Feministing’s Jessica and Amanda Marcotte of Pandagon have posts on the Lynn Paltrow of National Advocates for Pregnant Women, and her attempts to have people see reproductive rights through a wider lens.
We’re living in a time where pregnant women are roundly punished—whether they decide to terminate the pregnancy or carry it to term. Paltrow told stories of women who were put in jail for having a stillborn, women who were forced to have C-sections against their will (one of whom died) and other such ridiculousness.
Paltrow’s, and the conference’s, aim seems to be making those connections between women who advocate for pregnant and birthing women and women who advocate for abortion rights—because we’re all fighting for the same thing really. Something Paltrow said really resonated with me: how our capacity for getting pregnant is what connects us all in this mess of discrimination and punishment.
Here’s reminder of where the debate about “foetus rights” can lead:
At age 13, Angela was diagnosed as suffering from a rare and fatal form of cancer. Despite the odds, she survived and was cured after years of aggressive and often experimental chemotherapy and radiation. Ten years later, however, she developed another form of cancer. She bravely fought for life again, returning to chemotherapy and radiation and resorting to multiple surgeries. Ultimately, she consented to a hemipelvectomy, the surgical removal of her left leg and hip. After more chemotherapy and radiation, there were no signs of cancer anywhere. In 1986, three years into remission and confident in her ability to rob the grim reaper, Angela married and became pregnant. Because of her disability, she was eventually referred to the High Risk Pregnancy Clinic at GWUMC, where she was enthusiastically accepted as a teaching case.
According to her clinic obstetrician, Angela emphasized two points about her health care: she wanted to be watched closely for any signs of recurrence of cancer and, having struggled so long to survive, she wanted to be sure her own health was not compromised because of her pregnancy.
Unfortunately, during the 25th week of gestation, Angela was admitted to GWUMC and eventually diagnosed as having a lung tumor. Again, fighting to live, she wanted everything possible done to prolong her life. Surgery was ruled out, leaving chemotherapy and radiation as the only means of prolonging her life. Angela was informed that her baby was too small to be born, meaning too premature to have a good chance to survive, 2 and that her doctors did not consider intervention on behalf of the fetus appropriate until 28 weeks.3 She was also informed of the added risks to the fetus from chemotherapy and radiation, but Angela still decided to institute aggressive treatment of her cancer. This course was so clearly understood that her attending obstetricians did not consider, much less attempt, intervention for the fetus later that night when Angela’s condition rapidly deteriorated, depriving Angela and the fetus of substantial amounts of vital oxygen for many hours.
The next morning, events took an unexpected turn. The hospital’s administrators (who were also its liability risk managers) learned of the decision not to attempt delivery of the fetus. The administrator questioned the right of anyone but a court to make decisions affecting a potentially viable fetus, particularly in light of the political controversy over fetal rights. Although the decision was supported by Angela’s parents and husband and by the obstetrical department as a whole, as consistent with the wishes of their patient, and despite the advice of legal counsel that the doctors should exercise their best medical judgment under the circumstances (which was not to deliver the – extremely premature and highly compromised fetus), the hospital required a court to decide what should be done for the fetus. Technically, the hospital sought a declaratory judgment as to “what it should do in terms of the fetus, whether to intervene and save its life.”
In response to the hospital’s petition, a court hearing was hastily convened at the hospital, counsel was rounded up in the hallways of the courthouse and appointed to represent Angela, counsel for the fetus was also appointed, and hospital counsel appeared for GWUMC. The hospital summoned all the witnesses who would testify at the hearing. Angela’s family was brought to the hearing just before the proceedings began, with only minutes to confer with Angela’s counsel. Angela’s long-term cancer specialist, who had been at GWUMC the day before to consult on her case, was not contacted at all.
