Pregnancy, Parturition, and the Patriarchy: how do we best serve women?

It's taboo to show a birth video to students, (at least here in the US it is, despite the fact that porn is actively being viewed on smartphones in the classroom). How do we effectively change this?

Wow, you're right, that is insane. Why on earth should it taboo to show childbirth.

But the notion that a woman can give birth and be up and running less than 24 hours later is absurd.

I wonder if this isn't something that has been affected by the "women are as capable as men" idea. At a certain point, certain customs that had accepted that women had different needs seemed to disapear. Like expecting them to opt out of swimming when they had their periods.

Of course its good that it isn't expected, but now it seems like you can't really. I know some girls that go on birth control because they can't take any time out of sports teams to deal with their period. It's like we think we have to say "oh, I had a baby, but that doesn't make me less useful than a man employee..."

Being more likely to live apart from extended family makes a difference as well.

My birth experiences were varied, none were great. My first was a c-section, mainly because they managed it shallowly, IMO. I didn't know what I was doing really. Second I tried VBAC but had a section with baby in distress. It was ok, my doctor had to leave in the middle because her father unexpectedly died but I liked the women who delivered me.

I also tried for a VBAC with my third, and it was horrible. I was very much abused by the doctors there - two women and a man as it happens. It was a different hospital with a bad attitude, not up on best practices at all.
My fourth baby I had a planned section - the policy here is no VBAC after three sections and I was happy with that. It was all pretty low key.

So like anyone, this has affected my views in various ways. I am pretty pro-midwife and home-birth where appropriate (which is not usual here we have only a few midwives and home-births are difficult to get) and I think interventions need to be thought out carefully.

I am big on non-paternalistic care and working with the health goals of the patient. I think under normal circumstances people should be able to choose a caregiver of the same sex.

On the other hand, I've been involved in health enough to know that not all patients are reasonable, and some do things which make it impossible for their medical staff to help them. Circumstances can make what you want impossible (My dad for example lives in a town with two doctors who staff a tiny ER. Chances are you have no choice about the sex of your doctor, or even nurse, when you arrive in an emergency.) And there is a line where any doctor of person in a position of responsibility will say no, I can't do that, even if it's what you want, I don't think that would be an ethical medical practice. I don't think you can train people and give them a lot of responsibility, and not allow them to have boundaries like that.

About maternity care in general - so much of it is not science based. But part of the problem is so much of it involves things that are not really amenable to medical trials.

One thing about the powerful experience of birth thing - I think that is true. But it also causes a problem in that sometimes people put so much weight on that, it creates its own baggage. Whenever people build up a vision of the way something is going to be, it causes problems. I remember when I was doing doula training, and older doula I worked with told me that really, she found that women who put too much time and effort into birth plans and things tended to sabotage themselves.

Spud and Sonic

I too developed what I think, in retrospect, may have been PND. It went on for 10 years before I finally summoned the courage to reveal that something was wrong and ask my doctor about medication. I have no doubt those 10 years of depression adversely affected my daughter, though I tried very hard not to let that happen; they nearly destroyed my marriage, though we recovered with counseling; and they contributed to my giving up or losing, depending on how you look at it my first career.

Yes, I think if there was one thing I’d like to make expectant women understand, it’s that you’re going into a situation where the only person who will truly advocate for you and your baby is you

Other people’s laziness, sexism, burn out, tiredness, pre conceived ideas etc will get in the way. Don’t fully trust anyone

It sounds bonkers but I really believe it.

For various reasons I basically insisted that DS2 was born by cesarean. He unexpectedly turned out to weigh 12lbs as I had undiagnosed gestational diabetes. DS1 was a section too, so it would have been my first vaginal delivery. Fuck knows what would have happened if the medics had had their way. I feel very lucky in retrospect

My labor and delivery was nearly textbook, though painful as I did natural childbirth, and then there was, at the end, a rushed episiotomy that had me screaming blue murder. Still, I thought all in all, I was treated well, and this was in the US, with a hospital that had "birthing rooms" where my DH was with me the entire time and then through the first night sleeping.

The issue I had began the next day when I and my baby were moved to Pediatrics because she was jaundiced. The nurses made it clear I was not their patient, and I accepted that. I was able to sleep in the same room with my newborn-under-glass, and I was glad of that -- but it was only an armchair I was given to sleep in; I was clotting badly; I might not have been the patient on the pediatric ward, but I felt that I was, still, someone's patient, or should have been.

But there was/is a complete absence of after-care. I don't know if that's changed. But the notion that a woman can give birth and be up and running less than 24 hours later is absurd. I was exhausted, unable to sleep well in a chair, and that exhaustion followed me home when my baby was discharged and took a very long time to lift -- at home, too, I was no one's patient, and with lack of paid leave what it was in the US, I was pretty much alone with my baby, DH at work, family far away.

