Tag Archives: pro-choice

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.

The Myth of the 39th Week Abortion

29 Sep

If you are a Canadian living in Canada (or even a Canadian living abroad, or maybe even a non-Canadian), you’ve probably been hearing a lot about Motion 312. I know I have!

In case you’ve been living under a rock and/or you’re not up on Canadian politics, here’s a section of the motion that should give you a good idea of what it’s about:

That a special committee of the House be appointed and directed to review the declaration in Subsection 223(1) of the Criminal Code of Canada which states that a child becomes a human being only at the moment of complete birth and to answer the questions hereinafter set forth;

 (i)            what medical evidence exists to demonstrate that a child is or is not a human being before the moment of complete birth?,
 
   (ii)            is the preponderance of medical evidence consistent with the declaration in Subsection 223(1) that a child is only a human being at the moment of complete birth?,
 
 (iii)            what are the legal impact and consequences of Subsection 223(1) on the fundamental human rights of a child before the moment of complete birth?,
 
 (iv)            what are the options available to Parliament in the exercise of its legislative authority in accordance with the Constitution and decisions of the Supreme Court of Canada to affirm, amend, or replace Subsection 223(1)?

You can read the full text of the motion here, on Conservative MP Stephen Woodworth’s website.

The Conservative government has been quick to point out that this is not a motion put forth to criminalize abortion, or even reopen the abortion debate. They want you to believe that they simply want to update the 400 year old definition of what a human being is.

The issue is that this motion could pave the way to giving personhood to fetuses, which would certainly cause legislation to be passed on when and how abortions can be performed.

Currently, abortion is not limited by law in Canada. This means that you can have an abortion at any point in your pregnancy, right up to the moment when you give birth. By ascribing personhood to a fetus, the Canadian government would begin moving towards criminalizing abortion. Because, of course, having status as a “person” would mean that the fetus would be protected by the Canadian Charter of Rights and Freedoms.

And on the surface, that seems pretty reasonable. I mean, a typical pregnancy can go to 40+ weeks, but we all know that a baby born earlier can often survive with little or no medical intervention. My son was born at 36 weeks and, other than a little time on the C-PAP machine (which was more likely needed because of my c-section than because of his premature birth), he was totally fine. I even have a friend whose daughter was born at 25 weeks gestation and, while she obviously needed a lot of medical aid in the beginning, she is now two years old and thriving.

So how, in good conscience, could we allow women the legal right to abort a fetus that could survive outside of the womb?

I’m here to tell you that we can, and we should.

When I was pregnant with Theo, I had my first ultrasound at 11 weeks gestation. I’d had some bleeding early on in my pregnancy, and, going into the ultrasound, I was terrified that they would find something wrong with him.

The minute the probe hit my belly, though, itty bitty Theo appeared on the screen. He was perfect; all blobby torso-head and stubby little limbs. When I saw him, I laughed with relief, and when I laughed, he jumped, waving his arms and legs in protest. We watched, mesmerized, as he wriggled around, his heart a flickering beat in the middle of his chest.

To me, in that moment, he went from being two-lines-on-a-pregnancy-test-morning-sickness-and-achy-breasts to being an actual little person. Seeing him on the screen made me fall in love with him.

And this is the problem: if my feelings could make me believe that a baby the size of a fig is a person, then someone can likely argue that any fetus, at any gestational age, is a person. If I, a staunchly pro-choice feminist can, under the right circumstances, believe that a fetus of 11 weeks gestation is a person, then it’s not impossible for our government to come to the same conclusion.

Yes, I understand that in M-312 they promise to examine “medical evidence” in order to decide whether or not a fetus is a “person” before birth, but really, you could find “medical evidence” to back up just about any claim.

Would they say that a fetus is a person once it can survive on its own, outside of the womb, without any medical aid? Because there is honestly no foolproof way to test this.

Would they say that a fetus is a person once it reaches viability  at 24 weeks? Because the truth is that only 50% of babies born at 24 weeks gestation will survive, and those that do live are likely to have a lifetime’s worth of medical complications. As well, dating ultrasounds are not very accurate, especially once a woman enters her second trimester. Without knowing the exact date of conception, no ultrasound tech could say for certain whether a fetus is 23 weeks or 24 weeks.

