On Childbirth And Bodily Autonomy

29 Oct

A friend of mine recently gave birth. She’d planned on have a natural, drug-free childbirth, but instead wound up having an emergency c-section. After 30 hours of labour, her son’s head still wouldn’t (or couldn’t) engage, and his heart rate started to plummet frighteningly low. After a few minutes of discussing their options with her midwife and the on-call OB, they decided that a caesarean was her best option.

Her son was born not long after that, a whopping 9 pounds 5 ounces, with a full head of dark hair. He was beautiful and healthy, but instead of feeling as if she’d made a decision that could potentially have saved his life, she felt as though it had been her fault that she’d had to have a c-section. She thought that if she’d just somehow tried harder, or prepared better, she could have had the birth she’d wanted.

I talked to her a few days after her son’s birth, and, of course, asked how she was feeling. “I feel like I failed,” she said, sounding as if she was about to cry. “My son is only a few days old and I’ve already failed him.”

I knew what she meant, because I’d been there. When I’d found out that I would have to have a caesarean, I also, irrationally, had felt as if it was my fault, as if I was already failing my son. I still feel weird about my son’s birth, even now, nearly two years later, or rather I feel like other people are weird about it. I can’t tell you how many times I’ve had someone ask about my childbirth experience, only to shut down the whole conversation when I tell them I had a planned c-section. I often get the sense that other people think that I haven’t really given birth, or that I’ve taken the easy way out.

If you don’t have kids and/or haven’t spent a billion hours on the internet debating all things baby, you might be wondering why natural childbirth is such a big deal. Why does anyone even care?

For starters, giving birth without drugs or interventions means that you and your child will not have to experience the side effects of sedation or the potential harm from invasive procedures. Babies born naturally are more alert, which will make bonding and breastfeeding easier. Plus, not having an epidural means that you can get up and walk around during labour, or find the position that works best for you when it’s time to push. Without drugs, the mother’s recovery will be faster, and she can often leave the hospital the same day, if she wants to. And, of course, there’s the persistent idea that childbirth is more of a “real” experience if you are able to feel every sensation associated with it.

Many people advocate for natural births these days; even the nurse who taught our prenatal class was pretty anti-epidural. Part of this comes as a backlash against the medical model of childbirth, which, not that long ago, saw women in labour being put into a Twilight Sleep, a drug-induced state in which women were conscious but not lucid, and, though these women still experienced pain, were not able to remember it afterwards. In many ways, natural childbirth is an attempt to reassert control over our own bodies; to tell the doctors (most of whom were and are still men) that pregnancy is not a disease, and should not be pathologized. Another part of  the desire for drug-free childbirth comes from the assumption that “natural” is better, or from the idea that our bodies are designed to give birth without the aid of drugs or interventions.

Unfortunately, it’s hard to have a natural birth, and I don’t just mean the physical pain and exertion associated with drug-free childbirth. Hospitals make many people anxious, and trying to give birth while surrounded by beeping machines and scary-looking medical equipment is challenging, to put it mildly. On top of that, you have a regular rotation of people coming in and out of your room, wanting to check how far you’ve dilated, what your heart rate is, what the baby’s heart rate is, and a whole laundry list of other stuff. So giving birth in a hospital setting isn’t exactly conducive to that whole Mother Earth Goddess ideal that many of us hold.

So why not give birth at home? Good question. The answers range from being worried about not making it to the hospital in time if there are complications to not want to have to be bothered cleaning up the mess afterwards, and everything in between. One response that I hear very frequently form Ontario women is that they weren’t able to find a midwife; this was my experience as well.

When I had my first prenatal visit with my family doctor, I was eight weeks pregnant. She asked if I’d thought about how I wanted to give birth, and I told her that I wanted a midwife rather than an OB. She looked at me like I was crazy, and said that there was no way I would be able to find a midwife this far into my pregnancy. But I’m only eight weeks! I said. Technically I’ve only been pregnant for six weeks, if you take into account the fact that the first two weeks of  a 40 week pregnancy happen before a woman ovulates.

