Wednesday, July 10, 2013

Reflections on the current birth culture

The outward freedom that we shall attain will only be in exact proportion to the inward freedom to which we may have grown at a given moment. And if this is a correct view of freedom, our chief energy must be concentrated on achieving reform from within.
~ Mahatma Gandhi

Things I learned after the birth of my second child. I hope they help some of you mothers out there hoping for a natural birth in Bangalore.

1) There's nothing more diametrically opposite to natural birth than going to a hospital, to an obstetrician, to have your baby. OBs are trained to find and fix pathology, they are trained to handle high-risk cases and perform life-saving procedures - hence they treat every woman like an emergency waiting to happen. You know the saying that if you have a hammer in your hand, everything looks like a nail. The medical model trains doctors to approach any case with a full knowledge of what the hundreds of things are that can go wrong and how to treat each such problem. This is valuable when treating disease. But pregnancy is not a disease. It is a naturally occurring life event. When a natural sacred occurrence is approached from a pathological framework, it becomes a medical event when it is not meant to be one. OBs do not trust birth and they especially mistrust women's bodies - they are convinced that babies cannot be born without the assistance of their drugs and instruments. Fear enters in a big way - fear of the unknown and the desire to control the entire process and make it "safe" and predictable - in the process stripping it bare of all its spiritual, transformative and joyful aspects.

2) Natural birth proponent Michael Odent and legendary midwife Ina May Gaskin constantly stress on the need for a safe, private, dim "cave" for the birthing woman to labour in so that the oxytocin can flow freely and labour proceed smoothly. This is a given for any mammal - even cats seek out cupboards to give birth in. Hospitals are the polar opposite - bright lights, invasive cervical checks by different people on shift, being strapped to the bedside monitor inhibiting movement, being denied food, nurses popping in to check every now and then whether your body is "performing" up to speed or not, the pressure of being "on the clock" with the scalpel hanging over your head. This kind of ambience invariably slows labour and causes the very problems that they then seek to fix with their cascade of interventions.

3) Your OB will only show up after you're fully dilated and pushing, or if you're approaching the 12-hour limit that most hospitals have before the woman is timed out. In the latter scenario, the OB will show up with the intention of ending your labour one way or another - either with Pitocin (manufactured from the pituitary extract of various animals) and/or instrumental delivery (vacuum, forceps), or most commonly a c-section. Most private hospitals have a huge clientele and want their LDR rooms vacated in 12 hours, patients in and out like clockwork, business as usual. This ties in really well with the OBs' agenda and training which is to manage, control, intervene, fix and save lives regardless of whether the lives need saving or not. Hospitals have a time limit and OBs ensure they produce a baby within that time limit. A made for each other relationship.

4) The other side of the equation is the consumer - the "patient". As a society we teach our women to be passive, compliant and to revere the medical model. We teach them not to trust their bodies on every level. We teach them that birth is dangerous though the truth is that birth is as safe as life gets. When many women willingly and ignorantly pass over the responsibility for their births to the system they make it more challenging for those who choose to take responsibility for their births, as the systems are dependent on consumer demand and set up for averages. It's important to be aware of the roles we may play in supporting and perpetuating such systems which have their roots deep in patriarchy, power and profit. Both sides of the coin - the patriarchal hospital system that caters only to its own bottom line, as well as the ignorance and passivity of the consumer - both go to make up the overwhelming juggernaut of a machine that is obstetric care. One woman stands very little chance against that juggernaut.

5) Some sources will have you believe that if you go into the hospital system with a strong birth plan and a midwife/doula in tow, you can achieve the natural birth you want. This is like trying to order idli sambhar at McDonald's. They may humour you for a while but when the time comes to deliver they will serve up what they have always served up - burger and fries. It's like trying to have a homebirth at the hospital. You can perhaps do it if you are lucky enough to have an express train labour and birth under 12 hours in textbook fashion. There are so many variables in labour and birth and every women is different - a 3 hour labour and a 3 day labour are both just variations of normal. However, hospitals do not cater to individuals, they cater only to their own policies. They have ways of using fear, coercion and manipulation so insidiously that by the time your OB walks into the room and plays the ace up their sleeve - the dead baby/dead mom card - you're broken down and ready to capitulate, no matter how strong or well-informed you are. You're extremely vulnerable at the end and they know what buttons to push.

6) I learned that the crux of the whole issue is taking responsibility. We've been deeply conditioned to trust the voices of others over our own inner voice, to look for guidance from outside.

Naomi Aldort writes, "Through schooling and other numbing of the true being, children grow up to become overly dependent on external guidance in all areas including their health, money, clothes, food and relationships. They lose authority over their own lives and turn responsibility of their own experiences over to “experts,” the state and the mythical “others” all of whom swallowed the same pill. Without a separate system of experts people would gain autonomy over their own lives, such as birth, death, care, etc. and would not play the game dictated by the money monopoly."

We ignore our inner guidance at our own peril. A woman may not know the things that a doctor knows, but she is the expert of her own body and the particular babe that is growing within her body. She is the creative process itself and therefore knows on a deep level what is best for herself and baby, how and where to birth. But this truth is undermined by the people around her and the doctors who think they are the experts, that a woman should submit herself to them, and is being foolhardy if she doesn't.

Many of us birth at hospital so that we don't ultimately have to take responsibility. If you give the hospital system the responsibility then you can expect them to take it. Don't be surprised, shocked or upset when you have to comply. A care provider can only provide the illusion of safety - that they will be responsible. They can't. Ultimately only you are responsible because it's only you and your baby that will face the consequences of their actions.

7) Know your birthing options.

These are natural birth centres in India which follow the midwifery model of care - a model of care that is holistic, supportive and nurturing of the birth process:

The Sanctum, Natural Birth Center in Hyderabad led by US-Certified midwives with backup OB/Gyn emergency care in the same building.

The Birthing Sanctuary, in Goa.

BirthVillage, in Cochin, Kerala.

If you'd like to locate a homebirth midwife, or a doula, post a query in the BBN yahoogroup  or the Birthindia yahoogroup.

May a truly joyous birth be yours!