Would a fetus become a person at 20 weeks, the age at which some studies have said that they can feel pain?

Would a fetus be declared to be a person at 19 weeks, which is the gestational age at which, if a Canadian woman miscarries, she becomes eligible for maternity leave?

Would a fetus become a person when their heart starts to beat, when they start to grow limbs, or even from the very moment of conception?

You could find medical evidence for all of these claims, but there’s no way of empirically proving when a fetus turns into child, except for the moment of birth, when they begin to live independently of their mother’s body. So, ultimately, the decision would, at least in part, have to be based on the emotions of the committee appointed to decide when personhood begins.

Pro-life advocates would like you to believe that abortion is too common in this country, that people use abortion as a form of birth control, or that it’s wrong to abort a fetus because it could grow up to be the person who cures cancer. Most of all, they want you to believe that women in Canada are actually aborting fetuses at 39 weeks gestation via intact dilation and extraction (more often, and incorrectly, called partial birth abortion).

First of all, let’s look at the prevalence. In 2005, the last year for which this data is available, the abortion rate was 14.1 abortions for every 1,000 women – so, 1.41% of Canadian women had an abortion that year. You guys, that is not a very big number.

Of that number, only a tiny percentage – in 2010, it was something like 0.2 percent of the TOTAL NUMBER OF ABORTIONS – were performed after 21 weeks gestation. I am having a hard time finding actual government statistics for this, but I got that number from a pro-life site, so I doubt that they are underreporting.

Regarding the use of abortion as the only form of birth control – I have honestly never known anyone who has done this. Abortion is still a painful medical procedure, and it’s not something anyone wants to go through. My other issue with this line of thinking is that it’s a way of saying that some abortions are okay, but some are wrong. Like, if it’s your first abortion and it’s because the condom broke and you took the morning after pill and for some reason that didn’t work, then it’s fine to have an abortion. But if you’re not careful with your birth control and you’ve have multiple pregnancies terminated, then it’s wrong to abort. As this brilliant article says, there should be no hierarchy of abortions. On demand, without apology.

The any-fetus-could-grow-up-to-cure-cancer argument is one of my favourites, only because it totally ignores the fact that, if the woman does terminate her pregnancy, maybe she will be the one to go on to cure cancer. Maybe the financial burdens of having a child would have made university impossible for her, or maybe the mental distress of carrying an unwanted pregnancy would have meant that she wasn’t up to the task of higher education. Maybe raising a kid would mean that she couldn’t spend hours and hours in a lab looking at test tubes or whatever the fuck it is researchers do. We so often hear about the fetus could-have-beens, but no one ever talks about what greatness the mother could have gone on to achieve.

And, finally, the 39th week abortion. The great myth of the 39th week abortion. This myth exists because technically, legally even, it could happen. Yes, it could happen – but it doesn’t.

I challenge you to find me an incidence of a healthcare professional who provided an abortion at 30+ weeks, because I doubt you can. Even second trimester abortions are hard to obtain in Canada, and women often end up being sent to clinics in the States if they are over 20 weeks gestation. The vast majority of these women are choosing to terminate that late in their pregnancy because they’ve only just learned that the fetus is severely or fatally impaired, or that there’s a significant health risk to the mother, or both.

I promise you that no one gets to 39 weeks of pregnancy and is suddenly like, gee, I’ve been meaning to get this thing aborted, I guess I should stop putting it off!

Finally, criminalizing abortion won’t stop it from happening; history has proved this time and time again. What it will mean is that women will be forced to seek out unsafe abortions with possibly life-threatening consequences. Sadly, this is an indisputable fact.

I’ve never had an abortion, and I hope I never will. I would frankly be beyond horrified if a woman terminated her pregnancy at 39 weeks. I’m still glad, though, that it’s possible from a legal standpoint. I’m glad that there are no laws that say what a woman can or can’t do to her pregnant body, which, by the way, is still her body. Because once you start creating that legislation, no matter how well-meaning it is, it’s a slippery fucking slope. A slope that ends in the Handmaid’s Tale. Kidding. Well, mostly kidding.