Trust Birth, Prepare For The Staff

The Age, a Melbourne newspaper, published an insightful opinion piece concerning birth preparation titled "Homework is the mother of prevention". The author, Monica Dux, discusses an issue that sparked my interest in the politics of birth when I was working on my PhD:

"There seems to be a widespread culture of passivity when it comes to labour. Many expecting mothers do dedicate an enormous amount of time and effort to preparation, yet, in my experience, there are just as many who refuse to do adequate homework, preferring to sit back and see how things develop. It's not that these women are unsure about what sort of labour they'd like to have (almost always an uncomplicated vaginal delivery). They've simply decided that "waiting and seeing" is the only realistic approach. Why bother committing to a detailed birth plan when it will probably go wrong anyway? Perhaps other wait-and-seers are simply in denial, preferring not to think about an experience that is understandably terrifying. The end result is that they approach the business of labour with less preparation than they would bring to buying a new car."

I have often thought how ridiculous it is that so many women put little thought or preparation into the birth that lays ahead of them. But then again birth is a normal physiological function, and we don't write ourselves poo plans before going to the toilet. The reality is that during birth a woman is more vulnerable than when she is on the toilet, and as a society men and women are granted privacy and assumed to be capable of going to the toilet without assistance. Society does not extend this trust to birth. Sadly most women have more trust in their medical care providers than they do in their bodies to birth safely and efficiently. This is problematic, as Dux notes:

"Medical experts bring their own subjective values to the decisions they make and the advice they give, and these may not be the same as those of the patient. Similarly, it is naive to discount the vagaries of the contemporary hospital environment. Most of us are suspicious of large institutions such as banks and government departments because we know they are not set up in a way that always serves the best interests of individual clients. Why would hospitals be any different, particularly when so many of them are over-stretched and under-resourced?

Despite all the rhetoric about the importance of consent and respecting the patient's wishes, my experience of giving birth in a big hospital is that women are encouraged to take a passive role, to defer to both their doctor's opinion and to the institutional imperatives. If you argue, you are often told "that's just the way we do things."

Dux concludes that "To just "wait and see" when the stakes are so high is simply negligent — both for the mother's health and for her baby." And she is right. When working on my PhD I collected a number of birth stories from women who had had their trust betrayed during birth. The effects of these betrayls lasted long after the baby was born and included the breakdown of a marriage, many cases of post traumatic stress disorder, breastfeeding problems and challenges to the motherbaby bond.

It is my wish that all women were aware of these issues and possibilities before giving birth for the first time. Dux has done a great job of raising awareness. You can read the full article here.




My own writings on this and related topics:

A Matter of Trust

Doulas: Mortal Ilithyiai

Your Childbirth Options