My friend, Mary-Rose MacColl (author of the excellent book, Birth Wars) writing about homebirth, and I completely agree with her here and this is something that has long been bothering me, too:
“You are sitting in a court of law, not a court of morals.” Thus spoke prosecutor Michael Byrne in his summing up of the case against a woman who’d taken a drug to terminate a pregnancy. The woman, just twenty years old, had been charged under Queensland law with procuring an abortion. This was 2010 not the dark ages. Protest marches were held all over Australia in support of women’s rights.
I’ve been thinking about maternity care and why there’s not the same outcry in response to what happens to women when they make choices about birth. When homebirth is reported in the media, it’s mostly because a baby has died and someone must be blamed. More often than not, it’s the mother and her midwife who are blamed. I wonder why we are demonising women, again. Are women really killing their babies? Are midwives? Is that what they were doing? Where is destroying-the-joint when it comes to birth?
I wrote my book The Birth Wars because when I worked for a review of maternity services in 2005, I met so many women who had such awful experiences of maternity care. I wanted midwives and doctors to know the cost of their wars on women and families…
.. How come the stories about homebirth in Australia never conclude that we should make it safe for women, if it’s not safe? Why is it that when people talk about homebirth, they blame the women who choose the option and the midwives or doctors who provide the care and not the system that doesn’t support homebirth? Why can’t we have safe homebirth, when the UK can?
I’m not a homebirth advocate, far from it. Love science, love medicine. I do worry though that we’re becoming increasingly vicious in our hatred of women who make a choice I might not make. And that really scares me.
And I am not a homebirth advocate either, one of my children was born in a birth centre and the other in a hospital, but as I have argued before in Essential Baby, it seems clear to me that birth choices are a feminist issue. Because here’s the thing about homebirth, like abortion the real issue is not whether you would choose homebirth yourself, or not. The issue is that some women will choose a homebirth and that homebirth has always been around and always will be, for lots of reasons, and given all that, how do we want to legislate for the reality of women’s lives? And do we not feel the tiniest bit suspicious of motivations to criminalise women’s lives?
I suspect it has a lot to do with not being able to trust women’s bodies – medics tend to only see the dramatic and the difficult and to therefore have limited experience of standing back and doing nothing, and in a lot of births that is the best course of action
I have had both my babies at home, admittedly the 2nd wasn’t planned to be, mostly driven by an over 90% intervention rate amongst my friends – in the UK currently going into hospital almost seems to guarantee that it will be hands on and traumatic – homebirth at least acts as a brake on progress back towards assuming that women cannot birth without drugs, inventions and heroic actions
Yup, totally agree, same here in US. I count myself lucky that I did not end with a C-section with my first, like most of my friends. My hospital had a 50% C-section rate, so really it was flipping a coin. I had to BEG for a chance to push, even though I was 10 cm and had been for over an hour when the OB showed up. Basically I was scared to go back to the hospital, not knowing what I would encounter there. Even after I had a quick and easy delivery, the attending OB made sure to let me know she was shocked I had made it through birth without an epidural and with my baby alive.
Can I just leap to the defence of the UK here. At least at the John Radcliffe in Oxford, going to the hospital doesn’t guarantee that birth will be hands on and traumatic. The midwife-led Spires unit is brilliant. I have had two births at the hospital and there wasn’t a doctor in sight (except when I got an epidural with my first!). It is very, very supportive of midwife care. I actually wanted a hands-on medicalised birth and definitely didn’t get it! With my second I barely even got gas and air…
I am not sure how the reform of the NHS is going to affect homebirths in the UK though since apparently independent midwifes will no longer be permitted.
Yes, I think in the UK there has been a pretty big commitment for birth to be “supervised” (can’t think of a better term) by midwives rather than doctors. Maybe having a tax-payer funded health system has helped with this – midwives and less interventionist births are cheaper.
