Tuesday, July 28, 2009

A Reminder

Someone anonymous posted a comment that had me really thinking how many women don't get the basic premise that their body is theirs!

"As someone who is about to have her first child in a geographic location where I am utterly guaranteed to have never seen the person delivering my baby until they glove up, I appreciate the familiar. I feel empowered when I know there are things I can rely on. Touring the hospital enivornment and getting to know the policies that will ultimately dictate my options has helped me to feel confident about things I can and cannot change and that has helped me build confidence in myself. "

To Anonymous and any other woman:

Your body belongs to you. Even in labor and birth, your body belongs to you. No one can force you to anything you don't want to do. That is assault. You can say NO. You cannot be spanked, punished, or disciplined because you chose to say NO. Your doctor, or whoever, is not your daddy or your mommy. You can say NO. It's not always easy but you can do it. And if you at all have a choice, find a provider who will have a partnership with you...not a dictatorship. You are in control.

I'm amazed at how often I have to remind women that they are in control. I tell her, you don't have to ask if the baby can stay on your chest after the birth. This really sparks some interesting thoughts on gender differences. But I am really tired right now and am not sure I can wrap my brain around that now...so more later maybe.


Anonymous said...

Anonymous here,

I agree with your reply; women should have complete control over their bodies in any setting. Although I wouldn't agree that they always do and will not be punished either personally or systemically for saying "no". I probably should have clarified in my original comment that the hospital policies and things I cannot change are not related to saying "no", but rather to saying "yes"! Please allow me to explain.

When I said "options" I was referring to options for pain relief (really should have clarified!!! I can definitely see where you are coming from as I am reading my comment over again!). The thing I'm mostly referring to is the birthing tub available in our hospital, it's what has been on my mind lately. We have one but it sits in the back and gets dusty because most of the on-call docs are not "comfortable" using it (???). I cannot change whether or not the doc I get will "allow" me to use it so I can't rely on the idea that I will be able to use that method of pain relief. As much as I'd like to control that, since I don't have the option of choosing my birth attendent there are no guarantees. There is no official hospital policy on the use of this tub so therefore the hospital is dictating my choice in that respect. However, every room is equipped with a large shower and staff encourage women to use them during labor so I can rely on that as an option for non-pharmacological pain relief that does not rely on my birth attendent. Because I am familiar with what options I can rely on and which ones are not a given I feel more confident in myself because I know what I will be able to do to cope with labor.

You bring up a valid point about the importance of emphasizing medical self-determination and autonomy. I think these are some of the most important medical tools we have, but I think that sadly not all women are able to be in control as you assert. Certainly you and I have the tools to self-advocate in this realm but that will not always be true for everyone. I've read your blog and I think it's fantastic that you respect the right to self-determination of the women under your care, but unfortunately I don't think that is the universal attitude in obstetrics or health care in general. A woman who comes into the ward fully dilated and drunk off her ass or a 32-week laboring blind woman who speaks only Russian need support and advocates to assist them in making autonomous decisions, both of which are not always available or provided to them. Therefore ultimately they may be denied the means to make their own decisions. It's not always as simple as saying "no" because the people you are speaking to may not be able to or want to hear what you are saying.

Beyond that there are mountains of recent legal cases where pregnant women have been punished by society and the state, just in the US alone, for making autonomous decisions about their bodies. Women charged with trafficking an illicit substance to a minor when their newborns test positive for drugs, charged with unlawful child neglect and homicide when they refuse caesarean sections and give birth to stillborns, and women arrested for the duration of their pregnancies to "protect the unborn". And perhaps most shocking of all, the case of Angela Carder who in 1991 (a while ago I'll conceed) was forced by the courts to have a caesarean that doctors were sure would kill her to save her 25 week unborn baby from certain death if she underwent the chemo she desperately needed (they both died). It's true that women should always have complete control over their bodies, but when it comes to pregnancy there is an overwhelming amount of legal precedent that compells me to believe that pregnant women are expected to conceed at least some of that authority for "the good of the children". It's a sad state of affairs.


Danielle said...

I can say I have been on both sides of the fence. With my first child, I also went along with the whole "good patient" thing. Until I had an unnecessary cesarean which changed me for life. Not only was I traumatized, but my trust was seriously breached.
So when it came time for my second child, I wanted a VBAC and I went into the situation GUNS A' BLAZING. MY body, MY birth, MY choices. No one was telling me what I needed to do or what THEY would "allow" me to do.

I was amazed during my second pregnancy how many people I had to tell that they were in charge of their own body.
Doctors are NOT God.

I still don't understand why women think they know it all.
They are human. They are not perfect.