Mamatoto is a word in Swahili meaning ‘motherbaby’, reflecting the concept that mother and infant are not two separate people, but an interrelated dyad. What impacts one impacts the other and what is good for one is good for the other.
Two pink lines. It’s hard to imagine one’s fate being determined by such an insignificant little sign, but there it was at 5:30 am, the verdict delivered by a small plastic stick. I’m pregnant.
I can’t say that you are the first to find out, but certainly after my husband, my children, my friends and family, you are. And now I feel privileged to embark on a journey that puts me even closer to the world of babies, pregnancy and birth once again. ‘You’re taking your work way too seriously,’ joked a friend recently.
To say this pregnancy hasn’t already challenged me is an understatement. At 43, and with my two children aged 9 and 12, I was well and truly sailing into the land of decreased maternal demand. My husband and I both planned the pregnancy, but when it actually became a reality, I was confronted by many doubts: would my body be able to take it? How would I manage the magazine? How would a new baby change the dynamics in our family? God, what have I done?!
Truth is, I love being a mum. And I look forward to visiting the baby-days again, and the grounding it brings. And with my oldest about to embark on adolescence, I can’t imagine a better way, nor a better time, to bring the family closer to home again.
Both of my previous births were at home under the care of a midwife. Back then my guiding light was Ina May Gaskin, author of Spiritual Midwifery and founder of the famous intentional community known as The Farm, home of one of the first out-of-hospital birth centres in the United States. She has been described as ‘the mother of authentic midwifery’; to me, she was the mother of authentic feminism.
I decided then, as I have now, that a hospital birth was out of the question. I couldn’t imagine doing something so primal, so animal, under bright fluorescent lights with machinery all around. This is not a decision I can boast about; it just so happens I was very lucky that I was afforded the choice. Really it was pure luck—certainly not my own genius—that delivered Spiritual Midwifery to my doorstep so long ago. And it was pure luck that I had friends who had homebirths, and a partner who had even attended a few, that positively influenced my decision to have a homebirth. Over the years I have realised that most women in modern society are given very little exposure to homebirth and even less so today than when I was previously pregnant.
Now that I am pregnant again, I have been shocked to discover that the birth scene has, in the last 10 years, become even more conservative and fear-based. In my prenatal yoga class not one woman has decided for a homebirth, while 10 years ago in the same community, a majority of the women in the room would be opting for it. The number of prenatal tests we’re expected to undergo has increased. And finding an independent homebirth midwife is more difficult, whereas years ago they were abundant.
Northern New South Wales, where I live, is supposed to be home to some of the most ‘free, alternative and progressive’ people in the country. Yet birth conservatism reigns. This saddens me. I’m not attempting to be some vanguard for homebirth here, but I do see this collective diminished trust and faith in women’s bodies as a sign of our diminished freedoms. While I don’t believe every woman should choose homebirth, I do believe—strongly—that every woman has the right to choose based on being fully informed. We all think we are freely making our daily choices; however, most of the time we’ve been funnelled into those choices by strong cultural influences. I believe we have a fundamental right to live unfettered by those influences.
Spirited Grammy-nominated songwriter Ani DiFranco said it best in an interview recently about the homebirth of her daughter: ‘I was shocked how hard it was to find a homebirth midwife… The whole experience of childbirth and pregnancy was an introduction to feminist thought and study that I’d previously been unaware of, in terms of the way that childbirth was co-opted, and is so controlled by the medical/patriarchal establishment,’
‘It makes me really sad that women have been ejected from the seat of their power in this society in terms of what happens around childbirth. I look at my society and think, how emancipated are we, really? We can play basketball but we cannot benefit from eons of women’s wisdom that accords a birthing woman the support and time to give birth healthily.’
I receive the occasional letter from a disgruntled reader who feels that Kindred leans too hard toward homebirth and prejudices readers against hospitals, or worse, against those who end up at hospital. Why are we not more ‘balanced’, they ask. I take those letters seriously, because the last thing I want to contribute towards is more division. But it’s a funny thing about the concept of balance in journalism: in post 9/ll society, it’s become a straw-man argument to keep the press impotent.
My response to these letters is to say Kindred’s balance is maintained by serving the balance to the mountains of media time given to hospital and medicalised birth. It’s not Kindred’s intention to perpetuate judgment towards those who birth in hospitals, as all births are sacred, and it is understood that the complexity behind choices around birth is far too immense to reduce to black and white. But it is our intention to set the record straight: girls, it’s time we all knew—homebirth, in most cases, is the safest option for both mother and baby.
It’s time we also knew that the cultural and medical influences of our time are preventing us from realising this fact. Alas, it’s not as simple as women just ‘choosing’ homebirth. Immense forces work against what is already a difficult decision to make. In every state in Australia, homebirth midwives are unsupported and even harassed by the system. They are bullied, scrutinised and pressured, and it is rare for them to receive open support from doctors and hospitals. Also, they are personally vulnerable to litigation, having lost their public indemnity insurance. According to Dr Sarah Buckley, in her book Gentle Birth, Gentle Mothering, there are around a mere 80 independent midwives Australia-wide.
To make it even more difficult, homebirth families must incur the entire expense of their choice. A homebirth, costing around $2,500, is not covered by Medicare and is rarely reimbursed by private coverage. Conversely, hospital and birthing centre births receive Medicare reimbursement.
