Cultural Reversal

This topic, from the Twelfth Carnival of Feminists, really got my mind a thinking. We're losing birth.

Giving birth is the absolute most powerful thing a woman can do. It's the unspoken driver behind the whole pagan/witchy Goddess thing. It's so powerful that we used to be worshipped for being able to do it, goes the common wisdom.

Now, in the name of choice, we're being anesthetized, strapped down and sliced open. Not very empowered, my sisters. Who is making this choice anyway? The latest information from the Listening to Mothers survey done by Childbirth Connections says that it sure as heck isn't us moms. They report that 9% of all women having primary (first time) c-sections report pressure from a medical provider to do so. Only 0.08% of mothers who hadn't previously had a c-section asked for one on their own with no medical reason for doing so. 98% of all mothers with primary cesarean identified medical reasons, especially concerns about fetal distress, position of baby, size of baby, prolonged labor.

81% of us mothers believe that, prior to consenting to a c-section, we should know every possible complication. Would someone please explain to me how, in the course of labor, you expect me to make a decision of that magnitude? Looking back at my 33 hour labor, I can tell you that Mother Nature has kindly blurred my memories of the strength of my contractions. She’s also blurred my memories of yelling at my care providers during contractions and then apologizing afterwards, although my doula, husband and other labor attendants swear that it’s true. I probably would have consented to any number of whacko things during labor and have no recollection of it now. During labor is not the time to try and come up with informed consent for a major abdominal surgery. So, that means beforehand, during your prenatal visit with your midwife. (Note that when I say midwife, I intend to include doctors, but I’m pushing my own agenda here, and want more people to visit midwives for their care.)

Don’t even get me started about Vaginal Birth After Cesarean (VBAC). According to this same survey, 45% of women with previous c-sections were interested in VBAC, but hospitals and providers deny this option. Excuse me? How come a hospital policy board is making a decision denying me the option of avoiding repeat abdominal surgery?

Here’s the sad, nasty truth, my friends: liability insurance companies have decided that, because of lawsuits, VBAC is a risky event, fraught with possibilities, and some of them don’t cover midwives or other providers who do it. Too dangerous. Check out the list of risks for c-sections! So, it’s ok for the medical/liability insurance community to transfer the risks of birth from themselves (lawsuits) to me. Is that what the upshot is here?

It’s time for some cultural reversal, here, ladies and gentlemen. Here’s my dream new paradigm:

• The vast majorities of births are done naturally, vaginally and our cultural expectations are that doing so is correct, important and valued.
• Women who do have c-sections for legitimate (not convenience of the doctor!) medical reasons are encouraged to VBAC in the future and are not vilified as failures.
• Hospitals are no longer where birth takes place. Rather, highly sophisticated and comfortable birth centers are prevalent all over the country.
• Workplaces value the creation of the next generation and adopt family-friendly policies to encourage their workers.
• Breastfeeding is acknowledged and accepted and enabled as much as possible. Formula makers all follow the International Code of Marketing of Breastmilk Substitutes.
• Mothers and babies are encouraged to breastfeed until the baby weans.

There. We’ve reversed the culture.