2011 - Talk Birth

“Doctors ‘know’ they are giving women ‘the best care,’ and ‘what they really want.’ Birth activists…know
that this ‘best care’ is too often a travesty of what birth can be. And yet on that existential brink, I tremble
at the birth activist’s coding of women as ‘not knowing.’ So, here’s to women educating themselves on
healthy, safe birth practices–to women knowing what is best for themselves and their babies, and to women
rising above everything else.”
I believe that every woman who has given birth knows something about birth that other people
don’t know. I also believe that women know what is right for their bodies and that mothers know what is
right for their babies. I’m also pretty certain that these “knowings” are often crowded out or obliterated
or rendered useless by the large sociocultural context in which women live their lives, birth their babies,
and mother their young. So, how do we celebrate and honor the knowings and help women tease out and
identify what they know compared to what they may believe or accept to be true while still respecting
their autonomy and not denigrating them by characterizing them as “not knowing” or as needing to “be
educated”? As [5]I’ve written previously, with regard to education as a strategy for change: People often
suggest “education” as a change strategy with the assumption that education is all that is needed. But,
truly, do we want people to know more or do we want them to act differently? There is a LOT of information
available to women about birth choices and healthy birth options. What we really want is not actually more
education, we want them to act, or to choose, differently. Education in and of itself is not sufficient, it must
be complemented by other methods that motivate people to act. As the textbook I use in class states, “a
simple lack of information is rarely the major stumbling block.” You have to show them why it matters and
the steps they can take to get there…
And, as the wise Pam England points out: ”A knowledgeable childbirth teacher can inform mothers
about birth, physiology, hospital policies and technology. But that kind of information doesn’t touch what
a mother actually experiences IN labor, or what she needs to know as a mother (not a patient) in this rite
of passage.”
The systemic context...
We MUST look at the larger system when [6]we ask our questions and when we consider women’s
choices. The fact that we even have to teach birth classes and to help women learn how to navigate the
hospital system and to assert their rights to evidence-based care, indicates serious issues that go way beyond
the individual. When we talk about women making informed choices or make statements like, “well, it’s her
birth” or “it’s not my birth, it’s not my birth,” or wonder why she went to “that doctor” or “that hospital,”
we are becoming blind to the sociocultural context in which those birth “choices” are embedded. When we
teach women to ask their doctors about maintaining freedom of movement in labor or when we tell them
to stay home as long as possible, we are, in a very real sense, endorsing, or at least acquiescing to these
conditions in the first place. This isn’t changing the world for women, it is only softening the impact of a
broken and oftentimes abusive system.
And, then I read an amazing story like this [7]grandmother’s story of supporting her non-breastfeeding
daughter-in-law and I don’t know WHAT to do in the end. Can we just trust that women will find their
own right ways, [8]define their own experiences, and access their own knowings in the context of all the
impediments to free choice that I’ve already explored? What if she says, ”why didn’t you TELL me?” But,
if we share our information we risk polarization. If we keep silent and just offer neutral ”support,” regardless
of the choice made, then doesn’t it eventually become that the only voice available for her as she strives to
make her own best choices is the voice of What to Expect and of hospital policy?
”Our lives are lived in story. When the stories offered us are limited, our lives are limited as well.
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