Sunday, August 16, 2009

Something interesting is happening in birth: Part I

Yesterday evening, I attending a performance of the play “Birth” by Karen Brody. The play was staged by Three Sisters, a company of professional actresses in Ottawa, and was staged in order to raise funds and awareness for the Coalition for Breech Birth. The Coalition was founded by consumers, women who had had their births stolen from them by a system which refuses to admit the reality of breech birth, a system which fails to instruct its physicians in catching breech babies, and allows those physicians to coerce mothers into unwanted, unconsented and unnecessary caesarian sections.

The play is beautiful. It tells the story of 10 women's births with their first (and in one case, second, third and fourth) children. There are stories of joy: a woman chanting a mantra as she births squating, supported by her husband and her doula, believing and trusting her body; a woman kneeling in a pool in her home, her three children beside her, cheering her through her labour. But there are many, many stories of sorrow. Women coerced into deviating from their birth plan, into denying the needs of their own body. Women treated with disregard and disrespect while pregnant and while labouring. Women assaulted while birthing: cut, without need or consent, while bringing her child into the world.

It's extremely difficult to watch, even when staged in a minimalist, Vagina Monologues-style format. An actress, mimicking birth, telling the true story of a true woman's birth, screaming, not only in pain but in terror, in sorrow, in rage, at the realization that, just as she reached between her legs to feel her daughter's head being born, her doctor, her practitioner, was slicing through her perineum. Watching it, it was not just unethical, and not just assault: it was rape.

This is happening. This happens far more often than we'd like – and than any physician would ever dare – to admit. This is one of the realities of birth in North America. Women experiencing the trauma of rape during their births.

What do we do? Me: I'm getting mad. I'm getting really, really mad. I'm getting vocal. I'm pissing people off. I'm happily making an obnoxious ass out of myself. But here's one of the problems: too often, when we start talking about birth choices, and making options truly available to women, those who've chosen non-traditional births (I'm using the word traditional in the, well, traditional sense, to mean the sort of births that women have been having since the dawn of Creation) and gone a more medical route, become defensive. Arguments start being made about the importance of medical intervention, the value of pain-managing medications, the reassuring availability of caesarian sections.

I struggle to express to people that my issue is not with their personal choices – after all, those choices should be theirs and theirs alone – but with the fact that for many, many women, their choices are not their own: they belong to a nurse, a doctor, a midwife. But not to the labouring parents.

I'm not fighting other mothers to make decisions the way I would make them: I am fighting a system that is telling mothers, all mothers, what decisions to make about their bodies, their babies, their births. I am not in the practice of fighting mothers. I am fighting the medical establishment. I am fighting social norms. But I am not fighting the mother in front of me.

For far, far too many people, birth continues to be viewed as a black and white issue. You're either all-natural, crunchy-granola, kum-ba-ya and western medicine is the work of Satan, or you're not. And so many of the people – men and women – seem to assume that we who are natural-birthers, who are birth activists or working with birthing women, see things that way, too.

I don't. Western medicine has saved countless women and children from certain death. This is a fact. Surgery has literally saved the lives of mothers and babies I've known. And thank God for it. Thank God that J, our prenatal instructor, and her son were saved when she suffered a placental abruption with her first birth. But thank God, as well, that she was able to go on to have two midwife-attended homebirths after that.

It isn't so simple as saying “old is bad: new is good”. It's equally not so simple as saying the reverse. There is a place for life-saving medicine in birth. But let it be life-saving. Let's not let it be time-saving or pride-saving. Let's not let it be about the doctors. Let's let the reasons for intervening in a birth be good ones, important ones, lives-hanging-in-the-balance ones. Let's not let it be about dates or estimated weights or breech presentation. Let's let it be about need.

So I will continue to tell people about birth. I will continue to cull statistics and research results and store them away in my mind for those conversations with sceptics and the uninformed where there is the possibility of educating one. More. Person.

And maybe, someday we won't have to. Maybe, just maybe, someday...everyone will already know.

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