Damned if you do-Damned if you don't: Or does it even matter? (our birth story)

It's unbelievable that it's been a month (ok, six weeks now; 2 weeks since we started writing this post!) since Annabelle was born! That it has taken us this long to write this post about her birth is a testament to the realities of life as new parents doing field work. In our case, it's also a testament to the complicated emotions surrounding the birth itself.

Whether the birth would've gone differently had we been living in the United States is unclear, and that in itself is quite interesting from the perspective of a medical anthropologist. Living in India, Jo had a late-term ultrasound at 37 weeks. This late stage ultrasound is not routinely done in the United States, and we aren't quite sure as to why it's not done at that stage here. The ultrasound showed that the umbilical cord was wrapped twice around Annabelle's neck. When the ultrasound tech told us this in a matter-of-fact sort of way, we were kind of in shock..."What does this mean"..."What will this mean for the birth, for the birthing options, for our unborn child?". There were so many questions. While Jo's next doctor's appointment wasn't for several days, we did know immediately that this information was going to what we had envisioned to be the birthing process.

Upon returning home, we did did what any obsessive and anxiety ridden parents-to-be would do (but shouldn't): we consulted the Pandora's box that is the Internet. For the next several hours, we uncovered countless contradictory accounts of how the cord wrapped around the neck doesn't matter, as opposed to those that claimed it caused a child's death or serious impairment. This conflicting information was quickly compounded by the conversations we had with our friends and relatives, who have very different perspectives on medical culture.

After two days of stewing in information and misinformation we went to see Jo's OB. She told us, whether or not this is true, that there was a 95% chance that Jo would require an emergency c-section if she tried to go for a natural delivery. In short, she strongly, strongly recommended "electing" to have a c-section as opposed to a normal delivery. With this advice, what we had envisioned about the birth (natural, quiet, and most importantly, not characterized by medical intervention) evaporated. As Jo was only 37 weeks along, the doctor said we had a few days to decide, but that she would like to do the "procedure" in the next week if we "decided" to go that route.

Over the next few days, I think we walked around the little park in our neighborhood enough times to wear a track in the cement. As academics, we couldn't help but see this decision as being fraught with incredibly complicated epistemological issues. At a first glance, this seemed like the embodiment (pun not intended) of the classic Foucauldian knowledge/power couplet. To paraphrase, Foucault wrote that knowledge is indeed power, but power allows those in control to determine what counts as knowledge. The knowledge/power complex dictates what can be said, and by whom, and through cultural institutions becomes embodied in our everyday lives through action, interaction, and social structure. Foucault wrote about these concepts extensively in The Birth of the Clinic. What counts as knowledge in this situation? Was the "information" we found on the Internet "credible"? Was it sanctioned by the medical establishment? No. And was it credible? Even if they cited peer-reviewed journal articles, many of the accounts we read were on online bulletin boards, and thus seemed devoid of power because they weren't from a medical authority figure. On the other hand, the information dispensed by our OB and medically-trained family members felt official, sanctioned, and wielded a lot of power.

This was a first-hand introduction to the ways in which questions of knowledge and power dovetail with the new responsibilities of parenting. This wasn't an abstract academic exercise for us; it was very real and soon to become embodied in Jo's own body based upon which decision we made. We have a relative who is pretty severely disabled with cerebral palsy, a result of...well, it depends who you talk to, but a cord being wrapped around his neck, oxygen deprivation, and a difficult birth. And that was without a late-term ultrasound to indicate that a difficult labor would be a strong possibility.

So after much ruminating, the "decision" boiled down to the age-old axiom, "You're damned if you do, damned if you don't". "You're damned if you do" amounting to the fact that going with the c-section meant that we were "caving in" (or so it felt) to the medical establishment and its interventionist ethos. "You're damned if you don't" amounting to the life-long guilt we'd feel if we went forward with a natural birth and something went wrong (however unlikely that scenario might be). I've been writing "decision" in quotations because from the moment we had the information about the cord, we felt to a large extent that the decision had been made for us by the biomedical establishment.

In the end, we chose to go through with the c-section. Looking back now, it hardly seems important, but at the time it felt like a life-and-death decision. We'll never know if it actually was life-and-death, but we ended up with a healthy and happy little girl, and an even happier set of new parents.

Welcome Annabelle Winifred Meek, born August 18th, 2011