What is the present Choice-based childbirth trend based on? Choices of course. In the last post we created a longish list of many of the ‘choices’ women want during The Birth. Some of those choices were what is called ‘cosmetic’ … like being able to birth in a hospital room that looks more like home or even to stay in the same room you labor in rather than going to ‘theatre’ … or a delivery/operating room.
Other ‘choices’ were about functionality: rooming in, early discharge, more than one support person, eating/drinking in labor etc.
Other choices had to do with whom or where you could birth … midwifery care or home birth.
But under all these other ‘choices’ was really another issue … the MOST IMPORTANT ISSUE … what happens during The Birth. It is this big issue that has created the rift in childbirth by putting so much emphasis on ‘what happens’. The standards of care that birthing women experienced would have been referred to as:
- medical assessments … blood or urine tests, periodic listening to the baby’s heart tones, palpating the baby’s position etc.
- monitoring … constant fetal monitoring, blood pressure variations, vaginal exams, IV drips etc.
- procedures … forceps, Caesarean, episiotomy etc
You might put an ‘assessment’ into the ‘monitoring or procedure’ category and vise versa. The bottom line is that all women experienced ‘standards of care’ under the Follow-your-doctor’s-order childbirth trend and there was a move by birth advocates to make changes. This was good and the list was long.
Much of that long list was put in place by hospitals. The political fight for midwives and home birth continues today. So much has changed and somethings are still in limbo. This means some ‘choices’ became part of a new way births were handled. This also means that some ‘choices’ are still unavailable. That puts women in a bind.
And then there is this Big Issue … assessments, monitoring and procedures. The first thing that happened was to lump all of these terms (and therefore all these things done to women) into one word: Interventions.
Lumping everything together simplified the word used to define all the fiddle … some used as ‘standards of care’ and some essential.
As the Choice-based childbirth trend matured, childbirth education classes began explaining the pros and cons of all these ‘interventions’. Birthing families created and still today create Birth Plans that try to cover all their ‘wants’ and ‘wishes’. These Birth Plans addressed all aspects of each family’s birth. Seems simple but it’s not even close to simple.
What happened? That’s an incredibly complex question. There was huge hope that each pregnant woman could choose the birth she wanted. Here is where ‘choices’ and ‘skills’ serve a different purpose. Sadly women can’t choose the birth they want. There is no way to know what your birth will be like. However, women can always use skills to work through their baby’s birth journey. This doesn’t mean that ‘choices’ are wrong or don’t actualize. It means that choice is not always available, things change, the unexpected happens and this leads to the disappointment so prevalent. Of course, women should have choices. At the same time, they need skills. Our society needs birthing women to have skills so they can ‘do’ something even when none of their choices are achieved.
Over many posts, we’ll talk more about how using one word … interventions … has added layers of complexity to the childbirth conversation. Couple this with the narrow definition used of words such as ‘normal, natural and physiological’ birth, no wonder birth satisfaction is achieved by so few women. That’s sad. That impacts our society, our families and relationships to partners and children.
NEXT POST: What do women want pregnancy?