Monday, November 13, 2006

living free: more thoughts on birthing autonomously

This post is a continuation of the comments from the Birthing Autonomously post:

When it comes right down to it, after another discussion with another friend on this topic today, I realized I am just plain fucking scared to go to prison. I realize that I would be the "perfect" midwife to be able to walk into a woman's home with nothing but her birth on mind; even in the most supportive of cultures I'd still have all of my own personal issues with which to contend. It feels like a massive defeat to admit this because I always felt so brave before, I felt like I was doing the work of the righteous and therefore I'd be protected, and I don't feel that way anymore. I feel defeated. I feel like "they" won. I no longer feel like that brave, radical protector of women and children who would do anything to spare them the horrors of Western medical obstetrical care. I feel like a wounded warrior who just wants to rest comfortably at home.

And the truth of the matter is I can say my inability to make the ultimate sacrifice is for my children, that I have chosen my primary path in this lifetime, and as closely linked to my mother path as midwifery is that my obligation to the two children I brought forth myself must be my first obligation, my undying commitment. It simply would not be fair to sacrifice my freedom to mother them for the benefit of another's child while they still need me. I could say that, and I do. And yet I find myself wondering if choosing motherhood wasn't in some ways my out for making all the sacrifices I feel I should have in this lifetime. Being a mother has allowed me to excuse myself from not being on the front lines in Oaxaca and in all the other places around the globe that have needed witnesses for peace and workers for justice. I always say that motherhood is my primary activism, and I still believe that to be true. I know that by raising conscientious, compassionate, honorable men I am doing the world a much-needed favor. But it feels a little like I took the cush route.

When my sister went to prison to serve her time for an act of civil disobedience directed at shutting down the School of Americas I was baffled by her choice and simultaneously enormously impressed that she could choose that level of sacrifice in the name of protecting others. I don't believe I could live without my freedom; I think I am a spoiled American convinced that I am entitled to be free even while others are oppressed. And I am working myself into a quandary trying to figure out how I am to be grateful for and manifest additional security and comfort and ease in my life, because I feel like I want and need that, while at the same time living in solidarity with those whose entire lives have been nothing but suffering and challenge and loss and pain.

Everything in our world is so fucking fucked up. You’re right, Ashaya, fuck all of that shit. I just don’t know what to do with myself. I don’t know how to fight the good fight and not get lost in it, and so I’ve been trying to live the good life to loose that vibration onto the planet, that’s what all the trance dancing and the Burning Man adventures have been. I seek the balance between following what my own heart wants for my children and myself and what my heart wants for all the children on the planet. It is difficult to find.

While I am at it I want to continue to express how angry I am at this maniacal state our world has gotten into because I feel it also impacts my ability to be a good mother. Yes, I know I am a good mother and I know I’d receive a bevy of protests if I tried to suggest otherwise, but only I can know how much better a mother I’d be if I weren’t forever having to sacrifice my time to the lords of money, if I weren’t parenting alone due to my own or my partners’ inabilities to sustain healthy relationships because our world never taught us how, if I weren’t always chasing some social validation to appease my wounded soul and always needing sleep and therapy to mend my broken body and psyche-- all casualties of my lifetime under the patriarchy. I am frustrated that none of us get to fully be who we could be because of the shackles that capitalism and sexism and racism and environmental degradation and dehumanization has wrought upon our lives. FUCK!!! And all my ranting and all my raving does nothing but give me an outlet so I can clear my privileged head enough to lay it upon my pillow and sleep through the night so I can get back on my hamster wheel and start my routine of doing the best I can under the circumstances all over again tomorrow.

And, specifically I also want to address some of the comments that I have received from the Birthing Autonomously posts, both on Blogger and Tribe. Inevitably and as if on cue, those who are afraid of the loss and afraid of the death or have learned well the story about the dangers of birth that our culture taught them have spoken up to assure me that one way or the other birth really ought best be under the care of trained professionals, ideally in a medical setting, and to you all I will assert once again, that you are wrong. In a well researched comment sent to me via e-mail a friend pointed out:

Global Infant Mortality Trends

For the world, and for both Less Developed Countries (LDCs) and More Developed Countries (MDC) Infant Mortality Rate (IMR) declined significantly between 1960 and 2001. World infant mortality rate declined from 198 in 1960 to 83 in 2001.

