Knowledge and
Empowerment.
By Jackie Mawson.
I am so pleased to be writing this
article, in support of 'informed' birth choices for all
women, and I will endeavour to share the enlightenment that
I have gained, on this particular subject, in my role as a
consumer involved in maternity services, especially in
relation to caesarean birth. I am the Convenor of a support
group by the name of Birthrites: Healing After Caesarean
Inc. and I would like to tell you why our group believes
knowledge is the key to empowerment. I, personally, have
found this to be true in all aspects of my life, but
knowledge is never quite so important as when women are
faced with the decisions that surround us when planning, and
giving, birth.
Our group aims to supply women with
information about birth choices, especially after
experiencing a caesarean(s), and we lobby to reduce the
current excessively high elective c/section rate that
Australian statistics sadly demonstrate. We aim to inform
women of their birth choices after a caesarean and
communicate to them that the old adage "Once a caesarean,
always a caesarean" is no longer the case. We are basically
pro-VBAC (ie, Vaginal Birth After Caesarean), but we do
support caesarean birth if the choice is made as a truly
informed decision. We endeavour to support women in many
different ways; by phone, with get-togethers, sending them
FREE information packs, producing a quarterly magazine, by
email and through the information displayed on our website
-(http://www.birthrites.edsite.com.au).
Birthrites' philosophy is
&endash;
"With knowledge
we can make choices that lead
to empowerment, and healing, through
birth."
We aim to supply women with
information (using books, mother-to-mother counselling,
referrals to empathetic medical people, the Internet, etc)
so that they can become informed enough to be able to make
their own birth choices. The decision of whether to have a
VBAC or a repeat c/section should not be made by their
doctor or midwife. We strongly believe that women should be
supplied with information so that they can personally make
the decision of how their baby is to be born. They should
then be supported in their 'informed' decision (VBAC or
c/section), and nurtured throughout their pregnancy towards
a positive outcome for both mother and baby.
Birth needs to be honoured as a
sacred event, involving rituals and respect for the mother's
birth choices, allowing it to become a healing experience.
This becomes especially true when a mother has experienced a
previous traumatic birth, such as an unexpected caesarean. A
c/section is about the most technological birth possible,
and women who feel traumatised, emotionally of physically,
by this past experience are often desperate for a truly
'natural' birth experience in any subsequent labours. It is
becoming so common for VBAC's to occur at home, now, that
they have been coined HBAC's (Home Birth After Caesarean) as
women distance themselves from the institutions and
technology that may have interfered in the prior birth
experience.
The general assumption surrounding
Birth, in Australia, by the 'average' Australian woman is
that you go to hospital and have your baby. The drugs are
there if needed, as is all the other wonderful technology
and, in doing this, you've taken every precaution to ensure
the safe arrival of your little one… WRONG! If women
choose this attitude, when birthing their babies, then they
are effectively handing their body, and their labour, over
to the institution and also giving the medical practitioner
in charge all the responsibility for the outcome. They are
gambling that by handing over the responsibility they will
receive a perfect product at the end, and have no
responsibility (and therefore guilt) if some crisis should
develop during labour that may cause their little one harm
&endash; they did everything they were told, didn't they?
Followed all the instructions, took all the tests, watched
the machine beep and accepted the pain relief drugs that
were suggested… So why did things go wrong?
Women can be left feeling like they
have been run over by a truck, especially when the initial
intervention (such as an induction) leads to another
intervention, and another, culminating in a c/section that
leaves the new mother flat on her back, in excruciating pain
but with a beautiful newborn baby to look after. Women are
so very strong, and somehow we manage to cope with a new
baby whilst recovering from major abdominal surgery…
But, trust me, a lot of the joy just isn't there.
Yes, there is a time and place for
c/sections. But these few legitimate reasons for Caesareans
are lost amongst the very high rate of unnecessary caesarean
sections. Thank God for the technology when it is truly
necessary, but consumers are being overserviced in a way
that endangers both themselves and their unborn child when
there is no true reason for the major abdominal surgery that
is being employed in delivering their baby.
Australia has one of the highest
c/section rates in the world. The reasons for elective
unnecessary Caesareans are many, but this method of birthing
our babies is usually chosen for reasons of self-interest.
Either in the selfish interests of the parents or, sadly,
those of the Obstetrician; Honeymoon vagina may seem to be
of utmost importance, especially to the males present, but
it is the most degrading reason touted. Ability to plan your
child's birth&endash;day exactly to coincide with employment
leave… Hhmmmm. How about when the Obstetrician has an
important meeting to hurry off to in an hour and the labour
is not progressing fast enough, or he/she is leaving on a
'well-deserved' vacation a week before your due date. These
are sad, sad reasons to initiate the birth of any child that
may not be ready (physically) to enter the world.
The parents are often making an
uninformed choice when they choose this option. They are
offered this alternative to natural childbirth, usually at a
vulnerable time in late pregnancy or during labour, and the
risks involved are not usually sufficiently highlighted.
C/sections have become 'routine' procedures, but that does
not mean they are without risks to both Mother and
Child… they are major abdominal surgery with all the
attendant risks involved in such. When a caesarean section
becomes as safe as vaginal birth, for both baby and mother,
and then it should become a legitimate birth choice for
women, not before modern technology has made it so... and so
far it has not.
