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.
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?