Thursday, July 18, 2013

How to get there from here?

I want to live in a world where women are empowered to make medical decisions for themselves and can be assured of timely access to medical care to facilitate those decisions. I want to live in a world where access to epidurals and maternal request cesarean is not a matter of luck. I want to live in a world, where no woman chooses to give birth at home because she thinks her right to make medical decisions will be violated in the hospital. I want to live in a world where being psychologically scarred from the experience of birth is better understood and a far rarer event. I want to live in a world, where the information provided on birth is balanced and reflects current evidence. I want to live in a world where women do not feel the need to justify having had a cesarean or having chosen to formula feed. I want to live in a world where there is a lot less focus on the things that do not really matter (mode of birth, type of feeding), a lot more focus on the things that do matter (physical and psychological well being), and a whole lot less mommy guilt.

I want to live in a world where the voices of moms like me are not drowned out by voices of advocates of natural birth or home birth. I want to live in a world where maternal request cesarean is as understood and as researched as home birth. I want to live in a world of truly informed choice - where women are not "sold" on what they should do, but rather are given the information they need on the choices available to them and are free to make the decisions that best meet their needs and those of their family.

The reality is, that the world as it exists now - is still distant from the world as I wish it were. That's the challenge - getting there from here. Improving pre-natal education and the information available to pregnant women. Improving access to reasonable choices. Improving the hospital environment. Improving the legal context. Improving access to resources for those who have been through a traumatic birth or for those who are grappling with difficult pregnancies. Improving the knowledge base through research. Giving voice to the women who have no desire to buy into the ideology of Natural Childbirth. It seems as though there is still a lot of work to be done.

So how can we get the work that needs to be done, underway? What is the next logical step?

This side of the spectrum has no Lamaze. This side of the spectrum has no Childbirth Connection. This side of the spectrum has no mothering.com. This side of the spectrum has no International Cesarean Awareness Network. This side of the spectrum has no National Childbirth Trust. This side of the spectrum has no Power to Push Campaign. This side of the spectrum has no Business of Being Born. In short - this side of the spectrum has no large organization that is advocating for the interests of it's members and undertaking the work that needs to be done to improve maternity care for women who want to avail themselves of the advantages that modern medical technology can provide to make birth less painful and safer for themselves and their children.

That's not to say that this side of the spectrum is completely bereft of resources and advocates. This side of the spectrum includes Birth Trauma Canada. This side of the spectrum includes the Fearless Formula Feeder, Suzanne Barston. This side of the spectrum includes The Adequate Mother, a Canadian Anesthesiologist. This side of the spectrum has published a very well researched book by Dr. Magnus Murphy and Pauline MacDonagh-Hull "Choosing Cesarean: A natural birth plan". This side of the spectrum also includes Cesarean Debate. This side of the spectrum includes Dr. Amy Tutuer, the Skeptical OB. This side of the spectrum includes the facebook group the "Cesarean by Choice Awareness Network". This side of the spectrum includes me. This side of the spectrum has tremendously educated women who are working as best they can to facilitate change - to improve maternity care for mothers and their families. However, it remains under-organized and as a result is not meeting the potential to make maternity better for a large number of women. It needs to be better organized and better resourced in order to facilitate the work that needs to be done - there is a large mandate that is waiting to be met.

So how do we become better organized and better resourced? How do we catapult ourselves to compete with the well organized and well resourced Natural Childbirth industry? How do we harness what is a group of intelligent and motivated women and interested others to make change happen?

Those are the questions I am trying to grapple with. There must be answers. There is a will, there must be a way.

2 comments:

  1. Thank you so much for posting this; it's an excellent commentary on the huge efforts being made by so many to ensure that ALL women's voices are heard, and that the FULL spectrum of birth choices is respected.

    Even more importantly, our work is about saving lives, and quality of lives, both of mothers and babies. It's about ensuring that "informed choice" means providing women with the truth about different birth plan risks and benefits - without ideological bias - and accepting that different women will have a different perspective (and tolerance) of each risk, and place a different value on the each benefit.

    It's not overall caesarean rates or 'normal birth' rates that matter in the end; it's the physical and psychological health outcomes of mothers and their babies that matter most.

    Pauline Hull, Co-author of Choosing Cesarean, A Natural Birth Plan

    ReplyDelete
  2. How, indeed? More women in positions of power and celebrity need to speak out and affirm that all birth choices are valid. I wonder if our Surgeon General has spoken out on childbirth issues.

    I'm especially worried about the availability of pain control in labour. That is the real 'human rights' issue!

    ReplyDelete