I agree wholeheartedly with this point–and I will add that I had both my children in the hospital–but I do want to nitpick with the opposition of homebirth and science/medicine; the scientific/medical evidence on the advantages of hospital vs. home is at the very least not so clear that only an unscientific-minded person would choose home. There’s a stereotype at play there that I think is the opposite of useful, and in my personal experience of women I know who choose homebirth, absolutely not true.
Yes I agree, it is a stereotype at play.
Yes and I feel like it is at odds with the general message of the article – shouldn’t the argument be to allow more science and medicine in homebirths? Rather than making it an either you can have science and medicine, OR you can have a homebirth.
As you say, the actual science often supports homebirth – and more generally, births that are less medicalised.
p.s. I think this is the first time I have commented on your blog and I sound peevish, but I LOVE what you do here; I don’t know anyone, anywhere, who is writing more insightfully about motherhood & feminism.
I too love the blog. love love love!
Also – never thought of myself as a homebirth “advocate” in the political sense. Just a woman who had one hospital birth (lame, scary, degrading, intimidated by midwife into taking narcotics – just like high school!) and one home birth – funny, joyful, chaotic, and I’m going to put myself into the lunatic fringe here but I just don’t know a better word: pain free.
I’m all for science but hospital births aren’t guided by science – they’re guided by the whims of doctor’s personal (unscientifc) preferences and convenience, in terms of everything from logistics (I know this is a busy time for you but if you could point your vagina to the light at the top of the room please? – just a little higher if you don’t mind – thanks luv – you’re a peach) to their social comfort (professionals don’t lie on floors; the CEO gives direction: Push! he doesn’t simply observe and support).
I know I’m making this about homebirth – not about choice which is totally not your point but honestly – the nonsense we’ve created then learned from about birth is an infuriating self perpetuating cycle. After the homebirth my husband looked at me completely astonished and said “I had no idea it could be like that!”
Sadly, neither had I.
In order to have meaningful choice that acts in our best interests it has to be informed. I think talking about the nonsense and misinformation of the various options is *essential* to talking about choice.
I think there are misconceptions and certain pressures for each option. It’s clear that whichever option is chosen, there always needs to be expertise that can intervene in the case of problems, but also that expertise must understand enough to not intervene unnecessarily.
I would love to read some research on best practice in this area. This is totally a feminist issue.
Cat, sounds like we had very similar experiences! After a horrendous 1st labour I had my 2nd at home and it was amazing. I agree with those who say women are put off homebirth for the stereotypes surrounding it so I’d like to put forward an alternative. Some women, like me, who are educated professional women just decide it might be nicer to be dealing with labour in the comfort of their own home rather than pointing their vaginas at the light every 5 minutes at a doctors request! (that made me laugh, hard!) at home I was relaxed and in control and able to manage.
I discovered your blog a few weeks ago, and can’t tell you how happy I am. The things you write about are so insightful and relevant!
I live in the US and had my now-eight-month-old daughter in a hospital, and it was an awful experience. Not traumatic–no one did anything abusive to me or pressured me to have a C-section or anything–but more just being in intense, all-consuming pain and having to sit in a waiting room for hours across from children and trying REALLY hard not to freak them out; having my birth plan completely ignored; feeling exposed and vulnerable and unsafe. I definitely want another child at some point, but I actually get panicky at the thought of giving birth in a hospital again–even though my labor and delivery were uncomplicated and not the horror stories you sometimes hear about. If I can find a homebirth midwife I’m comfortable with, I think I’ll go that route.
That said, the idea of something going wrong terrifies me, and so yes, I desperately want the system reformed so that women’s choices are supported and made as safe as possible..
Hear hear. I’ve have had one awful hospital birth OS and two midwife assisted home births in Australia.
I have also had to defend my position on home birth many times over with those who would otherwise consider themselves feminist. Aside from the fact that all women clearly should be able to choose where and how they give birth (irrespective of studies!!!), the question I have for doubters is how would you police those women who refuse to go to hospital?
And if the law determines that these women should be forced into hospital in some supposed concern about the baby-in-uteros safety then what is next? Will will start policing what pregnant women eat and drink lest they harm the foetus?
