Without trying to sound ageist or condescending, every time I see a 20-something year old on Jezebel bragging about the cesarean she’d sign up for if she were ever pregnant, I want to butt in and say “Don’t you see?!?! That’s what they WANT you to do!!!” Toward the end of this post I’ll explain what They want, and why we shouldn’t give it to them, but first, let’s talk about the language of “choice” in relation to birth.
So many young women today think that drugged-up births and cesareans are the “feminist” choice, and that labor pains are oppressive or patriarchal in nature. I understand… I really do. I once was that girl. I thought anything that could disconnect me from my biology meant freedom, and even joked about wanting a hysterectomy before I ever had kids.* I didn’t necessarily want a cesarean (I’m scared of surgery) but when I became pregnant, I had blind faith that the obstetrician I hired could easily and painlessly remove the parasite I was growing in my womb with a nice epidural cocktail and some forceps. Simple, right?
Of course I had no education whatsoever about epidurals or forceps or cesareans, and how much damage they could do to a woman’s body. I just assumed that if the technology existed, then they must have perfected it, and if it could keep me from feeling a contraction then by golly, I had to get me some of that.
We all know how that worked out for me. I learned the hard way that attempting to circumvent nature had a miserable outcome for me, and once that happened, I started to wonder why I’d had so little faith in (or love for) my body’s amazing abilities to begin with. And then I started to discover that my mistrust and contempt for my biological functions came from years of programming by The Establishment.
See, if I stay home to have my baby, the local hospital, OB, and pharmaceutical company doesn’t make a penny, and exercises no control over my body. However, if I go get me one of those cesareans, well… a whole lot of people are making money; obstetricians, anesthesiologists, drug companies, makers of surgical supplies, hospital administration, etc, etc. And me? I’m left with a scarred uterus for the rest of my life, which will greatly limit my choices in the next pregnancy, and further compromise my health.** Thanks Doc!
So, what if you decide to take control over your birth? Ah, well, The Establishment doesn’t like that. In this brilliant 2008 expose, Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First
In his book, Dr. Wagner (an obstetrician and former Director of Women and Children’s Health for the World Health Organization) explains,
“This table heaps contempt on women whose ideas and preferences for giving birth inconvenience the doctor. Many obstetricians find the table hilariously funny. Isn’t it frightening that the ultimate weapon obstetricians use to punish overly “independent” women is to cut into their bodies, using a surgical procedure (cesarean section) only obstetricians can perform, which completely deprives the women of control over their own bodies?”
Yes, Dr. Wagner – it IS frightening. Even more frightening is the fact that so many young women frivolously joke about electing a procedure that you describe as nothing short of violence against women. All the while, women and babies are dying at a higher rate in the U.S. than in most other developed countries. In a fact sheet offered by The Safe Motherhood Quilt Project, it is noted that,
“The maternal mortality rate for cesarean section is four times higher than for vaginal birth and is still twice as high when it is a routine repeat cesarean section without any emergency.”
In fact, our U.S. maternal mortality rates are so high, earlier this year Amnesty International released a report titled “Deadly Delivery: The Maternal Health Crisis in the US”, calling for the United States to make dozens of changes to women’s health care, including “establishing clear national guidelines… for the appropriate use of medical interventions and procedures such as c-sections.”
How did we get here, and how can we turn this around? Well, so many brilliant authors and film makers have already shown us the many ways that handing over the keys to our biological castle has backfired for women. All we have ever wanted to do is be treated as equals, yet instead we discover that The Establishment has found ways to capitalize on our desire for independence, and ultimately, punish us for it – during the most vulnerable and transformative period of our entire lives, no less.
All of this sounds very Debbie Downer, and my intention isn’t to scare women, or inject fear into a woman’s birth experience. Contrarily, books like Marsden Wagner’s are focused on exposing the problems, and proposing solutions to the mess we’re in. Independent women need to be aware of the real price of trying to buy the “perfect, painless” birth experience from surgeons, and think about ways to change the system for the betterment of all women and babies.
Last year I gave a 10-minute talk in an advanced public speaking course on this very topic. When I finished, one young woman raised her hand and said,
“Wow, I never knew any of this. I always figured I’d sign up for a c-section the minute I got pregnant, but you’ve really got me thinking.”
And that’s all I hope for. I want more young feminists to ask “Are we taking control over our own bodies, or are we really just unwittingly giving all the control away and labeling that a choice?” and “When I enter my birth environment, am I sure I’ll be treated with respect, or are the residents joking that my desires for an autonomous birth just bought me a ticket to the OR?” If it’s the latter, then it’s time to demand better, and to keep demanding it, until our maternal and infant mortality rates reflect the amount of money women are paying into our maternity care system.
I won’t put up with a doctor joking about cutting me just because I hyphenated my last name or wrote a Birth Plan, and neither should you.
Now… what’s your gut reaction to seeing the table above?
UPDATE: For those who were even one bit skeptical about whether or not I could possibly be right about physicians opposing autonomy, this week Kingsdale Gynecologic Associates in Columbus Ohio sent a letter to their patients banning doulas and birth plans. Here’s their letter: http://birthingbeautifulideas.com/?p=1922
There you have it. RUN LIKE HELL LADIES!!!!!!!!!
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*In a display of pure irony, the period I wrote about in that post ended up being my Last Menstrual Period (LMP) before I got unexpectedly pregnant with my first son. Sometimes the Universe has a way of forcing us to deal with things.
**No matter how many times I insist that SOME cesareans sections are 100% necessary and life-saving, people always complain that I don’t leave that disclaimer enough, so here it is again. SOME cesareans are 100% necessary and are worth the risks involved. However, The World Health Organization estimates that a national cesarean rate of 15% is “a threshold not to be exceeded,” yet our current national rate is 32%. In some hospitals, it’s twice that. This says a lot.
Gina I don't exactly remember how I came across your blog but I am glad that I did. I plan on having kids 5 years from now, and I have always been against a c-section, but I didn't know how frequently c-sections are given in perfectly healthy mothers. With 5 years tentative years to go I will be researching as much as I can to make sure that I have the birth experience that I want and not what some doctor decides to choose for me. Thanks :D
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