My exhaustion and utter depletion meant I was never able to get a good start on breastfeeding and from the second week had to supplement with formula, by three months was unable to continue.

There simply isn't enough physical support for new mothers both inside a hospital and outside of it. Because childbirth is seen as "natural," unless there's a C-section, it's not seen enough as a medical event from which a woman must heal and recover.

I did develop PND, I think - I never had a firm diagnosis as I didn’t want to let anyone know. I concealed how desperate I was feeling from everyone, and quietly planned how I would end my life if it got worse, rationalising that it would be for the best as DH would be able to find another, better woman to be with and DS would not remember me and would think of this other woman as his mother.

Really sorry to read this Spud, and it's exactly how I felt after my birth (which resulted in PTSD), probably for about 2 years. I was trying to think of "quiet" ways to "go" where nobody would notice, before my DC got old enough to become too attached to me and someone else could just be "slotted in", who would be a much better wife and mother, rather than this wreck of a person who was constantly going round and round in the same loop of trying to talk through every little detail of what happened in order to try to understand why.

I ended up with an emergency birth and full emergency team in the space of a few minutes and, tbh, that team were all great with the delivery, haemorrage, and resusitation. Everyone introduced themselves when they rushed in too, (although I was being pinned down and all dignity was gone).

But it was the hours of care from a midwife leading up to the birth which got me I think, where she dismissively told me to go away, several times, because I wasn't in labour (despite very frequent contractions and me losing a lot of blood, and vomiting from the pain). She had also sent my husband home. Of course it turned out I was fully dilated, baby was stuck and heart had almost stopped.

Thankfully, another midwife overheard me, checked me, and hit the emergency alarm and then everyone swung into action from there, but I had a lot of guilt about my inability to make myself be listened when it was so serious and life threatening for me and DC, and that it was a chance intervention by someone else which was the reason why everything turned out OK, whereas I was just going to sit there quietly, like a good little girl not making a fuss, until the worst happened . Why did I do that? I was really angry at myself about that, and also at the midwife.

Affected, not effected! The shame

I don’t know how it effected me as a mother. I did develop PND, I think - I never had a firm diagnosis as I didn’t want to let anyone know. I concealed how desperate I was feeling from everyone, and quietly planned how I would end my life if it got worse, rationalising that it would be for the best as DH would be able to find another, better woman to be with and DS would not remember me and would think of this other woman as his mother. Thankfully it went away fairly quickly but it was a dark old time. I do remember being terrified that my stitches weren’t healing and that I’d have to be stitched again - the thought of going through that in cold blood was horrific. Happily my lovely (female, if it makes any difference) GP sorted things out and put my mind at rest, and I was ok. I could hardly speak down the phone to the receptionist to make the appointment, I was so terrified. But that might have happened anyway, there’s no way to know for sure.

In general it’s left me with a faint distrust of medical professionals. I know there are many good ones - my mum is a nurse! - but I don’t automatically assume they’re going to do what’s best for me, or listen to me. I would have done once. But I don’t have that level of trust any more.

When I had my first baby 20 years ago, I was in a side room waiting to be induced and a man came in with a load of other men. The main man asked the others if they knew what was "happening here".

There were a few guesses.

The man if they knew what the machine I was hooked up to was and what it was used for (foetal heart monitor).

The men stayed in the room for about 5 mins or so. No one even looked at me let alone spoke to me or introduced themselves.

Can someone link to the other thread?

I had an EMCS at 35 wks to save my baby's life.

I had a student midwife who stayed with me for the first part of the evening when my baby's heartbeat was being monitored for induction the following morning. She was lovely.

When it was decided around midnight that an emcs was necessary for the baby to survive, i felt very much surplus to requirements. Things were happening around me and no one really explained anything or even acknowledged that I was a person. The female surgeon mocked me for getting upset and asked "what on earth" I was crying for. The midwife replied, "I imagine she's scared for her baby". I was was really grateful for her response given I couldn't say anything. I'd already had an injection at that point and was feeling very out of it.

The kindest person was the male anaesthetist who stood at my head, stroking my hair and telling me how brave and strong I was being and that everything was going to be ok.

The overwhelming lack of empathy generally was astounding.

The idea that "people have been giving birth since the beginning of time" negates this predicament is bizarre. People have been dying in acute pain for thousands of years; you don't hear that as an excuse not to give a dying person pain relief today

Yes, I dont understand it either. It always seems to be womens pain that is disregarded as 'natural' and to be endured. Be it period pain, endo or childbirth and so on.

The interesting question I saw raised on the other thread was - it is one thing to insist all mws are female (or easily available if requested) or even all obgyns (or easily available if requested). But how does that work when extended to any other staff who may care for you during pregnancy and birth? Anaesthesiologists, sonographers, porters, HCAs - just for a straightforward case. All neonatal staff too?

