Maternity care

[lucyintheskywithdinos]

My first thread here, been lurking for ages though.

I have been thinking about the way the medical professions treat women, particularly in regard to pregnancy and birth. This was sparked by one woman's comment at the natural birth support group I help out at. Her exact words were that she felt 'as though I wasn't human, I was thinking for God's sake, will someone just explain what you're doing down there'. While she was thinking this 'they' had actually performed an episiostomy with her husband's consent and delivered her baby by forceps.

I have expereinced a similar thing myself, DD1 was rushed away for recussitation my DP went with her, noone thought to tell me what was going on. I thought she'd died.

It seems to be quite a common thing amongst women I've supported (I'm a BFC), is it common in general? As a newbie feminist is it a feminist issue? And what can be done about it within hospitals?

I think you're right and it certainly is a feminist issue. Look at how many women on here ask for support with birth options because 'they' have told them that they are only 'allowed' to do certain things. I usually post reminding the woman that 'they' won't be delivering her baby at all if she doesn't turn up - that interventions can be questioned and should be consented to. It's not the processes itself that I object to - sometimes they are very necessary - but nobody should be told they have to do something.

lucyintheskywithdinos - yeah for coming out of lurkdom!

I definitely think it is a feminist issue.

Some posters mentioned these on the intro thread and I was hoping that someone would start a maternity/birth thread.

Here are some of the comments which were made on that thread:

tortoiseonthehalfshell said:

"I'm really passionate about the whole medicalisation of birth/disempowerment of women thing, which is currently playing out in Australian policy as a classic power struggle between male obstretricians and female homebirth midwives (home birth is incredibly rare here, about 0.5% of people do it)."

StarlightMcKenzie said:

"VERY broadly, my feminist views are about how woman's work has been so devalued that she has to apologise for it and often feels judged about any attempt to 'not be in control'. She has to demonstrate this control to feel valued and to feel a 'good parent'. There is no allowance made for a woman who will alow herself to be led by her child, as this implies weakness.

"I think there is a similar argument wrt childbirth. A woman cannot 'let go' and free-fall because if 'she' doesn't control it whe feels stupid, humiliated etc. but even worse, when giving up 'control' in this way, it leaves room for other people to take it, as she would be judged and critised for not having a child with a set routine perhaps."

QueenofDreams said "It would be interesting to see some discussion of the politics of childbirth in a feminist context. The way women are treated in America is shocking beyond belief. I just get the impression they're almost treated as non-human while they're in labour!"

I think it's very widespread.

I didn't consent to my episiotomy or forceps either.

I don't think was asked to either though.

One of the reasons I had an ELCS second time round was because I felt that if someone was going to butcher me again I wanted it to be done in the way of my choosing and with my explicit consent.

Oh, and similar to avril's experience - when I was being stitched up after my forceps delivery without any anaesthetic the SHO was chatting away to her colleagues about what she was doing "this part is the lower vagina, we'll put this back together first"

Complete lack of compassion about the fact that I'd rather not hear how my genitals had been completely obliterated. One of the people watching her had to say "excuse me but your patient is screaming in pain" because she was totally oblivious to me.

I have been perved at by plenty of men in my time but no other experience on earth made me feel as dehumanised as that.

Jesus christ. I'm so sorry to hear what you have been through. Should I ever have children, I will have to say that I don't want anyone touching me without permission and telling me what is going on! How mad is that? I thought it was obvious!

My personal issue with giving birth to DS 2.11 is that the midwife did not read my birthplan and DH did not try to implement it.

If I could do it again I would have a doula.

TBH I tried to have a go at writing my birth story and I couldn't - and it really really is not at all bad. There is a service run called "Birth Afterthoughts" where you can discuss through your notes. I think they have this at lots of hospitals. Maybe I should to it to get some closure?

I've had a look in my reclaiming the F-word book to see what's said about birth:

A few years ago, Naomi Wolf's book Misconceptions revealed the negative impact of contemporary birth practices on women. Childbirth, she argued, isn't seen as a natural event in a woman's life, but instead as pathalogical. The medicalisation of childbirth has had innumerable benefits, saving thousands of women eaach year from dying ehile giving birth. But once doctors took over, they had to run the show. Clock watching began, with birth speeded up interventions which many argue are unecessary."

The OP said "what can be done about it"?

One thing is for us to complain about any problems we had wrt to giving birth.