At the hearing, family members, including Angela’s husband, opposed Caesarean surgery because Angela was not expected to be able to survive it and because all agreed that Angela would have opposed it. The treating physicians also opposed intervention based on their understanding of Angela’s wishes and the clinical status of Angela and the fetus. However, a neonatologist, who had no familiarity with Angela’s medical status, also testified at the hearing that the fetus had at least a 60 percent chance of survival (just slightly less than a fetus from a healthy woman at that gestational age). (Other medical experts have since concluded that there was virtually no chance of survival and that the fetus was already brain dead)
At the hearing almost no attention was paid to what was clinically best for Angela or to what she would want since, according to the hospital, it was “the apparent desire of the patient and her family” that no intervention be done on behalf of the fetus. Instead, the hearing focused on whether to “rescue” the fetus. Balancing Angela Carder’s life expectancy as a cancer-ridden patient against that of the fetus (based on the neonatologist’s unduly optimistic guesswork), the court ordered the Caesarean. Despite the court’s order, the obstetricians refused to carry it out. The hospital was then in the ironic position of being in contempt of an order that the hospital itself had sought. Reluctantly, a staff obstetrician agreed to perform the surgery.
Although assumed to be near death and unconscious, Angela was lucid and able to communicate when, after the court made its ruling, one of her obstetricians told her about the court’s decision. When her doctor explained that she might die as a result of the ordered surgery and that he would not perform the surgery without her consent, she said repeatedly, “I don’t want it done.” However, this declaration did not sway the hospital to withdraw its petition or the court to amend its order. A three-judge appellate panel upheld the decision during an emergency telephone appeal. Minutes later, having just been told that she probably would not survive the surgery, the woman who had courageously cheated death for fourteen years was rolled into the operating room. The fetus died within two hours. Two days later, Angela Carder died, never having received the cancer treatment she requested.
I was not familiar with the Angela Carder case. A tragic story and a good reminder that there is still ways to go on reproductive rights.
Thanks Anna.
Top post, Anna.
How appalling that all the administrators and court members could think of is “rescuing the foetus” rather than treating an articulate adult at risk of death according to her clearly expressed wishes.
Yet how sadly not surprising.
This is appalling – and is part of a continuum of the appalling ways in which most pregnant women are treated in hospitals and by medical staff.
I think this is an issue which should be a feminist issue and has been ignored (for the most part) for too long.
If anyone wants to read more about it I suggest:
Living Laboratories
Immaculate Deception
as a starting point. If I trawl through my bookshelves at home I can probably come up with some more titles if anyone is interested.
This is a desperately harrowing story, but it needs to be pointed out that the situation has moved on since 1987, when Angela Carder died. To prevent its use as a precedent, the court decision was overturned on appeal. Three years after her death, the hospital reached an agreement with Angela’s family which included the implementation of a new policy:
(you’ll probably need to register with the NYTimes to read the article)
Here’s a rather more local choice-related issue: when’s a bill decriminalizing abortion going to reach the Victorian parliament, like parts of the state ALP backbench have been agitating for since well before the last election?
Moved on like we have when abortion was legalised? Yes, it happened in 1987. But we’re still having the same debates now, and it’s still being framed the same way.
The story you’ve linked to is also outlined in the link I provided in the post, glebe, and you don’t have to register for it.
It has been a feminist issue for decades. It’s at the centre of a patriarchal world view that constructs women as a (discardable) vessel for reproduction.
I don’t think the way women are treated during childbirth has been a geniunely mainstream feminist issue – I wouldn’t say it’s been ignored totally (I did link to two books about it after all), but neither would I say it’s been seen as a central, mainstream issue, the way abortion has, or accessible child care or equal pay or the right to a career – and yet it’s as important as those issues. Most women when they have their first child have absolutely no idea what their options are, what the real risks of hospital birth are, or how they will get treated by medical professionals. Most of the books women read while they’re pregnant – like the ubiquitous “What to expect when you’re expecting” – do nothing to help this, as they reinforce the paradigm that medical professionals know best and birth is an inherently risky medical procedure.