My doctor just shrugged and said that there weren’t enough midwives in Ontario, then asked what hospital I wanted to deliver at. When I told her, she frowned and said, Oh, I don’t know if we’ll be able to get you into Mount Sinai this far into your pregnancy. I honestly thought that she was exaggerating, but it took three referrals before we were able to find an OB at Mount Sinai who was still taking patients for my due date.

That was how I learned how insanely competitive giving birth is in Toronto.

There are 540 registered midwives in Ontario, serving a total population of 12,851,821. 1 in 10 births in this province are attended by midwives; 4 out of 10 pregnant women in Ontario would like a midwife but can’t get one. That obviously makes having a midwife-assisted birth in general, and a home birth in particular, pretty challenging. Which, as I said above, can make having a natural birth difficult or even impossible.

That being said, you would think that the natural birth community would be pretty understanding of the fact that most women still end up using the medical model of childbirth. While I would say that the majority of us are pretty chill no matter how your kid comes into the world, there seem to be a lot of people passing judgment on how women give birth.

It’s bad enough that some proponents of natural childbirth make women feel as if they’ve “failed” if they end up having unplanned interventions, but that’s nothing compared to their treatment of women who know ahead of time that they want an epidural, or those who choose to have a planned c-section. The funny thing is that these are often the same women who are very pro-choice and will throw around the phrase “my body, my choice”.

Well, is it our choice, or isn’t it?

It’s different, they’ll argue, when there’s a wanted child involved. It’s not your body anymore. You need to act in the child’s best interests. They’ll send you scary news articles, like this one, which references a study showing that children born before 37 weeks are 5 times as likely to have autism. That particular article is one that someone sent me when they found out I was going to have a planned c-section at 36 weeks; when I told her that the article had upset me, she said that she wasn’t trying to be mean, just giving me the “facts”.

Here are the facts: if I had had a natural childbirth, my son could have died. If my pregnancy had progressed past 36 weeks, my doctor felt that there was a good chance that my water would break, which could have lead to an umbilical cord prolapse, which would have meant death or brain damage to my son.

The thing is, no matter whether or not you are carrying a child, it’s still your body. You still have bodily autonomy. I’m not saying pregnant women should go out and do lines of coke chased by vodka shots, but I do think that we need to allow women to make choices regarding childbirth without judging them.

The argument that I hear most from people decrying women who choose the medical model of childbirth is that they’re selfish. They want an epidural because it’s easier for them. They want a c-section because they don’t want to have to go through labour. They’re planning to be induced at 39 weeks because they want to skip out on the last week of pregnancy. If these are thoughts that you enjoy thinking, here’s something I really, really want you to keep in mind: you do not know the whole story.

You don’t know why someone wants an epidural, I mean, not really. You don’t know why they might want a c-section. Sure, they might give you a reason, but what they tell you may not necessarily be the whole truth. They might have a medical condition that indicates a c-section, or they might be a survivor of sexual abuse and feel triggered by the idea of a vaginal birth. Or they might just not want to have a natural birth, and that’s okay too. Know why? Because bodily autonomy, that’s why.

The thing that frustrates me the most about this judgmental behaviour is how purely anti-woman it is. It stems from the idea that most women aren’t capable of making decisions regarding how they want to give birth. It assumes that a woman who chooses to have a planned c-section hasn’t done her research, has been brainwashed by the medical establishment, or is uneducated when it comes to birth options. It plays into the idea that women are irrational, thoughtless and downright selfish. It promotes the idea that, being left to our own devices, we will make choices that are harmful to us and our children.

These are the same ideas that lead to the body policing that many pregnant women have to endure. We’re told to eat more, but not gain too much weight. We’re cautioned not to exercise too hard, but also to stay fit and healthy. We have people watching every bite we eat, and I even know someone who was denied service at Starbucks because the barista didn’t think that she should have caffeine. When are we going to let women be responsible for their own bodies?

