The Marathon of Birth: a conversation with Donna Tabas, CNM
I love being part of the local professional community and talking birth. Anyone who has taken my childbirth education classes has heard me compare labor to running a marathon - it is hard work! My friend Donna Tabas took that analogy even further, and wrote a satirical piece describing what it would look like if we asked every marathon runner to take the same precautions that a select few may need - this is similar to what can happen in a medicalized view of birth. Medical professionals may take protocols that are important and vital for the safety of a few patients and use them on every laboring woman.
MARATHON RUNNING ANALOGY COMPARING INAPPROPRIATENESS OF MEDICAL MODEL OF BIRTH TO BIRTHS FOR LOW RISK WOMEN
You are a healthy 28 year old woman in good health with no medical problems. You have been training for 9 months to run a marathon.
You have a coach who is managing everything about what you will do, wear, etc; to “best” manage your running because he is an expert, especially if something goes wrong: he really wants to cover everything that might go wrong. He has seen so many women run this marathon, and has seen all sorts of things that have prevented them from finishing, like a muscle spasm, a torn knee ligament, hyperthermia, dehydration, etc. He is going to do whatever he can to make sure that while you run this marathon none of these things happen to you, because he “has seen it all.”
So, he says to you, “Mary, I have seen so many women have knee injuries while running this marathon that I need you to wear these knee braces that will stabilize your knees so your risk of having a torn ligament will be reduced. Here is how you wear them: you put these straps above and below your knee, so it can’t bend, but it does provide great knee support so that you don’t have to worry about getting that injury. I know, it keeps your legs straight while you are running, so you will look a little funny, like a tin soldier marching with straight legs, and running like that will slow you down, but it is really important to wear them because I’ve seen about 10% of women marathon runners without these braces who endure terrible injuries to their knees that require intricate surgery to repair; if they only had worn these knee braces, that wouldn’t have happened!
Ok, another thing I need you to do is wear this cool pack that covers your whole body: when women run, they can get very overheated, so wearing this 12 pound cool packet will regulate your body temperature during the whole race so that you will not suffer from hyperthermia. Yes, I know that it is heavy to wear, and will slow you down even more, but it’s really important not to get overheated; that can have very severe side effects; even death, so you must wear the cooling pack to keep your body at the right temperature.
Mary, you also lose a lot of water in your body from sweating during the running, and it is very important not to get dehydrated. So, we need to insert this tube into your stomach that will deliver 8 ounces of fluid into your stomach every half hour, and you have to shlepp this water container on your back that holds this water so that you won’t run out of water. I know, it feels gross to have that tube in your throat, but believe me, when women get dehydrated during running it can cause all sorts of problems like electrolyte imbalances, cramps, etc., that can threaten your ability to finish the race, and can make you very, very sick.
Now sometimes while running, women can be distracted by all the bystanders, and they can have trouble focusing on where they are running on the track, and may even be tempted to stop and talk to some of these bystanders which will really make your chances of finishing this race in the quickest time almost impossible. So, you will need to wear these blindfolds so that you can focus only on the running with no distractions. Yes, I know, sometimes it gets a little difficult to see where you need to go with this blindfold on, but don’t worry, we have Staffers placed all along the trail so that if you start going in the wrong direction, they will redirect you to where you need run.
Ok, so I think you are ready to go.
Knee bands, on!
Cool Pack, on!
Water tube, in!
On your mark, get set, ready, go!”
Sounds pretty ridiculous, right? Sometimes we need the knee braces or the cool pack or continuous electronic fetal monitoring or the saline drip IV. But sometimes, we need to stand back and let our bodies do what we have been preparing for.
Donna Tabas, C.N.M., M.S., the Owner and Founder of North Jersey Midwifery Care, L.L.C. that serves the women of northern New Jersey and New York City is a Columbia University trained Certified Nurse Midwife with 33 years of experience working with birthing families. For more information or to get in touch with Donna, check out her website at northjerseymidwiferycare.com.