You catch more flies with honey than vinegar, or so the saying goes. Amateur kitchen scientists on youtube show otherwise though. Apparently, because vinegar is fermented – or rotten – it attracts more bugs. Makes sense if you ask me! So in light of maternity care around the world, I think it’s time we put the honey back in the pantry and started splashing the vinegar about more liberally!
Why do we need to do that?
- We have a one in three caesarean rate, higher in many places, all contingent on postcode rather than health.
- We have outrageously low VBAC rates, some venues refuse to attend them, others just make it somewhere between unlikely and impossible despite taking the business of hopeful women.
- Women who refuse episiotomies are given them anyway, some even whilst saying NO.
- Women are denied access to food and water during labour.
- Women are unable to access midwifery care because doctors are in charge of everything.
- Midwives are afraid to attend the births of needy women because they may lose their licenses if they do.
- Women who seek a caesarean using alternative methods such as the “calm caesarean” are regularly denied.
- Women are forced to have painful vaginal exams, it’s not uncommon to hear stories from women who have been held down whilst they screamed in pain and fear.
- Maternity care is standardised rather than based on individual needs or the actual service the woman wants.
- Maternity care providers don’t tell women that standardised care is not compulsory care, and that women have the right to refuse or to request non standardised care.
- Most women give birth on their backs, regardless of what’s on their birthplan.
- A quarter of women are induced to begin labour, and even more have their labours augmented with synthetic drugs. The risks of the synthetic drugs are almost never explained.
- Women are shamed and manipulated into compliance with non evidence based protocols using what we refer to as “the dead baby card”.
The list goes on and on and on. The membership in birth trauma groups keep on growing, the membership in VBAC groups isn’t slowing any either. Maternity care, for a huge number of us, is better titled as Maternity Scare, because women are so terrified of what people will do to them when they’re in labour. Women are afraid of losing control of their bodies and humiliation. Birth is a private event, not a spectator sport, but hospital care provides no privacy, or respect for individual women.
It’s at this point that someone invariably chimes in with “But MY hospital was <insert gushing superlatives here>”.
To anyone contemplating that tangent I want to say this. THAT’S REALLY GOOD! It’s really good that you were treated well and that you are satisfied with the care you received. However that’s not what we’re talking about. We’re talking about the women who were bullied, lied to, cheated, abused, or assaulted violently during their births. Everyone knows that there are a lot of women who are happy with their maternity care, but there’s a shortage of people who are prepared to acknowledge the prevalence of substandard care. So it’s good that you were happy, but don’t try to silence other women. Don’t try and distract us here. If your maternity care was so good, surely you want other women to experience the same.
The horrible reality for many women is that there isn’t a single woman centred birth care provider in their area. Furthermore for those who can geographically access high quality personalised care, many are unable to afford it, or they are risked out for spurious reasons. Maternity care is showing the cracks, and you only need to spend half an hour in a birth trauma or VBAC support group to see them.
Periodically someone vaguely papers over the cracks. They might try introducing a new protocol which does something to reduce the caesarean rate, or increase the VBAC rate. A couple of years ago the US caesarean rate was reduced by 0.1% and everyone exuberantly lost their minds. My question is this. If you were a woman seeking VBAC in this climate, would the 0.1% be likely to have much of an impact? Why on earth is that figure, probably no more than a statistical anomaly even worth mentioning! We need to see an ongoing trend of decreasing caesarean rates, not a 0.1% change in one year before we crack the champagne.
The caesarean rate went down from one of the highest in the world …. to one of the highest in the world! Why wasn’t I invited to the party?
Let’s all praise the doctors. Let’s grovel and thank them for the crumbs of our bodily integrity that they’re throwing in our general direction. Let’s not talk about the WOMEN who are being forced into operating theatres unnecessary, either by fear and manipulation, or outright refusal to provide vaginal birth services.
It’s time we stopped grovelling. It’s time we made our voices heard, and it’s time we gave ourselves permission to be MAD AS HELL about these continuing institutional abuses of power against vulnerable women, and in turn babies.
We’ve been asking nicely for years and every so often we get something like one hospital putting a couple of birth tubs in (although who uses those is unclear, because it’s not overweight, VBAC, induction patients, and many women are booted out to push). We might fight to save a birth centre but the restrictions on midwifery therein make it impossible for huge numbers of women to use the service. A hospital might lift it’s outright VBAC ban but they barely alter their protocols so no VBAC happens anyway. A woman fights and eventually gets a “calm caesarean”, but does the hospital ever do another one? Do they become routine for the women who require planned caesareans, or for the women who request them? Nope. All these changes are nothing but crumbs in the honey pot.
Every little crumb we’re shown becomes cause for celebration, but it’s not enough, and it’s NOT making change on the scale that we need to see. If we keep applauding change at this rate we’ll find ourselves with a 100% caesarean rate, still asking nicely to use our vaginas. Women don’t want crumbs, they want the whole cake. And what pregnant woman doesn’t deserve cake!