Look, I’m all for natural childbirth. That was what I wanted when I was pregnant with Theo, and if I ever have another child, I would like to try for an unmedicated VBAC. But that’s my choice, based on research that I’ve done and what I’ve heard from friends. If another woman makes a different choice, then I’m sure as hell not going to tell her she’s wrong. Your child’s birth is one of the most important days in your life (I mean, probably, right?), so why would you want to make someone feel bad about how theirs went down? Shouldn’t we be celebrating the fact that we all went through hell, in one way or another, to bring our children into this world?

I think a big part of the problem is that we still haven’t really figured this childbirth stuff out. We still don’t know what works best for us, both as individuals and as a society. The medical model of childbirth has seen the infant mortality rate decline 90% in the last hundred years, and the maternal mortality rate has declined by 99% in that time. On the other hand, within that medical model women still feel as if they are being bullied into interventions and procedures that they don’t want, and often come out of childbirth feeling as if they were coerced into accepting “help” that they felt they didn’t need.

I don’t know what the answer is, I really don’t. More midwives, for a start. Better education about birth options and the possible complications of interventions would also be good. Above all, though, I think we need to put more trust in women. I think we need to allow women to make more of their own choices, and we need to believe that they are capable of making the right choices, not just for themselves, but for their children.

15 Responses to “On Childbirth And Bodily Autonomy”

  1. torontonanny October 29, 2012 at 2:38 am #

    I loved this. I’m not a mother yet, but when I am, I really am thinking I’m not going to share my birth plans with anyone but my doctor and my close friends. Because I’m sick of the judgement about them . . . and because yeah, they can change, but guess what? It’s still my choice and my prerogative to research and plan what I can. *HUGS* You’re awesome.

  2. mandaray October 29, 2012 at 2:55 am #

    I never knew there was so much drama surrounding what kind of birth you decide to have. Children have never really been on the horizon for me, so it’s not a world I’ve ever been exposed to…I figured people just did whatever they wanted/was necessary, and that was that. Suppose I should have known better, considering how many people on this planet seem to make it their life goal to police what happens in a woman’s body.

    • Matt October 29, 2012 at 3:02 am #

      I’m not even capable of being pregnant, and I was astounded and appalled by the degree to which people seem to think that talking to a pregnant woman gives them license to dispense advice and criticism. The same goes for walking around with newborns. It’s almost people think that, by becoming pregnant, you deposit your brain in a vat in the hospital for the next year and a half, and forget how to act with the safety of your child in mind.

      “It takes a village to raise a child” is one thing, but when you don’t know the parents, the only thing I can think is, “how about shutting yer fuckin’ mouth?”

    • bellejarblog November 1, 2012 at 1:40 am #

      The judgment that some people pass on how you choose to give birth is seriously BANANAS. I didn’t know about it either until I was pregnant, and then I had a pretty rude awakening. Uggghhhh.

  3. sarahdaigen October 29, 2012 at 3:34 am #

    While I am fairly understanding and less critical of the ‘pro-choice … until you decide to have the baby, then you need to consider them’, I still think people telling other women how to give birth etc. are wrong, but more from the ‘as long as it’s not ridiculously egregious don’t tell anyone else how to make parenting decisions’ perspective. The friend who sent you that heavy-handed article wanted you to be informed; meanwhile, you had more information than they did on what was right in your particular situation (and not out there in the perfect fairyland world where natural birth 110% of the time is the right decision). And that’s what I think people lose sight of whether with pregnant women or Mom or Dad pushing the baby stroller – even if/when it ceases to be a ‘bodily autonomy’ issue (which I’m not 100% sure it does during pregnancy, either – just saying I see room for both perspectives here), it becomes a ‘I’m the parent who makes choices for my kid until they can make their own’ issue.

    And none of that is even getting started on the insensitivity of the ‘I feel strongly on how you should give birth crowd’, to the adopted parent community. While everyone is arguing about which form of giving birth somehow is more real, makes you more of a parent, is somehow more ‘real’ or better for your baby, do those of us who walk into a hospital or social services office and walk out with a new family member not count? This isn’t directed at you in any way as I know you know we do – but just the sheer insensitivity of the idea that giving birth and how it is done is somehow impactful on how legitimate a parent someone is. End of my own rant. 🙂

    • bellejarblog November 1, 2012 at 2:06 am #

      To be clear, I’m not saying “women should drink and shoot up while pregnant”, but more that we should trust women to make the best decisions for their own bodies, be they pregnant bodies or not. I mean, obviously it’s different if the woman is not competent to make her own medical decisions, but for the most part I think that we should assume that people can and should make their own choices, you know? I guess I kind of feel like it’s a slippery slope, especially as the list of things that a pregnant woman “shouldn’t” do grows longer and longer.

