GET ME OUT

I had one of those ahah! moments when I was reading a quote in the book I’m just finishing up that really feels like it aligns with my understanding of the issue, it goes something like this:

“How you view childbirth is a reflection of your philosophy of life. One of the things I feel really sad about is our culture where the message is that women’s can’t have a good childbirth experience without turning themselves over to the control and interventions of the medical community. Starting parenthood with the notion that somebody else has to manage the process is not empowering [...] I’m not opposed to C-sections, but I’m pretty sure a 30 to 40 percent rate is not justified.”
– Marcie K. Richardson (Obstetrician and Instructor)



This book by Randi Hutter Epstein (MD, Journalist) has been a nice, easy to understand retrospect about maternal health through the ages and the horrors that have been inflicted on women, driven by money, power and even in the name of science.

In an effort to reclaim their power, some women have seemed to fall into two desperately different categories of childbirth, on one side they want the right to every possible intervention available or on the other side they want to deny themselves any intervention even as far as assistance. Both these types of women are left to feel guilty for the choices they’ve made. Of course, it’s not so clearly black and white. The context, in which a tremendous amount of conflicting information floods the media all the time, only piles on the issue. So when did women lose informed consent, or more appropriately why did women never have informed consent on the issue of childbirth? Why is it that women must select between an obstetrician and a midwife, and still find herself sandwiched amidst their power struggles? Why can’t she have the best of both worlds? Does she not know her body best?

In my short clinical experience, women were classified on admission in one of three categories: routine, high risk pending c-section, and high risk planned c-section. None of these categories allow much of any decisions to be made – beyond an extra blanket and perhaps some ice chips – by the soon-to-be new mom, new family. Those who had a midwife in hospital were not “admitted” and had an even more ambiguous stay, as the midwife attempted to stake out territory in an unwelcoming environment. Even family doctors are not encouraged to birth their own patients, and are given no incentives to do so, for they are not paid for it unless they have privileges at the hospital. Of course, I have little to say about those who gave birth at home, but they may be the lucky few.

The situation puts me to shame and I question my role as a nurse in this mess.