I don’t think the way women are treated during childbirth has been a geniunely mainstream feminist issue
I know from reading your blog Rebekka that you are a young woman – I’m considerably older. I think situation resembles the manner in which 70s feminists forgot the work first wave feminists did. In truth, a bucket load of mainstream feminist work was put into this stuff in the 70s and 80s. That’s where we got rooming in, fathers at the birth, birth centres, water births, home births, a vast leap in the recognition of midwifery as professional practice and all those other changes that improved life for mothers and babies. We need to relive those battles, just as we are forced to fight for the right to choose AGAIN.
Ask Sheila Kitzinger about mainstream feminism – she and other birthing activists like her were women who thought the raw hungry power of childbirthing bodies should be celebrated and adored.
Myself, I still think childbirth choice is a mainstream feminist issue, but it’s just not framed that way because people think birth is about families and see feminism as being about individual women. Same way I guess as they see being pro-choice as somehow anti-birth, when of course it isn’t.
How unfortunate that a precedent needed to be avoided in the first place.
This is one of my greatest gripes with the anti-choice movement – the inherent belief that the life of a fetus is more valuable than the established life of a woman.
The fact that this is a pregnancy issue relating to the direct health of the mother is even more appalling. It’s interesting how easily the life of a woman is reduced to that of a glorified baby baker.
I agree with Bekk regarding this being a ‘mainstream’ issue. The attribution of decision making to pregnant women isn’t an issue that is considered highly – more stories like this should be registered and understood by the general population.
Not that young! But thanks.
I was actually writing my thesis on this for my history honours year, so it’s not like I don’t know what happened. But I still wouldn’t call it a mainstream feminist issue in the sense that abortion, child-care, career issues etc are mainstream feminist issues. I have whole histories of feminism that only mention childbirth in passing, if at all – and usually only to say that Queen Victoria made it possible for women to use drugs during childbirth – hurrah.
Ahem. We GOT homebirths in the 70s/80s? Okay. Life was improved for mothers and babies? Perhaps you’d like to look at the statistics. We have a c-section rate in this country around 30% – it’s been rising steadily since the 1970s. Most major hospitals still won’t “allow” water births, even if they condescend to “allow” women to labour in water. Home birth hovers around 1% – can you really claim to have achieved that as a viable option for most birthing women? Most women don’t even think they have it as an option.
While there have always been people like Sheila Kitzinger – and she’s an amazing advocate for natural birth – how many people have heard of her compared with how many have heard of Betty Friedan or Naomi Wolf?
Childbirth is seen as an issue that’s only an issue for pregnant women. And we’re told we have choices – you can make a birth plan. You can choose a birth centre attached to a hospital (which in my experience as a birth support person are hospitals with nicer rooms, not places with a different philosophy about birth). You can tell your obstetrician you want a natural birth, and they’ll reply with something patronising like “You can have your baby hanging from a chandelier, if that’s what you want dear”, but you’ll still be sectioned for “failure to dilate” if you don’t labour at a pace that pleases the hospital. The vast majority of what has been achieved in terms of women’s rights during childbirth is window-dressing, pure and simple. And it always will be until it becomes an issue that’s about the whole of society, and not just an issue for pregnant women.
Um, Rebekka, hasn’t it got a hell of a lot to do with medical negligence litigation too? One suspects that if specialists and hospitals did not have to worry about being sued for millions for the life long support of a disabled child, they would be somewhat less assertive about birthing decisions. (From recollection, tort law reform of a few years ago did not remove this as an issue, but did make some changes to keep doctors and insurers a bit happier.)
Actually, maybe this is partly what you meant when you referred to it as a “whole of society” issue? But then again, you do seem to be coming at it from primarily a feminist point of view which seems to me to not be all that relevant to the financial one of litigation.
Also, I think everyone recognises the caesarean rate is abnormally high in this country, but I don’t know it is from lack of goodwill that it is proving hard to find the answer to it. (Personal disclosure: my wife had our 2 kids by caesarean, first one in the public system and second was a planned one at private hospital. The experience in both systems seemed very respectful of the mother.)
Steve, isn’t the datum that financial/litigation issues are outweighing the actual preferences of women for birth experiences that they control indicative of absolutely why this is a “whole of society” issue?
