“But what should I do??”
“Nothing, dear, you’re not qualified.”
Monty Python, Meaning of Life, Birth.
Birth activists are fond of pointing out the expertification of obstetrics and it is undeniably a field rife with Experts of all kinds, shuffling around the machines that go ping, wielding the dopplers that go swoosh, and ignoring the
incubators birthing women. Many Doctors and a good proportion of midwives alike seem to believe that it is their presence alone which keeps birth safe and stops women from making all manner of silly decisions which might lead to injury or insurance pay outs. Women, of course, are apparently the least invested in the outcome of pregnancy and birth, well down the list of interested parties like ultrasound technicians, surgeons, midwives, pathologists, GPs, maternal child health nurses and anyone else not gestating the baby in question. I think there are few of us who would quibble with how offensive and unnecessary it is to treat women like dangerous, childish incubators who might up and do damage to future leaders of the nation as soon as someone’s back is turned. Generally speaking, with some notable exceptions I won’t mention, those who work in normal birth are less prone to this sort of thing but are we really being honest with ourselves about the expertification that’s becoming a feature of our own communities?
In our wellmeaning effort to compete with surgical experts as birth experts, have we forgotten who the real expert is at any birth?
Midwives, godsibs, knee women, sisters, friends and mothers were once the women around us who’d birthed themselves, who’d witnessed many births, who’d supported birthing women through all manner of births. There wasn’t anything particularly special about this, nor was there anything special about birth for a long time. It was women’s business, it was just what most women did, it was something you knew you’d probably have to do if you had sex enough. Sure we lacked some stuff which would have been helpful but it certainly wasn’t the bloodbath modern obstetrics would have us believe. As smart women know, most complications are prevented with good nutrition and some complications are simply unavoidable whatever our skills and equipment. So then doctors got in on the game with their famous lack of handwashing [Has this changed?] that killed many, many women and it’s been pretty much all downhill for western women since then. Despite how propaganda tells us we’re so very lucky to be birthing now and not a hundred years ago, the reality is very different and now the inexorable rise of caesareans replacing birth is beginning to kill more women every day.
Critiquing all this is so important. It’s so vital to keep providing information that contradicts what’s readily available on countless illinformed forums, websites, Facebook pages, you name it.
So it pains me that lately I’m noticing more and more courses, more and more qualifications, more and more women with, I’m sure, the best of intentions who can reel off their qualifications like they swallowed alphagetti. There are now birth doulas, postpartum doulas, doulas who only do childcare, doulas who teach hypnobirthing, calm birth, slow breathing birth and probably nice, quiet, compliant birth too. You can see lactation consultants with thousands of letters after their names, some accepted in various countries, some not. There are different stripes of midwife with different letters and legalities. You can even pay to do courses in order to become a registered, certified placenta encapsulator and that was when I started to twitch a little, frankly.
When I see doulas checking each other’s credentials, I start to think we might be straying a little from a mirror which keeps us honest with ourselves.
Just as we can clearly see that credentials don’t make for safe careproviders, (go look in a hospital and see more credentials than you can poke a stick at. Feel safer now?) are we sure that extending credentialling, hierarchies, expertifying birth and its related actions is really serving the needs of birthing women? Are you sure? I’m not. Playing a game whose rules were set by the hierarchy of obstetrics isn’t serving women. When we look to our status, or the status of those around us, when we try to mimic surgeons in our advertising or fees, we simply continue the dynamic of women as lesser than careprovider. This is believing we can dismantle the master’s house with the master’s tools and it will never work. (Thanks, beautiful Audre Lorde) Implementing an alternative industrial culture will not bring birth back from the edge of the precipice from which we’re dangling. Supporting women to make their own decisions, supporting women in their bodily autonomy, saying no to pornography and all its sick relatives, speaking out against violence in women’s homes, supporting women to birth how, where and as they see fit when they come from a place of personal power rather than fear, becoming feminists who see birth as just part of a raft of issues in which women need to be honoured, these will serve women and serve birth. We already have a longterm, proud movement which supports women’s rights, it’s feminism and we need to get into it and out there and get down and get on!
When birth is simple and women are in the centre at all times, who cares what letters you have to be able to prepare a placenta for longterm consumption? And paying to learn this skill then charging women as a practitioner who only sees the woman for that one task, seems to me to be in danger of again fragmenting the kind of care many of us have been trying to centralise in the one birth attendant. A doula for birth who you’ve met twice before you give birth? A doula who comes over and does the dishes and takes the kids out but doesn’t go to your birth? A placenta encapsulator who only pops over to pick up your placenta and has no other relationship with you? A childbirth educator who talks to you in a large group but won’t be with you when you birth? Someone who teaches you how to switch off your flight or fight mechanism which might have kept you safe in the hospital but who doesn’t have a relationship beyond that with you? The current rash of movies about midwives and doulas like we’re some kind of cute accessory everyone wants and we’re like, totally fab, and totally radical like wow natural birth proponents, and totally brilliant, and women can’t possibly have Natural Births without us really gives me the irrits. I want to see more doulas and fewer don’tlas, thanks.
Further industrialising normal birth isn’t going to serve women nor will it serve birth. While there are good things about women having the kind of support which suits them, birth still happens without all of us, without special birth pools, without a credentialled professional placenta encapsulator, without special anything really. And a lot of the time, we don’t necessarily make birth better for women even if it might be handy for those who like me holding a drink and offering something to lean on. Those women would birth just fine without me, without you, without everyone who has a qualification in something. Except maybe the pizza delivery person who needs a license to drive the car they bring the supreme in for the hungry mama.
When we think about how we love birth and we wish to serve women as they birth, maybe we could start thinking about doing less not more? Why don’t we think of ourselves as really unimportant to the process, move our specialness out of the way with our egos, and see what women can actually do without us? If our hearts really hanker to be present and in the reflected limelight of others’ lives, perhaps we could become wedding planners or celebrants instead?
Perhaps the magic we experience at births is too lovely for us to say goodbye to it and we love to immerse ourselves over and over? It’s true, it is undeniably awesome in every true sense to be at a birth and witnessing a woman in full flight. But whose interests are being served by our attendance? Can we be totally sure we only bring that which is needed?
I think many of us feel that we can help bring birth back on track if we work really really hard in our birth-related careers but how about we work really hard on supporting all women to exercise bodily autonomy without blinking an eye? That way true birthing freedom lies, when every woman makes the decision that’s in her gut and soul, not the one that pleases others or into which others would coerce her. But let’s not reinvent the wheel, let’s use our existing movement and learn more about that, and steer it into the relatively unchartered waters of birth in a feminist paradigm. I’d dearly love to see the renewal of feminism in Australia and why not on the backs of birthing women, the long ignored of feminism?