Childbirth rights- are you pro-choice?

(94 Posts)
Feminist5 Thu 23-May-13 18:30:39

I am sure majority of the ladies who post on the women's rights forum are pro-choice, and support a woman's right to terminate a pregnancy.

My question is more about the woman's rights when she chooses to continue with the pregnancy. Should she have full control over how she gives birth?

I'm not talking about outrageous requests like demanding that a doctor perform IVF and get you pregnant with sextuplets or that a doctor perform an appendectomy or chop off a limb during pregnancy just because the woman wants it.

However, childbirth is a slightly different situation because the baby will come out somehow and I feel liken the woman should have a voice in how and where that happens. It is also quite common for doctors to be biased towards fetal rights and override what the woman feels more comfortable with.

So I am therefore referring to a woman's right to choose how she should give birth, as I happen to think this is a feminist issue.

Do you think women should be able to choose the following (as long as they are fully informed about the pros and cons)?

A home birth?

An elective cesarean?

An epidural?

An elective induction?

Or do you think that a doctor should be able to force a woman to give birth in a way that she doesn't feel comfortable?

Despite the NICE guidelines saying that it is ultimately the woman's choice if she wants an elective cesarean or a home birth, women are still having to fight for these unconventional choices.

Just as it can be disempowering to be forced to stay pregnant against your will, it can also be disempowering to give birth in a way that you don't want

PeaceAndHope Fri 24-May-13 14:34:50

It is pointless to argue about whether or not doctors can be forced to perform a procedure because that will never happen.

Should women have absolute control over how they give birth? YES.

I have had a miserable vaginal birth that I was forced into and it killed a part of me emotionally. I felt like I had no control over my body and the health care professionals had stripped me of my autonomy and rights. I felt violated and objectified.

My planned c-section in contrast was a peaceful, calm and empowering experience. It felt amazing to be able to choose how I would bring my baby into the world and to take ownership of that decision.

I don't mind doctors getting women to sign waivers if they aren't fully on board with whatever treatment the woman is requesting. Referring the woman to another doctor is also an option. There are ways to work around disagreements! Denying the lady a choice in such a life-changing event is never an option.

It amuses me when women who are pro-choice about abortion say that there is no right to 'demand' treatment. So women can 'demand' abortions but not epidurals/c-sections/etc? Why? Abortions aren't exactly risk-free and doctors can have medical or moral issues with performing an abortion as well.

I've skimmed through the thread and it seems that some people can't understand that doctors can all have different opinions on the same thing.If every doctor was 100% correct and ethical and unbiased then there would never have started the concept of a second opinion.

Doctors are human-they are not God. They can make mistakes and they can be biased for or against a certain kind of birth.

My SIL wanted a VBAC. The first consultant she asked refused because he felt that the risk of rupture was too serious and shouldn't be taken. She persisted and was referred for a second opinion after much drama. The second consultant agreed without a fight because he believed that VBACs were better.

Does that mean either doctor was unethical/wrong? No ! They just had different perceptions of risk and different interpretations of the existing evidence.

JedwardScissorhands Fri 24-May-13 15:08:49

Totally disagree with that. Unless the procedure would involve the doctor breaking the Hippocratic oath, it is irrelevant what their preference or view is. What a load of paternalistic rubbish.

PeaceAndHope Fri 24-May-13 15:17:35

Sorry, was that in reference to my post? I don't think it matters what a doctor's preference is either to be honest. Unfortunately our healthcare system will always tip the balance of power more towards a doctor than the patient. The next best option is to have the right to a second opinion or a waiver. I am not saying denial of preferred treatment should ever be an option.

NiceTabard Sat 25-May-13 16:57:58

I think that women should be given the facts (risks etc) and then allowed to choose (within reason).

I also think that there should be much more information and support around post birth difficulties inc trauma, mental health, continence issues, sexual function probs and all of the myriad of things I have read about on here. At the moment there seems to be a culture of women thinking they have to "put up" with stuff which they wouldn't normally, because it is related to giving birth.

PeaceAndHope Sat 25-May-13 21:33:00

Viva, it seems that planned c-sections are considered safer than VBACs.

www.bbc.co.uk/news/health-17353803

(I know this is a derail but I'm sharing the link because the topic was discussed earlier on in the thread)

VivaLeBeaver Sat 25-May-13 21:46:19

Peaceandhope, the Drs I work with definitly tell women that vbacs are safer. The research in that link just looks at the risk of uterine rupture which are obviously going to be higher in vbacs, therefore stillbirths also higher. But if you look at the actual figures its a v small risk.

