It’s Time for Birth Climate Change

My recent article, “Culture’s Influence on Birth” sparked some comments on Women’s roles and responsibilities within the present culture of birth.


A Doula “Bears Witness”


Dr. Nancy over at Your Birth Coach made an interesting observation about a doula’s role within this paradigm.  She empathized that a dilemma that lies in the dichotomy of a doula is that a doula is there “partly to bear witness to birth.”

Bearing Witness always means that I have the absolute honor of being present at the moment a new life takes its first breath.  It is such a spiritual moment and so intensely personal and intimate.  I remember after the very first birth I attended, leaving quite promptly following the birth.  I felt like my presence was so invasive in this intimate experience of greeting their first baby.  I gave hugs, left quickly, and ran stop signs on my way home, delirious from a long overnight, my mind stimulated with after-images of guttural moans and gurgly first sounds.  I’ve learned a lot since that birth.

I’m regularly reminded of the intense power a laboring woman holds inside herself; and disturbingly, I often discover how that power dynamic can shift in an instant.


The White Horse Mentality


Watching a woman transform through her labor is spectacular.  As the intensity of her labor increases, I get to bear witness to her surging power and confidence.  I get to watch her OWN her labor.

But so often, mom gets to feeling a little pushy, and in comes the battalion.  Her care provider appears, dons his uniform for this momentous event, and proceeds to rescue the laboring woman from herself.

Finding herself breathless  at the top of an enormous wall that she’s just heroically scaled,the laboring woman is suddenly and enthusiastically “cheered on” the way an NBA coach might shout at his team members on the court.   The shift from quiet, murmuring support to court-side chanting can be stark and alarming.  As she’s told what to do and how to do it every step of the way, the message is clear – she can not be trusted with her own urges, her own intuition.  Her confidence crumbles, as push by push, she relinquishes her ownership in the process over to her care provider.

Check out this clip from “A Baby Story,” complete with counting and chants of “Good Girl!”

It’s interesting to note, too, that it’s not the mother who ultimately gives a final push to complete the birth; rather the doctor maneuvers the baby the rest of the way out, reinforcing the idea that this, in fact, is not the woman’s birth to own after all.

In this clip, we also never get to see that baby handed to mom .  As mom  looks anxiously over her abdomen, craving that first intimate touch, her doctor dutifully hoards those precious moments for himself.  Detached and aloof, he suctions the baby boy (a fact he announced abruptly during the birth, stealing yet another of the profound little joys of self discovery from the parents) AT THE END OF THE BED, offering a play-by-play as some sort of consolation.


Doula as Advocate


In the midst of this, a doula must remain an advocate for the mother.  But how?  A doula walks a fine line when it comes to advocacy.  Certainly she works for the mother, but it is also important for her to maintain positive relationships with hospital staff so that her advocacy is well-received.

A doula can not change the culture in which a woman chooses to give birth.

Feminist symbol courtesy of Zazzle

This means that I can advocate for a mom as far as she has paved the road for me to do so.  This includes careful consideration of where she will give birth, as well as ongoing honest communication with her care provider to ensure that they are on the same page.

Advocacy becomes futile where the atmosphere is toxic and primed only for Woman as Patient.  This climate requires more than advocacy, it requires a revolutionary revolt.  While I may feel called to play an active role in the revolt, the time of a woman’s labor is the wrong time to pull out my bongos and start chanting “THIS IS WHAT BIRTH REVOLUTION LOOKS LIKE!”

And you know how I feel about “changing birth one woman at a time.”  (If not, you can read my feelings on it here.)  While revolution is often sparked by an individual’s active resistance, change almost never occurs out of separate, isolated acts of resistance.  The individual resistance needs to fester inside the marrow of Womankind.


Looking Back


If we take a moment to look back to the establishment of institutionalized birth it becomes clear how we’ve arrived at this place of inherent need to rescue a laboring woman.

Check out my follow-up post, where I explore Dr. Joseph DeLee’s rhetoric of saving women from “the evils natural to labor.”

In the meantime, what are your thoughts on a doula’s roles of “bearing witness” and advocacy?

Visit Spirit of Illithyia at her homepage or on facebook.

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  1. says

    I agree that changing birth one at a time isn’t moving the empowered birth movement forward. That was one of the reasons I wanted to share my birth publicly (baby born live online October 2011). If those of us who know what gentle, empowered births look like, have these wonderful births in the peace, calm, and privacy of our own homes, no one knows just how different birth can be. If no one sees it they don’t know just how wonderful it is. So how do we change birth on a mass scale. How do we create a revolution? In my opinion it must start with women demanding something different and not submitting to the system. How do we allow women to break free of the fear we have instilled about childbirth so they can move into their power and birth their babies in faith and confidence? What would it take to shed the fear around birth?

    • Kathi says

      Dr. Nancy, for sure observing NORMAL birth is integral to changing women’s perception, and thus, the climate of birth. I loved that you streamed your birth live. So, yes, we need to create revolution, and the beginning of that, in my opinion, is educating women about not only NORMAL birth, but also to the history of birth in this country. Until women understand the oppressive nature of institutional birth and how women were subjugated in the process, we can’t fully change the perception of birth as a whole.

      Women can only have “positive” and “negative” experiences as far as their understanding of those concepts around birth allow. In other words, if women believe that most women “can’t” have a natural childbirth, and their goal is only to avoid a C-section, then their satisfaction of their birth outcome is skewed by that perception. If women aren’t aware of their innate power (a concept robbed of us during the process of industrialized birth) then surely we can’t exercise that power in reclaiming birth.

      So I think revolution begins with education and enlightenment. This requires openness. Women need to be open to viewing normal birth, which is contrary to mainstream birth culture. They also need to be TOLD of the blatant paternalism which is the foundation of industrialized birth.

      As birth workers and activists we need to be loud and outspoken about these things. I, personally, do not feel at all compelled to mince words about these issues. I respect every woman’s experience as personal and honor it as such, but my place in the birth community is less about speaking delicately and walking the line and more about affirming all women as powerful, questioning the climate of oppressive birth, and exposing the history that displays one group asserting power over another.

      Revolution usually takes much time. The civil rights bus boycotts lasted for more than a year before any demands were heard. Can you imagine all women boycotting hospital births? (That image just made me chuckle!) We have a long way to go in simply helping women gain an understanding of the injustices surrounding birth before revolution really takes off.

      I’d love to hear other thoughts on the matter!

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