When my family recently went back to Old South Wales we were able to show the kids not only where their daddy used to live but the window of the bedroom he was born in. Before the mid-50s the majority of Western births were home-births.
Having had complicated births myself I’m a big fan of having high powered technical intervention available for the occasions it is needed. But most women simply do not need to go high-tech, and there are proven hormonal/neuronal postpartum benefits to both mother and child when high-tech intervention is avoided when unnecessary. It is exactly those benefits which are tromped on by a financial/litigation decision that caesareans are preferred by the medical providers.
I really can’t see the what the relevance of bringing up the dubious legal treatment of a woman in the US in 1987 has to the claims being made about how pregnant women in Australia currently get a raw deal. After all, the US is far and away the most litigious society in the world and is notoriously hung up about “fetus’ rights”.
I must admit to being a bit hostile to all this Sheila Kitzinger schtick. My wife bought all this stuff after reading that book for our first child – the consequence was that both she and our son very nearly died. It took her years to get over the trauma and, terrible to say, long affected her attitude to our son. So we had the full intervention – planned induction, epidural, etc – for the next birth and the experience was completely different – far,far more comfortable for all, including our lovely daughter.
The “natural process” for human birth, as tigtog’s ancestors would have known, is a high neonatal mortality and a non-trivial maternal mortality rate. It’s the downside to the combination of a huge brain and a bipedal stance.
Rebekka, I think overall we agree, but Steve is right to say that the litigious culture of modern society has led to a distinct unwillingness of the medical practitioners to play ball (and as the Federal Government persists in making them the responsible parties for patient outcomes, who can really blame them?). But window dressing? I think we’ve come a little further than that, particularly if you are not so silly as to choose to put a private obstetrician in charge of your birthing experience in the first place, but stick with public hospitals where you are usually left to make up your own mind, unless it’s dangerous.
We do also have to accept that the actual preferences of women for birth experiences that they control (Tig Tog) includes c-sections. I guess, in an important way, that’s also about choice, although I don’t think that decision always results in the best outcome, but then who am I to judge? Choice is the theme here.
Anyway, this is a very moving and important post. I don’t wish to take away from it. I do have a sense that obstetrics has, in the last few years, favoured teh baby over the mother, and that doesn’t help the c-section rate along at all. I hope it swings back to valuing women, and that we don’t forget Angela’s story.
which in my experience as a birth support person are hospitals with nicer rooms, not places with a different philosophy about birth
That’s disappointing, Rebekka. I have had much happier experiences at the Birth Centre at the Canberra Hospital, Their philosophy – and their actual practice – is all you could hope for. The major difference that enables it to really work is continuity of care – most women see one midwife during their pregnancy, labour with her, and are seen at her by home post natally. Every woman who wants to should have access to this type of service.
As most recent birth centre experience was three days ago, I haven’t been up to blogging for choice today, which I would have liked to do. Thanks Anna for a great post.
Hey Zoe, congratulations!
I’m glad you had a good experience at Canberra birth centre – that’s where my sister-in-law had her second baby, and it wasn’t such a great experience for them. But it doesn’t always work one way or the other.
You get great continuity of care with a home birth too – it’s a pity that option’s not available and funded as are other options.
PART of the solution – and I did say it was a whole-of-society issue – is definitely tort reform – we need a no-fault compensation scheme. But it’s also got to do with attitudes towards women, and women’s bodies, thus the feminist issue.
Neonatal and maternal deaths went up when women started having babies in hospitals. They only came back down after the discovery of antibiotics. F*ck with the natural process and you start causing problems – in fact the leading cause of neonatal death and injury in this country is iatrogenic error – caused by doctors – not births going wrong on their own.
Neonatal and maternal mortality also went up post-industrial revolution, when rickets became more common and women could not easily give birth.
I tend to think if women are expressing a preference for c-sections, it’s an uninformed choice. The effects on the baby are documented and long-term, and maternal mortality is four times higher. There’s a higher risk of stillbirth in subsequent pregnancies. All this is all very well when it’s a life-threatening situation – but not when it’s just a “preference”. If a woman is expressing a preference for a c-section, in most cases I would assume she is unaware of the risks to her baby, herself and any future pregnancies, and perhaps that she has fears about labour that she might need counselling for.