I find it astonishing that just because women wouldn’t choose home birth for themselves that some would entirely forget what is essential and fundamental (to me at least) about allowing a woman complete body autonomy, even whilst pregnant.
And there’s a similar mechanism at work in birth choices as there is in choosing an abortion. A general attitude of ‘if you don’t make the ‘right’ choice, we withdraw all medical support’. You can have your abortion but it has to be a backdoor one. You can have your homebirth but it has to be unsupported. Not that we’re there yet but I suspect some people would like to be. It makes women very vulnerable.
That is always the main point I make to people who oppose it on the basis of ‘safety’… giving birth is something a woman’s body does. how can you legislate for a bodily function in that regard? one of my friends was born in the front seat of a 1970s Holden on the side of a country highway after his parents left it a bit late to get to town – labour was pretty short and the dad was late back from work. should they have been fined? (my favourite part of this story is that my friend’s mum broke the seat.)
I’ve said this before but I find the debate about homebirth and the current demonisation of it ever baffling, having grown up in a part of Australia where lots of women have homebirths. (planned ones I mean, not like the one on the side of the road. hehe)
Sorry typing on my phone is hazardous, but my last point refers to what I believe is fundamental ABOUT FEMINISM ie body autonomy. I left out some key words but in think my point is made.
Thank you for the lovely comments on my blog! Very chuffed to read them.
I became interested in birthing choices because I am a pro-choice feminist. And in some ways I was lucky to birth in another country where I was protected from some of the rhetoric around homebirth/birthing centres/intervention-free birth. I also had a lot of support from fellow expats who were very concerned about birthing choices. It was only after I had my son and entered the world of Internet mummy wars that I discovered many pro-choice feminists and spaces were not supportive of birthing rights. I’ve seen so many cases where affirmation of choice and reproductive rights only extends to terminating a pregnancy. I know that in many countries women are still fighting tooth and nail for the right to choose to terminate a pregnancy, but I find some of the rhetoric around a woman’s right to choose what happens to her body during birth very troubling as well (especially when it comes from feminist voices).
I love science too, and I am a great supporter of home birth. The two are not mutually exclusive. In fact, the more I learn about the science of birth, the more I advocate for home birth!
[…] piece from Blue Milk, on her blog, about home birth: You don’t have to be a homebirth advocate to see that homebirth is a feminist issue. I (Deb) agreed with Blue Milk on this, but I thought it revealed some sharp contrasts between New […]
I’m looking into starting to try to conceive in the next few months, so I was looking at what I’ll be doing once I do – and have been kind of shocked at the lack of options in brisbane. There’s only one birth centre – RBWH, and I live outside of the catchment for it, so am not eligible. And even if I *was*, I’d have to go into a ballot system to try to get a place there.
So I’m left hoping that I’ll get into the mater midwifery group practice (which seems like it’s equally exclusive to get into), and if not… am I stuck having to go into a hospital with high intervention rates, and reportedly low respect for women’s autonomy.
And all of a sudden I find myself toying with the idea of home birth with a private midwife, which I don’t really want either.
Oh, and after saying all that, I feel like I should aknowlege my privilege in living in a biggish city that at least has *some* options.
Alien Tea: As a fellow Brisbanite, let me assure you that you are within the RBWH birth centre’s catchment area, even if you live south of the river. You’ll need to contact the birth centre itself to get them to confirm, since if you talk to anyone else at the hospital they will tell you RBWH only caters to north of the river. To get into the birth centre from the south, you’ll need to register with Mater public first, and then transfer if you’re offered a place.
There are some weird ups and downs to not coming from the main RBWH catchment area, and I certainly mentioned that in my feedback! Mind you, this was before Campbell Newman took over, so who knows what state Qld Health is in now.
The women I know who’ve been through Mater midwifery have been very happy with it. My concern was that if something terrible happened, I didn’t want to be in an anti-abortion Catholic hospital.
The statement “I’m not a homebirth advocate, far from it. Live science, live medicine”. Cause homebirth advocates are anti-doctor witches???