In 1993 a lady called Margaret Jowitt wrote in her book ‘…with very few exceptions, technology has no place in childbirth’ .
For thousands of years women have been birthing babies without the necessity to have lots of technology or consultant hospitals. Not all babies survived and not all women did either but enough to perpetuate the human race to populate the entire world. In a recent bulletin from the WHO (2010) it was found that in China there was a direct correlation between increased institutionalised birth settings and an increase in caesarean birth to levels well above their recommended rates. The World Health Organisation went on to say that institutionalised birth was not the only factor in the increase but that also the medicalisation of antenatal care contributed.
Moving childbirth into the medical field disempowers women. The medicalisation of childbirth changed childbirth by moving it from women supporting women to a more clinical, medicalised and scientific approach. It moved childbirth into the realms of a hospital system with a greater reliance on experts in the scientific field with their complex words and scientific language. This has created a barrier to women being a part of the process, encouraging them to be a passive recipient of treatment. The reduction in physiological birth has created a whole generation who have no experience of childbirth without medical and scientific input. The medicalisation of a normal physiological event in a woman’s life is becoming more and more intense. It starts from the moment you have that first booking appointment where rather than being made to feel excited about this wonderful event in your life you find yourself being asked a barrage of questions in an attempt for the health care professionals to see what ‘interventions’ they are going to suggest to you. It is hard to counter all this when you are left feeling vulnerable.
I often hear women say that they have been told they must have, for example, an induction for a spurious reason. The women then feel that the only way to counter or challenge this is to go out and seek evidence to support their stance to present to the health care professional. This angers me greatly – it is the health care professional who seeks to intervene in a normal physiological event. They therefore need to go out and find the evidence to back up their desire to intervene before they make the comment or statement. They should then allow the women time to discuss this, digest this and then make their own decisions without coercion. Frequently I try to explain this to women and have devised an analogy to help with this:
‘Pregnancy and birth is a normal physiological event in your life just like eating is. Using the hospital/midwifery service is like choosing how to eat. You can choose if you go to a restaurant or to eat at home; you go in and you choose from the menu what you want to have; and you choose how much to eat etc; and you choose when to leave – the restaurant have no business to force you to go there; to force you to eat or to force upon you what you choose to eat; or force you to stay. The waiter/waitress will offer you choices, take your order, serve you the food, clear away afterwards. They are there to serve you, not to serve themselves.
The same goes for the maternity service. You can choose to go in to the hospital or to stay at home. The services offered are similar to a menu – they can offer what they recommend but it is ultimately up to you whether you have that or something else or nothing at all!! And you can ask as many questions as you like about what they are offering before deciding. The menu contains everything from whether you have an appointment with a midwife or a consultant, whether you have a blood test or a scan, whether you have any drugs, whether you use a pool or a bed or both or neither, whether you are induced or not etc etc. You can pick and choose off that menu or decide to have nothing at all. The health care professionals are the waiters/waitresses. Through your taxes you pay them to offer you choices, take your order, serve up your choices (with a smile), clear away afterwards. They are there to serve you not to serve themselves.
You wouldn’t stand for a waiter/waitress being rude or not listening or bringing you some thing other than what you ordered. You wouldn’t stand for them keeping you waiting or not providing the service that you are paying for – don’t stand for it from the health care professionals either. It is Your Body, Your Pregnancy, Your Birth, Your Baby, Your Choice!