Drs also generally consider other risks of sections, so higher risk of pph, higher risk of dvt, higher risk of sepsis. Sepsis and dvt are the two highest direct causes of maternal death in the last two CMACH reports so not to be treated lightly.

Then there's the risk to future pregnancies, higher chance of scar rupture, higher chance of placenta accreta or previa.

NiceTabard Sat 25-May-13 21:55:29

I was told when I was deciding between vbac / elcs for child no. 2 that vbac carried slightly higher risk for the child and elcs carried slightly higher risk for me. So meh really.

What gets on my nerves is that possible post birth recovery difficulties with cs are told in detail yet similar risks for vb are ime not mentioned at all. I know so many women who have been utterly unprepared for the long term damage wreaked on their bodies by vb and I also know lots of women who held back from getting help as vb is "natural" and so the after-effects are as well so don't make a fuss type thing.

PeaceAndHope Sat 25-May-13 23:39:46

Viva, ELCS doesn't have a higher risk of PPH smile In fact a planned c-section has a much lower risk of PPH than a vaginal birth. (This is what the latest research by NICE indicates). The impact on future pregnancies will not be applicable to every woman, because not every woman goes on to have more than 2 children. It's misleading to say that the risk of stillbirth is a 'small' risk and nothing to worry about. When it does occur the consequences are devastating. The risk of DVT and embolism is equally small with an ELCS, yet we are happy to scare women with that. There has to be a balanced debate for women to be able to make empowered choices.

I would be very reluctant to trust any doctor who told me that a VBAC was safer. It would be rather obvious that this was being said to parrot trust policy or to cut costs. It's fine to have a discussion on the pros and cons of either mode of delivery but to categorically call one safer is wrong IMO.

NiceTabard, I am inclined to agree that a VBAC is most certainly riskier for the baby. I am not sure what is riskier for mum- a pulmonary embolism is as bad as a uterine rupture, but less likely to occur. Only the lady herself can decide between the two options.

"What gets on my nerves is that possible post birth recovery difficulties with cs are told in detail yet similar risks for vb are ime not mentioned at all. I know so many women who have been utterly unprepared for the long term damage wreaked on their bodies by vb and I also know lots of women who held back from getting help as vb is "natural" and so the after-effects are as well so don't make a fuss type thing."

I absolutely agree with this! The risks of a VB are rarely mentioned to women even though the consequences of a VB can be far more devastating than those of a CS. (I have a friend living with incontinence caused by anal sphincter damage during a forceps delivery).
It irks me when all these pregnancy brochures insist that VB has a shorter recovery. It does not always.I have had a VB that took me 18 months to recover from and an ELCS that took 2 weeks.

tungthai Sun 26-May-13 08:48:23

I wanted a VBAC for ds2 and the midwives and Doctors were both very supportive of that. However I stated that if the labour was not progressing well I wanted a c-section I didn't want a forceps delivery.

I had a long labour, longer than they agreed they would let me go but all three parties were in agreement to let me continue. Then the labour stopped, the contractions just faded away. The midwives told me that I was going to have a forceps delivery despite my wishes not to. The registrar and senior midwife had an argument next to my bed as the registrar was of the view that a c-section was safer. Then the registrar examined me and said that I wasn't fully dilated which didn't surprise me as I didn't have any urge to push. Cue more arguments between the registrar and midwife before the consultant came along and whipped me off to the theatre for a csection.

Up until this point I was extremely satisfied with my care but then I felt that my wishes and my safety were being put at risk because midwifery staff are in favour of natural births.

PeaceAndHope Sun 26-May-13 14:36:12

I've noticed most ladies who are saying their choices were supported wanted a VBAC. We if you want what they want you to have, then obviously they will be enthusiastically support that choice.

There are so many threads on mumsnet itself about women who want repeat c-sections are being refused. sad

Tungthai, your experience is not at all unusual. In fact you are lucky that the consultant at least favoured a c-section. I know two women who had forceps against their wishes- one ended up fecally incontinent and one had a brain damaged baby. I think forceps are medieval tools of torture and I genuinely think they shouldn't be used as often as they are.

PeaceAndHope Sun 26-May-13 14:37:05

The second sentence was meant to read like this-

"Well if you want what they want you to have, then obviously they will enthusiastically support that choice."

Ushy Tue 28-May-13 12:05:01

Well said Peace but what I find so odd is that natural birth is seen as a feminist issue when it is nothing of the sort.

I could understand it in the days when women were forced by male obstetricians to give birth on their back and be subjected to a variety of instruments of torture to extract babies.

