I'm currently reading Pushed: The Painful Truth About Chilbirth and Modern Maternity Care by Jennifer Block. I'm only a few chapters in, but it is already confirming both my limited experiences in the pregnant world and the reading I've been doing. Before getting pregnant I was already wary of the medical world and leaning more toward the side of natural childbirth. Now 6 months into this pregnancy I am more than ever convinced that natural - and by that I mean as little medical intervention as possible, even outside of a hospital - birth is the best way to go. Each medical intervention isn't a bad thing on its own. I'm glad we have many tools to help women birth healthy babies. However, it's the attitude of the hospitals and the messages sent to women that bother me the most.
Women are increasingly "choosing" (there is some debate over this word - are they actually choosing? being strongly suggested to choose it by their doctor? choosing it when all of the other interventions aren't "progressing"?) elective cesareans. Some are choosing it because they fear the damages caused by vaginal birth. Birth is treated as this problem waiting to happen, rather than a bodily function that we are evolutionary designed for. Of course birth is hard and scary, but when left to progress in its own time, births do not have to cause damage to the vagina and other parts of the female body.
And that's the problem. Left to progress in its own time, monitored by patient and knowledgeable staff. There is no patience in the hospital. OB/GYNs have to get a lot of stuff done before their shift is over and make enough money to cover their incredibly high malpractice insurance costs. Hospitals don't have the time or the staff to let a woman labor for 24 hrs - or more. And one intervention inevitably leads to another. Once women are hooked up to IVs, monitors, catheters, etc she has to labor on her back - which is the WORST position for a laboring woman. This position is for the convenience of the doctor, not the mother. No woman left to her own devices labors this way.
The more I learn about the history of childbirth the more I see how it's developed out a deep misogyny and disrespect for the female form. Modern obstetrics does not come from the centuries old practice of midwifery, but from the developing field of medicine in the 19th century. In the Victorian era middle and upper class women wore corsets, were encouraged to be inactive and undernourished (being small and helpless was a woman's natural form), basically causing all kinds of problems for pregnancy and delivery. Women needed to deliver on their backs, as it was unladylike for a woman to be on all fours, ass naked, in front of a man/doctor. The bodily restrictions of the Victorian age led to the development of ways to speed along awkward deliveries - induction. The mentality that womens' bodies were ill adapted to vaginal birth underpins our modern medicalization of the birth process.
I read a quote in Pushed explaining why one sex therapist had elected a cesarean. "Why ruin a perfectly good vagina?" she said. This to me reveals the deep anti-woman mindset of our birth culture that women are absorbing. What does this woman mean by "ruin"? I'm guessing she fears tearing (so do I, but when birth progresses at it's own speed this is less likely to happen), incontinence (occurs after 2% of births, most female incontinence is old-age related), and the ol' saggy vagina. Complications to the vaginal area occur in c-sections too, but these get less press. This woman probably doesn't want to "ruin" her vagina FOR HER MAN. I may be putting words in her mouth, but this attitude that vaginas just won't be as good after vaginal birth is nonsense and is driven by patriarchal ideals of women - all vaginas should feel like 15 yr old virgin vaginas, all 40 year old women should be as tight and firm and fit as 25 year olds. Puh-leeze.
I also think this anti-woman attitude toward birth is fear of the female form. Pregnancy and birth are the two things the male body cannot do. While I do feel quite vulnerable in a new and profound way being pregnant (I find that I do not jaywalk anymore, that I cover my belly in unfamiliar busy places, that I move more slowly, etc), I am also amazed at the capacity my body has to carry this life, to grow it and sustain it and me. I may be moving more slowly, be not quite as sharp mentally, but I am in no way compromised. The female form is powerful. We'll see how I feel once I've birthed this little guy, but knowing that I will be medically and emotionally supported makes me EXCITED to see what this body can do. Women's bodies are completely capable of delivering babies into this world. I think men and the patriarchal medical establishment fear this. Births are messy and all parties are out of control. To help get doctors home to dinner and to control the unknown factors, and perhaps even to keep women in their place, birth has been put on a time table and contained by tubes and meters and drugs. Women expect this to be part of birth. Without realizing it they are being told that they can't handle it; they are told that they should be scared.
The more I read the more I am deeply relieved that I will not be birthing in a hospital. My baby is not an "outcome," another statistic for hospitals and doctors to put into one column or another. I don't want my physical integrity compromised for the efficiency of the hospital staff. I am not a problem waiting to happen. And I don't desire my care to be mandated by statistics and litigious ass-covering. I don't want my care based on a fear of their being sued. I want my care based on my actual health. I'm scared enough as it is about the whole birthing process and I don't need doctors I don't know to tell me what my body "should" be doing, to infer that my body and my baby don't know what to do.
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