Birth, language and empowerment

If we’re going to make the world better for our children, we ought to start from the very beginning

I realize that some women prefer to walk into the hospital to birth their babies with the mindset that the medical care providers are the experts and they are prepared to hand their care over with complete trust. I also realize that generally this works out, and generally women are satisfied with their care. This column is not for them. This column is to address the lack of knowledge and empowerment and the dissatisfaction that many other women feel after childbirth.

What might happen if we educated families about birth processes and came to see birth as a normal and natural state of being?

From a feminist standpoint of empowerment through knowledge and the ability to choose, this is problematic. I suppose one could argue that women make the choice to not have knowledge about the birthing process and to hand their care over, but I’m not sure if a choice can be made without the relevant information. Too often I hear that women do so because they are afraid of “something” happening, or a story of a friend who had a specific tragedy. Women don’t seem to know what those somethings are when questioned specifically about it, or to know if their risk factors were comparable to the women in the stories they’ve heard. This seems to lead to women being saddened by aspects of their birth experience, who learn only after it’s too late that they didn’t know things would unfold in the way they did. As I teach about standard medications and routine procedures used during childbirth, the moms (and dads) who are choosing to become educated are shocked at things that are being done to themselves and their babies as a matter of routine care without their consent or knowledge, and without medical indication for the procedures. Informed consent cannot be given without the ability to refuse.

What might happen if we educated families about birth processes and came to see birth as a normal and natural state of being?

Need for education

Education around birth is in fact not happening to women’s satisfaction. In a recent survey of 1,252 women in the United States conducted by the American College of Nurse-Midwives, 62% said they did not have conversations with their care providers about how to stay healthy during pregnancy, and 80% said they did not discuss how to prepare for motherhood. If we are to make decisions about our health and the health of our children, we need the relevant information to do so. Women need to be empowered to ask the questions they need, with care providers they feel have time for them. Changing our language around birth may be a first step in this process.

The language inherent in the medical framework is pathology driven. It can be a struggle to view the body, especially in pregnancy, as a healthy variation or as normal. Words like “labour” and “contraction” imply pain and hardship and “failure to progress”, “trial of labour” or “incompetent cervix” suggest that women inherently do not have the ability to give birth. I suggest that we apply an awareness to the words that are used around us, so that we are aware of the unconscious perceptions we have about birth, and life in general. This is not only a cornerstone of the child birth education program I am involved with, but is important for overall health and well being in my counseling practice.

The language inherent in the medical framework is pathology driven.

There are ways of talking about our maternity care that we can change that can begin to impact our empowerment around birth. I recently overheard a conversation that started with “My doctor isn’t going to let me…”. I sat with this phrase for quite some time, trying to figure out why it bothers me so much. Perhaps it’s the patriarchial or hierarchical nature I feel is involved. Parents and bosses “let” us do things, not people with whom we are engaged in collegial or reciprocal relationships. Indeed, care providers have expertise that is based on standards, policy, research or protocol, but they are not the expert on each individual nor on the circumstances of their lives. The statement implies that the woman felt quite differently about the medical procedure in question and that the care provider didn’t adequately communicate the reasons for the intervention. If this information has been communicated perhaps the language would be “I’m disappointed that… but it’s in my best interest to…”

The language of birth

“I had to…” is another pet peeve of mine around language of birth. Outside of any medically indicated reason I wonder why anyone “has to”. If a baby is lying sidways across the uterus or the placenta is completely covering the cervix, yup, you have to have a c-section. While there may very well be a clear best path or choice for a given situation, again, this lies in the language of handing over power to the care providers and not taking responsibility for the action. How much more empowering to say, “after looking at the options, the best course of action for me was…”. For example, I didn’t have to get bloodwork done before my Rhogam shot. It was required, it’s apparently hospital policy, it was something I chose not to argue about and just got it done. My blood type hadn’t changed, surprisingly, and I had asked my care provider specifically if that was a possibility. While I have declined all other tests and interventions to date, this was one that I felt was important, and although the bloodwork was unnecessary, as confirmed by my care provider, I made the choice to have it done.

Question your care, why things are done the way they will be done and speak up if it doesn’t make sense or fit with your understanding of best care for you.

Another very basic way to begin to shift the empowerment back to women during birth is the use of the word “delivered”. I would love for all care providers to begin answering the question of how many babies they’ve delivered with either “none” if they are male, or a disclosure of how many children they’ve given birth to if they are a woman. Stating that someone else delivered your baby is a pretty complete way for a mom to remove herself from an experience that could otherwise be powerfully positive and life changing. Care providers assist and attend births, but the mom is always the one who gives birth.

Women, choose to give birth to your babies, fully and completely involved in the process. It’s such a unique opportunity to learn about yourself and to have an amazing start to your new family. Question your care, why things are done the way they will be done and speak up if it doesn’t make sense or fit with your understanding of best care for you. You deserve an experience that will propel you into the next stage of life with confidence and happiness. Join me in paying attention to the words and language we use around birth as the effect it has on the psyche of our culture is leading us to rates of intervention that are many times higher than any health organization deems safe.

As a mom I hope to make the world just a little bit better for my children. Here’s a way to start at the beginning.

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