Guest post by: Courtney Cooke.
Courtney lives in Boise, Idaho with her three strong willed daughters, infant son and patiently supportive husband. Courtney blogs at The Exponent Blog as CorkTree. She is passionate about science and natural health practices and hopes to merge those with her feminist vision by going into practice as a midwife when her children are all in school.
I recently finished reading the movement-inspiring Half the Sky by Nicholas Kristof and Sheryl Wudunn. No review can ever do it justice. If you haven’t read it yet, do what you must to get your hands on a copy. We all must learn to see the world’s social, economical, political and moral problems from this perspective. For me it has bestowed a brand new lens from which to filter my world view, and it contains powerful ideas that I believe will truly change the world if enough of us work to implement them.
That said, I found it unfortunate that the authors’ ignorance of the potential benefits of certain practices (or elimination thereof) came through in regards to issues that I believe can have more positive outcomes if viewed with more information. With no intention to take away from the momentum of the movement, I would like to add a word of caution alongside a small handful of the issues that the book raises. As a new midwife student, my natural focus is on the descriptions of maternal morbidity and mortality, and what we can do to turn the tide on the numbers of women that are falling into these categories around the world.
The authors of the book repeatedly caution against indiscriminate or unnecessary use of exaggeration in arguing one’s point of view and rallying people to your cause. Yet they (unknowingly perhaps) do this themselves in over-generalized descriptions that arise from being misinformed on issues such as what constitutes safe birth locations and qualified attendants as well as the false necessity of male circumcision.
To be clear, however, I blame the providers of care and the leaders of western medicine that perpetuate these untruths and push an agenda of medicalizing and co-opting childbirth, not only in our own country but abroad as we spread our ideal views of civilization. They have convinced such a large portion of industrialized society to accept these terms that the facts are rarely questioned and labor and delivery is still falsely seen as inherently unsafe; something which even the power of education has had difficulty dispelling as myth.
As a feminist with interest in action and not just adoption of a term, my goal to become a midwife has equipped me with a passion to work toward all women everywhere having the ability to choose their ideal birth and to be educated enough to make an informed decision. Naturally I tend to view my own birth choices as ideal in general, and I try to support others in making similar decisions for their own health and that of their babies. But as a feminist, I recognize the need for options and the ability to choose what is right for each of us.
The sad truth, however, is that in many of the countries mentioned by the authors, the ability to choose how, where and with whom a woman births is not reality. The concern over high rates of medical intervention becomes secondary to the issue of women not having any options to choose from other than what is imposed upon them by circumstance. In reading the book, you will see many examples of labor gone wrong in rural communities, and care providers who have either become jaded and lost compassion for patients, or are unable to help them as they could if they had resources and support. But this does not mean that homebirths themselves are unsafe or result from lack of education. Nor should the numbers of women who die around the world in childbirth be used to scare women into hospitals.
The reality is that it’s most often the relatively young age and sub-optimal health of the mothers that makes homebirthing appear dangerous. Yet instead of focusing on these as the issues that need improving, the initiative is directed at getting women to hospitals and exposing them to western medicine, where most of the women in these countries will rarely be exposed to such again. It is another example of pathologizing childbirth and treating it as something that it inherently is not. Childbirth is shown to be overwhelmingly safe when women are given adequate nutrition and are developed enough to handle the work and effects of labor with a qualified (not necessarily certified) attendant at their side. The midwifery model of care is shown to be effective, safe and desirable when a woman is able to choose it as an informed decision. This is the truth that we need to spread and encourage as we support our sisters around the world.
In seeking ways to improve the lives of women and their children, we need to be careful not to push our own views and fears onto them, and instead support efforts that improve their nutritional reserves, promote safe and clean housing, advocate for later marriage (along with extending education) and get qualified labor attendants out to rural areas. It is even suggested that cesareans be taught to rural midwives to lower the cases of obstructed labor in women that are really too young or not built well for childbirth, but who’s culture has pushed them into marriage (or sexually dangerous situations) before they are able to handle the consequences. It is my opinion that this needs to be the focus rather than getting women to hospitals because the medical community is still telling us that a home birth is not as enlightened or safe.
We need to make sure as we set out to provide aid and support of local, grassroot efforts in empowering women, that we are truly considering what is best for them in their environment, and not what we view as superior by our standards. I believe Half the Sky does this quite effectively in almost all areas relating to empowering women, except for this. And this is simply the misinformed view of the authors as I see it. Not wrong, but not morally or medically superior either.