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Guest Post: Why can’t we be proactive instead of reactionary?

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This guest post was submitted by reader Susan. 



I have, quietly, been a healthy birth advocate for almost 20 years. Since my first birth that was more like a horror movie than a joyous occasion. Things were done to me that still bring tears to my eyes and a twist to my stomach. Things that I did not know I could refuse. Things that affect me physically and emotionally ever after.

It came about gradually. My second child was a hospital birth with the limitations of constant monitoring and lithotomy positioning (the two things my OB would not bend to) but no other intervention. My third was a hospital birth with a midwife who protected me like a lion. I would have said this was the ideal situation if the staff had not been horrible to me once she left. Because of this treatment my fourth and fifth were born in the peace of my home where we could curl up in bed after and receive home care for days afterward.

Having experienced this range of situations, I chose to support home birth. To me this was logical. To others I was eccentric, a radical or just plain stupid. They would listen to my reasoning and nod but always say something utterly ignorant like, “Well, squatting in the bushes is not for me. I need drugs! Midwives are not doctors!” At first I thought this was about ignorance and the unwillingness to do research. Over time I have come to realize the situation is far more complex and involves a healthy dose of fear fueled by misinformation. It involves the fact that women should be free to have choice in any direction. I now believe that the best balance would be solid collaboration between woman, midwife, doctor, home and hospital. A birth utopia, if you will. A birth utopia where no one would have to lie and information was openly shared. Truly, if you have looked at the risks and made an informed choice, then you should have the right to make that choice.

I am writing this from a dark place. Lately I have felt this birthing ennui overtake me. I am tiring of educating against the sick stereotype that midwives are uneducated or less qualified. I am ground down by the women who believe that the cesarean rate is too high and the procedure overused but still believe their own operation was a necessary emergency. (I am NOT saying that C’s do not have a place or this situation is impossible but I have NEVER personally met a woman who thought her C was unnecessary. Only online. I attribute it to a need to believe it was necessary to protect against any feeling of loss. Much like the healthy baby pacifier.) I wish to weep whenever a first time mom tells me of her grand plan to go in and sign up for an immediate epidural. When I gently ask if she has considered the risks I am met with the standard, “My doctor tells me it is completely safe.” Like defensive automated phone systems spewing catch phrases. Deaf to all else. I am sometimes shamed when I read comments from women lambasting birth advocates for not supporting their choices to have interventions because it was “the right choice for them”. I am sometimes shamed that I have wavered in being outspoken to be more “politically correct”. My heart breaks for those who have had belief in their bodies stripped from them and their bodies cut open only to be told later that they will never be allowed to birth vaginally because it is against policy. I hate the fear that women feel to go against or outside of the system in order to have a say in their own birth. The joy of birth is being lost to me because I only see despair and struggle ahead. This is dark and heavy on my shoulders these days.

Maternal care is a feminist issue. ALL women should take the time to research and question what is being offered or even forced. Women are using the “choice” banner to defend the choice to give up choice. When the chips are down, who is really going to argue with personal choice? It makes my head spin. My worry is that most women, in majority, will not stand up for their right to control what happens to their body during pregnancy and birth until we have no control. It is going there and we see it every day. Women being imprisoned in hospitals, ordered by the court to undergo surgery, refused vaginal delivery because of a policy made by strangers counting dollars. Women being confined to beds and their bodies forced into hard labor with chemicals under the threat their doctor will “drop them” or their “baby will die”. Women feeling the only choice is to labor at home without an attendant because it is illegal for a midwife or doctor to attend them at home, where they feel safest. To me this is an echo of women hiding in their bathrooms with a knitting needle. You know of what I write.

Why can’t we be proactive instead of reactionary? Why can’t we stand strong to keep what we have a right to instead of fighting for something we have lost?

I am ever thankful to the people out there loudly advocating for all women and their babies to have safe and healthy births and admire your strength to stay the course in the face of such resistance and complexity.


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Reader Comments (22)


I'm sorry for what you went through.

Thanks for this post. It echoes my thoughts and feelings to the "T."

Having had a scheduled c/sec for breech and an HBAC after ECV, and having seen the VBAC climate in our area, which was already bad, get worse, and having seen firsthand how social services treats people when they are called...I am actually terrified of getting pregnant again. Because I would choose homebirth again, it is what is best for me and our baby (unless of course, there were indications that a hospital would be the better choice). But if something went wrong, aside from grief I may have to endure, I'd be terrified of the establishment, y'know? Someone called it "psychological sterilization."

Unfortunately, it's a horrible time for birth in this country. And I know how you feel, I too am just weary of explaining it to people who don't want to understand, or even to understand that their choice might not be someone else's choice.

February 18, 2010 | Unregistered CommenterRachel

Oh, this is so sad. Susan, your exhaustion is valid and hard-earned. Please take heart in the knowledge that at least SOME women are educating themselves and fighting the system. And they are doing what they can to educate their friends and family, and to stand up for the rights of women to truly give informed consent.

February 18, 2010 | Unregistered CommenterSmoochagator

Thank you for writing this article! It captures a lot of what I'm feeling right now and haven't been able to really voice. At least not as well as you did, Susan. I'll be sharing the link to this blog for sure.

And to Rachel's post...Even after such a great HB experience, I too fear getting pregnant again. It's nice to have that feeling validated by someone else.

February 18, 2010 | Unregistered CommenterMama&Ellie

There are a few areas in which I’m proactive, but I tend to be more reactionary. If someone is happy with the way things are going for them and comfortable with the level of research/second opinions/trust, then I don’t really care what they do. On any given day, there are thousands of women who question whether they’re getting accurate information from their doctor or are sick of having to fight for vaginal birth.