I wouldn’t be so harsh Rebekka. I agree, there are situations where one intervention leads to another but I would not make a blanket statement concerning the choice of women to have a C-section. If I were to have another child I would be booking myself in for the theatre. Sure, this is mainly because I had a horrid labour that ended in an unplanned C-section first time round but I think the point that someone made further up this thread is key: it’s about informed choice. Not everyone is given the same information or the ability to make a choice but I would be wary of judging women on their choices. Hwo do we go about giving women all the information to make the choice that is best for them? I can’t pretend to have the answer to that and a lot of it is bound up in facilities available. For example, women in the regional areas simply do not have access to the facilities enjoyed by women in the city. How do we change this? Changing the philosophy and thinking around birth is one thing, altering the distribution of health funding to provide such services is another.
I’m not judging, I’m saying they don’t have all the facts. As for working out how to give people the facts? I don’t have the answers.
Can I ask why you would opt for a c-section, rather than a less medicalised labour?
Sorry, just wanted to emphasise that non-judgement thing as I am sure birth is different for every woman and there is no way anyone can know exactly how things happen. The lack on information and tendency of some OBs to hold information as if it is sacred is a real bugbear with me.
In answer to your question, basically because if I had another child I would not want to go through another 30 hours of non-productive induced labour only to find out that the baby was not coming out. (He was too big). I would rather have had the hospital staff call time on the labour long before they did, it was obvious it was not going to happen, C-section was the only answer. I would not risk stressing the child.
Great to hear ya Zoe!!!
Pregnancy and birth is an amazing concept (and reality)so thanks for the facinating post Anna. I must write of my personal experiences soon, but have to dash right now. Wil try and write something later!
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I must have had a very enlightened Ob/Gyn when I was pregnant. He didn’t believe in letting labour go for longer than 12 hours without being in attendance. In my case it meant emergency c-section for a very distressed baby. I heard some horror stories later about very long labours that almost killed babies and mothers. Even so I felt that I had no control at all the moment I went into hospital, every decision was made for me, not that I cared towards the end but I did give it a lot of thought later. The information available now, the difference in attitude towards midwives and birth centres is a big step forward but I don’t regret not going through it again.
As a pro-woman ob-gyn of my acquaintance once said to me, the rate of unnecessary c-sections is distressing, but then so are the unnecessary vaginal births … meaning there are women who are traumatised by difficult births, and (particularly in public hospitals), allowed to continue past the limits of human endurance. Sometimes this results in disasters for the mother, like full tears and fistulas, and for the baby.
I also get rather het up about unnecessary caesars, and particularly about cascading intervention, when one interference stuffs up the entire process and makes caesarean inevitable, but I do think that there’s an important person involved in the decision, and her fears count for something. Mind you, I’ve yet to meet a public hospital doctor who is prepared to schedule an elective caesar without good reason.
The Canberra birth centre experienced by Zoe (congrats Zoe) is world’s best practice and modelled on British programmes that have reduced caesars to the WHO gold standard of 10-15%. The midwife is involved closely with the woman and works to resolve her fears throughout her pregnancy. The result is a confident mum and an easier delivery. They also fund home birth support, and there’s a nice slick state of the art medical unit right next door. All women should be so lucky to presented with such palatable choices!
Georg, the idea that a baby is “too big” and that a c-section is necessary for this reason just about sums up the medical attitude towards childbirth – women’s bodies are flawed, we can’t really do it ourselves, birth is a medical event. My sister-in-law gave birth to a baby who weighed more than 5kgs, at home, without even a tear. I’d bet pounds to peanuts if she’d been in a hospital she’d have ended up with a c-section.
There’s no effective way of telling whether a woman’s pelvis is large enough to birth her baby in advance – xray is notoriously unreliable (click here if you want more info) – but if babies didn’t fit out of their mother’s pelvis, we’d have died out a long time ago. Your pelvic outlet is around 30% bigger in a squatting position, too.
