The first time I became aware about my birthing choices was during a call to a local midwife to inquire about her practice. By this time, I had been diagnosed with PolyCystic Ovarian Syndrome, uterine fibroids, a possible uterine septum, and had experienced a miscarriage two months before becoming pregnant with my son. On spiritual and psychological levels I didn’t trust my body, and certainly wasn’t experiencing the empowerment and holy wonder that I expected pregnancy to bring. Instead of feeling the strength of my ability to bear life, I felt the frailty of the threshold between life and death, and struggled with my body’s role in that space. I acutely felt my body’s assumed “brokenness.” I couldn’t access my inherent dignity, nor could I grasp the “hope [that] does not disappoint” (Romans 5:5). I was willing to let anyone tell me what I needed to do because I felt I couldn’t trust myself. I just wanted to be able to bring my baby to term and to have a healthy son.
During this time I didn’t even consider how the pregnancy or labor would affect me—emotionally, physically, psychologically, or spiritually. Yet my discussion with that midwife made me realize how deeply the experience of pregnancy was shaping me. The space God was carving out within me was incredibly powerful, and the closer I got to birthing my son, the more I realized how spiritually and psychologically charged the birth experience could be. It was laden with the potential for either transformative beauty or despair.
I have since had many conversations with women who have given birth under many circumstances, from the most medically-managed hospital birth to birthing in their own bedroom. Many pregnant women have confided that they allowed cultural and medical pressures during pregnancy to color their decisions about their birth options. In short, women are routinely denied choices without even knowing it. They are coerced by fear—fear of their own bodies, fear of their own abilities, and fear for their babies—into having unnecessary surgery or enduring painful monitoring procedures during labor simply because they didn’t know they could say, “No. That is not what I want.” These experiences can leave lasting physical, emotional, and spiritual scars—and is a denial of both the woman’s and the baby’s Creator-endowed dignity.
Disturbingly, women frequently have their membranes “swept” (a procedure in which the care provider “sweeps” his/her finger around the cervix in order to try to detach the membranes around the baby from the cervix) close to their due dates, only to be told after the fact that their care provider was making the decision to jump start their labor. Others are pressured into a consenting without adequate knowledge of the procedure. Often women over the 40-week mark are pressured into premature inductions even though a baby isn’t technically “overdue” until the 42-week mark. One study showed that 81% of women are given Pitocin (a drug that is administered to speed up labor) at some point during their labor experience.
But those aren’t the only interventions that are often culturally accepted as part of the “normal” birth experience. Routine IVs, antibiotics, electronic fetal monitors tethered to women’s bellies, epidural catheters, Foley catheters in the urinary tract, intrauterine pressure catheters, blood pressure cuffs, and pulse/oxygen monitors are often just routine procedures in hospital labor and delivery rooms. On the surface, these interventions may seem benign, precautionary, and even helpful. Yet they cause laboring women to be denied the ability to move around during contractions, or even to eat and drink. Furthermore, the risks associated with each intervention are rarely discussed with the woman or are brushed off as “minimal.” And many women have no idea of the ripple effects of these very common labor interventions. All they know is that they are the cultural norm—even if they are far from truly normal.
Of the 32% of women who received a cesarean last year, I wonder how many of them were aware that a woman who has a c-section is four times more likely to die than a woman giving birth vaginally[i]? And how many laboring women who were reassured by the numerous monitors and drugs knew that, of the 33 industrialized countries that the World Health Organization studied, the US ranked 32nd in infant mortality[ii] and 30th in maternal mortality[iii]? There is obvious injustice associated with these numbers, and yet American women are daily pressured into relinquishing their choices regarding their birth experience.
Unfortunately, it gets even more unsettling: the highest percentage of c-sections are performed around 4pm and 10pm—right before the dinner hour and right before a surgeon might leave for the night.[iv] Furthermore, one study showed that most babies are born on Tuesdays[v]; not surprising considering that many inductions are scheduled for Mondays. While these numbers may seem benign, they actually point to a manipulation of pregnant women, a disregard for the empowering experience of spontaneous labor and birth, and an attitude that discounts whether or not the baby is actually ready to come when an elective induction is planned.
God’s creative wisdom is pushed aside in the name of convenience.
A low-risk, normally progressing pregnancy needs little more for birth than a woman’s belief in herself and a knowledgeable birth team. Yet our culture—intertwined with the politics and money of our modern medical system—tells us otherwise.
Women can be either greatly empowered or deeply scarred by their birth experiences. The early bond between mother and child can be enhanced or threatened by those experiences. The chance of post-partum depression can increase or decrease dramatically from those experiences. And yes, the pockets of insurance companies, pharmaceutical companies, and hospitals can be filled or emptied as a result of how women choose to birth.
The problem, as I see it, is that women don’t realize they have a choice in the first place. Some women who are pressured into c-sections or an IV of Pitocin for “failure to progress” walk away from the experience feeling disappointed that their bodies somehow failed. Women are shuffled through the maternity ward like part of an assembly line without proper reverence for their sacred experience, denying them an empowering opportunity that may never come again in their lives. There are so many resources available to help women through this experience: the support of doulas, childbirth education that teaches the midwifery principle of informed consent, assistance in writing birth plans, an environment conducive to birth (low lighting, soft voices, ability to eat, drink, and move), birth balls, birthing tubs, labor bars, and many other empowering methods of naturally-based assistance.
Every woman needs to make her own decision about what is right for her and for her family. I certainly recognize the importance of cesareans and other interventions when medically necessary, and honor the surgical skill of an obstetrician during an emergency. But for many women, entering a hospital without being educated about her birth choices usually means a woman is handing over the ability to make informed decisions about what is right for her body and her baby, and leaves her vulnerable to emotional blackmail.
There is a real tragedy to the assumption that we don’t know how to birth anymore, and that we feel our bodies are too fragile or confused to be able to handle it on their own. God gave us the power to do amazing things with our bodies when we trust the process. We have both a responsibility and a right to be educated about our birth options, and then we must have the courage to embrace those choices.
[i] Jennifer Block, Pushed: The Painful Truth About Childbirth and Modern Maternity Care (Philadelphia, PA: First Da Capo Press, 2007), xxv.
[ii] World Health Organization, The World Health Report 2005. Geneva, 2005.
[iii] C. Abou Zahr, Maternal Mortality in 2000: Estimates Developed by WHO, UNICEF, and UNFPA (Geneva: World Health Organization) 2004.
[iv] Abby Epstein and Ricki Lake, 2008. The Business of Being Born. New York: New York, Barranca Productions.
[v] Block, Pushed, 3.