All the celebration for barely noticeable change is absurd! Do we celebrate a 0.1% reduction in road deaths!? Of course not! We wouldn’t even view it as change, let alone improvement. We’d look at those figures and say “we need to do more! We need more aggressive action plans, advertising campaigns, stricter laws and fines for dangerous drivers” and rightly so! So why is it different in the birth world?
We’ve been so polite for so long, we’ve avoided ruffling the feathers of the people who dominate our reproductive rights, and what have they done to reward us for all the honey cakes? Nothing that has ever once brought any benefit whatsoever to me. I’ve had two caesareans, 9 miscarriages, and a stillbirth. Believe me I was lucky to find a midwife for an HBA2C, and even luckier when she stuck around until forty-four weeks for that birth to happen. For my next birth there was nothing anywhere, I’d moved states, so I freebirthed. And there are countless of my friends, and their friends, and women in the birth groups I frequent who have seen absolutely ZERO benefit from these small, but highly celebrated changes to obstetric practice. For most women the choices they face are forced obstetric “care” or freebirth.
The people in charge aren’t remotely concerned about losing their jobs, even though there are millions of women politely asking for services that they just won’t provide, so we keep on gulping down the vinegar and the crumbs. Why? Because they have a complete stranglehold on maternity care. A complete and absolute, impenetrable monopoly on all services that pregnant women may or may not wish to access. It’s working entirely too well for them, and to top it off they get fireworks and a barbecue for pretty much any kind of superficial change they offer.
It’s no wonder they keep telling us to ask nicely is it! If people are desperately begging me to share my cake, and periodically I given them a couple of crumbs, and then I get a party to celebrate my benevolence? I’m winning all round!
So what would it look like if we were to bring more vinegar into the equation. Would it require rioting and other acts of violence? Let’s hope it doesn’t come to that shall we? However let’s also be mindful of the fact that forced caesareans and episiotomies are acts of violence, so whilst we are peacefully asking for change, women are experiencing horrendous violence.
We need birth activists, ordinary women like you and me, writing to hospitals, doctors, and lawmakers, demanding that WOMEN be the only people who determine maternity care. We need the police to see how serious this problem is, they’re starting to get real with domestic violence, let’s add birth violence to their list. We need letter drop campaigns that name and shame hospitals, doctors, and midwives whose practices are substandard and / or violent. We need midwives to stand up and say that they WILL work with women who want their services, because women have that right, and midwives have the right to economic freedom as well.
We need to demand publicly accessible records which detail the rate of interventions for individual hospitals, care providers, and independent midwives and birth centres – these need to be compulsory, and there needs to be penalties for falsifying the figures. We need serious investigations into the complaints made against maternity care providers by women, and those records should be made public as well. Hospitals need to be held accountable for high caesarean rates and low VBAC rates, and a publicly available rating system for the number of natural births should be held online in one place for any woman who cares to research her potential venues for birth. Not only would these changes empower women, they would be a kick in the pants to the care providers who are expecting honey. They might have to actually WORK a little to earn money, instead of expecting pregnant women to do all the hard yards, and leaping through flaming hoops to be good enough to receive respectful, evidence based maternity care.
These are just a very small number of essential changes to maternity care. What’s most important about this list is that we should no longer be prepared to sit back and wait for these things. They’re really big changes, so there needs to be obvious work occurring to make them all a possibility sooner rather than later. There are no cookies for not being sexist, there are no cookies for not being racist, there are no longer cookies for improving the absolutely disgraceful, violent, oppressive maternity care that we see from one side of the globe to the other. No more cookies. JUST DO YOUR JOBS!
If you’re a woman who has experienced some kind of substandard maternity care, get angry! It’s ok to get angry! Don’t let anyone tell you otherwise, you don’t need to bury your feelings in a pile of superficial gratefulness. You don’t need to smash things either. There’s plenty of middle ground between forced gratefulness, forgiveness, and smashing things. Find the middle ground and we’ll all go there together.
The time has come for us to stop wasting our sweet honey laden words begging for more. The time has come for us to tip vinegar all over this joint which hold us hostage, telling us that we are ONLY safe if we give birth there, but not actually observing safety in their practices. Whilst women are being forced into caesareans and episiotomies, whilst we’re being denied basic respect and human rights in labour, birth in hospitals is NOT safe for us. I may walk away from a plane crash alive, but it doesn’t make plane crashes safe.
We’ve asked nicely for long enough, and we can plainly see that it’s not getting us anywhere. It’s time TO GET ANGRY! Our babies deserve better, our daughters, and daughters in law deserve better, and you know what? WE deserve better! No more honey, I’m bringing out the vinegar, and it’s cheap nasty white, home brand vinegar. The honey hasn’t trapped any flies, so let’s give vinegar a shot.
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