In addition, there’s a lot of scare-mongering about birth along with false assumptions about the safety of the medical option. ‘In terms of outcomes for mothers and babies, most studies of planned homebirth show perinatal mortality rates (the numbers of babies dying around the time of birth) that are at least as good as hospital, with lower rates of complications and interventions,’ counters Buckley.
The major risk of birthing in a hospital is unnecessary intervention, which has a high chance of leading to caesarean. (For an excellent account of how medical interventions lead to a devastating domino effect for mother and baby, see the documentary The Business of Being Born, www.thebusinessofbeingborn.com and What Babies Want available from kindredmagazine.com, a must-see for anyone considering a pregnancy). ‘Caesareans increase the risk of maternal death, even among healthy mothers, and a traumatic birth can make the transition to motherhood more difficult and painful for mother and baby,’ Buckley continues. Australia now has one of the highest caesarean rates in the world—just over 30 percent—up from 20 percent 10 years ago. Compare this to the World Health Organisation’s recommendation of 10–15 per cent. Make no mistake about it, this 30 percent is not because so many birthing mothers were saved by caesarean, but a result of so many mothers birthing within an over-medicalised system.
Modern mythology tells us that women must be in partnership with the medical system in order to birth safely. ‘Weren’t those women lucky,’ I overheard someone say when talking about the high caesarean rate. ‘What would those women have done before the days of modern medicine!’ Probably given birth naturally and successfully. An entire birthing system is built upon the premise of applying to the non-risk majority what should only be applied to the at-risk few.
Given all that’s working against a woman’s ability to choose a homebirth, it’s a miracle it happens at all. So the judgmental high moral ground some homebirthers take does nothing to foster women’s advance towards greater birth rights. It only divides us.
I am humbly aware that though my intention is to have a homebirth, any number of issues could arise and I’m ultimately in the arms of destiny. Such is the poignant surrender of motherhood. My ear pressed to the steely track of my fate’s oncoming train, I feel it approaching and can do nothing but remain still, stay calm and trust.
I don’t think we can blame the medical system entirely, however. Our birthing rights (or lack of them) have been caught up in feminism’s own attempt to define itself. Collectively women have borne millennia of persecution and violence. Each of us as women contain memories of that collective suffering and therefore consciously or unconsciously operate within it. Part of our collective feminine evolution has been to claim our freedom, our right for equality and sovereignty. Thanks to the biblical interpretation of woman (ie Eve) and birth (Genesis 3:16: ‘Unto the woman he said, I will greatly multiply thy sorrow and thy conception; in sorrow thou shalt bring forth children; and thy desire [shall be] to thy husband, and he shall rule over thee.’), feminism has supported mightily the modern day medical supposed reduction of women’s discomfort in childbirth. It has become our ‘right’ not to experience pain and to call on any medical intervention that would stymie that pain. Screw God and his threats, we’ll show Him.
Scheduling our births via elective pre-scheduled C-section has also become the latest feminist trend. It is our ‘right’ to have the baby when we want to. Three-time C-section mum Victoria Beckham has reportedly scheduled her births around her husband’s soccer schedule. How emancipated. And of course, our ‘right’ to have a skinny body is thrown in there too, with a worrying new survey of new mums revealing that more than one in 10 women believed having a caesarean would help them lose their baby bulge more quickly.
However, a recent study published in the international journal Birth reports that babies born by elective caesarean are almost 2 1⁄2 times more likely to die within their first month than babies born vaginally. Now we’re suddenly thrown into the domain of ethics and a few questions arise for us: Are birth choices merely an issue of a woman’s autonomy? What about the rights of the baby? Are women embracing their rights fully informed? And if they are not fully informed, is it truly ‘rights’ and ‘freedom’, or is it simply bondage disguised as freedom?
Feminism has more work to do—deeper work that embraces ancient maternal wisdom. As it has done in the past—broken the eons of subordination—it must now do so again. It must end our subordination to the medical system, to the modern corporate system that would send us to work too early for our babies, and to the Hollywood system, that tells us large hips and soft milk-filled breasts aren’t sexy. We have to walk that razor’s edge of demanding more rights, but not judging each other for choices made along the way. For it is only when we are united can we change the goal posts for healthy birth choices. Thus, all births, whether they end up in hospital, birthing centre or home, are supported with the foundation of trust, ancient maternal wisdom, sovereignty and empowerment.
I hope my own journey contributes in some small way towards greater insight into our collective birthing journey. I’ll be diarising my pregnancy, as honestly as I can, on my blog and look forward to reading your comments too. See www.kindredcommunity.blogspot.com
Published in Kindred issue 26, June 08
You can read more of Kelly’s writing at EQUUS, here.
Ina May Gaskin, Spiritual Midwifery (Summertown,TN: Book Publishing Company, 2002)
Dr Sarah J Buckley, Gentle Birth, Gentle Mothering (Brisbane, QLD: One Moon Press, 2005)
Interview with Ani DiFranco, ‘Righteous Babe y Mama’ Mothering magazine, No. 148, May-June 2008.
Barbara L. McFarlin CNM, MS, RDMS, ‘Elective cesarean birth: Issues and ethics of an informed decision’ Journal of Midwifery & Women’s Health, Volume 49, Issue 5, September-October 2004, Pages 421-429
Telethon Institute for Child Health Research (2007, May 21). Dramatic Increase in Caesarean Sections in Australia. ScienceDaily. Retrieved May 11, 2008, from www.sciencedaily.com– /releases/2007/05/070516091842.htm reporting on a study published in British Journal of Obstetrics and Gynaecology