Birth community and a little update

A while back I posted about wanting to generate a birth network here in the Cowichan Valley.  But the crazy few months that followed meant that that wish never got too much further than a blog post and a couple of discussions with friends.  So I was super excited when I was invited to join a circle of women at the new Matraea Centre in Duncan, called together by Sarah Juliusson of Island Mother, Dancing Star Birth, Birth Your Business, and other cool projects. Sarah took the initiative to bring a group of people whose work supports pregnant and birthing families for a Birthing from Within training for professionals and discussion about our local birth community. 

I was tired and rushed last night, and had had one of those days where it’s lucky I work mostly from home because other humans would not have appreciated my mood.  But I made it to Matraea nonetheless, and am so glad I did.  I already knew some of the women there including the midwives, and a postpartum doula (aka goddess) who founded the New Mom Centre, and I met some others whose services include pre and postnatal yoga, and prenatal dance and art.  It was amazing to be sitting in a room full of so much excitement–excitement about Matraea, excitement about building connections in this community, excitement about sharing a common enthusiasm for supporting women and families. 

It was exciting and also educational.  Sarah took us through an exercise designed to help us examine the way we listen and respond to women when they talk about pregnancy and birth.  We worked in pairs to practice not only reflective listening but also body language that shows our clients that we are ready to ‘meet them where they are.’  I took away the message that we need to really hear what women are saying, recognize the validity of their position, and work with them so that the choice they make is truly theirs and not an empty reflection of our values.  This process focuses not on the outcome–not on what a woman ultimately chooses to do–but on how she gets there.  Does she feel supported?  Does she feel confident?  Does she believe that she is the most important person in the equation?  Does she own her own pregnancy, birth, and body? 

Tomorrow I’m going to start going to one of Sarah’s Mama Renew groups.  I’m not sure I’ll be able to do the whole session; I may have a scheduling conflict, but I won’t know for a while.  So, in the meantime, I’m going and I’m really curious about what it’s going to be like.  I have pretty much no idea what to expect!  But I hear it’s an awesome group of women (8 or 10, I think), so I figure it can only be good. 

Tonight is the first ICAN meeting here at my house for the Cowichan Valley chapter.  I’m nervous, which is funny because there’s really nothing to be nervous about.  I’ve wanted to do this for such a long time, as I think a group like this can really make a huge difference in a woman’s life, if it’s there for her at the right moment.  So, even if no one comes, just spreading the word and waiting so that ICAN is available for any person who may need it at any point in the future is good enough.

Are women stupid?

It strikes me how often choices around birth—especially women’s choices (as opposed to choices made by doctors, midwives and other professionals)—are reduced and simplified, boiled down to the overall message that women are stupid and can’t be trusted.   

I remember distinctly during my second pregnancy when I’d tell people I was planning a homebirth being met with horrified gasps, and comments along the lines of, “Aren’t you scared?  What if something goes wrong?!”  Aside from the obvious responses (anything unknown is always a little bit scary, and something could go wrong at any moment of any day—it’s more likely I’ll get hit by a car crossing the street than have a catastrophic homebirth), I often found myself wondering if the people asking the questions actually thought I was stupid.  I got to the point where I would just retort, facetiously, “Oh, wow, I hadn’t thought of that because I don’t care at all about my health or my baby’s safety.  I’m just having a homebirth because I don’t know any better.  Plus, all the cool the kids are doing it.”  I’m not very nice when I’m pregnant.

There isn’t a lot of room in conversations about birth for the women who are actually having the babies and the reasons why we do what we do.  Our voices get drowned out amidst so much politics and ideology, and we’re left looking like idiots who really can’t manage our own lives.   For example, I read a comment in an article earlier this week about women being birth copycats:  a celebrity gives birth in this or that way, stupid sheep women follow suit.  So easy.

Spare me.

Yes, celebrities are influential.  To wit:  I became a vegetarian when I was 12 because of Howard Jones, and I joined Amnesty International in grade 8 because there was a membership table at the U2 concert I went to that year.  I bought white jazz shoes because Duran Duran wore them in several of their videos, and I still favour black clothing because of The Smiths.

But I did not plan a homebirth when I was 34 because of Ricki Lake or Cindy Crawford.  Nor did I have a c-section because of Britney Spears or Gwen Stefani (even though I do like the latter’s music, and appreciate how easy she has made it for me to teach my children to spell “bananas”). 

Celebrities can do a lot to normalize certain birth choices, and sometimes they launch advocacy campaigns of their own.  Widely publicized elective inductions and c-sections can make those procedures look like no big deal and help to strengthen a culture that encourages non-medically-indicated intervention in birth.  Similarly, Ricki Lake’s The Business of Being Born has encouraged critical thought about the birth industry to come into the mainstream, instigating conversations about things like homebirth that might otherwise never have taken place. But none of this automatically translates into women deciding to do x or y with their bodies during birth.  Taking such a reductionist approach really misses the mark. 

It seems to me, and some research appears to support this, that the notion that women make birth choices based simply on celebrity behaviour—or because it’s ‘what’s cool’ on MDC or Babycenter or among their circle of friends—is patently absurd.  It’s an assumption that allows a convenient side-stepping of the problems with the whole notion of choice in childbirth. 

There are multiple reasons why women make particular birth choices, and—libertarians be warned—those choices are rarely autonomous. More often than not, they (we) are ‘choosing’ the least problematic of the limited options available, with partial or flawed evidence plus heaps of personal constraints informing/directing the decision.  Reducing decision-making to one variable is the surest way to silence birthing women and to cut off any meaningful discussion about how to support women—how to change what is currently in North America a very, very flawed system—so that all of us can give birth in the scenario that is most comfortable, most safe, and leads to the best possible outcomes.

The painful point is:  none of us can make really good choices in a system that condescends to women as a group, and holds our integrity in contempt.

Rather than judge women for their choices, it might be more fruitful to question the professionals who control access to the bulk of the information (most women don’t have privileges at academic libraries and wouldn’t be able to read the professional journals, even if they had the time or inclination to do so), who interpret the scientific data for non-scientific audiences, and who market various forms of birth with motives that have little to do with women’s best interests.  It might be useful to bust open the false doctor-v.-midwife/vaginal-v.-surgical/home-v.-hospital dichotomies, and remember that real women’s bodies are the battlegrounds for what often come down to professional, ideological, and corporate wars.

It’s hard to make confident choices when you are doing so in the midst of a firefight.  I had a doctor literally throw my chart at me when I told her I was choosing midwifery rather than physician care for my second pregnancy.  I have been castigated for accepting interventions that supposedly led to my c-section, and accused of false consciousness for having felt empowered by my first birth because it was induced and thus not natural.  I’ve seen the same things and more happen to dozens of other women, often by professionals, but also by other mothers, many of whom react from a place of anger  or frustration with a system that may have mistreated them and/or betrayed their trust.  All of this is unacceptable.

Each one of us makes the best choices we can with the information we have available.  Information is rarely perfect or complete and knowledge is always partial, and sometimes choices made with the best of intentions turn out to be the wrong ones.  Rather than assuming that pregnant women are idiots, why not assume that they—more than anyone else—want to have their babies safely, in a setting that is appropriate for them and their families?  Why not admit that the system in which we give birth is adversarial?  What would happen if we didn’t blame women for being stupid or vapid, and instead looked at the reasons why they’re putting their trust in Ricki Lake instead of their midwife or OB?

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