What Does a Feminist Birth Look Like?

Feminism has a motherhood problem. Something about birthing a member of the next generation seems to exclude women from feminist discourse. Don't believe me? Consider the fact that women with young children are routinely asked to leave feminist events, that the child-free movement freely uses grossly sexist language without feminist corrections, and that many feminists continue to believe that staying home with children is not work.

Nowhere is this issue more prevalent than in the debate over birth. Home births have steadily increased over the past decade, yet this sudden surge in reproductive activism is hardly a blip on the feminist radar. When feminists do wade into the childbirth debate, it's usually to assert--with absolutely certainty--that there is only one correct way to birth a child. This dichotomous approach to parenting completely neglects the very real issues feminist mothers face, not to mention the stunning coercion and abuse women face when they give birth.

There is no single feminist way to give birth, but there is a feminist way to approach birth.


Why So Many Women Have Problems With Their Births
Think the women who develop elaborate birth plans or who seek home births are crazy? Before you judge, consider the following:

• 73% of women who experience episiotomies--a procedure during which a doctor cuts open the vagina, and which studies overwhelmingly suggest increase the likelihood of negative birth outcomes--say they did so against their will. 
• Even when a recommended procedure is only a doctor's preference, and not a medical procedure, hospitals have sought court orders to force women to undergo dangerous surgical procedures. Courts have repeatedly ruled that doing this is illegal, but by the time an appeal makes its way to a higher court, the woman has already been violated. In some cases, women have died due to forced c-sections, such as in the case of Angela Carder, when a forced c-section killed both her and her baby.
• In many hospitals, it is routine to tie women's arms to the bed when they undergo C-sections, even though there is no medical reason to do so. Doctors are literally tying women up. 
• Hospitals often put medication into women's IVs without seeking their permission or telling them what the drug can do. 
• Some drugs routinely used during childbirth, notably Cytotec, are not FDA-approved to induce labor and are linked to deaths and uterine ruptures. 
• Doctors sometimes induce labor solely for the sake of convenience. Induced labor is more painful, increases negative outcomes, and is sometimes presented as a medical necessity--even when it is not. 
• Laboring women are often treated as guinea pigs, with medical students breezing into the delivery room and doctors performing procedures to teach these students how to do them--even when the procedures are unnecessary and the mother has not given consent. 

This is something every woman, and certainly every feminist, should be concerned about. Reproductive choice does not begin and end with abortion. Tying a woman up to cut her open, cutting open her vagina without her consent, and allowing other people to watch unnecessary intrusions upon a woman's body without her permission all sound a lot like sexual assault to me. 

This is usually where the debate veers out of control. Doctors insist that they know best, that they should have broad discretion to choose what's right for their patients. They're partially right; patients sometimes make bad decisions. The problem is that doctor do, too. Our nation's C-section rate is at least 300% higher than it should be, thanks in no small part to the discretion of doctors. And dozens of procedures doctors once endorsed--knocking women out to give birth, routine episiotomies, never breastfeeding--are now known to be unsafe. 

Even when women do make bad decisions, though, they are entitled to make them. You never hear doctors suggest that cancer patients should be forced to undergo chemotherapy, or that men should undergo forced vasectomies even when it would be in their best interest. This suggests to me that paternalism, not quality medical judgment, is the real reason doctors think they should control what happens to women in labor. 

Some women insist that womanhood should not be a miserable experience, and that pain should not be the test of whether a woman is a good mother. I agree with them. Epidurals during childbirth are a fundamental right, and a woman who doesn't want strangers peering at her vagina for hours should be allowed to choose a C-section. The problem is when we transition from saying women should have access to all medical options to insisting that those medical options should be forced upon them. 

A Simple Feminist Rule: Informed Consent
A feminist birth is quite simple: one in which the woman has access to quality information--not information colored by the doctor's desire to get to his golf game or the nurse's desire to hear no more screaming. With this information in hand, a woman should be allowed to make whatever decision she wants. Without this information, consent is not informed, and therefore not really consent. After all, if you consent to sex with someone you think is wearing a condom, but he takes it off at the last second, he's violated your consent. The same principle holds with the doctor who tells you an episiotomy is medically necessary, and not just a convenient way for him to speed up the birth.

Informed consent. It's all that's necessary for a feminist birth. Simple. To the point. And, of course, built upon the sort of reproductive choice and bodily autonomy that all feminists should embrace. Almost 10% of women show signs of PTSD after giving birth. This suggests something is very, very wrong.

Judging Other Women's Births Always Means You're Doing it Wrong 
All of this boils down to something really simple: if you think there's only one feminist way to birth a child, you're doing feminism wrong. You're also being an asshole, since none of us can know or fully understand another woman's story. That woman who declined a "medically necessary" intervention might be a rape survivor doing everything she can to protect her bodily autonomy. The woman with the scheduled C-section might be so terrified of an episiotomy that she'd rather not run the risk. That "crazy" home birther might have had a hospital birth so traumatic she can't set foot in a medical facility without a flashback.

Assessing one birth as more feminist than another is every bit as ridiculous as telling other women that there's only one feminist way to dress, that all feminists must work within specific occupations, or that only certain sex acts can be deemed feminist.

Worse still, as soon as you tell another woman her birth is unfeminist, or stupid, or whatever, you've become part of the cacophony of voices undermining her autonomy, self-esteem, and intelligence. Pregnant women already get enough grief. Birth is plenty stressful on its own. No woman needs you telling her her birth is wrong. It's up to the woman to seek out the information she needs; it's up to the rest of us to trust that she alone knows what's best for her.