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Posts Tagged ‘Canada’

Choice

Birth – like Life — is full of choices!

I am all for choice and accessibility to good drugs, but it seems strange to me that “natural childbirth” is considered a radical movement by so many people. People wonder if they “can do it” without the epidural, as if unmedicated birth is the “alternative” only for special unicorns, the epidural being the expectation and default. There are absolutely people who need an epidural for a safe and/or trauma reducing birth, so thank goodness we have them. I think it would be terrible to not have access to them.

What concerns me is the language we tend to use around epidurals chosen in normal birth, phrases like “I couldn’t have given birth without one,” Most often epidural use is about the privilege of choice and accessibility when the level of sensation or tiredness involved with birth is not desired . That isn’t a bad thing. But It isn’t literally that we couldn’t “do it” (barring special circumstances, remember), because if accessibility were removed, most folks WOULD “just do it”.

A truer statement for many people is “I didn’t WANT to do it without the epidural when I felt how tough the pain was to work through.” And that is okay! We don’t need to apologize for our choices in birth. Ever. People are awesome birth givers with or without epidural. But it is powerful to own a choice rather than relegate our reason for pain relief to an assumed organic failure of our collective birth giving body/mind.

My concern is that “I couldn’t do it” feeds the cultural norm of birth being generally undo-able, a legacy passed down to the next generations of physiologic birth “impossibility”. It is powerful to say “Given the epidural’s accessibility, I chose not to ‘do it’ because I preferred the idea of reduced pain” There is nothing shameful about exercising that choice. The power to own choice seems to be a stronger legacy to leave than a belief that phyiologic birth is virtually impossible.

–My friend and birth heroine, Lesley Everest, founder of Motherwit (Montreal and beyond!) wrote this reflection. — Cynthia

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Three thousand midwives are gathered today in Durban, South Africa.

Think about that! Three thousand midwives, from all over the world, are gathered in one city, determined to bring healthy birth to every corner of the world.

If three thousand midwives can be in Durban, think about how many more midwives there are in the world who stayed home to catch babies. That is the amazing number! So many more than three thousand. Thousands and thousands of women have made it their life’s work to guide babies into this world with love, care, compassion, and deep respect for the rhythms of nature. Midwives are doing this work, yet they remain largely invisible. In some places, they are even still persecuted. I was so happy to give birth to my second child in Ontario, where midwifery is not only legal, but fully supported by the government.

No wonder, then, that the president of the International Confederation of Midwives comes from Canada, eh?

So many modern women in Canada and the United States and Europe think the word “midwife” refers to uneducated women from the 1700s who helped women give birth before modern medicine stepped in. My undergraduates invariably pronounce “midwifery” “MID-WIFE-ERY” when I teach about birth in medical anthropology. They’ve never seen or heard that word before. (They can usually pronounce “obstetrician” just fine!)

I am so grateful that I live in 2011, so that I have access to obstetricians AND midwives. We are SO blessed in our time. And in our place.

The balance between midwifery (the science and art of low-risk pregnancy and birth that requires low-tech watching and waiting, mostly) and obstetrics (the science and art of high-risk pregnancy and birth that requires high-tech interventions) is what makes birth so safe in our modern world. Ironically, the places in the world where there isn’t enough midwifery, like the United States, and the places in the world where there isn’t enough obstetrics, like rural Africa or rural India, suffer from the same problem: bad birth outcomes. Why is that? Well, when we treat a low-risk pregnancy like a high-risk pregnancy we create bad outcomes. And when we treat a high-risk pregnancy like a low-risk pregnancy we create bad outcomes.

Worst of all, of course, is when a pregnant woman has no access to care at all.

We desperately need more midwives in the world! You can follow the International Confederation of Midwives in Africa this week at http://www.internationalmidwives.org.

Here’s a taste from their press release:
Midwives from over 111 countries will gather today at the International Confederation of Midwives Triennial Congress in Durban, South Africa. They will call for governments worldwide to take the necessary steps to end to needless deaths of women in pregnancy and childbirth. Congress will start with an inaugural rally and march at 1.30pm on the 18th June, when 1000 Congress delegates and supporters will walk for 5km through the city. This is the first time ICM has held a Congress in Africa. The event and the march represent a show of solidarity with mothers and midwifery colleagues across a continent which has some of the highest rates of maternal and infant mortality in the world. According to global estimates around 364,000 women die in pregnancy and childbirth each year. 99% of these deaths occur in low resource countries.

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