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Evidence based support - I don't think it means what you think it means

by lizzi (follow)
Helping plant the seeds of positive birth. www.sproutbirthing.com.au
I got up this morning to find myself tagged in a comment in a group that I am in. I occasionally get tagged in this group by someone mocking my work and so that I can be reminded that I am a horrible human being. Or something like that.

The comment this morning that had my name against it went a step further though. No longer content to simply mock me, I am now being accused of killing babies, by way of supporting a woman’s right to bodily autonomy.

The comment has been deleted. I’m assuming the person who put it up probably came to the understanding that leaving it there was a legal risk.

Anyway – I would like to suggest that the logic here is a little faulty.

As a supporter of a woman’s right to choose homebirth, if she deems it to be the best option for her, I am responsible for any deaths that occur during homebirth. Regardless of whether I’ve ever even heard of the family in question. BUT what if I were to say (and rightly so!) that all women should be allowed to choose a caesarean if they deem it the best choice for them? Am I responsible for all the women who then die as a result of a caesarean? And am I also responsible for the babies that end up in NICU as a result? Does it extend to me being responsible for the women and babies who experience placenta praevia and accreta next pregnancy?

What about those of us who support a person’s right to enjoy dangerous sports like rock climbing, horse riding, racing car driving? Are we responsible for any deaths that occur as a result?

If I support your right to a medicalised hospital birth and you suffer iatrogenic complications, is it my fault? Image courtesy of Pixabay.

The members of the group in question believe that as an admin of a vbac group I have a duty to ensure that women planning a freebirth or HBAC are aware of all the risks involved. If I don’t lay out all the ways their baby could die, I’m responsible. BUT:

“Did you know that induction increases the risk of fetal distress?” – Judgemental bitch - It's my body, my baby, my choice!

“Having an elective caesarean results in a 3 times greater risk of maternal death” – Fearmongering cow! The mortality rate is still low and, you know, bodily autonomy!

"Babies can suffer serious injuries from forceps" - How dare you suggest that - my baby was fine!

As usual women are “allowed” to be supported in their “bodily autonomy” if they are making socially acceptable choices. Apparently that is “support” in the eyes of this group. They'll support you if you do what they say, read only the research papers they present to you, interpret them how they tell you to and make the same choices as they would.

Author's own image.

The next thing is: I am a blogger, a doula, a childbirth educator, a birth activist and a mum. I have NEVER claimed to be a research scientist or medical professional. If a woman is basing her birth choices solely on my writings that is NOT an informed decision. And I advocate for informed decision making. Although I am a bit chuffed that they consider me to come across as such an authority on the subject.

However I do believe that as competent adults, women deserve to make the choices that they wish to make, how they wish to make them.

When making a decision you should use your BRAIN. Author's own image.

My friend Erin runs a group and posted this: “BUT (and in my opinion MORE IMPORTANTLY) all of our members are competent adults. If they want to consult 17 different obstetricians, a Facebook group, or the entrails of a goat (messy and you might run out of goats) - that is ON THEM. Please respect their decision making process. As individuals we are all responsible for our own decisions, no matter how we arrive at them.”

OMG – responsible for our own decisions? The world as we know it is about to end.

I would also like to say that I have never suggested that any particular woman SHOULD homebirth or freebirth. It’s not my place to tell a woman how, where or with whom she SHOULD birth her baby. I suggest that women make an informed decision and own it. If a woman is whinging about her local hospital, her OB, her midwife I will suggest that she look into other options. Check out what’s available in her community. If she doesn’t want to then that’s fine. Make the decision and own it.

So why do I write what I write? If I don’t think all women should choose homebirth why do I keep banging on about the maternity care revolution, obstetric violence, consent and that poor AMA guy?

Because I believe that just because a woman chooses hospital doesn’t mean that she deserves substandard care. Because I see so many posts in my group that show that trust in our care providers is LOW. Women and babies are at risk due to the women’s personal experiences of being abused by the maternity care system.

How many times in the last week have I seen this post:

“I’m experiencing reduced fetal movement (or some other concern) I don’t really want to go to my hospital because I know that they just want to section me. What should I do?”

Yes, I always tell a woman that attending her hospital is the safest and best option. I recommend that she take a support person if needed. But how many women out there are choosing NOT to attend hospital for worrying symptoms simply because they have been abused there?

A woman I know was planning a vba2c at her local hospital. Throughout her pregnancy staff had bullied her so much that her level of trust was low. When she went in for what she thought was premature labour she was recommended a caesarean. She was convinced they were only telling her that because they had been saying it throughout her entire pregnancy in the absence of any indication for one. She did consent to a caesarean, but wondered to me later whether it was her fault that her baby struggled when he was born because she didn’t trust her care providers. She went on to say “No. It’s not my fault. If they hadn’t bullied me during my pregnancy I would never have questioned their motives and would have consented quicker.”

THIS is what I am fighting for! Author's own image.

The abuse that goes on in maternity care isn’t just “a bit disappointing” for women. It’s not making women “feel a little uncomfortable”. It’s putting women and babies at risk.

The Australian maternity care system has stopped serving women and started serving Obs and administrators. My fight isn’t that all women SHOULD homebirth, it’s that the system starts serving women so that freebirth doesn't become the only option that makes them feel safe.

My fight is that we start recognising that healthy babies deserve healthy mothers.

PS: For those who are concerned about how my mental health is holding up in the midst of the cyber bullying and harassment - I'm fine.

Keen to read more about the maternity care revolution, obstetric violence, consent and that poor AMA guy? Check out the links.

The Australian Medical Association - Blaming women for problems they created

Obstetric Violence - What happened to consent??

Trust us - we're the experts

I could have died!

Evidence based care - No thanks!

Reasonable woman syndrome - an epidemic sweeping our maternity care system

Why Australia NEEDS a maternity care revolution
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Above all, childbirth is about a healthy baby; not about female power.
Hello lizzi, it may take a bit of time for people to get that natural home births will be accepted as much or more so than hospital births, give it a few more years. I agree with your argument, for those who have trouble in listening (don't have to agree) and are stuck in their thoughts. These opinions are mainly based on fear, rather than accepting, we can think for ourselves when making decisions and threats aren't the key to making up our mind, but knowledge followed by choices, is.
There are mothers who have no clue, not usually whinging, just scared and need someone like yourself, brave enough to raise this controversial topic, explaining that home births exists, and that a hospital isn't the only choice.
As a soon mother to be, 34 years ago, I don't remember having choices, dragging myself to hospital, it never felt right to be surrounded by strangers, with the strong smell of chemicals, following clinical instructions was truly a cold and terrifying experience.
These days, I can't help myself from smiling to the amazing new generation of mothers, knowing in my heart, how much they are part of the pregnancy and delivery.
I hope you will keep writing to open our minds to there being other choices when it comes to our 'typical main stream lives'.
Our healthy eating habits were laughed at for years, seeing a naturopath was laughed at for years, no one was up exercising at 6am 34 years ago, friends laughed at me for years, nowadays there's a boot camp every 5 metres, saying we see a counsellor was a sign of weakness for years!
There's no need to confront what we don't understand, with 'what are you talking about' (screech)!
lizzi, I trust where you are coming from, and readers will trust in themselves to make a decision based on a door opening, and whether they walk through or not.
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