Induced labour is often ineffective – because labour hasn’t been triggered by the baby, your own body is not ready for it. Labour in a hospital or other stressful environment is complicated because of your body releasing stress hormones including adrenaline, which counter-act the effect of contractions.
If you’d laboured when your body was ready to labour, in your own environment, in upright positions without medical intervention, I’d bet that baby would have come out just fine.
Rebekka, I’m glad your sister-in-law had a positive experience of home birthing a large baby. The thing is, not everyone is going to have that experience. The key is enabling women to do what they feel comfortable with and supporting them in that choice. (For the record, I had seen midwives only throughout my pregnancy, was booked in at a Birth Centre, not the maternity ward, tried the Birth Centre but was not able to stay there simply because the labour did not progress. I was given the choice of staying or moving to a labour ward. I chose the latter when it was obvious that things were not going to go smoothly. Also, the baby was 4.7kgs and two weeks late. He would not have been born any other way).
I agree that there is a medicalisation of pregnancy and labour and all through my pregnancy I was determined to avoid medical intervention. As it was it did not turn out as I had envisioned. This does not mean that my experience was wrong, or flawed. I have no guilt or shame about not ‘performing’ in labour. And this is where the expectation of a totally natural birth can be dangerous. Especially when that expectation is put on women by other women.
‘Giving in’ to gas, to pethidine, to an epidural is not a bad thing in itself when a woman has made the decision armed with knowledge. I admire women who manage to give birth without any intervention but I would not like to see such births held up as the thing all women should aspire to as the perfect labour. Life just isn’t like that. Women have enough to deal with after giving birth without feeling they have not performed during labour. As long as the baby and mother is fine, surely that is the most significant outcome.
(I’ve never given birth, but hey, it doesn’t stop the blokes…)
Rebekka, I appreciate what you’re saying, but in general the idea of something being “natural� and therefore good for you kinda gives me the creeps. There are lots of things that happen naturally that used to kill us, or make life much harder than it needed to be. We take painkillers, antibiotics; we air-condition our houses and fly in planes…
If human knowledge and technology can make a labouring woman’s life easier, or healthier then that’s great. Forcing women to have procedures they aren’t comfortable with is one thing – assuming labour is the only area where human cleverness has nothing to offer is another.
Bek,
My wife was in Labour for 22 hours and was still only 6cm dilated. Our Baby’s heart rate started dropping during contractions, and a C-section was performed.
I find it quite incredible that you advocate pro-choice when it comes to an abortion, yet look down you nose when women also exercise a right to chose a c-section.
chose = choose!
I’m with Georg on this. I had very high blood pressure and had to be induced. The attitude of most the of the maternity nurses was appalling especially when I decided not to breastfeed but once again my doc was trumps and explained that a c-section plus the other complications can cause the milk to dry up. A bottle was produced, mother and baby were happy until the ‘breast is best’ nurses started. I walked out of that hospital destroyed as a mother.
Re: ‘giving in’ to pethidine, epidurals, gas, and the other etcetera of the pharmacists’ and anaesthetists’ party bags.
Give in, mothers, give in well in advance, and by instruction. Mortification of the flesh is sex perverts, for Loyolaist freaks and Mexican festivals, certainly not for anyone with the option to avoid pain. Then, once you’ve extruded the annoying little artifact, give in to cold beer, wine, and whatever else takes your fancy from the wonderfully medicalised food and beverage industries of your industrialised societies.
Why should getting medical with your life stop with the traumatic? Bring strong self-medicated pain relief into every prosaic part of human existence, I say. After all, choice is nothing if not exercised frequently and joyously.
Rebekka, you’ve jumped to all sorts of conclusions – Georg didn’t say she was induced, or anything like that, but made it really clear that the the decision that the baby was too big was made in the middle of labor.
