First ICAN Cowichan Valley meeting: Success!

The first ICAN Cowichan Valley meeting took place at my house this past week, and my immediate response was why did it take me so long to get around to organizing this?!  I wish I’d done this 4 years ago, when I was postpartum with my daughter.  If you’re unfamiliar with what ICAN does, you can read their mission statement and more information here.  It’s critical to have an organization advocating for women, and supporting women who experience cesarean sections, and ICAN does incredible work in many different ways, both through its central office and local chapters all over the world.

The turnout for the Cowichan Valley meeting was better than I expected.  Out of respect for confidentiality, I’m not going to write anything about the women who came, but suffice it to say that there is a clear need for this group in our community.  It’s gratifying to feel like we’re doing something for one another in the immediate sense of offering face-to-face emotional support, information and resources.  More than that, it’s energizing to be taking concrete steps to make a bigger change:  to ensure that women have access to VBAC, to talk about how to make the c-sections that do happen more family-centred and woman- and baby-friendly, to strategize around how to talk with our care providers and ensure that we’re being heard, before c-sections happen as well as afterward.

These meetings are small steps, to be sure, but sometimes even the tiniest movement is meaningful.

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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?

Healthy Beginnings

I had the pleasure this week of being a guest speaker at a couple of Healthy Beginnings meetings, which are drop-in groups for young children, babies and their caregivers sponsored by the local health unit.  I spoke to one group in Duncan earlier in September, and two groups on Thursday in Shawnigan Lake.  I did a little demo of core work with the women (all moms except for one nanny), and checked a few for diastasis recti (everyone was good to go!).  But aside from encouraging more people to strengthen their pelvic floors, I really wanted to get two points across:  a) let them know that I’m here as a resource for them in the community; and b) emphasize the notion that fitness is holistic, and that postpartum fitness, especially, has little to do with fitting into pre-pregnancy jeans.

Let’s talk about the second point first.  I’ve written about this before here so I won’t repeat those points now.  But I was struck at the drop-ins by how much women focus on changing their size after pregnancy.  Of course I already knew this was the case, but every time I see signs of it, the red light starts to flash in my head: teachable moment!  teachable moment!  There are practical reasons to want to get back to pre-pregnancy size–the most significant of which is probably financial, as buying an entirely new postpartum wardrobe right after buying a new maternity wardrobe is an onerous expense.  But there is nothing wrong with taking time to get there, and moreover, a healthy lifestyle + time is the best formula for healthy and lasting post-pregnancy weight loss.  Anything extreme–extreme exercising, or even not-so-extreme dieting–is dangerous, plain and simple (and most likely ineffective).  

The thing is, we all know this, and beating people over the head with such information doesn’t work.  So instead, I tried to focus on the positive:  rather than telling people what not to do, I suggested what they can do to improve their health and wellbeing after baby, and to strengthen their bodies so that they can move with freedom, and with the knowledge that they are protecting their bodies from injury. Even more importantly, I tried to emphasize that they can do that without having to be away from their babies.  (Although there is nothing wrong with working out solo either–the point is, women have lots of options and they can pick and choose what is right for them at any given time.)  And I’ll tell you–it felt very good to look around the room at women’s faces and feel like they were soaking these messages in.  I know the relief I often feel when someone in a position of some authority/expertise gives me permission to be kind to myself and to follow my instincts about what is right or wrong for me as a parent, and I hope I was able to do that for some of the women there.

On the second topic: although part of my reason for going to the drop-ins was to let women know about Fit 4 Two, I had a bigger purpose in mind, and that was to let them know that there is a place they can go if they have questions about things to do with health and fitness during pregnancy, birth, and postpartum recovery.  I got involved with Fit 4 Two because I wanted to reach out to women as someone who is not a clinician of any sort, but has other kinds of information to share, and is happy to be a source of support.  Sometimes people hesitate to call on professionals when they have questions they feel are minor, or they have questions that professionals may not be equipped to answer (even the best birthy clinicians may know little about exercise physiology, for instance).  I wanted to introduce myself to the women as a fitness professional, but more importantly as their peer:  I know a lot about pre and postnatal fitness, but I’m also someone who has struggled through the pre and postnatal phases  and can lend an empathetic ear if they too are facing challenges.  So I was so glad to have the chance to go into these groups and let the women there know that they can email or call me any time with questions; if they are within my scope of practice, I’ll answer, and if they are outside it, I can help connect them with appropriate resources.  The point is that they aren’t alone, and they don’t have to pay a penny to be supported at this time in their lives, when so many women end up feeling isolated, inadequate, and often (sadly) at war with their own bodies.  Of course I’d love for them to take my classes, but it’s not about that; it’s about creating genuine relationships, and meeting women where they are, whether they are ready for and interested in a group workout or just need some basic information about how to work with their pregnant or postpartum bodies.

Oh, and I got to cuddle a newborn.  That was probably the highlight of the whole thing for me, personally.  There is nothing better than holding someone else’s newborn baby…  😉

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