However, IMR remained higher in LDCs. In 2001, the Infant Mortality Rate for Less Developed Countries (91) was about 10 times as large as it was for More Developed Countries (8). For Least Developed Countries, the Infant Mortality Rate is 17 times as high as it is for More Developed Countries. Also, while both LDCs and MDCs made dramatic reductions in infant mortality rates, reductions among less developed countries are much less than are reductions among the more developed countries, on average.

As illustrated in Figure I, infant mortality is strongly proportional to decreasing per capita GDP (Gross Domestic Product).

My response to this is that it is not the excellent medical care women receive in MDC’s or the improvement in medical standards in the last 50 years that has lead to a lower infant mortality rates, rather it is the access to nourishing foods, safe and clean water supplies, sanitary living conditions, and reliable information on the best ways to care for oneself during the prenatal period, with access to those conditions being highest in the MDC's. Ironically, the United States, arguably the Most Developed Country, with its epidemically high rate of epidural and cesarean section and almost universal reliance on hospital birth and the use of MD’s as primary maternity caregivers ranks behind 42 other MDC’s for its infant mortality rate. Yes, you read that right. The United States of America ranks 43rd in global infant mortality rates, which means 42 other countries in the world have better success keeping infants alive at birth.

You want to know why? Most of the rest of those countries still have a longstanding tradition of midwifery care and/or a cultural acceptance for homebirth and/or socialized medical care which takes the profits out of giving women medications and surgeries during labor and leans toward providing care that is known to have the best possible outcome, not the highest profit margin.

And while I am not prepared to cite the study right this minute because it is late and I am tired (but I will if you insist, I know it exists because I utilized it both in my midwifery training and in my undergrad research for my BA in Women’s Studies), the most comprehensive research ever done on the safety of homebirth versus hospital birth revealed evidence that not only is homebirth equally as safe, as determined by rate of neonatal and maternal mortality and morbidity, as hospital birth, but even for a “high-risk” birthing population, some evidence shows that homebirth is considered SAFER than hospital birth.

However, I must make it clear that this research proposed those statistics based on homebirth with a trained attendant, i.e. usually a midwife, because to include the spontaneous births at home in the population that did not plan unattended home births but ended up unexpectedly birthing at home without an attendant (due to “precipitous labors” or uneducated/underserved populations who did not seek care because they could not afford it and therefore, in theory, also did not have the appropriate resources for adequate nutrition or education in the prenatal period) throws the numbers out of favor for homebirth. Mind you, NO ONE has ever done a study of the outcomes of planned, unassisted homebirths in a population of informed consumers with sufficient access to adequate nutrition, prenatal education, and self-assessment tools and techniques, so we have no idea what those numbers would look like, but anecdotally, the stories are reassuring.

So to say that because poor women all over the world are still dying in greater numbers when they birth autonomously at home does not adequately support the idea that it is safer to give birth either with an attendant or in the hospital. Sorry. I stand by my story. I still believe it is our fear of and inability to accept death that leads us to cling so desperately to the idea that there is a safer or safest way to give birth in someone else’s hands and on someone else’s terms. Birth is beautiful and birth works, but like the rest of Mother Nature’s wild creation, birth refuses to be tamed and behave in a manner in which we always have control. Birth is autonomous in and of itself, and in the aftermath of facing death at birth’s gate I feel more sure than ever that I trust it as a process.

Blessed be.

1 comment:

elon said...

agency in birthing
has to be a community effort.

you can build it.
i know you can.
you will need help, and support.
my faith in you is untouched.

you can borrow on that.
you are still fierce, and brave.
remember that doubt is an aspect of faith.