When discussing the politics of reproductive rights, many of us focus on abortion access and care (which is essential, of course), and forget about the other side of the coin — that birth and birth choices are also a feminist issue; and many women* are being kept in the dark, unaware of and denied their options.
The spectrum of reproductive choice doesn’t end once a person decides to continue with a pregnancy — choosing to be pregnant is only a small piece of the reproductive choice puzzle. For many, birth choices are veiled by the idea that birth is a dangerous thing that needs to be controlled in a hospital, highly medicated, and under constant observation and instruction. What’s left is a culture that distrusts womens’ physiological ability to birth their babies; a culture that believes that women and their bodies are too incompetent to make their own decisions about birth. And let’s be real — some of us are starting to believe it.
Let’s not pretend that this view doesn’t have it’s roots in good ol’ misogyny. The unnecessary medicalization of birth is just another way that the powers that be (read: powerful men) have taken it upon themselves to once again lay claim to our bodies. We’re told that we’re incapable of making our own choices about contraception, sex, abortion, and childbirth, and if we’re not trusted enough to make decisions about our own bodies and physiological processes, how could we possibly be trusted enough to go into the world and lead countries, start successful businesses, or be seen as equals in a professional setting? But that’s exactly the point.
The truth is that these misogynistic undertones work to belittle our strength and capability, and frame us as damsels who are constantly in need of a good rescuing. They believe that — often without giving us the chance to do it our own way — that they must take charge of our experience or else we will fail (and in doing so kill our babies, kill ourselves, or do whatever other horrible thing they can threaten us with that goes against actual medical research). Being poked and prodded and examined without being fully informed of the alternative options or being given a second opinion sends a clear, patronizing message to people giving birth — silly girl, you don’t know what you’re doing, leave this to the experts!
We’ve been conditioned to believe that we are unable to do it on our own. That the pain will be unbearable, that our babies are just too big for a vaginal birth, that if we’re not given induced at 39 weeks that baby will stay in there forever. The injustice comes when people are not given the appropriate information to make informed choices about their care — whether it be that induction can double the liklihood of cesarean, or that lying on your back is, physiologically, one of the worst positions for birth. Don’t get me wrong: having access to medical intervention is an absolutely essential piece of the puzzle that keeps people safe and maternal mortality and morbidity rates down. But studies also show that in healthy pregnancies, the outcomes for women who have planned home births with midwifes are as good if not better than those with planned hospital births (whether attended by a midwife or physician). This information is often kept from women, with home birth still being looked at as the dangerous “fringe” choice rather than a safe and valid one. Thankfully, the Ontario Health Insurance Plan (OHIP) covers the cost of midwifery care and the Ontario government is taking steps to offer more choices to women; the introduction of birth centers is a perfect way to bridge the gap between home and hospital birth.
As a doula, I view birth as a physiological process that women are absolutely capable of experiencing on their own without intervention the vast majority of the time. I also realize that some people don’t want to have a natural birth at home in the bathtub with a midwife by candlelight. Some people want epidurals or to be able to plan the day of their baby’s birth, and that’s okay too! The key here is that there needs to be a dialogue between the mother and her care provider, rather than a pre-laid medicalized plan that dehumanizes the mother and turns normal birth into a sterile, medicalized event. My job is to respect the choices of pregnant women without judgement — regardless of whether or not they are ones I would make for myself. What’s important is not whether or not women are making “right” or “wrong” choices (according to whom, I don’t know), but rather whether or not they’re making fully informed choices that work in a way that’s best for them — and that when all is said and done, they can look back on their birth experience with joy rather than with regret, able to take full responsibility for their own decisions throughout the process (and therefore able to bask in their success!).
We need to take birth back and make it a priority in our communities. As important as the issues of access to contraceptives, abortion, and well-women care are — it’s also essential that we’re given the chance to birth in a way that is empowering, rather than disenfranchising. And the only way to make birth a universally positive experience is to give the reins back to the people who are birthing and respect the choices they make in regards to their birth experience. Whether that means a drug-free home birth, an epidural, or a scheduled c-section — we need to respect that people truly do know what is the best route for themselves. Afterall, the best way for a person to birth is however they feel the safest.
From a feminist perspective, it’s all about taking the power back. We are powerful and smart and amazing enough to make these choices for ourselves. We can rely on the help and expertise of doctors, midwives, and doulas to walk with us through our journeys in birth — but it’s essential that we’re put at the forefront of the decision making process. The power of birth is systematically being taken away from us by a culture that believes that our bodies and minds are fundamentally flawed to the point where birth is no longer a natural process, but rather a medical one —and that absolutely makes birth a feminist issue. Our babies and ourselves deserve so much better.
* While not all people who can get pregnant or give birth are women, all of my experience and research about pregnancy and birth has been focused on the experiences of women. Because there is so little information out there about trans*/genderqueer/agender people who choose to give birth, I feel uncomfortable talking about their experiences with any type of authority. I’m hoping to one day become more familiar with the birthing/pregnancy experiences of non-women, but until then my writing will be focused mainly on the experiences of cis women, though I will try to use gender neutral language as much as possible.