What's the cost of a woman facing disrespect and disempowerment during childbirth? Is she denied a sacred rite of passage that lays the foundation for her new life as a mother?

I was only 22, but I knew what kind of birth I wanted. Raised by a woman who managed to achieve natural births in a rural hospital in the late 1970s and breastfed my brother and me until we could lucidly discuss the pros and cons of "extended" breastfeeding, I understood birth was a healthy, natural process until proven otherwise.

It is not a disease. Pregnant women are not necessarily "sick" women. I knew I did not want to be treated like a sick person unless I became, well, sick.

Pregnant women are not necessarily "sick" women.
I knew I did not want to be treated like a sick person unless I became, well, sick.

I knew I wanted as few interventions as possible. I did not want an induction. I did not want an epidural. I wanted to birth my baby without interference or interruption.

I began my care with an OB/GYN associated with a research hospital in a neighboring city. I asked her a lot of questions. At my fourth or fifth month appointment, I asked her how she feels about letting women labor a long time, or in fits and starts (as sometimes happens). In other words, "Will you let me labor as my body wants or will you freak out if I don't fit some medical book timeline?"

She looked at me, rhythmically snapped her fingers and said, "Well if I don't see you progressing the way I think you should, I'll give you Pitocin."

I never went back to that doctor.

In fact I switched to a birthing center attached to a hospital facilitated mainly by midwives.

I switched because I could tell this birth was about her. I switched because I could tell she had no faith in my ability to birth my own baby, in the natural process of it all. I switched because she believed I was something to be managed, controlled, handled as a sick or incompetent patient.

My power was gone, and I wanted an empowered birth.

Unexpected complications arise sometimes and we must act accordingly, and I am grateful I live in a time when modern medicine is available to address those needs.

I believe an empowered birth occurs when a mother is respected and heard and treated with dignity. Obviously we do not always get the birth we want. I had preeclampsia with my first baby and was, in the end, induced, though I did not use pain medication and there were no other interventions. Unexpected complications arise sometimes and we must act accordingly, and I am grateful I live in a time when modern medicine is available to address those needs.

However, women are often treated as passive participants in their own birthing processes. Though I know some women prefer that the birth process is "managed" by others and would rather stay as removed as possible from the whole thing, other women are bullied, manipulated and straight ignored until they bend to the will of their providers. They are treated as radicals, extremists, problem children.

What message is this sending women? What sort of foundation are we setting for the entrance into motherhood? Birth is a rite of passage. Through it, we become mothers. Nine (actually 10!) solid months lead up to the final couple of days or hours. When the baby finally emerges, we are transformed.

Transformation

The birth of our child prepares us for our time as mothers. So what does it mean if we have entire medical establishments telling us, "You can't birth the baby you made." You don't know how to do this. You're incapable. You need me to handle this for you.

Rather than an empowering rite of passage into motherhood, during which time a woman may gain a new love for and understanding of her own strength, depth and power as a woman, reaffirming her belief in herself and laying the foundation for the incredible work that lies ahead of her, the central message sent to the mother is: "You can't do this."

The other aspects of birth, as a spiritual, emotional and psychological preparation for motherhood, are ignored.

Refusal to allow birthing women to move around. Denying them food and water during the most difficult work of their lives. Episiotomies without permission. Offering epidurals even though she repeatedly says "no." There are a million ways women are denied an empowered birth, and I wonder what this does to a woman, particularly when the world looks at her and says, "Well at least you're both healthy." The other aspects of birth, as a spiritual, emotional and psychological preparation for motherhood, are ignored.

We cannot deny the importance of the rite of birth. Obviously the spiritual, emotional and psychological aspects of birth immediately fall to zero importance in the face of a real emergency, but many births are filled with small indignities that remove the power of choice from the mother, unnecessarily so. She is taken control of, denied and ignored because her provider "knows better." Then, she is sent out on her own to mother her child, suddenly everybody expecting her to "know best." That's what mothers do, after all, isn't it?

Not all mothers "birth"

I know not all women birth babies to become mothers. And I know physical birthing is not what makes a mother. Not at all. However, there are thousands of women giving birth to their children each day, and for them, birth is the entrance into a new world, of life and of parenthood.

For the care provider, it's just another woman and baby. For that woman and baby, though, it's the beginning of life: The woman as mother; the baby as her child.

I believe it's time we start treating it as such. While there will always be complications forcing interventions, until we understand birth as a rite of passage into motherhood, we will continue undervaluing its importance to the mother, and her child, and their lives together.

More on birth

How I had a natural birth in a hospital
What makes a birth good?
Why I'd only give birth in a hospital

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