      And yeah, I can imagine how hurtful it must be to be an adoptive parent and read stuff about how a REAL mother has such-and-such a type of birth. And, I mean, where do fathers fit into this? What makes a real father? Ugghhh. Parenting these days. I tells ya.

  4. Joy October 29, 2012 at 10:37 am #

    It’s funny because I experienced the opposite in my pre-natal class: the nurse was very pro-epidural and openly admitted that women who wanted a natural pregnancy needed additional training (I was at Sinai). I think that’s the other side of this: many women want a natural birth but how many actually get the training needed for it? I don’t even know what type of training would be needed except it seems to me that being pain for hours is something you should prepare for.

    I tried to obtain a midwife at 6w and was too late. My midwife friend told me to get a midwife in Toronto that the first calls after seeing those two lines on the test should be to the midwife offices. And then you might get a midwife.

    • bellejarblog November 1, 2012 at 1:55 am #

      Yeah, the midwife situation is bonkers. I don’t know how any of my friends ended up with them.

      I heard the same thing about training for natural birth. I’m also not sure how you would do that? I guess you could practice meditating or visualizing stuff, and there’s the whole hypnobabies thing that teaches you to hypnotize yourself during labour…

  5. Leopard [Crates and Ribbons] October 29, 2012 at 5:25 pm #

    Absolutely! I guess it stems from society viewing women as baby-machines, such that their individual needs and perspectives are deemed unimportant once a baby comes along. People are incredibly judgmental about the choices women make regarding pregnancy, birth and parenting. A few things I’ve heard:

    -If a woman doesn’t want children, although her husband does, she’s selfish.
    -If a woman decides to stop at one child, the child will not learn how to interact with others properly. She’s being selfish.
    -If a woman decides to have three children, the middle child will suffer from ‘middle-child syndrome’. She’s selfish.
    -If a woman wants to have many children, such that she can’t devote all her time to them, she’s selfish.
    -If a woman has an epidural, she’s selfish.
    -If a woman has a caesarean, she’s selfish.

    And let’s not even start on the judgment that is heaped on her after the kids are born!

    • bellejarblog November 1, 2012 at 1:53 am #

      Women can never win. No, seriously. Mostly I just feel like we are always set up to fail, no matter what :/

  6. Jodi October 29, 2012 at 10:17 pm #

    Reblogged this on Mama To Bean and commented:
    With the storm raging and my little Bean needing me more than normal today I don’t have time for much. But I had to take the time to re-post this amazing piece of work by Anne at The Belle Jar. She echoes much of what I went through as well.

  7. twentysixandpregnant November 2, 2012 at 7:29 am #

    … Thank you for this.

  8. Erica Fox March 25, 2013 at 3:23 am #

    The people you were around when you were pregnant must’ve been much more liberal than the people I was around. Here’s a teaser-trailer of what I heard during my pregnancy in response to, “Y’know, I think I’m gonna do it without drugs, like my mum did and hers did.” (I’m Filipina. Only three women in my family have even seen a doctor during pregnancy.)

    “Ohmygosh but you’re sooo small, you won’t be able to push her out on your own!”
    “You’re going to want an epidural, because you’re so small.”
    “I know you’re trying to be brave, but don’t be a hero.”

    My high school gynecologist even told me I’d need a c-section because I’m small-framed, essentially robbing me of the opportunity to even give natural childbirth a shot. When those nine months were over, it took me all of four-and-a-half unmedicated hours to crap my kid out. (Filipinas are really good at having kids. It’s why there are so many of us.)

    The point you made about people calling themselves “pro-choice” who actually really aren’t? Yeah about that.

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