VBAC is an option that should be
given to all birthing mothers who are pregnant after a
previous caesarean (no matter how many previous Caesareans)
as studies have proven it safer than elective surgical
birth, even after more than one previous c/section.
Unfortunately there appears to be a great reluctance among
Australian Obstetricians to encourage VBAC, or even support
a woman's valid choice of experiencing ' natural' childbirth
with no interventions entailed.
Worldwide evidence states that
natural childbirth and VBAC are desirable, fully warranted
and safer than an elective caesarean section, where there
are no predisposing reasons for the surgical delivery.
Here are some
facts:
- You have more chance of your
uterus rupturing from being induced than while attempting
a VBAC.
- There is a 4 times higher rate
of maternal mortality involved with a c/section than with
a natural birth, and at least a 2 times higher mortality
rate involved with repeat elective
c/sections.
- Mothers are more likely to
suffer from febrile morbidity (complications with a
fever) after a c/section than after a vaginal
birth.
- Major risks for baby are
respiratory distress or iatrogenic (doctor caused)
preterm birth.
- The risk of death for baby due
to hyaline membrane disease is higher in babies born by
elective caesarean.
It is time to remind women that
we are entitled to these basic rights:
- Choices in health
care
- The right to be
informed
- The right to safety
- The right to be heard
- The right to redress
The 5 basic rights above were
clearly stated by The National Health and Medical Research
Council (NHMRC) in May 1987 after a year long study into the
safety of homebirth. Unfortunately it is more theory than
practice.
The only way to change this is to
inform consumers - the Birthing Mothers. When women have
access to accurate information, when they become involved in
the many decisions surrounding their pregnancy and labour,
when they are truly able to make 'informed' decisions about
every aspect involving the well-being of their unborn child,
and themselves… This is when they regain the
responsibility and they will discover/rediscover the
empowerment that they may have previously lost.
When a traumatised woman is on the
other end of the phone, or sending a message to me by email,
asking "Why???" Why she ended up with a c/section when she
had envisioned a wonderful birth, why she felt powerless to
stop the interventions that cascaded to the concluding
c/section, why it all happened? All I can truly offer her is
empathy, surround her with a wonderful support network of
mothers who've been there, and the knowledge that it doesn't
have to be that way next time.
The knowledge that our body is
capable of birthing our babies vaginally, with no drugs, no
interventions of any kind, is priceless. Women lose that
faith so quickly when their babies have been removed from
their belly surgically. So the path towards healing
begins… We need to read, read and read some more. We
need to find studies on the risks, pros and cons of VBAC vs
elective c/section, we need to find supportive caregivers
for future pregnancies, we need to talk to mothers who have
'been there' and we need to regain that belief in ourselves.
That is what Knowledge returns to us. Rediscovering that
faith in our body's ability to birth our baby naturally is
an invaluable gift, a gift of empowerment.
So many women have read books from
the Birthrites' Suggested Reading List, and come back and
said "Thank Goodness, I thought I was going insane. I was so
depressed, and negative, about the c/section and yet
everyone I tried to talk to about it was pointing out all
the positive things (ie, my beautiful baby, the fact that I
am alive today). I could see these positive things, and felt
thankful for them, but I still felt so negative about the
whole experience. Through reading some of these books I have
found that other women have felt the same as me!" Another
gift… knowing that you are not alone in your feelings
surrounding the c/section, that it is okay to grieve for the
loss of that 'dreamed of' birth experience.
A long time ago (actually it was
just over 6 years ago… It seems a lifetime ago) I
sought support and information about VBAC, neither of which
was available in Perth. This lack, and my subsequent
c/section, led me to set-up Birthrites' (with the help of
other committed women &endash; Thanks Kym and Amanda
especially) in the hope that giving women the knowledge, and
the support, they need would allow them to achieve healing
birth experiences.
Birthrites is a non-profit
organisation, and has been declared a benevolent society by
the WA tax dept. We continually struggle to cover the costs
of the postage of FREE information packs to women
(world-wide), but when we can no longer cover these costs
that is when we will cease to be… Our primary aim is to
supply women with information so that they can make
'informed' decisions about future birth choices after a
caesarean, and so far we have sent out thousands of those
FREE information packs.
I personally feel that if only one
baby had been born vaginally , that may have otherwise been
born by c/section through lack of parental knowledge, then
Birthrites' has done a wonderful, wonderful thing, it has
achieved it's aim… I KNOW that many babies have been
born the 'right' way due to our group's efforts (thanks to
the wonderful feedback we have received) and we will
continue to provide information, and support, to women so
that many, many babies are born the way Mother Nature
intended.
Knowledge is a powerful tool. I
hope that birthing women will continue to recognise it's
strength, and thier own, and hold on to the magic and
empowerment that surrounds natural childbirth. Think of the
chain of birthing women, leading to you, through the eons of
time. Feel their strength, envision the innate ability
expressed when they birthed your female ancestors, then
capture that faith in your own ability to birth vaginally.
Your ancestors did it, didn't they? Wouldn't it be sad if we
were the last generation able to make that declaration? Our
daughters will look to us for guidance. We can do it, and
they can too! Have faith in your body's ability, and gain
the knowledge to 'allow' the empowerment.
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