You know when a series of seemingly unrelated events coincide, and then you start to realise that in fact they aren’t unrelated at all? Yeah, well that happened to me this past weekend.
I was scrolling through Facebook late one night in bed (as I often do despite knowing it does terrible things to the serotonin levels in my brain) and I saw an article that a friend of mine from Norway posted. It was in Norwegian (of which I know not a single word), but thanks to Google Translate, I was able to get the overall gist of the article. The title of the article is “Det store barselsviket” which Google tells me means, “The Great Maternity Ward”. What really caught my eye though was the brilliant cartoon that accompanied the article;
Drawn by leading Norwegian artist, illustrator, writer and musician Marvin Halleraker, I realised that all was not rosy in Scandinavian maternity care. I think that many of us assume that women giving birth in places like Norway, Sweden as well as other European countries like Holland have the Rolls Royce of maternity care systems. Well, apparently not.
A couple of days later, I was teaching a Lamaze class and during a break one of the dads came up to me to say that he and his partner had recently gone on a tour of their hospital. “It was really good to see the birth suite and everything.” he began. “But, umm, it’s a bit of a baby factory isn’t it?”
I laughed (although not too much) and agreed with him. “Good observation. It can definitely be a bit of a conveyor belt,” I replied as Halleraker’s dystopian illustration popped into my brain.
The reality is that most women giving birth today in hospitals (which accounts for almost 99% of us), will encounter firsthand the “conveyor belt system of maternity care”. One of Australia’s leading and most respected birth educators and commentators, Rhea Dempsey writes in her excellent book, Birth With Confidence: Savvy Choices for Normal Birth, that based on her research and over 40 years of experience, less than five per cent of Australian women will achieve a totally normal, physiological birth. We tend to talk about birth in very binary terms – “natural” or “Caesarean”. First of all, I believe that ALL birth is natural in the sense that no woman should ever be made to feel less than whole, less than a total rock star because her baby didn’t emerge from her vagina. But we also have to be careful not to describe all vaginal birth as “natural”. A woman that is induced, monitored continuously, subjected to regular vaginal checks, given an epidural, has her labour augmented with Syntocinon (synthetic Oxytocin) and then experiences an instrumental delivery as her baby is extracted with a ventouse did not, I repeat, not have a “natural” birth. Was her baby born vaginally? Yes. Did she experience a normal, physiological birth? Hell no.
The other week, I went along to a professional development workshop. As a private childbirth educator, I was a bit of an anomaly in the group, which primarily consisted of perinatal mental health professionals; psychologists, psychiatrists, as well as midwives and maternal and child health nurses. The topic of the presentation was perinatal anxiety and depression, and specifically addressed how maternity care providers can improve screening, identifying and ultimately referring women on to perinatal mental health professionals for early intervention and treatment. It was an excellent presentation on an incredibly important topic. But… (did you sense there was a “but” coming?)
But… when it came to question time at the end, I was so disappointed to see once again, health professionals dismissing and downplaying the critical role that our fragmented, medicalised and highly interventionist maternity system plays in terms of being a contributing factor for perinatal anxiety and depression.
Someone in the audience raised the topic of birth trauma. In this groups’ collective opinion, birth trauma was almost universally agreed upon to be a by-product of women having “unrealistic expectations” of their birth experience. Way to blame the victim again. I mean, God forbid that a woman desires to have a positive and meaningful experience for the birth of her child. I was absolutely stunned that no one in the room made the correlation between our disjointed maternity care system and an unprecedented number of women suffering from severe anxiety and/or depression following the birth of their child. Did no one stop to think that perhaps, “Hey? Maybe it’s the SYSTEM that is failing women?”
At one point I had to physically restrain myself when one person said, “women need to stop believing that birth is all about essential oils and having a quote, unquote, ‘experience’.” (The group erupted into laughter). I mean JEEEZUS. And we wonder why women are traumatised?
I couldn’t let that one go and I did make a comment. I was proud of myself for not using a lot of profanity (trust me, it was hard not to), but I noticed a couple of eyes rolling and it was pretty obvious to me that I was generally considered to be the “crazy birth lady” in the room and not a “real” professional.
If you are pregnant and reading this, it is my most sincere hope that you understand that you do not have to be dragged along the conveyor belt of birth. You have options and you can make really good choices for your birth. You will have a more positive experience and that is your RIGHT. It is okay to have high expectations of your birth. It is okay to want more than to come out of your birth alive and with a healthy baby. That is the absolute bare minimum that you should expect. That is a given. We are living in Australia in 2018 – not Southern Sudan where more than 2,000 women per 100,000 die around the period of giving birth and 25% of South Sudanese children will die before their fifth birthday. I, for one, am totally over this victim-blaming mentality and this idea that women just need to be quiet, compliant “good girls” who should simply be grateful that they and their baby are alive. Sorry, but I am calling bullshit on this. Our maternity care providers and policymakers need to understand that we are failing our mothers on a monumental scale.
If you are currently pregnant, or planning to have a baby in the next few years, I would not be holding my breath for dramatic and systemic change to happen in our maternity care system overnight. If you want to avoid the “conveyor belt of birth” then follow this five-step plan:
- Choose your care provider very, very carefully.
Do they support normal, physiological birth and can they prove that with their care practices and stats?
- Choose your place of birth very, very carefully.
Does this location support normal, physiological birth? (A hospital with a 90% epidural rate and 50% Caesarean rate is a bit of a dead giveaway).
- Seek out midwifery continuity of care models – Midwifery Group Practice (MGPs) or Midwives in Private Practice as your primary care provider.
Because midwives RULE.
- Take an independent childbirth education class. (I promise you, it will be worth EVERY CENT.)
- Hire a doula. (This will also be some of the best money you will ever spend).
Click here if you are asking yourself, “What the hell is a doula?”
It’s time to dismantle the conveyor belt and build your own pathway to a better, more satisfying, healthier, safer birth. YOU hold the power mama, never forget that.
Tanya Strusberg is the founder of birthwell birthright. She is a Melbourne-based Lamaze Certified Childbirth Educator, doula and a Fellow of the Association of Certified Childbirth Educators (FACCE). Tanya is also a member of the Lamaze International Board of Directors, the first non-North American to ever serve on the board in Lamaze’s 60-plus year history. She is a passionate advocate for women’s maternity care and her articles have appeared in The Journal of Perinatal Education, Australian Midwifery News, Science & Sensibility, Interaction – the journal of the Childbirth and Parenting Educators Association of Australia (CAPEA), International Doula, Empowering Birth Magazine and Rockstar Birth Magazine. Through her internationally-accredited Lamaze Educator Training program, she is very excited to be training a new generation of Australian Lamaze educators. Last, but absolutely not least, she is also the mum of two beautiful children, her son Liev and daughter Amalia.