical intervention and organ shut down, I have to say I don’t agree. I didn’t see the signs. I didn’t know what was normal (and it turns out my experience was decidedly not). My doctor read me the riot act when I didn’t cut back on work hours, and called my boss to say maternity leave was starting early. His paternalism (or maybe expertise?) saved my life. And my son’s.
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