Don’t you think Georg was actually in a position to judge? After all, it was her fanny in the firing line (and I’m not for a minute suggesting that Georg was only worried about her fanny). She is right that labor is not a performance. My experience of pregnancy and childbirth was the entire thing was a work of surrendering control over one’s body to forces you cannot control.
Women have complicated experiences of birth. Too many birthing activists present simple, blunt messages that actually eliminate discussion of those complexities. That turns women off, yet it is those women that birthing activists need to reach.
I’m with the same birth centre as Zoe, and my experience so far has been wonderful. My midwife is knowledgeable, but never forces her opinions on me. She just answers my questions and has provided me with constant support throughout the pregnancy.
From our conversations, I feel quite sure that she will empower me to make my own decisions during labour. I am planning to have a water birth, but know that I can change my mind at any point. I also know that if things go on past the point of my personal endurance level that she will have no hesitation in helping me to go upstairs and enlist the support of the hospital staff to hurry things along. I am not keen for that to happen, but would certainly choose to do so if my baby’s heat rate dropped or I felt that continuing with labour was simply beyond me.
All that said – the waiting list for the Birth Centre is huge and a similar experience is not available to all women in Australia. If only it was…
That’s not exactly what I was saying. I was saying medical intervention often happens for no good reason and does not improve outcomes.
Sure, no arguments. But often technology does exactly the opposite.
Assuming human cleverness can improve on an extremely complex process honed by millions of years of evolution ain’t unproblematic neither.
Georg – I was not suggesting you made the wrong choice, I was suggesting that you almost certainly could give birth to a 4.7kg baby vaginally if given the right support and the right environment.
Lettersfromthefront – I was not making assumptions, Georg SAID she was induced – “30 hours of non-productive induced labour”
That’s bullshit.
As I’m sure georg will attest, a pelvis can only expand so far. History is littered with stories of women and babies dying precisely for that reason.
Excuse me Alex? Male AND an expert on the female pelvis and giving birth are you?
The pelvis is not a stiff bone, it’s full of joints that loosen towards the end of pregnancy because of a hormone called relaxin.
A woman’s pelvic outlet is 30% bigger when squatting.
Many women have given birth to babies larger than that – my sister-in-law included (if you scroll down here you can see her birth announcement: “She is 5 kg, or 11 pounds!!! She was born with me standing, no tears at all!”), vaginally, when given the right support in the right environment.
Being told your body is not able to birth your baby is exactly what I think is wrong with the way the medical profession treat women as inadequate and birth as a medical event. History is littered with women who died as a result of their babies being too big post-industrial revolution, when women were often malnourished and had rickets. Rickets often results in the pelvis being malformed. It’s a relatively recent phenomenon – and not one that well-nourished Western women need to worry about. Babies evolved to fit out their mothers’ pelvises.
Georg was obviously told at some point that it wasn’t okay for her to wait for her baby to trigger labour, that she needed to be induced. Induction very often leads to a cascade of interventions resulting in a c-section. It’s a well-documented phenomena. If she had had a midwife who was willing to observe placental function carefully and wait for labour – and there’s no reason at all why you can’t go three weeks overdue – the outcome might have been completely different.
The medical profession does not trust women’s bodies.
Alex, here’s an article for you to read that may enlighten you about the amazing female pelvis!
I have to say that it’s rather strange that my ‘fanny’ and pelvis have both become topics of discussion on this thread, I’m feeling rather strange!
Yes Rebekka, I may have been able to wait for labour to start naturally. Who knows when that would have happened. I had contractions before being induced but they weren’t serious enough to warrant not going ahead with the induction. The baby had never fully engaged, even two weeks after due date. The point for me though was that I had a choice. I did wait for two weeks, despite my extreme discomfort but I was quite happy in the end to go for the induction. The baby had to come out and more to the point I WANTED the process to start then. The midwives in the birth centre I had attended had given me a lot of information about options and I felt I needed to invoke that option.
I can’t stress it enough, choice, choice, choice. I understand your concerns with unnecessary medical intervention but I am also wary of making childbirth an endurance sport that only ‘real’ women can endure without the assistance of whatever help they need. Seeking help is a choice, as is choosing to give birth to a huge baby in your lounge room while squatting.
