Give Birth Like a Feminist. Milli Hill

Чтение книги онлайн.

СКАЧАТЬ birth to be like and lay out what is important to you in that time as part of your plan. You may also like to make a separate postnatal plan too, with a clear idea of how you are going to navigate the first few weeks with your baby, and a list of useful numbers for help and support with feeding.

       Get it read, get it signed!

      Make sure that everyone involved in your birth reads your birth plan in advance of your labour. Your partner, doula, and any other birth supporters need to have a clear idea of what you want on the day. Discuss your plan in advance with health care providers especially if you have specific needs or requests that deviate from the norm. Ask them to record details of conversations and decisions you have made in your notes and to sign your birth plan. These discussions will help your care providers to demonstrate that they have fulfilled their obligation to have a balanced and individual discussion with you about your personal circumstances and risk factors, and you can demonstrate that you have understood the information given to you and that your wishes have been documented. Your birth plan will not have legal status, but it is still evidence that your views and preferences have been discussed and noted.

      In the worst of cases, birth plans – and the questions to care providers that usually accompany them – can be interpreted as a sign of lack of care or ill will towards the unborn child, of being a ‘bad mother’, because of course, as a woman is repeatedly told, what happens in the birth is unimportant, as long as there is a healthy baby at the end of it. ‘I wanted to know more about why they wanted to induce me, but in the end the doctor just said, “You’ve waited a long time for this baby, haven’t you?” ’, Laura from the UK told me. ‘He was questioning my desire to be a mother, he was questioning how much I cared about my baby, and even how much I wanted them to live. It was a horrible moment but at that point I decided to comply with the hospital’s wishes.’

      Some birth workers refer to this practice as ‘playing the dead baby card’,[11] and it is certainly a dimension of the current fear-based climate that can be very effective in silencing a woman who is trying to argue her right to make her own choices about her body. Michelle Quashie, a mum of four from London, recalls her obstetrician similarly ‘shroud waving’ when she was determined to have her third baby via VBAC: ‘He asked me, in quite a dramatic tone, “What is more important to you, a natural birth, or being a mother to your other children?” and as he did so he looked very pointedly at my husband as if to say, “take charge of her”.’ Michelle’s story is reminiscent of the remarks of Irish obstetrician Dr Donal O’Sullivan who caused controversy when he said during a radio interview in 1996 that, if a woman wanted a home birth, her husband ought to put a harness on her and drive her to hospital like cattle.[12]

       A part of me, even then, could not tolerate passivity, but I identified that part with the ‘unwomanly’ and in becoming a mother I was trying to affirm myself as a ‘womanly woman’. If passivity was required, I would conform myself to the expectation.

      Adrienne Rich, Of Woman Born[13]

      Telling women not to try to plan birth but instead to focus on the end result carries the underlying message that a woman in labour must ultimately sacrifice herself – her hopes, needs, desires, dignity or even her life – in order to save her baby. This is interesting, because, although you might assume most women would happily give their lives for their unborn if they had to, this is not always the case. If you ask pregnant women – and their partners – this rather unpleasant question, ‘You can only save one, who do you save?’ they will almost overwhelmingly tell you, ‘the woman’. And yet, for historical, moral and religious reasons that we will explore later in this book, maternity care can often be clouded by the notion that the safety of the baby always takes precedence.

      Safety first?

      In some notable cases, we can gain a window (albeit one we would rather not have) into what happens when total priority is given to the life of the baby over the wishes of the mother. In April 2014 I was privileged to speak[14] – via an interpreter – to Adelir Carmen Lemos de Góes, a 29-year-old Brazilian woman who, when expecting her third baby after two caesareans, had researched VBAC and become interested in giving birth naturally, with the help of a doula. In early labour, she attended the hospital for a check-up only to be told that her baby was in the breech (bottom down rather than head down) position. Doctors demanded she stay and have her baby by caesarean, but she signed papers to discharge herself, and left, saying she would return when her contractions were five minutes apart.

      Later that night, her labour intensifying, she was picking out a dress to wear to the hospital when she saw headlights outside the windows of her house. After overhearing incredulous expressions from her husband and doula, she told me, she decided to go outside herself. ‘There I was confronted by a justice officer, who stood up in front of me and said that I had to be transported to the hospital mandated by a court order that he had in his hands.’

      Doctors had that afternoon obtained a court order for a compulsory caesarean.

      ‘The whole discussion was so surreal, everything was so unbelievable and we were just trying to understand. There were about nine policemen and they were all trying to make my husband get back … and just take me away.’ Adelir, by now experiencing strong contractions, agreed to go with them: ‘I couldn’t refuse – it was either do what the court order said or be handcuffed. And I was so scared – frightened with my whole body … having chills in my whole body.’

      Adelir was driven to the nearest hospital and, although she was 9 cm dilated and nearly ready to push, her baby was born by caesarean as the court order dictated. Her husband was not allowed to be with her and she did not see him until six hours later. ‘Everything had happened so suddenly and I felt pretty much robbed and kidnapped,’ she told me.

      Adelir’s story is extreme, made more shocking, perhaps, by the fact that there was no question over her ‘capacity’ – she was felt to be of sound mind, but simply judged to be ‘wrong’ in her decision to try to birth naturally. Interestingly, when I discussed Adelir’s story at the time with others, two questions repeatedly arose: ‘What were the risks of the VBAC then?’ and, ‘How about this breech thing, didn’t that make it more dangerous?’ Questions like this miss the point: by trying to judge the rightness or wrongness of her decision, we fall into the same trap as the Brazilian authorities – declaring that a grey zone exists in which a pregnant woman can be compelled to make the decision that others judge is best for her, regardless of what she would choose for herself. As human rights barrister and founder of UK charity Birthrights Elizabeth Prochaska put it to me at the time of Adelir’s story:

      ‘Risk might sound appealingly scientific and rational, but it is not. When it is used to compel women to receive medical interventions, it is an expression of violent patriarchy, pure and simple. Would a Brazilian court order a man to undergo an invasive kidney transplant to save his dying child? No. Only women’s bodies are treated as public objects subject to the whims of the medical profession backed by the coercive power of the state.’

      Some may feel that a pregnant woman should not have the right to make a decision that puts her baby ‘at risk’, but, unfortunately, as unpleasant as it may sound, the unborn child can never and should never be considered to have any rights – and as soon as we put so much as a toe in this water, we begin to stray into a place in which a woman can be taken from her house by the police and compelled to undergo major surgery against her wishes. There is a creeping nature to such a mindset – once we begin to make provision for the occasions when doctors or the state may overrule a pregnant woman with full mental capacity, we are on a very slippery slope indeed. Instead, the point needs to be made clear, often over and over again, that we have to trust women to be the ultimate decision maker in birth, no matter what. This is enshrined in law, and in global principles of human rights, that I will outline in СКАЧАТЬ