I think what the feminist movement missed was exactly the point you are making so well. It has never been about 'natural' birth. Feminism should be about respecting women and the choices they make - the imposition of natural birth is as much misogyny as the paternalistic obstetrics practiced in the past.

The tricky thing is that in the past it was mainly men doing it to women. Now it is just as often women imposing it on other women.

But then, women in their thousands opposed women suffrage...so nothing new I guess

PeaceAndHope Sat 01-Jun-13 17:36:36

Ushy

I agree with everything you have written.

Certainly a woman who chooses a natural birth should be supported (and IMO most of them are supported within reason). However, women who want ELCS and epidurals should equally be supported and it shouldn't be up to government funding bodies or health care professionals to take that choice away from us.

AmandaPayneNeedsANap Sat 01-Jun-13 18:05:19

I agree that feminism should support women's choices.

However, I disagree that it is routine that women are supported to have a natural birth if that is what they want. I wanted a natural birth for DD1. What I got was little support for the pain I was in, a dismissive attitude (because I wasn't in active labour. Never mind the fact that I was into my third day without sleep and felt like I was being kicked in teh back by a horse) and pressure to accept interventions that I didn't want. I think natural birth is supported in much the same way breastfeeding is supported - lots of talking about what a good thing it is but very little in the way of solid knowledge and support for women who find that difficult.

Similarly women are encouraged to VBAC in many areas, yet they are also hamstrung by so many procedures and rules that many of them will never succeed (some would obviously have not done anyway, and those who want planned sections should be supported 100%) because they are clock watched and tied down. Other ways to ensure safety are available -but they need better equipment and more staff.

Feminism should be about every woman being properly supported in her birth choices, whilst recognising that sometimes every plan needs to change. Sometimes that means a theatre full of people to help deliver your baby surgically. But equally a natural birth may need support and it shouldn't mean one disinterested locum drifting in for 10 minutes every 2 hours.

I could weep when I think of all the women I know who have had unnecessarily traumatic birth experiences because of the chronic under funding and the failure to truly listen when women speak - both before and during labour. I don't buy the 'well the NHS is underfunded' argument either. You wouldn't perform even fairly minor surgery without all the people that surgery required present and correct in theatre- so why we let women labour in that way is beyond me.

Justfornowitwilldo Sat 01-Jun-13 18:17:19

Women should be supported in the choices they make about how they want to give birth. Whether that involves an elective c section or a quiet room with a birth pool and candles. Give them the information, allow them to choose and back up that choice.

You can be bloody sure that if men gave birth we wouldn't have hospitals pushing them into vaginal births after previous birth trauma, routinely performing sweeps and internals without expressed consent and refusing effective pain medication.

PeaceAndHope Sat 01-Jun-13 18:42:55

AmandaPayneNeedsANap, I don't dispute what you're saying at all. I was merely speaking from my experience. My friends who have wanted natural births have been encouraged and supported by NCT and NHS midwives. I always wanted an ELCS or at the very least an epidural. I was first denied the choice and then shamed, guilted and judged for my preferences.

I think the system is so broken that nobody is getting what they want. They seem to think that encouraging a VB or breastfeeding is the same as forcing it on women who have made informed choice not to do it. All the while women who want to have natural births and breastfeed somehow end up not doing it.

Like yourself, I don't buy the "nhs is underfunded" argument either. There is no excuse to treat pregnant women badly and to deny them choices over their own bodies. If this isn't a feminist issue, I don't know what is.

AmandaPayneNeedsANap Sat 01-Jun-13 19:16:47

Sorry Peace, I wasn't disagreeing with you exactly. I was mostly responding to Ushy's comment that "I find so odd is that natural birth is seen as a feminist issue when it is nothing of the sort", which was a follow on from what you'd said. Sorry if I wasn't clear.

On your second paragraph, I also think that there is a lot of encouraging natural birth and not much enabling of natural birth. Much like breastfeeding. And the women who 'fail' at natural birth are also guilted and judged in some quarters (though possibly not as openly) . I agree, it is a broken and misogynistic system.

Ushy Sat 15-Jun-13 19:38:25

Amanda what I meant by natural birth not being a feminist issue is that
there is nothing feminist in browbeating women into something that some women don't want.

The genuine feminist cause is enabling women to have the choice that they want - whether that is caesarean or an 'enabled' natural birth.

I agree with you though, a broken and misogynistic system.

AmandaPandtheTantrumofDoom Sat 15-Jun-13 22:18:03

Ah, sorry I misunderstood. Totally agree with that - there is nothing feminist about railroading women.

Join the discussion

Join the discussion

Registering is free, easy, and means you can join in the discussion, get discounts, win prizes and lots more.

Register now