How the Home vs. Hospital Debate Misses the Mark

I feel excited whenever a new study on birth is published because it is a step toward transparency. Whether it’s a study on planned homebirth or birth center births or hospital births, women deserve access to evidence-based information.

Homebirth hospitalAll studies will be imperfect; all studies will have flaws. No study can accurately or precisely predict something as unpredictable as birth. So it’s good to look at any study with a critical eye. Not just the ones that reveal statistical outcomes that challenge our position, but also the ones that affirm it. 

It always becomes an interesting debate, though. And it continues to have the same predictable players in the overly dramatic conversation. It’s a debate that misses the mark, entirely. It strays quickly from centering around the statistical information to supposed safety or lack thereof and is shortly followed by shaming, blaming and a sinister discussion about women’s rights to choose.

Why do we continue to be so invested in the ways women use their uteri, cervixes and vaginas?

If a woman uses birth control she’s selfish and also a slut. If a woman has an abortion, she’s selfish and also heartless. If a woman chooses a scheduled cesarean, she’s selfish and also vain. If a woman births her baby at home she’s selfish and also stupid.

Notice a pattern?

These conversations  – about homebirth studies, about home vs. hospital – they’re never really about safety.

They are about control.

They are about keeping women in their place.

They are about restricting access to choice.

They assert that the issue needs to be continually “dumbed-down” so that pretty little women can understand the repercussions of their actions, and again, make the “right choice.” In other words, the choice that the authority-of-the-moment has deemed best for all women.

What if I told you that women ARE the authority? What if I suggested that the reason these conversations miss the mark is because we’ve replaced what should be the central figure in the conversation – the pregnant person – with another “authority” and his or her beliefs about women’s bodies and women’s rights to make choices about their bodies?

There are people who are pissed every time baby is cut out of a uterus; and there are others who act like raving lunatics whenever a baby comes out of a vagina on a family’s bathroom floor.

Each position is obnoxious – not because they are extreme, but because they deface a woman’s humanity. They draw firm lines and straight boxes and insist that women stay within the confines where they belong.

It’s time to start erasing the lines and smashing the boxes. It’s time to insist that they just don’t need to exist. It’s time to start believing in and honoring a woman’s deep investment in her health and the outcome of her birth.

Until we fix this fundamental flaw in this ongoing discussion, pregnant and birthing women will continue to be placed at risk by systems that place rhetoric, routine, convenience and cost over the best interests of women and babies.

It’s time to change the focus of this tired conversation from imposed, biased and angry judgement to what should be the central focus – a woman’s fundamental right to choose her own birth circumstances and how care providers, legal systems, and society can best support those choices.

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Comments

  1. Kate says

    Kathi, this is BRILLIANT! Probably my favorite blog post you’ve ever written. Love this part especially — “Why do we continue to be so invested in the ways women use their uteri, cervixes and vaginas? If a woman uses birth control she’s selfish and also a slut. If a woman has an abortion, she’s selfish and also heartless. If a woman chooses a scheduled cesarean, she’s selfish and also vain. If a woman births her baby at home she’s selfish and also stupid.” All I can say is right on, sister, right on.

  2. says

    Fantastic post! I just found you and I’m sure I’ll be here to stay. I’ve personally experienced the freak outs about what I do with my body. “You had an abortion? Well, you don’t deserve your children.” “You had homebirths? Well, I hope some one called CPS on you.” I have fantastic, well adjusted children and what I do with my reproductive organs is between me and, well, me.

  3. Julimaude says

    I completely agree with you! Women should be the only ones to decide for what happens with and within their bodies and I really hope I get to feel they do, all the time, in all circumstances!

    However, for now, I’m afraid many steps still have to be taken to get to this ideal. I am therefore sooo very happy that we now can be backed by studies that couterbalance the mainstream thinking that’s been aroud for too long: that birth is a dangerous event that must be closely supervised by professionals and too often acted upon.

    This way of envisioning birth has unfortunately been internalized by many women and has somehow ripped them off of their confidence in their bodies and ability to listen to their intuition. (I’m a student midwife and am always amazed at how worried women are about the whole pregnancy/birthing thing. Most have been culturally exposed mainly to images of women, birthing on their backs, screaming powerlessly and asking to be relieved . People still say: “Dr Such delivered me.”! We’re still far from empowerment, even in the words that are used.)

    I feel studies like this are still needed to bring all possibilities into the light. Once all the extremes and eveything in the middle are seen by everyone, then, there will be real choice and power.

Trackbacks

  1. […] All studies will be imperfect; all studies will have flaws. No study can accurately or precisely predict something as unpredictable as birth. So it’s good to look at any study with a critical eye. Not just the ones that reveal statistical outcomes that challenge our position, but also the ones that affirm it. http://birthanarchy.com/home-vs-hospital-debate-misses-mark […]

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