"We need to talk about what happens when women's needs in pregnancy and birth are not respected." Photo: Getty Images
'There's no shame in an epidural'
'We shouldn't shame c-section mothers'
'No one should be shamed about how they birth'
Shame. It's a word that crops up frequently when we talk about childbirth. Along with the word judgement, shame is dropped into conversation ostensibly to encourage consideration of the feelings of others.
In theory, this is a noble objective. Intending to cause great offence on any topic—let alone denigrating how a woman gives birth—is pretty darn low.
Yet, given its ubiquity in conversations about birth, we need to address what accusation of shaming actually means, and consider the silencing implications of its widespread use in this context.
I recently read a piece arguing the innocuousness of caesarean section and suggesting that questioning or 'shaming' another women's birth choices is anti-feminist.
Now, I regularly suggest people keep their opinions about other women's uteri to themselves. But, I wonder, is it anti-feminist or shaming to point out that women are often being let down in birth?
In Australia, between 800 and 900 babies are born every day. In some places as little as 15 per cent of women are giving birth without obstetric intervention. No medical procedure comes without short or long term risk yet these risks are infrequently explained. Over one-third of Australian births now take place via caesarean section, a procedure that carries increased risk of infection, admission to ICU, haemorrhage or death.
Does highlighting these facts cause feelings of guilt, regret or righteous anger in some? Undoubtedly. Myself included. But is it anti-feminist to bring it up?
Despite the care undertaken to ensure the safety and health of women and babies, women and babies are injured in birth every day. One in five Australian women will develop postnatal depression and up to six per cent of women experience post-traumatic stress following childbirth. That is about 50 Australian women every day.
The cost to the Australian public of treating perinatal mental illness comes in at almost half a billion dollars a year.
Factors associated with the development of post-traumatic stress following childbirth can include poor or unnecessarily painful medical care or poor communication by care providers. Overwhelmingly, trauma is associated with a feeling of loss of control, a sense that things are happening to you and you are a helpless passenger.
For these reasons, highlighting our rising medical birth intervention rates is desperately overdue. Not only in childbirth-related circles but in broader feminist discourse. Equality cannot be achieved without women's emancipation from reproductive restriction, and breaking free of that restriction means increasing women's unconditional and informed choice in birth, dismantling the social assumption that childbirth inevitably means a loss of control, autonomy and dignity, and dispelling the implicit expectation of childbearing women's submission and deference to authority.
And, yep, sometimes arguing for these things upsets people.
The hasty reassurance that all that matters is a healthy baby and healthy mother is kindly intended but misguided. It is an attempt to placate the feelings of hurt, frustration, confusion or anger of so many women. The woman who wished not to be induced, but her OB insisted at forty-plus-seven and she ended up with a C-section. The woman who wished for a vaginal birth but was told her baby was "too big". The woman who called her local birth centre at eight weeks pregnant, only to be told they were booked out four weeks ago.
We need to talk about this. We need to talk about what happens when women's needs in pregnancy and birth are not respected. So, while no woman should be vilified for what happened during birth, we need to be careful of tipping the scales in the other direction, acceptance of continued imperfect care.
Certainly it is essential to be mindful of not hurting others. But we also need to stop infantilising women by assuming that the provision of information, stats, facts or anecdotal evidence is a burden too great to bear. Of course, there's mature, progressive debate and then there's trolling nonsense. But too often the presentation of simple facts is accused of 'shaming' others. Too often women are patronised to the tunes of let's-all-play-nice-mummies-and-get-along.
While we skirt around the edges tut-tutting lest we hurt anyone's feelings, we miss the question desperately in need of answer: Why are dozens of pregnant women every day facing the same level of trauma as that of soldiers returning from war?
All women deserve the courtesy of being treated like adults. Silencing or hand-patting doesn't benefit anyone because it's possible to present information with empathy and respect.
It's time to drop 'shame' from dialogue and listen to women's voices. Risks and rates of overused procedures aren't presented to 'make people feel bad' but to help people make informed decisions. Acknowledging birth trauma is not criticism of the valid choices of some, nor disparagement of skilled and caring health professionals, but drawing attention to an overcrowded, risk-averse field in need of improvement.
Birth is yet another area of society where to remove gendered oppression we need to stop moralising and listen to women, despite how confronting it may be.
There is no shame in that.
Kim Lock is a writer, mother and the author of Peace, Love and Khaki Socks. Her second novel is currently under consideration. Twitter: @KimRLock
