Politics
-- The political side of birthing and parenting
The six Ws of modern birth
Ask yourself if you really have
choices
by Denise Iskiw
There has been substantial progress towards
equality and rights for women over the years, but when one
examines the situation of the fairer sex more closely, an
enormous lack of progress appears at the heart of womanhood:
giving birth. At every turn women's birth choices are being
challenged.
Unfortunately, in our seemingly democratic
society, the how, who, what, when, where, and why (the six
Ws) of modern birth are being controlled by select groups
of individuals, the majority of whom are male. The recommendations
of these elite medical establishments are constantly limiting
birth choices and imposing their experience and higher education
on birthing women. Yes, there are women in their ranks but
very few, and they have been exposed to such a medically
saturated work environment that they have lost touch with
who they are. These female physicians are under tremendous
pressure to adopt medically generated ideologies of birth
to prove that they are worthy to be members of the exclusively
male dominated clubs.
How are women's birth choices being controlled
by these elite medical groups you ask? For one, women are
being told how to give birth. If you are
not too short, too overweight, too small in build, and had
no previous C-sections (the list goes on), you may possibly
birth the way nature intended, vaginally. I wonder, will
the criteria developed and used by doctors to categorize
birthing women become so strict that eventually not one single
woman will fit the profile as being able to give birth vaginally?
Secondly, today's birthing woman is told when her
baby will be born. I always believed that the due date was
an estimated date of delivery not written in stone. Yet if
nature does not comply, artificial means are introduced to
meet the scheduled deadline with a medically induced birth
or C-section delivery.
Women are told by so-called experts what interventions
to routinely expect when giving birth. Women are convinced
into believing that for a natural birth to be (allegedly)
safe for mother and baby it must be medically assisted in
a hospital bed, with intravenous feed, electronic fetal monitoring,
forceps, vacuum extractors, prostaglandin gel applications
or pitocin drips, epidurals, episiotomies, and C-sections.
Contrary to popular belief, vaginal birth with countless
drugs and interventions is not natural birth.
Women are told where they
are allowed to give birth. For birth to be safe, the experts
insist that it take place in a hospital. This is especially
true if the woman has experienced one or more C-sections
and desires a VBAC (vaginal birth after Caesarean). Community
hospitals are currently refusing care for VBAC clients, and
the only birthing centre in the Edmonton area has banned
VBAC clients altogether.
A woman's choice of who will
attend them at birth is very limited as well. Most general
practitioners no longer deliver babies and do not support
VBAC clients. In turn, obstetricians that are specialists
in high-risk pregnancies and births are overbooked because
they are caregivers to both high- and low-risk pregnant women.
Obstetricians are surgeons, so Caesarean sections are performed
more frequently. Despite the greater risks of repeat elective
sections for both mother and baby (not to mention the greater
cost to our health care system), they are promoted and preferred
rather than supporting VBAC clients.
The lack of governmental support and funding
available for midwifery makes this choice out of reach for
women who cannot afford to pay for services out of pocket,
and the number of registered practising midwives is steadily
declining in Alberta . On the opposite side of the same coin
is the possibility that if midwifery were funded by the government,
midwife assisted VBAC home births could be banned as a result
of regulations imposed by the Society of Obstetricians and
Gynaecologists of Canada and Alberta Medical Association.
Women desiring a VBAC would be forced to birth to hospital,
where the number of successful VBACs is reduced because of
the interventionist care that birthing moms with a previous
Caesarean are expected to endure. In actuality, the medical
interventions increase the risk of a repeat Caesarean. Women
with two or more prior C-sections will be forced to undergo
a repeat elective section or resort to unassisted home births
if it is made illegal for midwives to attend VBAC home births.
Again, birth choices are being limited and controlled.
Why do these elite groups
of doctors and medical institutions exude so much authority
over birth choices? There are several explanations. Firstly,
both women and men have been conditioned to believe unquestioningly
in the words of their doctor even if their words are contrary
to our instincts. Secondly, our lives are so hectic that
we are too busy to manage our own health care and explore
any alternatives to invasive medical procedures. We want
to make doctors fully responsible for our care so that we
can sue them later for negligence. Thirdly, freedom of choice
is bad for business, and maternity services are a business.
The more limited the consumer choices are, the easier it
is to administer said services, apply changes in practice
along the way, and collect the profits. Finally, women have
allowed these groups to impose their will over women's right
to freedom of choice regarding the birth of their babies.
Women have given them the power without realizing that eventually "women
will lose their choice and lose their voice."
Possible options to solve this situation
do exist. Women need to regain the control and power that
has been voluntarily entrusted out of ignorance into the
hands of doctors and hospitals. Women need to become the
primary decision-makers and take responsibility for what
happens to them during pregnancy, labour, and birth, the
most profound journey of a woman's life. Women need to self-educate
on the topic of natural birth, Caesarean avoidance, safe
alternatives in childbirth, etc. Women do not lose their
intellectual abilities when they become pregnant and are
fully capable of making responsible and well-informed decisions
and are very capable of giving birth and doing it well. The
choices that are made will affect the type of birth experience
the woman will have. The onus should not be placed on the
doctors because the decisions that they may make may not
necessarily be in the best interest of the woman but made
because of the doctors' desire for financial gain, for lifestyle
convenience, and to avoid lawsuits. (Do not kid yourself:
these motives exist.)
Women need to demand a change in the type
of maternity care being offered and the reaction and support
their birth choices are receiving from the medical establishments.
The birthing woman should be the one to decide the six Ws
(the how, who, what, when, where, and why) of modern birth.
After all, women are the consumers of the services that are
provided by obstetrical doctors, and if these services are
rejected, eventually changes will have to occur. Women need
to be responsible for their bodies, their babies, their birth
choices, and their birth experiences. It is time to turn
the tables and allow birth to empower women again.
Article from Spring 2005 issue
of Birth Issues magazine, published by ASAC in
Edmonton .
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