The spectrum of birth possibilities in the western world spans from unassisted birth to elective caesarean and even surrogacy. For some people, the choice is made for them, for reasons beyond their control. For others the choice is absolute. When the absolute choice is at one of the extremes, it can be very difficult to access. The choice may be met with actual hostility, perceived hostility and logistical difficulties.
Those at the extremes by choice often find themselves in the realm of ‘advocacy’. It is these people that push the boundaries, boundaries of thinking and accessibility. By pushing these boundaries, they help preserve the freedoms of those at the centre of field. Without these advocates ensuring the boundaries stay open, we could see more and more restrictions on our autonomy, more limitations on our choices and indeed the loss of choice all together. We have already seen this in regards to the natural extreme.
Recently, Call the Midwife actress Helen George reportedly chose to have a caesarean based on her experiences with the show and the horror stories she was told. Helen George is far from alone in this choice. Increasingly women are electing for surgical birth for their first birth in order to avoid natural birth, often based on a misguided and deeply ingrained belief that natural childbirth is painful, dangerous, undignified, unpredictable or unnecessary. Media representations of dramatised birth, the relayed horror stories of friends and colleagues are not alleviated by the medicalised model of maternity care. If anything, the medicalised model of maternity care actually reinforces the belief.
Helen George had a list of justifications for a choice she had made before she was even pregnant. Essentially it seems that what it boiled down to was tocophobia. The Fear of childbirth. For women experiencing this, when a real medical reason presents itself, it is met with relief and “I told you so”. This is very interesting, and Helen George refers to it as knowing what her limits were, knowing what was best and right for her. If she were forced to birth naturally, chances are it would not have gone smoothly because birth is not just a physical process. It is a mental process. We need to feel safe, supported and respected. Birth Trauma is very real, and it is NOT related to birth type or outcome. It is related to how a woman felt. This phenomenon is known as The Nocebo Effect. The nocebo effect is different to general fear or uncertainty. The nocebo effect is the absolute belief in a negative outcome.
Modern birth is plagued with negative thinking, which has skewed the normal towards the medical extreme. And it can be argued, in a chicken-egg manner, that it is a necessary skew. It can also be argued, as with climate change, that childbirth is at the tipping point of a man-made crisis, and without urgent action will irreversibly skew toward the medical extreme.
The ‘natural birth advocates’, doing the best they can to support those women wanting autonomy and trying to avoid unnecessary medical interventions. Not because they are against the medical interventions, but because they understand that the more we skew towards medical birth, the harder it is to have a natural birth. This means that more and more women are faced with forced medicalised birth or forced unassisted birth, as homebirth midwives are forced out of practise by redtape. FORCED. This is not ok, and #ENOUGH is enough!