2011 - Talk Birth

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The Illusion of Choice (2011-12-30 09:39)
A choice is not a choice if it is made in the context of fear.
Informed choice is a popular phrase with birth professionals and healthy birth activists. I’ve read
impassioned blog posts from doulas and birth activists claiming that if we support women’s right to homebirth,
we must also support her ”choice” to have an elective cesarean. But, I believe we have constructed
a collaborative mythos within the birth activist community that an informed choice is possible for most
women. The statistics tell us a different story. I do not believe that women with full ability to exercise their
choices would choose many of the things that are typically on the “menu” for birth in mainstream culture.
What’s on the menu?
Women give their blanket ”informed consent” to all manner of hospital procedures without the corollary
of informed refusal–is a choice a choice when you don’t have the option of saying no?
In many hospitals, women are STILL not allowed to eat during labor despite ample evidence that
this practice is harmful–is a choice a real choice if made in the context of hospital ”policies” that are not
evidence-based?
Women are told that their babies are “too big” and then “choose” a cesarean. Is a choice a choice
when it is made in the context of coercion and deception?
Women choose hospitals and obstetricians that are covered by their insurance companies. Is a choice
a real choice when it is made by your HMO?
Women choose hospital birth because they cannot find a local midwife. Is a choice a real choice
when it is made in the context of restrictive laws and hostile political climates?
Women often state they are seeking ”balanced” birth classes that aren’t ”biased” towards natural
birth (or towards hospital birth), but is a choice a choice when it is made in the context of misrepresented
information? Because, as Kim Wildner notes, balance means “to make two parts equal”–what if the two
parts aren’t equal? What is the value of information that appears balanced, but is not factually accurate?
Pointing out inequalities and giving evidence-based information does not make an educator “biased” or
judgmental–it makes her honest! (though honesty can be “heard” as judgment when it does not reflect one’s
own opinions or experiences).
On a somewhat related note, recently, the subject of “quiverfull” families came up amongst my friends and
comments were made about feminists needing to support those women’s “choice” to have so many children.
However, I worry about women who are making reproductive ”choices” in the context of what can be a
very repressive religious tradition. Women’s choices about their lives are not always made with free agency.
And, that is where some feminist critiques of other women’s choices come from–a critique of the larger
context (patriarchy) rather than the woman herself. Is a choice a choice when it is made in the context of
oppression?
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