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Creating a Cesarean Birth

From A WOMAN IN RESIDENCE: A doctor’s personal and professional battles against an insensitive medical system. Michelle Harrison, M.D.


Dr. Harrison did her OB/GYN residency in the 1970s, and found her medical training consisted of practicing surgeries (hysterectomies, c-sections), routine episiotomies & forceps, straps, narcotic drugs, forced pushing, constant monitoring, and worst case scenarios. 



   “I picture dancers on a stage. Once, a dancer fell and sustained an injury and now wears a neck brace. We try to make the stage safer, to have the dancers better prepared, and have them all wear braces. But can a dancer wear a brace, just in case she falls? The presence of the brace will inhibit her free motion. We cannot say to her ‘This will be entirely natural except for the brace on your neck, just in case.’ It cannot be ‘as if’ it is not there, because we know that creative movement and expression cannot exist with those constraints. The dancer cannot dance with the brace on. In the same way, the birthing woman cannot “dance” with a brace on. The straps around her abdomen, the wires coming from her vagina, the pole to which she is tethered, change her birth.

   The birthing woman is an orchestra of her body, her soul, her baby, her loved ones, her past and her future. Doctors cannot lead the orchestra, because they are not within the process. Unable to hear the music, trained only in modalities of power and control, they can only interfere with the music being played.

   What should they be able to do? They should stand ready to help the player in trouble to get back into rhythm. Instead, they take over. Instead of supporting the mother, they say ‘Okay, you have failed. It’s our piece now.’

   How do you get a 30% cesarean-section rate? You orchestrate it. You write a piece in which the third movement is a cesarean, then build the first two, with that in mind. You write in a different language; you write in terms of centimeters of dilation, external fetal monitor, internal fetal monitor, scalp electrodes, pitocin, fetal distress, arrest of labor, cephalo-pelvic disproportion, ultrasound, post-maturity, induction, epidurals and lack of progress. Those are the words, the notes, while the piece is played to the rhythm of fear.”



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