And how do you think the role of your midwives or physicians or nurses (or the system) contributed to those feelings?

The attitude and approach of any birth attendant is absolutely central to the birthing experience. A shift change, and/or new personnel can instantly alter the dynamic and the atmosphere entirely. For better or worse.

It used to be the case, not sure if still true - that you could have a named mid-wife, who would stay with you throughout the entire labour and delivery ( certainly in home birth situations).

Black women are 5 times more likely to die in childbirth in the uk.

www.bbc.co.uk/programmes/m0006sg5

Listening to woman's hour right now; sorting it out for black women is definitely a priority.

Just horrendous to hear outcomes for UK black women are much worse than for white women.

Birthing rights are human rights. And women's rights.

We all have a right to bodily autonomy. To to informed consent.

That means that each woman chooses where and with whom she births. It means we trust women to analyse risk. It means we support women to feel safe to make decisions. It means we don't allow anyone to say that at a certain point in pregnancy/childbirth the woman ceases to be important.

Women are not always the best birth attendants, but any woman who chooses to be surrounded only by women should have that right guaranteed, unless there is an emergency situation. And even there, where possible prior permission should be sought so that the birthing woman knows who will be called in and what might happen if something goes not as planned.

Women need information. We need to be empowering everyone to understand what their bodies are doing, what is normal, when they should be concerned. Education matters.

And respect matters. Nothing makes it clearer that women are not considered human than the fact that during pregnancy/childbirth/postpartum we are so often treated like meat, spoken to disrespectfully, ignored. That so many who interact with women at this time can't be bothered introducing themselves or asking permission to do something, or explain what is going on is telling. It's woman hatred on a grand scale.

The fact that withholding care or painkillers is common should raise alarms for all feminists. The fact that so many tell the same stories and yet nothing changes should raise eyebrows.

And yet, talk with many women and they will either downplay the problem or start trying to justify which moment in the pregnancy they personally believe her to lose her autonomy because 'there are two patients/people'. This is a slippery slope and I believe we need to stop allowing this derail. Either we are human adults and have the right to make decisions about our bodies or we are not.

Crap, the formatting didn't work. So sorry for that essay with no line breaks!

I have been very fortunate to have two straight forward labours. They were very fast (2hrs, and 40 minutes start to finish) and I am very fortunate there were no complications, particularly with DD1.

The midwife for my first labour kept trying to send me home as my contractions weren't regular (and nor would they ever be). Despite the ward being very quiet, she didn't want to examine me, so I asked if I could stay and labour regardless. With my OH backing me up, she reluctantly agreed.

I insisted that I wanted the pool for pain relief, but she wouldn't examine me to check I was far enough along. DD was back to back so she said I would feel more pain, but that I wouldn't be 4cm yet. Eventually, she gave in and let me get in the pool. She spent the entire time doing paperwork in the corner and didn't acknowledge me.

About 15minutes after getting in, I told OH that my body was starting to push, which he relayed to her. She didn't act until he told her he could see DD's head. Suddenly, I found myself being man-handled and pulled by 2 midwives into a "more optimal position" (leaning back, rather than on all fours). It was MUCH more painful, but I was mid contraction and I couldn't fight them off or verbalise that they needed to stop. In this new position, it took another 3 pushes to get her out. I was panicking as I knew she should already have been born, and was getting no reassurance. I'm convinced it was the change in my position which delayed her. There was no shoulder dystocia.

In some ways, I am grateful this midwife was so useless, as it gave me a lot of confidence in my body, and I had DD2 at home with a lovely supportive hands-off midwife who made the birth so so much better. She was very switched on and was quick to notice when things had ramped up, despite irregular contractions, a fast labour, and no vocalising from me.

However, I am now expecting twins and I'm incredibly anxious about the birth. I realise I have developed a distrust of medical intervention during birth - something which will be much more difficult to avoid with a twin labour. There are all sorts of interventions seen as standard and it is making me VERY worried to consent to any of them. I think this is as a result of the intervention I had in my first labour, which made things more difficult for me. I have talked it through with my twins midwife, but I still feel (irrationally) completely distrustful of anything other than being left to my own devices.

I know many women have suffered far more than me. Some of the stories on here are just awful. But I feel it's important to share that even easy straight forward labours can have a lasting affect on your mental state for future births, if care is poor.

I felt the misogyny was primarily located in the availability of pain relief.

It is frankly bonkers that induced women who ask for an epidural find themselves at the mercy of whether an anaesthetist is available or not.

The idea that "people have been giving birth since the beginning of time" negates this predicament is bizarre. People have been dying in acute pain for thousands of years; you don't hear that as an excuse not to give a dying person pain relief today.

And there's no other reason for it apart from the old legacy of the sins of Eve.