I have seen this Mia Freedman article come up a few times in my newsfeed from various birthing / parenting pages that I follow. And every time I read it, I’m filled with frustration…
I firstly want to say, I find the notion that wanting a homebirth / hypnobirth / waterbirth / natural birth is selfish and about the mother, not the baby completely offensive. A lot of the research I have read and my desires for a natural birth ARE FOR MY BABY, not me!! Also, just because someone is passionate about a birthing experience or having choices in birth does not mean that they aren’t as equally passionate about safe arrival and care of their child.
“An increase in surgical birth rates was not associated with any clear benefit for mothers or babies, “but is linked to increased morbidity for both. Elective caesarean delivery could increase neonatal morbidity and mortality.. and is known to be associated with respiratory distress syndrome” — Professor Villar, leader for maternal and perinatal health research in the department of reproductive health and research at the World Health Organisation
The reason why birth rights advocates speak up about birth plans, the need for empowerment of women and informed birth choices, is because we can clearly see a system that is heavily inclined to unnecessary medical intervention, fear-based practice from both medical professionals and for the women, and a belief that birth can be different for both mother and baby. There is an endless amount of literature that talks about benefits to both mother and baby for natural vaginal birth over c-section. I have found this site excellent in sharing the pros / cons to each drug or intervention offered in labour: http://www.mybirth.com.au/
For most women I speak to about birth plans or birth preferences (how I prefer to talk about it) is not in some formulaic recipe of how we want birth to go and we’re going to dummy spit it if something goes wrong, eg:
Step 1. Calmly labour at home for 6 hours.
Step 2. Go to the hospital for birth and politely decline any intervention.
Step 3: Have my baby in a squatting position at 11:52am.
It is more about having thought about what we would prefer in any given situation not only for the birth, but with the forethought for care of the newborn after. One of my biggest motivators in wanting a natural drug free birth is that I will be alert and in best position for the easiest recovery so that I am there to bond with, nurture and attend to my newborns needs, not because I want to be defined as a birthing hero to wear as a badge of honour. To me anyone that has a c-section can wear that badge of honour high and proud… because for me, that is much bigger fear that if I have to face will be a huge triumph. I am lucky to have some great support with my family, but as a single mother – I know that at the end of the day, looking after my baby lies completely in my hands and the thought of not being able to drive for 6 weeks or the risk of infection or not being able to get around the house comfortably to do everything that is required for newborn care is something that I would prefer to avoid if possible. (Yes I know there is a chance that my vagina may end up ripped from top to bottom also and recovery may be just as challenging, which is part of the reason I’m trying to prepare my body and mind with as much knowledge about positioning, perineal massage, the birthing process and how to avoid tearing / episiotomies in best case scenarios).
“One can not help a physiological process. The point is not to hinder it.” – Dr Michel Odent.
Now, I really don’t want women who read this post who may have had inductions or c-sections to feel offended or that I am having a go at them. I have found it one of the most challenging things to talk openly about my concerns of having a c-section without feeling like I’m offending someone who has. I know many women have had equally positive c-section deliveries and would now prefer c-section delivery for subsequent children. Which is great! I think it is absolutely fantastic and wonderful that we have medical intervention available for when required! And I don’t think anyone should be made to feel bad about their birth choices.
I would also like to add – that I get a lot of scepticism about some of the things I say about the way I feel about the over-medicalisation of pregnancy from women who have had great experiences with the medical services during their pregnancy and labour, like I’m just some hippy leftist complainer who is delusional and spending too much time on forums freaking myself out unnecessarily and I should just suck it up and be okay with it all. To which I say – I’m very happy for you and your positive experience, but women are all wired differently, and we all have different needs and views about what is best for our children. This is demonstrated by an endless amount of potential conflict for parenting choices and styles – do you breastfeed or bottle feed? Is it okay to smack when you discipline children? When do you start solid feeding? Do you co-sleep? What school do you send your child to? Do you spoil your kids? Choices about birth are no different, and neither should be judged, but CHOICES SHOULD BE SUPPORTED!
“It is no only that we want to bring about an easy labor, without risking injury to the mother or the child; we must go further. We must understand that childbirth is fundamentally a spiritual, as well as a physical, achievement. . . The birth of a child is the ultimate perfection of human love.” – Dr. Grantly Dick-Read, 1953
I really think “BRAIN” should be a standard part of operation at every interaction with every woman throughout their pregnancy and labour:
Benefits – What are the benefits of this procedure? How will this help me / my baby / my labour?
Risks – What are the risks of this procedure? How might this negatively affect me/baby/labour?
Alternatives – Are there alternatives to this procedure? Are there other options?
Intuition – What is my gut feeling about this?
Need Time or Nothing – Can I delay this procedure and take some time to think about it? What will happen if I choose to do nothing for now?
Trust me, at just over 7 months of constantly worrying that my son is okay and looking forward to his arrival… I will not be doing anything to put his life in jeopardy! But what I don’t need is Mia Freedman placing further stress on the choices I want to make. If she doesn’t like birth plans – she doesn’t need to have one. If she doesn’t want to have a homebirth – she doesn’t have to have one. All she needs to be is comfortable in her own choices, and leave every other woman to do the same.
“Remember this, for it is as true and true gets: Your body is not a lemon. You are not a machine. The Creator is not a careless mechanic. Human female bodies have the same potential to give birth well as aardvarks, lions, rhinoceri, elephants, moose, and water buffalo. Even if it has not been your habit throughout your life so far, I recommend that you learn to think positively about your body.” ― Ina May Gaskin
In saying all of that, I still do have my concerns about maternal health care offered in Australia (NOT about the choices women are making); considering there is so much evidence coming out that the intervention rates in Australia are beyond what they should be. The World Health Organisation recommends a caesarean rate of 15%, and we are at 30%. This statistic alone highlights that there is a lot of UNNECESSARY intervention going on! Unless someone can point out a very good reason why Australian women require more intervention than women from New Zealand and the UK who have similar population demographics, yet sparsely different birth intervention rates. And why is this the case? Not because of the inability of Australian women to birth, not because we have more “higher risk” pregnancies, not because Australian women are “too posh to push”, but because the services offered to support women in birth are completely different. Both New Zealand and the UK have wonderful homebirth programs and opportunities, a great emphasis on midwife care, and are supportive of vaginal breech birth delivery. (NB – I have a lot to say about vaginal breech birth delivery, but will probably save it for another post further along in my pregnancy. I’m 32w5d and found out yesterday that my little man is in a breech position. I know it’s still too early to worry, and am hoping he turns soon, but still have been looking at my options).
“The primary objective should not be to reduce the rates of caesareans: it would be dangerous, if not preceded by a first step. This first step should be an attempt to promote a better understanding of birth physiology and particularly a better understanding of the basic needs of women in labour. In hospitals where the watchword is to reduce the rates of caesareans, the first effect is usually an increased number of difficult births by the vaginal route and of dangerous last-minute emergency caesareans. This is exactly what we should avoid in the age of the safe caesarean. I have had many recent reports of deliveries during which the obstetrical team tried “everything” in order to avoid a caesarean: drip of synthetic oxytocin, epidural anesthesia, and, finally, either a forceps delivery with episiotomy or even a caesarean after trying the use of forceps. Forceps have their place in museums. The last time I used forceps was in February 1965.” — Obstetrician Dr Michel Odent