Should I Compromise On My Birth Wishes?

Should you compromise on your birth plan to help other people stay in their comfort zone?

Should I Compromise On My Birth Wishes?

Compromise seems to be a popular concept when it comes to other women’s births. Unfortunately it rarely involves anything that constitutes actual compromise. It seems to involve women doing what other people want them to do, and then labelling it compromise.

When a woman is pregnant she is at her most vulnerable, she needs the complete, unquestioning support of the significant people in her life.  Women shouldn’t be compromising or overhauling their birth plans to accommodate anyone else, not their husbands / partners, families, and certainly not their care providers. Our whole society needs to support pregnant and birthing women, and stop stigmatising their needs and wants as “hormonal”.

Women write their birth plans using words like “wishes” and “preferences” rather than just saying what they want during labour. There are two reasons for that, the first is that “plans don’t always turn out the way we want them to”. However any birth plan that doesn’t take that into account is a VISION, not a plan. A true plan takes into account the true nature of birth – it plans for it.

Is that a Birth Plan or a Birth Vision??

The second reason is that they are confusing assertiveness with rudeness. it is wrongly assumed that using “wishes” and “preferences” will smooth the edges off the language used, and not offend anyone. But why is it offensive to say “No vaginal exams” or “Intermittent monitoring only”? It might be assertive, it’s definitely direct, but it isn’t rude.

Realistically speaking, the fewer words there are in a birth plan the better, after all staff are caring for LOTS of women, they don’t have an hour to read a five page birth plan full of wishy washy language.

Another thing women compromise on is where and how they will give birth. Husbands or family say they are “uncomfortable” with homebirth, midwifery care, birth centre birth, VBAC, or whatever else you can come up with, so women “compromise” by stepping out of their own comfort zone and into someone else’s.

The meaning of compromise, as defined in the Merriam Webster dictionary is:

1.a :  settlement of differences by arbitration or by consent reached by mutual concessions

   b :  something intermediate between or blending qualities of two different things

So when a woman goes to hospital rather than having an out of hospital birth for the sake of her husband, it is not a compromise. A compromise would be a birth centre, and it’s probably the only compromise, because if a woman wants an out of hospital birth, she isn’t getting any of  her needs met by a hospital birth. All that’s happening is that she’s conceding to his wishes.

Conversely, if the family or husband / partner would like the woman to have a home birth, but the woman wants a hospital birth, home is not a compromise. Nor is a birth centre. The woman wants a hospital birth, there is no compromise to be had. Of course this isn’t a situation we see often. Generally it is the woman who wants a homebirth, and in that instance, she generally goes to hospital against her own wishes. Perhaps she hires a midwife or a doula to attend to her, but that isn’t a compromise, it’s an addition to her husband’s birth plan. A placation perhaps, but not a compromise.

It goes without saying that men are impacted by birth, but without a shadow of a doubt women are MORE impacted. After all, it is their body on the line. Women often say that their husband is opposed to homebirth because they or their baby might die, but this suggests that women and babies always live if they are in hospital. Unfortunately death is always a possible outcome of birth. It’s impossible to argue that anyone could be more affected by death than the woman herself ….

Good relationships involve compromise, but good births don’t. Good births are dictated by individual pregnant women, health, and nothing else. All too often, we confuse support with control. When someone makes their support contingent on the complete surrender and acquiescence of one party, especially the party most impacted by the outcome, it is control. Many people are uncomfortable with that, and so be it. It is neither support, nor compromise when a woman’s fundamental wishes for birth are altered for the comfort level of others.

The only possible compromise when it comes to issues like this is that the woman retains complete bodily autonomy, and when it comes to the husband’s body, he also maintains complete bodily integrity. Whether or not he is circumcised as an adult, or chooses foreskin restoration, whether he has a vasectomy, whether he undergoes a penis enlargement, it’s up to him. But how the woman gives birth, is up to her, unless she can decide that his vasectomy is to be done at home, with an axe. Ok so we’re kidding about that last bit, but you get the point.

Everyone from nurses and doctors, to husbands and families, need to set aside their personal preferences during pregnancy and birth if they are to be genuinely supportive. It often appears that we trust everyone BUT the woman herself. This cultural attitude is proving to be extremely damaging with high rates of birth trauma and PTSD in new mothers.

The idea that men, families, or care providers are “rational” and must take charge of “irrational pregnant women” is a modern one, because historically, we always trusted women to care for themselves during birth.

Hormones do not make a woman irrational, they just make her pregnant, literally! Women can be trusted to do what is safest for them and their babies because only the woman knows the impact that a negative outcome for birth will have on her both physically and emotionally.

Birth is not just about extracting a baby. It is about welcoming them with love, and supporting the transition from woman to mother. The laws in most countries very clearly state that a pregnant woman retains decisional capacity, and yet medical professionals and families frequently fail to recognise that. Somehow they fail to recognise the pregnant woman herself as the ONLY voice that matters, and then they label the upheaval of her birth plan as a “sensible compromise”. 

FOR FURTHER READING

Compromise - Pregnant woman and husband in front of brick wall
Compromise has no place in birth
License: Creative Commons CC0.

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