A Different “Right to Choose”: America’s Cultural Denial of True Choice in Childbirth By Stacia Guzzo

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.

Categories: Childbirth, Motherhood

Tags: , , ,

7 replies

  1. This is so important. Birthing power is female power and sacred power except when it is taken from us. Sounds like doctors and insurance companies have done a good job of silencing the women’s health movement that was part of the second wave of the feminist movement. It is sad to think that all these battles need to be fought again and this time the forces lined up against us are even more powerful. When the moment of birth is sacred, when fathers are present, when undrugged parents are allowed to bond immediately with an undrugged baby, there is potential to change the way we all relate to each other, a small step to changing the world.


    • Carol, you are right in your statement about the backlash against the women’s health movement that came with the second wave of feminism. Birth is now so medically managed in the mainstream culture that one out of three births ends in a c-section–it’s almost hard to imagine that figure in its reality. And sadly, many women just assume that childbirth will be a terrible experience and assume they will need drugs to manage it before they even get pregnant. Most women that find out I had a natural childbirth tell me that they never could have done the same–and I always respond, “Of course you could have!” For normal, low-risk pregnancies, medication isn’t needed (wanted, perhaps, but rarely needed)…and I wish I could give insight to women beforehand of how empowering the experience can be when you cross that threshold and conquer it through will and prayer and sweat.
      Pioneers in the birthworking field such as Ina May Gaskin have worked hard to emphasize to a new generation that birth is normal; however for several generations now the definition of “normal” has become somewhat blurred. There are so many studies that show how Pitocin can’t do all of the jobs that natural oxytocin does, including setting off some key chemical reactions that strengthen bonding after the birth. That is not to say that it is impossible to bond with a baby after a medicated birth, but I think it is more difficult for both the mother and the child when compared to the alternative.


  2. I wish that more women saw the connection between the sacredness of women’s body and our divine power and the birth process. It seems like even some of the most religious women I know don’t ever put the two together. We have been so trained that birth is scary and dangerous that sometimes we ONLY view it as a medical event and never see the religious and spiritual aspects of it. So thank you for your post. I hope that more women will start to see things differently, because birth DOES matter so much!


    • Thank you for this reply! I agree wholeheartedly. The Spirit is so present in birth–it truly is a co-creative process. It’s so sad to me that, as you say, we have been told as a society that birth is a frightening and painful experience. Speaking for myself, I can say that although I experienced some of my darkest moments at the peak of my labor, I also experienced some of the deepest reliance on God that I have ever felt. And perhaps that is where my feeling of empowerment comes from–that “my” strength had to come from a place completely outside of myself, and I had to surrender to it. It almost feels like an understatement to simply call it “a spiritual experience.”


  3. Beautifully written and I agree to a point. I had a medicated labor and was fully educated and aware of all of my options. I took LaMaze classes, read too many books, and wrote a birth plan. My hospital experience was wonderful and I appreciated my OB who gave me medical advice my whole pregnancy and took wonderful care of me prenatal, during labor, and postnatal. I often feel, as a woman who chose a medical birth in a hospital, that I am looked down upon by people who choose natural childbirth. Having an IV of antibiotics and a monitor on me part of the time did not take away from the sacredness and beauty of this moment. When it was done, I was free to walk and move as I pleased, until, when I became uncomfortable, I chose an epidural. It does not mean I am not strong, and it does not mean I love my baby less. And to Carol, I guess I wasn’t an “undrugged parent” because of the epidural, but that did not lessen my immediate bond to my daughter. I enjoyed my labor, focusing on her and not on the pain. We all do need to make our own decisions for ourselves, but for those of us who choose a hospital and doctor to care for us, we are not missing out on the sacredness of the experience. Childbirth is beautiful!


    • Lisa, this is a very important perspective to bring to the table. When writing this blog post, I wanted very much to make sure that no woman felt that I was discrediting her birth experience. Yes, I am a strong proponent of natural childbirth; however, a medicated birth doesn’t take away from the beauty and sacredness of the threshold of childbirth. My point in writing the post was to say that many women go into childbirth with very minimal (and, frankly, a narrow-viewed) education about childbirth. Unfortunately some of the most popular pregnancy books on the shelves in mainstream bookstores have some of the most biased information out there against natural methods of pain management during labor. I personally do not look down on any woman who has looked at all of her options and made an informed decision, but I am also of the opinion that a true education will include researching the statistics on the possible effects of various drugs, researching natural pain relief methods and trying them before medication (you mentioned LaMaze–I will also mention the Bradley method, Brio Birth, Birthing From Within, and Hypnobirthing as other methods; hot water in a shower or tub; rebozo techniques; labor balls; birthing bars; homeopathy, and many others), and interviewing birth attendants to help serve as advocates within a intervention-inclined medical system.
      The reason I feel so strongly about this is because I had a birth that brought me to the brink of despair–and to be bluntly honest, if I had been in a hospital, I very likely might have asked for medication. But I came out of that experience knowing that I was far, far stronger than I thought I was. I don’t think that women who ask for epidurals are weak–but I do think that the majority of them (majority being the operative word) do not give themselves enough credit for the strength they innately possess. There are so many things that I have felt empowered to conquer since birthing my son, and many of these things have nothing to do with birth. This includes healing old wounds, forgiveness, following a different career path, and continuing to breastfeed through a blindingly painful situation until the problem was fixed. After my birth, I felt like I walked hand in hand with God through fire, and we came out on the other side able to do anything together. I wasn’t one of those women who had an easy labor. Some have said I am foolish for not wanting to be medicated throughout it. But in retrospect, I feel very grateful to have made the decision I did.
      As I said in the blog, each woman needs to make the decision about what is best for her and her family. It is a highly personal decision. And childbirth in any context, medicated or not, is beautiful and has the potential to be empowering. But in my opinion, far to many women underestimate their strength–and because of that, they rule out their options before they even know that they are available.


  4. I am so happy to see that more and more families are choosing to raise their children naturally. As adults we need to be setting the example for what is a healthy lifestyle so if our children see us doing it they will pick it up. It feels good to know my child will have the best life she can because of my families choices:) Also by following the idea of attached parenting my daughter is happier and easier to calm when upset. She is never not with me.


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