Perceptions of Birth.
By Gail Hancock.
The more involved I become in the wider birthing community, the more apparent it is to me that when it comes to childbirth in our culture, thereÕs a wide black line right down the middle of our collective unconscious: on one side of the line is the medical model and on the other is the natural. The sites of intersection between the two are very few and far between. What concerns me most about this line is that itÕs not just a metaphorical division between discrete models; itÕs also about divisions between people. On the one side, there are the scientists, the obstetricians, the medical model midwives and the women and their partners who opt for the benefits of this model. On the other side, there are the home birthers, the water birthers, and their partners and midwives and doulas and sisters and mothers, and even a few women who decide to go it completely alone, the unassisted home birthers. There is always strong debate between the two sides, but at present in most of the world, the medical model is seen as dominant. In parts of South America, for instance, the caesarean rate is as high as 75% . I believe itÕs a good thing that we have so many choices in childbirth, and that both these models operate freely in the community, but I also think that itÕs time the two sides began to actively search out sites of possible interaction and negotiation with one another, for the ultimate benefit of all.
I think weÕre living in a time when thereÕs a real possibility of birth in its natural state disappearing forever. I heard an obstetrician saying on the radio a few months back (and I canÕt remember who he was) that the only real benefit of natural birth is that itÕs natural, and that we have science to fix up natureÕs mistakes. Hearing this statement really shocked me. It hadnÕt occurred to me that there might be obstetricians who really believe that nature has no place in childbirth. I think IÕm a bit na•ve, perhaps, but I still believe that nature is good, and it makes me feel good to believe in that. I think it would be a pity if nature were seen to be of such little value in childbirth that it was completely obliterated by science. IÕve had three babies in my time. Two hospital births complete with Ōthe lotÕ, including forceps in my first birth and a caesarean in my second, and then much later, a natural birth at home. For me, the benefits of the natural birth far outweighed the benefits of the hospital births, by themselves. I donÕt regret my hospital births, I have two beautiful big sons as a result, but experience for experience, I wouldnÕt choose hospital birth again. Not everyone would agree with me, and many millions of women choose hospital birth because thatÕs what they want. IÕm not anti-hospital birth; I just donÕt like it for myself. And as long as there are people in the community who feel the way I do, we need natural birth.
At the Birthrites conference recently, I had the experience of noticing the differences between the natural birth group and the medical birth group first hand, and I thought about it a lot when I got home. Although the sharing of ideas was useful and positive, I think that the line between the two sides was very obvious. The fundamental beliefs of each are vastly different. As I see it, the medical model starts with an assumption of birth being risky, while the natural starts with an assumption of it being safe. The medical model uses science, medicine and a controlled environment to allay what is seen as risk, whereas the natural model sees the risks involved as a tiny part of a complex natural process and, with love and faith, allows birth to happen. The gulf between the two seems pretty wide! ItÕs not difficult to see why the two ends of the spectrum have trouble with one another from time to time, and why each fails to truly understand the position of the other. However, itÕs not all bad news. Although these two sets of beliefs are so very different, the values of these groups are possibly shared, and the aims of each are identical; that is, a safe birth and a live, healthy baby, despite differing methods of achieving those ends.
ItÕs traditional for people with such different belief systems to steer clear of one another, to refuse to accept the other, and to each go on believing that only they are doing it the right way, while the other is misguided or plain ignorant. As someone who sits on the natural side, though, IÕm worried that the natural model will disappear altogether, because of the comparative power of the medical model, itÕs widespread acceptance as ŌnormalÕ, and the fact that in general the two sides donÕt communicate with one another. We need to work to keep all options open to women so that the availability of choice remains, and so that fewer women will have to go through births that have left them emotionally and physically wounded for whatever reason. Every woman deserves a memory of childbirth that she feels nothing but good about. Perhaps this is our birthrite? I would love to see more opportunities for consumers and providers on both sides of the debate to talk to one another, to each accept the other, and to work together for the common good. We already know what it is that makes us different, now I think itÕs time for us all to find out and work with what makes us the same. As I see it, medicalised birth is at the intersection of science and nature. Our goals as people who have an interest in birth, whichever side of the debate that we sit, should perhaps not be to nullify one or the other structure, but to negotiate those few existing sites of intersection for the greatest benefit to all women and their babies.
Reference: Cotzias C, Fisk N. Patient demand for Caesarean section. Advances in Obstetrics and Gynaecology, Issue 15, p.9.