Monday, March 23, 2009

Birth Activism: Where Is It?

I found this quote on the blog "Musings of an OB Nurse in Transition" and found it interesting. Her question, basically, is "Where did all the birth activism of the '70's go?"

"First day out of the gate (in her new job), I went into a total state of shock.

"This was the late Nineties...I had "come of age" in the Seventies, in the era of "Our Bodies Ourselves", Ina May Gaskin, fighting for our rights in the hospital to have our partners at our side, to birth our babies naturally, without the fog of Scopalamine or Demerol, of immediate bonding and breastfeeding, of Bradley, Lamaze, and VBAC. Although I didn't give birth myself until nearly fifteen years later, I totally absorbed that mind set. I had pretty much gotten what I wanted when I gave birth for the first time in the late Eighties. I had no idea how much things had changed (read that regressed) in the "Self Empowerment in Birthing" school of thought. I was stunned at all the planned inductions, the "epidural as norm" attitude, and the relative ease with which the decision to perform a Cesarean Section was made. Honest to God, I even remember a physician sitting on the edge of the bed of a newly admitted, beautifully laboring multip, with a history of two vaginal births , then a c/section, and finally a successful VBAC, trying with all her might to convince the mother that it was too dangerous to "attempt" another VBAC, and that she should immediately prepare for surgery! She didn't, thank God, despite what was essentially a temper tantrum by her physician...the same physician who had attended her VBAC!!!!!

"Needless to say, things didn't go well for me. I was simply aghast that mother's seemed to just accept drivel like this, few if any took childbirth preparation classes, or if they did, they managed to squeeze them in during an 8-hour marathon Saturday class, and that most of them wanted to "stop being pregnant" by 39 weeks, so they gladly scheduled their inductions, and the first question out of their mouths upon arrival was not "How soon can I breastfeed my baby", but "How soon can I get my epidural"?"

Being that I am new to the birth world, I only have a hazy sense of how things have changed over the past 30 years. Have things regressed or progressed? Or perhaps both at once? And if the birth scene is more bleak than it was 20-30 years ago (in terms of high c-section rate, high induction rate, lack of preparation for childbirth by parents, lack of independent thought/action by parents) why is that so?

I can think of a couple of possibilities:

- Perhaps the natural birth world of the '70's was just as tiny as the natural birth/homebirth movement nowadays - it just seems bigger when you're involved in it.

- Could lack of true preparation for labor/birth have caused mass turn-off to natural birth? A lot of childbirth classes seem to try to cover up the reality of birth (read: "pain") by using euphemisms like "hard work" and etc. Experiencing the pain of childbirth after being prepared only for 'hard work' could definitely be a turn-off.

- Could it be that natural birth has been abandoned as a vestige of the hippie movement, which most people don't want to be associated with? Or could it be that society is tired of militant feminism, which natural birth can sometimes also be associated with?

I'd be interested if anyone out there had any thoughts on this. It's a very interesting question.

Regardless of whether the birthing scene in America has progressed or regressed, it's a certainty that American women are, at this time in history, very compliant and obedient to the medical authorities. I constantly hear women saying, "My doctor decided to induce me..." "My doctor decided on a cesarean...." "My doctor wouldn't allow me to go into labor...." "My doctor wouldn't let me labor more than 12 hours..."etc. etc. ad infinitum (or ad nauseum). One rarely hears of a woman telling her doctor "No" when a bad medical decision is made on her behalf, or of a woman making her own decision against her doctor's advice.

Part of this is, I think, simply because doctors have the ultimate trump card - the "dead baby card." As in, "Yes, you can go against my authority, but you'll have a dead baby if you don't do what I say." That's the way to get a mother to fold before the fight even starts. A friend of mine had this happen to her this year. They were trying to coerce her into an induction which seemed pretty unnecessary (her labor process had already started), and she was questioning the reasoning behind it - so the doctor pulled the dead baby card. It worked. It would have worked on me too. Thankfully my wonderful midwife doesn't play that game!

Part of it is also the hierarchy. When I'm with my midwife, I'm with a friend. We're on the same level. She advises me, but it's friend-to-friend. I don't feel the need to bow down or obey. Independent thought is openly encouraged. But when I visit an OB, there's the instant hierarchy. The white coat, the stethoscope, the chart, the clinical atmosphere, the coolly professional tones with lack of much eye contact, having to conduct one's entire conversation while seated on an exam table. Even though I don't believe in medical hierarchy ("believe in" as in "support"), I immediately feel the need to obey, to avoid questioning, to comply. It's just part of the system.

I'm wandering.... Back to the subject.

Anyhow, though, aside from that, American women are definitely on the whole apathetic about natural birth. Generally the plan is, "Don't want to take childbirth classes because I don't want to think about it; going to hospital to get an epidural." That's not the greatest plan in the world. It's not that epidurals are evil, but that uninformed medical choice (or lack thereof) is foolish. If you go into an epidural knowing all the risks, fine! But if you're just showing up at the hospital and accepting all advice and all interventions suggested, most likely you'll end up with a cascade of unnecessary interventions, which affect both mum and baby, and quite likely (in today's climate) a cesarean.

This entry has been all over the place. But really, my question: Why the apathy among American women? Why the unquestioning compliance to one's OB? Why? Especially when American society is otherwise rife with independently-thinking, feminist-oriented women? Why did birth get left out of the philosophical equation for 95% of American women?

Interesting to ponder.

1 comment:

  1. Thanks for this important post - I do think that there is a decline in conversation among women.


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