Misogyny, Paternalism and Dice 'Em Up Obstetrics
I am constantly irritated by the seemingly endless stories of bad births I hear about from unsuspecting mothers.
These bad births are often rooted in a system of paternalism still prevalent in obstetrics. If you don't believe me, read the definition of paternalism.
Paternalism- refers to an attitude or a policy reminiscent of the hierarchic pattern of a family based on patriarchy, that is, there is a figurehead....that makes decisions on behalf of others ... for their own good, even if this is contrary to their wishes. The paternalism of a parent (strictly, a father), even one who restricts the liberty of a child in the child's own interests, has not generally been thought to require extensive justification.
It is implied that the fatherly figure is wiser than and acts in the best interest of its protected figures. The term may be used derogatorily to characterize attitudes or political systems that are thought to deprive individuals of freedom and responsibility, only nominally serving their interests, while in fact pursuing another agenda which is directly against the interests of the individuals.
I am sick and tired of this attitude. It is rampant. The whole pat on the shoulder, and the gentle reassurance to the mother that the doctor will "Take care of everything" is ridiculous. I used to be just angry at the profession as a whole. No longer. I am disgusted that women continue to buy into this in the hopes that it will somehow make the entire event of birth somehow painless and easy.
Letting somebody take care of you for your pregnancy and birth is not the way to have a great birth. It is a sure fire way to have a horrible experience that often resembles assault and that is traumatic to recover from.
Let's think about this in action:
A first time mom is excitedly pregnant! She is looking forward to inviting a baby into her home and family. She is however apprehensive about the pregnancy and birth. Why wouldn't she be. She has her whole life heard horror stories from her mother, other women, and the media about the miseries of pregnancy and the pain of birth.
She makes an appointment with a care provider. She is interested in a natural birth and mentions it in her first visit. He seems to brush aside the idea, and mentions that most first time mom's need an epidural to endure labor. After all, why should she suffer? He says. "Don't worry, I know what I am doing. I have been doing this for years. After all, it is what I went to school for."
Mom continues to trust her doctor. He continues to in offhand ways refer to her inability to give birth on her own. Her visits with her are brief. But there is comfort in knowing that he is an expert.
The time for the birth approaches. Mom is huge and uncomfortable. The doctor suggests an induction. After all, she doesn't want to be pregnant forever, does she?
An induction is performed on the appointed day. Pitocin, followed by an epidural, followed by distress, stress, and the eventual "necessary" c-section ensues.
Mom is grateful that she had her doctor there to save her. Otherwise, she and the baby surely would have died.
Mom returns home to recover from her surgery and try to raise a baby. She has no confidence to do so. She is in pain. The system has convinced her that she is incapable of basic female functions, and she believes it.
This happens every day. Every single day.
Whose fault is it anyway? Is it the system that treats women like incompetent vessels of a foreign object? Is it the doctor who assures her of his expertise? Is it the mother who goes along with this line of bull?
There is probably enough fault to go around for everybody. I refuse though to place all the blame on the system and the care providers alone. I refuse to place all the blame on a culture that is simply misogynistic and in which women are only valued when they resemble men.
We as women must take responsibility for our own births. We can not pass the buck.
Who is going to recover for weeks from this surgery? Who is going to deal with postpartum depression? Who is going to struggle with breastfeeding because of this surgery? Who is going to have a baby with increased risks for countless things? Who is going to have to struggle to VBAC? Who is going to have to limit her family size because her body can not handle any more surgeries? Who is going to catch a dangerous infection in the hospital? Who is going to wonder why things happened that way?
The answer is you. YOU ARE THE ONLY PERSON WHO WILL ULTIMATELY CARRY THE BURDEN OF YOUR CHOICES. That doctor, who was so comforting and said he would take care of you is not going to come to your house when you have a breakdown. He is not going to do your laundry when you can't lift the basket. He is not going to feel like he has a broken body because his birth did not go as it should have.
It is easy to to let somebody take care of us. We all have a little girl in us that would like to do this. It is the same little girl who doesn't want to experience any pain. This same little girl wants to give up when the going gets tough.
But you are not a little girl any more. You are a woman. You are a mother. You are stronger and better than that.
You want to take responsibility. You want to do this even if it means eating better than you ever have. Even if it means exercises, reading, switching care providers, and just being different than everybody else around you.
It is time we took responsibility for our own births. I can guarantee you that this is the only way that things will change. ACOG and their cronies have ZERO motivation to change obstetrics. We do.