The overwhelming and dominant power in birth in this country at this moment in history is fear. Almost every decision made by a woman (and her partner) is, at its root, motivated by fear. The assumptions that are brought to birth, the assumptions that are made about birth, the very core of what most people believe about birth is intensely flavored by fear.
No it isn’t you say, pregnancy and the birth of a child is a time of joyful expectation.
Why do we have all that prenatal testing done? Mostly, of course, because everyone else does. But why does everyone have it done? Because there might be something "wrong" with the baby, or "wrong" with us. It seems that the chances of something being "wrong" must be pretty high, for so many women to have early ultrasounds, alphafeto protein tests, chorionic villous sampling, amniocentesis, glucose tolerance tests, mid-pregnancy ultrasounds, late pregnancy ultrasounds, non-stress tests, biophysical profiles, Group B streptococcus cultures and of course, serial vaginal exams as the pregnancy nears its end. After all, think of what horrible things could result if we didn't know an exact "due date". Think of what horrible things could happen if our baby is bigger than average and we didn't know it. Think of what horrible things could happen if our cervixes were or weren't dilating and effacing prior to labor. To refuse a prenatal test, even a test that only presents you with "facts", not options, is somehow risky. Odd. Scary. Certainly not the "norm".
Why do we pick surgical specialists to "deliver us”? Usually because we know no differently, that's just the way it is done. But why? Well, just in case. Just in case of what? Just in case something "bad" happens. We are afraid of "something bad". It seems that the chances of "something bad" must be pretty high, to justify the use of a surgical specialist, to make the choice of a surgical specialist the "no fault" decision in our society. Any other decision, be it a Family Practitioner, a Certified Nurse-Midwife or even a "Traditional" Midwife just seems, well, risky. Scary. Outside the "norm".
What do we think about as we approach our "due date", such as it is? Labor. Will it ever start? The convenience of others. Will my mother/husband/boss's schedule be ruined if I don't labor on time? Pain. What is it going to be like? Will my childbirth preparation class help? Will I "need" an epidural (or will I be able to get it as soon as I want)? Will I be "out of control"? Will my husband/mother/sister be worried/upset/able to "deal" with it? Will my doctor be on call or will I get one of the partners? Will it take long? Will I "need" an episiotomy or will I tear? Will I "need" a cesarean? Will my baby be all right? We go to our births scared to death of what might happen.
Why do our beloved surgical specialists do what they do to us? Fear. Fear of that "something bad" which for them includes a lawsuit. Fear that the “delivery” might deviate from some restricted and fundamentally arbitrary notion of “normal” and thus out of their limited experience and capacity. We are induced from a fear of birth on an unknown time frame or fear of a baby outside of "normal" limits. Our membranes are artificially ruptured out of a fear of a "long labor" or out of a fear of our baby being harmed by labor. We are given drugs to calm us and numb us out of fear of pain and "loss of control". We are given drugs to stimulate our uteri out of a fear of long or ineffective labor contractions. We are given antibiotics in our veins out of a fear of infection. We are confined to bed, with electronic instruments attached to our babies, and us inside and out, because of fear that our labors will kill our children, out of fear that the drugs we are given will harm our children. Our bodies are cut, our vaginas and our bellies, out of a fear that our own bodies will kill our own children and that our children will damage our bodies.
The really sad part is that it's almost impossible to escape. Oh, you can escape the cycle of fear I've outlined above, I did it. You can understand and believe that the chance of "something bad" happening is actually quite small (if birth is left alone). I birthed my third child at home, with a wonderful Traditional Midwife. I had very little prenatal testing (although what I did have was done out of fear - fear left from the previous miscarriages I'd suffered). I wasn't afraid of the pain; I didn't want medication readily available. I wasn't afraid that my labor would kill my child or that my child would damage my body.
But I still made decisions based, in part, on fear. I chose home because hospitals scare me. I didn't want access to drugs because I'm afraid of what they might do to me and to my baby. I didn't want an "elective" repeat cesarean because I'm afraid of major abdominal surgery. I didn't have a "due date" because I was afraid of the stupid and insensitive things people say when you pass your due date. I didn't have prenatal testing that provides only "facts" and no options (other than abortion) because I was afraid of the Pandora's Box that such testing opens. I did have to constantly remind myself of the facts about birth, about vaginal birth after cesarean, about homebirth, so that the all-pervasive and invasive fears that surround those topics didn't creep in and make me fearful of birth itself.
Fear is dramatic and fearful birth is high drama. It rates well on television, which is why a dramatic birth is one of the "aces in the hole" for a television series that needs a ratings boost. The trust we do manage to have is usually placed in the most fearful people of all; those surgical specialists that we depend on to guide us through a dangerous and frightening delivery. We trust them to deliver us from evil.
But what if there was no fear associated with birth? What if hope, joy and trust were the dominant powers behind birth? What if everyone just knew that birth is safe, that birth can be trusted? That our bodies can be trusted? That our babies are working with us to be grown and born, not against us? That only very rarely does "something bad" happen and that there are people available to quickly and compassionately care for us in those rare moments when help is needed but that those people are better left in the background unless we do need them? What if there was no evil to deliver us from?
What if "just in case" was something that you never said or heard with regard to pregnancy and birth? I almost can't ever imagine it in these dark days - to make choices in birth that aren't fear driven, neither with the mass fear that most suffer nor the fear of what birth has become. Too often, it seems impossible to me. But what if? What would it be like, if there were no fear?
Women would conceive their children, and carry them with eager pride and joy. They would look forward to the day that labor started, knowing they will be supported and strengthened by people who also look forward to birth with joyful expectation. They would labor - it would be very hard work for most, painful for some but no suffering - and transcendent joy at the end - a baby, a new life in this world. And these women would look back on their pregnancies and births with simple and deep joy. Some would have an eagerness to conceive and birth again, others would be ready to move on in their lives but would cherish the memories of one of the most joyful times of their lives. They would mother their children with a confidence that comes out of passing through a rite of passage. They would tell stories of joy and pleasure to their sons and daughters about the days when they were born. It wouldn't be dramatic at all but think about what it would be - whole, healthy, human. Not boring, I don't think pregnancy and birth could ever be boring but how about normal? Simple? A Fact of Life.
Can you imagine it? I almost can, but my vision is fleeting many days. We need to imagine it. We need to dream it. We need to do whatever we can to make it real. It’s too late for us but for our children, we need to dream this so that it can become real. We need to set our daughters and sons free of fear. We need to give them the gift of hope, joy, trust and love. A new kind of birth. It starts now.
Revised June 16, 2006