I just figure that if people say they’re happy and comfortable, I take them at their word.

On a non-pregnancy/birth related note, I find myself intrigued with the way people make decisions about their health care. The history of how the “everyone is sick” model was marketed in the U.S. is fascinating.

February 18, 2010 | Registered CommenterJill

It's hard to be proactive instead of reactionary when what we have a right to does not adequately exist, or doesn't exist at all. I, too, tire of the birthfight. It shouldn't have to be this way.

February 18, 2010 | Unregistered CommenterJill P.


Thanks for this. You should not be discouraged. Because of your efforts and those of the so many other supporters of physiological birth and birth rights, I had access to the information that changed my mind. Before reading about all of this on the Internet, I would have been one of the many duped by the system. I planned on going in and getting an epidural and doing what the doctor said. Now, I'm pregnant and working with a midwife, and planning to deliver a home, and I'm happy and comfortable with my decision.

All these efforts are not for naught, and we aren't just talking to ourselves. Even the lurkers who never speak up help by increasing the visibility of good sites on the Internet.

What we need to do in this country is support evidence-based medical care and individual bodily autonomy as two linchpins of modern health care. It isn't physician versus midwife, or woman versus medical establishment. It should be all of us working to create a healthier country, period, in birth, in life, and in death.

February 18, 2010 | Unregistered CommenterMaureen

"Birth Utopia" yes, that's a good phrase. I like that a lot.

When people tell me I complain too much because after all I had a healthy baby, I shoot back, "Bad things don't change unless enough people complain about them!" Not that complaining is all there is, but it's a place to start. I used to feel bad when doctors would get all huffy about my uncomfortable birth-related questions; now I enjoy it. I don't expect to change minds with one conversation, but I can plant a doubt, and shake them up a little bit. And the more times a given person (doctor or not) has to deal with a new idea, the more familiar and less threatening it becomes.

February 18, 2010 | Unregistered Commenteremjaybee

Please be encouraged and keep working for women's rights in childbirth! Because of women like you, when I first became pregnant, I was able to fully inform myself about my birth choices and read all the things doctors will never tell you. As opposed to some of my friends ("ooh, get the epidural!" was one of the comments made to me when I announced my pregnancy), after doing the research I realized that the hospital was NOT for me and used a midwife instead... where, 10 days after my due date, I had a 26 hour unmedicated labor that ended in a beautiful water birth. I know that had I been in a hospital, I would have been constantly harassed to get pitocin and so the spiral of intervention would have begun, possibly ending in a c-section -- and most certainly not ending with the euphoria I experienced on the birth of my healthy son. I will never forget that feeling. And I would not have known any better if it hadn't been for advocates like you taking the time to educate and inform. So please keep up the good work!

February 18, 2010 | Unregistered Commentersr

This exhaustion must be in the air. A couple of weeks ago, I was feeling similarly but was too mentally exhausted to put it into words. Besides any words I came up with, would have sounded more despondent than I really am.

There are people fighting for these rights all over the place, doing many different things, taking many different strategies. That's how grassroots works. And what we're struggling against is so big, with so much power and influence with the PR people to pontificate the rhetoric. When I first entered the arena of birth advocacy, I looked around and saw all of these grassroots efforts and wished that there was some unifying body that could bring strength to their voices. I think organizations like Childbirth Connection and the Coalition for Improving Maternity Services might be able to do that, but we need some of ability to be spokespeople like MomsRising who have a voice in the legislative lobby.

Right now, I'm working in damage control however, lending support to mothers who have been traumatized by the abuses of the system with Solace for Mothers (www.solaceformothers.org) and giving them a place to report on their so called care and find better more respectful care with The Birth Survey (www.thebirthsurvey.com).

I think the arena of birth advocacy needs a policy center. I think class action lawsuits against ACOG is needed for their misuse of and the harms caused by Cytotec, Pitocin and unnecessary c-sections, for their turning a blind eye to proven detrimental practices, for their not sanctioning their members for the care that causes known harms, for the emotional distress (trauma and PTSD) inflicted on mothers by their members violations of human rights and informed consent regulations. The FDA probably needs a class action lawsuit against them too for allowing themselves to be hamstrung by the medical lobby for abuses of Cytotec.

In order this happen, there needs to be organization, some body that collects the reports from women, who seeks out the medical experts who will testify on their behalf. What is happening is wrong, unethical and illegal, therefore the legal system must be involved. There needs to be punishment for providers and recourse for patients. The medical establishment does not police its members well.

There needs to be sensitivity training if you will for providers so they stop the abusive practices that they are using on pregnant and birthing women. And if they don't stop and do it anyway, they need to be aware of the clear and decisive consequences.

Not to mention the need for collaborative care relationships between homebirth midwives and hospital doctors, the legalization of homebirth services nationally and protecting parent's rights to make decisions on behalf of their children.

Boycotts are nice, warning women away from certain providers helps, but its damage control. It will be a long ways down the road before it changed practices. There is progress being made. The work in the last couple of years is really making a difference. I believe that there are ways to harness the collective good for greater impact.

February 18, 2010 | Unregistered Commenterjenne

Susan, thank you for sharing, and I feel for you. And I also love the new term "birth utopia"!

I agree with Jenne. There is truly not enough accountability for "care providers" and their actions. And I would love to see abusive docs and nurses suffer consequences for their actions.

February 18, 2010 | Unregistered CommenterBri-Wonderfully Made Mommy
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