(I must say that I haven't done this )

Some useful links:

www.birthtraumaassociation.org.uk/

• see their links page also

www.sheilakitzinger.com/

All PCTs should have a Maternity Liaison Services Committe - I would like to volunteer for my local one when I've got more time.

www.chimat.org.uk/mslc

Avril do you know whether your complaint was looked at by the MLSC? I'm interested in whether they are operating effectively.

The only reason I'd heard of them was because I found a link from the birth trauma website.

IMO what happens to a lot of women in childbirth in this country is worse than rape.

Definitely some maternity care is abusive.
I was lucky in that mine wasn't.
One of the problems is that it isn't a simple male-female, dr-midwife split. Plenty of female staff do things which IMO are abusive to labouring women.

Recently someone asked me for my advice - she's going to have her first baby - and I really struggled to be able to say 'arm yourself to the hilt and prepare your dh to speak up for you, because the risk of mistreatment is not negligible'. But I hesitated because I didn't want to frighten her.

was mostly satisfied with delivery, postnatal aftercare was a bit grim - in one respect probably negligent, and in other respects I felt treated like a naughty schoolgirl, and unsupported with bladder problems and to some extent with a sleepy jaundiced baby. all the poor treatment was by female hcp.

It's horrific that incidents such as these are still happening.

Have any of you read 'Our Bodies Ourselves' - originally published in the 70s in the US but updated since then. As well as generally being a really useful book it's got a really really good, really forthright section about medicalisation of birth and women's rights re this. Quite depressing to hear that the picture hasn't changed much since the 70s.

I haven't had any children yet but I think actually that, whilst being informed that you may need to arm yourself up is daunting, it's also really really useful advice. At least knowing that you may need to be really clear and forthright (or get someone to be clear on your behalf) about which medical treatment you will and won't consent to.

It all seems part of a wider issue to me to do with medical detachment which means they end up viewing patients as specimens rather than actual people with feelings

BrightLight- glad you brought this subject up. In many ways I think routinely bringing men into the birth process has led to disempowerment, even though it's seen as "a step forward" from when I was born (75) when far fewer fathers attended the birth. In a way, I think maybe women should "reclaim" birth for themselves as a sort of rite of passage.

I think many men struggle with seeing their partners in pain and therefore maybe encourage them to take steps to make labour more comfortable/ speed things up - have already told DH that if he can't deal with it then to go and sit in the corridor! I think women are better at dealing with pain in another woman and supporting them through it.

my birth partner was a woman

I think it is also linked in to the social class issue from another thread - as often with medical matters. Both because women with money are more able to access support to assert their rights (doulas, independent midwives), and because women who are able to use the 'right' language (ie that of the doctors they are interacting with) are more likely to be listened to.

There are quite a few good books on this subject.
Misconceptions is thoroughly depressing, in fact it made me weep. It would be a more important book if it were less personal. Naomi Wolf's agenda seems to me to be to prove that misogynistic maternity care is unavoidable, and she finishes by going for more of the same. Yet she interviews one of the most prominent and brilliant non-mainstream maternity care providers....there are other options, and at the time of her second birth there was an excellent clinic in the city she lives in providing fantastic care. I couldn't figure that out.

Birth: A History by Tina Cassidy is good. However it suffers too from being a personal journey to find out why her C-section was almost inevitable.

If anyone is really interested in how male drs got their hands on the childbirth industry here, read Safer Childbirth? By Marjorie Tew. It's fascinating. She was a statistician who set a problem for her students: show using statistics that better medical care has equalled lower maternal and neonatal death rates. They couldn't. She takes no prisoners. And it's British, so far more relevant than the other two.

it really scares e that htey would take my husband's consent over my own :(

Thanks for the Marjorie Tew link, Prune, that sounds really interesting, will track it down.

My sociology dissertation was on the medicalisation of women's bodies, based largely on kitzinger as I adored her work. Looking back though I wish I could re write those 10,000 words with the addition of what I know now as a mother rather than a rather naive 20year old rushing through a load of books.

Because brightlight, it is much cheaper if we put up & shut up.

Sex ed/free contraception we get because it saves the State money.

Brightlight- I sort of agree, but women have to take responsibility for educating themselves. I knew absolutely jack all about childbirth before I got pregnant (apart from the basics obviously)but now I feel able to have a balanced and educated discussion with my Obs ahead of time. You can get all these books from the library and there is a lot of information online.