Knowing and understanding cascading intervention is bad, as I do, I still think there’s a fundamental problem here Rebekka.
Things can and do go wrong and you just sound silly if you assert that the only reason women and babies got stuck or died in childbirth was from malnutrition. Pelvises can only do so much and your repeated assertion that a squat opens the pelvis by up to 30% is not particularly relevant in a country where women just do not squat for that length of time, and become easily exhausted.
Last time I was in my ordinary country hospital labour ward, there was a woman who gave birth exactly the same way as me. I didn’t have a stitch. She ripped her pelvis nearly in two. I am not exaggerating. She fractured it. She tore all the ligaments and all the skin from her vagina through to her tailbone. Both healthy, well-nourished and in a positive environment, under the same doctor. My pelvis did what it was supposed to and hers didn’t. She walked again, only because of the surgical skill of the doctor we shared.
The introduction of caesareans DID lower infant and maternal mortality and morbidity, in a steady rising curve until the late 70s. In the 80s and 90s that curve has moved slightly downwards, because too many are being done, but you simply cannot argue that caeseareans are unjustified. W.orld Health Organisation guidelines suggest that best practice results in a caesar rate of 10%
Faith is a wonderful thing, but I prefer to take each case on its merits, and respect choices.
Rebekka, with all due respect, one doesn’t need to be female to be an expert on the pelvis and giving birth, as many a trusted, caring and professional male gyn/ob will attest.
What’s more, Alex is not purporting to have any such expertise, merely claiming that many women and/or their babies have died in childbirth despite the best efforts of trusted, caring and professional midwives, and would not have died had they had a c-section. This is a claim you can refute if you wish, but not by pointing out that he has a penis.
An uncharitable reader might think that you’re just lashing out at the nearest man, because so many women here have taken you to task.
Not me though:)
TO keep things in perspective could i suggest we take a look at this article about a hospital for young women in africa, set up to repair birth related fistulas.
I know its not perfect here in the Western world, but lets not let our quibbling over details mean we lose sight of the big picture of how fortunate we are to have these choices in the first place.
I have to say, for one, that reading everyone’s comments is interesting…. but you know what, how many of you have experience offering continous care to mothers to assist them with keeping childbirth normal, healthy and tolerable ? Say, have you assisted 100 mothers ? a few hundred ? a thousand ? It is something to wonder~ what knowledge and experiential base is represented in the many words here. That is perhaps rough to mention….but:
World Health Org. has said that normalacy in childbirth is compromised the minute the mother leaves her home. yep. Do we realize that almost all our studies, research and accumulated stats come from Disturbed childDeliveries ?
It was shared that:
“The introduction of caesareans DID lower infant and maternal mortality and morbidity, in a steady rising curve until the late 70s. In the 80s and 90s that curve has moved slightly downwards, because too many are being done, but you simply cannot argue that caeseareans are unjustified. W.rld Health Organisation guidelines suggest that best practice results in a caesar rate of 10%”
~~Isn’t it fact that the greatest proportion of improvement came from the availability of life-saving antibiotics, improved sanitation and nutrition ?
I will just paste a qoute, perhaps you’ll want to track down the source (I don’t have it immediately available):In the 1960s, in a rural, impoverished California county, introducing midwives into the county hospital more than halved the newborn death rate. When doctor opposition to midwives blocked renewal of the program, the newborn death rate promptly tripled.”
…and this; “Overall neonatal death rates have also improved since the 30s, but homebirths appeared to be safer even then. In 1939, Baylor Hospital Charity Service in Dallas, Texas, published a study that revealed a perinatal mortality rate of 26.6 per 1,000 live births in homes compared to a hospital birth mortality rate of 50.4 per 1,000.[1]”
and this “The World Health Organization recommends that national maternity policies reflect a preference for midwife-supported, planned out-of-hospital birth, and a November, 1996 study in the British Medical Journal verified that planned home birth is a safe option for women with healthy pregnancies.”
a mother a midwife