September 22, 2012

Human Rights in Childbirth: Women’s Choices in Childbirth are Restricted & We Are not Going to Take it Lying Down!


September 20, 2012 was the world premiere of Freedom for Birth.

I hosted one of the 1000+ screenings at Shining Light Prenatal Education, in Pittsburgh, Pa. We had a nice turn out and good discussion afterwards. It got me thinking (no big surprise there). Birth is a Human Rights issue. So why is it that women are often treated as if they are incompetent to make their own decisions regarding their own bodies and babies? Why are things done to women and not for women? The answer that’s been rolling around in my head is this:

We value the baby’s life over the mother’s.

Wow, that’s a big statement—we value the baby’s life over the mother’s. But it’s true. When we have politicians saying that abortion should be outlawed even in cases of rape, incest or when the mother’s life is at risk, we value the baby’s life over the mother’s.  When we tell a mother that she’s being ‘unsafe’ by having a birth center birth or a home birth, we value the life of the mother over the baby.  By telling a mother she needs an intervention “just in case,” we value the life of the baby over the mother.

Yet a woman is an autonomous individual and she has a human right to have dominion over her own body. She has the ability to choose.

We can choose to become a parent, or not, by terminating a pregnancy.

We parent during pregnancy with our choices of prenatal care, exercise and the food we eat.

We parent during labor with our choice of care provider (OB, midwife), the friends or family who are with us during birth, our location of birth and the medical interventions we receive during birth.

We parent again at the moment of birth: breastfeeding or not, circumcision, or not, newborn tests and procedures, or not.

We are parents till we die and we makes choices for our children constantly.  As a parent of a minor child, you make all the legal, financial and ethical decisions regarding your child.

But yet, during labor and birth, women are sometimes coerced into making choices for their baby, they would not have made on their own. Women are meant to feel like “the baby will die if I don’t comply.” In my professional circles we call it “playing the dead baby card.” No woman wants her baby to die, so she will acquiesce to medical interventions she doesn’t need or want. Even the strongest woman will fold when threatened with a dead baby.

Women are sometimes threatened with phone calls to CPS if they refuse a c-section. Occasionally, CPS is called. Women tend to back down and again, acquiesce to interventions they don’t want or need for fear of having their baby taken away.  Women are sometimes declared mentally incompetent during labor and their rights are stripped away. The hospital can then make decisions about her body and her baby without her consent. This is abhorrent.

Women need to know first that they have options, second—what those options are and third—how to act upon those options. Women need to know that their voice should be heard, that they don’t have to have routine procedures simply because they are routine. Women need to know that they deserve, and are entitled to, Informed Consent and Informed Refusal with regards to any medication, treatment or procedure for themselves or their babies. For more information on your rights,please click here.

When seeking homebirth women must understand what the legal implications are. We know that homebirth is safe for low-risk women, when they are attended by a properly trained, skilled attendant. In fact it is safer for this group of women to birth at home, rather than in hospital. High-risk mothers would need to be in hospital because they are the ones who need the medical interventions. However, most pregnancies fall in the low-risk category.

Homebirth needs to be truly and fully available to all women.

You also have to understand that pregnancy is not an illness. Pregnant women aren’t sick. But yet, an overwhelming majority of women are treated as if they are sick. You’ll get IV fluids “just in case,”  full time electronic fetal monitoring “just in case,”  an epidural “just in case” you need a c-section, or a c-section “just in case” we are right and there’s something wrong with the baby and so on. Better to be safe, then sorry!

But yet, that safety is an illusion.  The US ranks 50th worldwide for maternal mortality, but yet, we spend the most money on maternity healthcare. Our infant mortality rate is relatively low, but when you look at us in comparison to other countries we rank 13th in the world. We can do better. Mothers and babies do not need to die in such large numbers from complications from childbirth, especially when many of those complications are iatrogenic, such as infection or blood clots from surgery. So, what to do?

Birth is a Human Rights issue. Take back your birth. It is yours and yours alone. Speak out. Speak out not only for yourself, but also for those women who can’t speak for themselves. Speak out.

This is a top down issue. If you want to fix the system, you have to get in the system. You have to understand the constraints and restrictions your doctors and nurses work under. You have to understand that there is an OB and a nursing shortage, understand that an OB’s malpractice insurance is $100,000+ per year, understand that OB’s and L&D nurses are not trained in normal physiologic birth, and even if they are, they don’t have the time or the ability to practice the way they know is best.

Call your doctors and hospitals. Talk directly to them to ask for change. Standing on a street corner with signs, chanting for change will not work.

We have systemic issues in our hospitals. We not only need to demand change, we need to actively pursue it.

Talk to your health insurance company. Ask for coverage for a birth center birth, or a home birth.

Talk to your legislators. Help them to craft laws to protect your rights to birth where and how you see best.

Talk to other women, other mothers and get the ball rolling in your community. You deserve to be treated with respect. You deserve to only have medical interventions that are truly necessary. You deserve full informed consent.  It is your body and your baby. It is your right.


Editor: Kate Bartolotta

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