02 July 2010

Coming Out as a Birth Activist

I've decided to officially come out as a birth activist on this blog. As my first step, I've added a widget to my side bar that will let you listen to Gloria Lemay's weekly Blog Talk Radio programs (and her archives). She's a home birth midwife in BC, Canada & has been attending births for 30 odd years. From her writings and ''broadcasts'' I get the clear sense that she knows what is normal in birth, how wide the range of normal is, and how to keep things normal. Because of her beliefs & experience, she has chosen not to become registered, but to practice independently.

Midwives like Gloria provide an important option for women who want home births. Midwives who choose to become licensed, registered, or otherwise regulated can be hampered by protocols & standards of practice, which are designed to be uniform and therefore are not always flexible enough to allow truly individualized care. If I were ever to become I midwife, I would want to be one like Gloria Lemay. My disillusionment with the trends I saw in California home birth midwifery (along with my dislike of late nights and unpredictable events) let me to drop my pursuit of midwifery as a career in 2008.

However, I am still passionate about what I see happening in the current obstetrical system in the US. Our national C-Section rate has risen to more than 33%. That's right. If you enter a US hospital in labor, you have a 1 in 3 chance of having major abdominal surgery during your stay. And once a woman is cut open, it becomes nearly impossible for her to every have a vaginal birth in the future. The cascade of interventions that lead to the over use (and, in my option, abuse) of cesareans has been well documented in many places.You can read a brief overview here or a more lengthy discussion here.

The lack of real options for birthing women in this country, and the lack of information about the real risks of many common tests and procedures appalls me. It is time for change. Feminists demand power, choice, and respect in many areas of women's lives, but they do women a disservice by ignoring one of the major rites of passage most women experience--pregnancy and childbirth. It is left to the birth attendants & to the birthing mothers themselves. As another wonderful birth advocate, Dr. Sarah J. Buckley writes:

"Birth is a women's issue, birth is a power issue; therefor birth is a feminist issue. My logic may be correct, but the issue of birth has been at the bottom of the feminist agenda in western countries for some years, well behind matters such as equal opportunity, sexual harassment, bedroom politics, abortion, and body image, to name but a few.

"Feminism has championed many other women's health issues and resisted the medicalisation of menopause, the other major rite of passage in our culture; however, there seems to have been no equivalent analysis of birth. Yet most women in our culture will give birth at some time in their lives, and for the majority, it is their first experience as a hospital patient, with the loss of autonomy implied in that role. Many will feel the conflict between their own desires, needs and ways of knowing, and the technology-does-it-better approach that the medicalisation of birth has produced."

I now add my voice to others to demand access to true choices and full information about those choices in childbirth. This issue has been ignored for too many generations. It is time for women to take back the rite childbirth. Each woman should have the right to make truly informed choices, based on a realistic assessment of all the risks and benefits, and which risks she is most comfortable taking. But many women are not given this information. They are instead asked to sign "informed consent" forms, implying that "once you are informed, you will consent." This may make things easy for doctors, nurses, and institutions, but who's rite of passage is this anyway? The mother's and her baby's. So what is more important--convenience for hospital staff? Or respecting the wishes of the birthing mother?

I'm not advocating a complete shift to where home birth becomes the only option. I'm just asking that it stay a viable option for the women, like me, who want it, and that we be able to find midwives who are free to give individualized care, based on each mothers needs and desires. And I'm also advocating that hospitals offer balanced information on the risks and benefits of any procedure, and time for the mother and her support team to think about it before deciding what to do, as long as there is no immediate danger to mother or baby.

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