MEDICATE, SUBJUGATE, DOMINATE, OPERATE by Gayle Lemke

All this week on themotherhoodblog.com: THE (SORRY) STATE OF BIRTH IN AMERICA

Why so high?
Did you know that New Jersey's average rate for birth by cesarean section is now 38.3%? And the 2007 national average is 31.8% ?* Why are so many babies being 'born' via major abdominal surgery? Is it making birth safer for mothers or babies? And what does it say about contemporary attitudes towards women and their bodies? This week we present the responses of three local women whose work is dedicated to educating and supporting pregnant and nursing women, plus one writer whose only choice for giving birth — three times — was at home.

WEDNESDAY, APRIL 15
You're So Brave (I Bet You Think This Birth is About You)
by Helena Holgersson-Shorter

THURSDAY, APRIL 16
Corporate Undermining: Setting Up Mothers to Fail
by Maria Parlapiano

FRIDAY, APRIL 17
You Make Me Feel Like a Natural...Cesarean?
by Kim Collins

TODAY: SATURDAY, APRIL 18
Medicate, Subjugate, Dominate, Operate
by Gayle Lemke

*http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_12.pdf


Medicate, Subjugate, Dominate, Operate
by Gayle Lemke


It’s my opinion that a combination of factors are to blame for the high cesarean rate — not the least of which is women’s deep, culturally introduced and ingrained disconnect from our perfect, able bodies:

• Over reliance on drugs and technology and, paradoxically, the practitioner’s fear of litigation, because the very drugs and machines they trust so completely don't work a lot of the time
• Induction for bogus reasons — including convenience (convenience!?), “too-big a baby” or “low amniotic fluid” — has been cited recently as a primary reason for rising cesarean rates across the country
• The fact that surgery (cesarean section) is far more lucrative, time-efficient (45 minutes from incision to suture) and practically litigation-free compared to vaginal deliveries, must persuade a lot of OBs and "med-wives" to go the surgical route. (If they get used to a certain lifestyle, what would inspire them to change a standard of practice that affords them a lot? A conscience?)

Factor in the consistent media portrayal of "scary birth" (hello, ratings!) which reinforces those ingrained cultural beliefs, and you have the perfect storm.

To quote midwife and author Elizabeth Davis in Midwifery Today:

“We’re in a culture that would rather women did not go wild. Our cultural response to women in any of her blood mystery passages — menstruation, birth, or menopause — is medicate, subjugate, dominate, operate. Women need to experience faith in their own power in order to pass it on to the next generation.”

But young girls and women are being initiated in all the wrong ways and media holds major sway. I know this because my own 11-year old, despite what she’s learned from my being a prenatal yoga teacher, childbirth educator and doula, wants nothing to do with what she already perceives as a painful process to be dreaded and feared.

She and countless other girls have inherited this cultural legacy. For decades, we’ve been messing with a divine blueprint for birth that has worked pretty fabulously since the beginning of time. Yet, despite our alarmingly high rates of infant and maternal mortality and morbidity, we’ve continued to apply medical model protocols and technology to fix what isn’t broken (the US currently ranks 29th in the world in infant mortality, tied with Poland and Slovakia, according to the most recent data available from the CDC’s National Center for Health Statistics website).

Consider that in basic animal husbandry, the standard protocol for successful birth is simply, Do Not Disturb the Mother. These conditions apply without hesitation to protect mother and offspring; no strangers, dimmed lights, freedom of movement, familiar environment, unlimited nourishment, and respectful quiet. These considerations are the norm, along with when to use technology in a true emergency. These are givens because to do otherwise invites “unexplained distress” or sudden demise of the offspring.

In our modern, so-called advanced hospitals, these instinctive givens are typically 100% reversed.

If the first line of defense for mammals — from foaling mares to whelping terriers — is to protect their nutritional needs and provide comfort at birth, then how is it that birthing humans aren’t afforded the same? It’s an affront to societal common sense, but this has become accepted as our cultural norm. At their most vulnerable, women continue to be bombarded by the choices and opinions of others who don’t have their or their baby’s best interests at heart.

So, how can we reduce the cesarean rate and take our bodies and our birth back?

As a doula, two ways in which I know I’m most effective are these:

• Getting women to switch practitioners if the one they're working with has a high c-section rate and
• Supporting them and their partners in laboring at home as long as possible. This is often my biggest challenge but its key in avoiding the unwanted interventions that await if they get to their birth facility too early.

In simply comparing birth outcomes in the countries where infant mortality and morbidity is lowest — The Netherlands, Norway and Sweden among them — we find the critical difference is a Midwifery Model of care.

As a society, we need to orchestrate a major strategic shift back to a midwifery model of care and to home birth as a safe, viable option for low-risk women.

We have a vested interest, as mothers, fathers and a society, to educate girls differently regarding their bodies and birth. It’s become the last frontier in women’s rights and, yes, we have a lot of work to do.

Gayle Lemke is the Director of Shakti Ma and a birth doula.

Gayle Lemke, Director
Shakti Ma
Yoga, Wisdom & Ritual for the Childbearing Year & Beyond
973-763-2288
www.shaktinj.com
gayle@shaktinj.com


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Resources
We urge women to educate themselves fully about their options for birth, including all the risks associated with cesarean sections, and vaginal birth after cesarean section (VBAC):

Childbirth Connection: http://www.childbirthconnection.org
A source for up-to-date, evidence-based information and resources on planning for pregnancy, labor and birth, and the postpartum period. Founded in 1918, Childbirth Connection is a national not-for-profit organization dedicated to improving the quality of maternity care.

VBAC.com: http://www.vbac.com
A woman-centered, evidence based, website providing childbearing women and maternity care professionals access to research-based information, resources, continuing education and support for VBAC* (vaginal birth after cesarean).

International Cesarean Awareness Network: http://www.ican-online.org
The International Cesarean Awareness Network, Inc. (ICAN) is a nonprofit organization that was founded by Esther Booth Zorn in 1982. ICAN’s mission is to prevent unnecessary cesareans through education, to provide support for cesarean recovery, and to promote VBAC. Information about local ICAN chapters can be found on the website.

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