This post by Courtroom Mama makes me want to stand up and cheer. It confronts a common tendency to counter natural birth advocacy with the claim that any critique of mainstream birth practice is automatically a self-righteous judgment and denigration of the women who move through that system. This line of argument declares natural birth advocacy irrelevant—or worse, anti-feminist—by claiming that those who work to expose the problems in the mainstream system are actually working to limit women’s birth choices.
Courtroom Mama takes on an issue that has great personal relevance for me. My own advocacy work really started after having my second baby by c-section, when I realized that the current system makes it virtually impossible for women to know whether or not they are receiving appropriate maternity and birth care. Unnecessary interventions are so common—in both medical and midwifery models of care—and misinformation and fear are so ingrained as the basis on which both health care providers and the women they serve make decisions that I’ve begun to wonder if “informed choice” in prenatal and birth care can ever be more than a pipe dream.
Part of my struggle to come to terms with my c-section has been acknowledging that no matter how educated an individual woman is (I knew a lot) or how skillful and trustworthy her providers are (my midwives, and the OBs on call at the hospital the day Annika was delivered, were awesome), the system sucks. Although unassisted birth is not for me, I can understand why some women choose to move as far away from formal prenatal and birth care as possible, to try their damndest to get outside of a fundamentally broken system. Because however risky birthing unassisted might seem to many of us, the fact remains that the mainstream system is just as risky in its own unique ways.
And it’s this denial of risky-ness in the mainstream that has been at the heart of my struggle. It’s the fact that if you walk into a hospital in labour you are all too likely to come out with unnecessary stitches, or to be treated like an object instead of a subject at the moment when you are most vulnerable, and then to face a world that denies not only your right to complain but to even acknowledge that you’ve been treated like crap.
It seems that the mere acknowledgment that it is normal for women to be treated poorly during pregnancy and birth—to be treated with disrespect, to have their bodies manipulated unnecessarily as a result of, frankly, bad science—is so threatening that there is a veritable cottage industry dedicated to erasing our complaints.
One of the most powerful forms of erasure is to flip the argument and claim that women who speak out against mainstream practice are just self-righteous whiners with nothing better to do than try to make other women feel bad about their birth experiences. There’s no doubt that there are a lot of self-righteous whiners out there. However, the world of natural birth advocacy certainly doesn’t have the market cornered on that. Moreover, as Courtroom Mama puts it so succinctly, “just because someone is ambivalent about their birth experience,” it does not mean she thinks “that everyone MUST give birth in a certain way. This is horseshit.”
So, let’s put the name-calling aside where it belongs and focus on the more important issue here: that women are speaking out of turn, and that telling us to shut up, for whatever reason, just isn’t going to work anymore, especially if it’s because it makes you have to think about your own experiences from a critical perspective. That is not self-righteousness; that is unapologetic analysis allowed to make whatever impact it makes as individuals digest and apply it.
Ultimately, as Courtroom Mama explains, advocacy in this context is not about telling anyone what to do. There are political implications when women choose medicalized births. Those choices shore up a system that does as much harm as good. But would I ever deny a woman the right to choose that kind of birth? Absolutely not. Yet I will still critique it. Why? Because the only way to make change is to take the risk of questioning the status quo. Those questions might hurt sometimes. Believe me, I’ve been on the receiving end of the hurtful questioning, so I do understand. And at the same time, the questioning must continue because I don’t believe women really do get to make choices unless we actually have options, and the only way to actually have options is to be sure that we have good information from trustworthy sources. Right now, when it comes to pregnancy and birth, most of us just don’t. And those of us who think we do (or in my case, thought we did) can’t even really be sure because the whole system—the research designs, the funding bodies that control the research, the peers who review it, the journals that publish it, the providers who put it into practice—is so completely twisted and separated from what should be fundamental, which is giving all women appropriate and safe care. I wish it were different, but wishing won’t make it so—questioning might.
My favorite part of Courtroom Mama’s post is where she writes, “there is an ideal way to give birth, but not a right procedure. The right way is the way that leaves the mother feeling at peace with the birth. If she’s at peace with her elective cesarean or her epidural or her water birth, that is the right way. If she’s left feeling disempowered, scared, unsure, this is the wrong way.” Indeed, this is the crux of my argument, and the sentiment that motivates my work. Women deserve to feel at peace with their birth experiences, and confident about their birth choices. When I question common birth practices, it’s not to make anyone feel bad—there is already more than enough sadness and pain going around in this context. Rather, it’s to make that peace and confidence possible for more women, to insist that regular women—not only doctors and midwives—have the right to be part of conversations about birth, to say what we like or don’t like, what works or doesn’t work, and to be heard, whether or not people like what we have to say.