Vicki’s Manifesto: Radical? Or Normal?

This was my very first blog. It’s an adaptation of an article I submitted to a new radical childbirth publication called SQUAT. I love the name!

What do you think? Am I a radical? Are you? Or are we just working toward something sensible and equitable?

Some mamas get way too much intervention in childbirth, and others die from lack of access to medical care when it’s truly necessary. In such a world, we must ALL advocate for equitable, sensible, evidence-based care.

For some, radicalism means unassisted childbirth. I believe that this trend has a valuable sociological purpose — to remind us that most humans give birth just fine — but I’m concerned that some individuals may pay the ultimate price. In some cases, the presence of a qualified, well-trained midwife might make a life-or-death difference. And if, say, the umbilical cord precedes the baby, or the baby is stuck in a shoulder-first presentation, or the placenta is blocking the cervix, or the placenta detaches before the baby is born, cesarean section is essential for survival.

To me, “radicalism” means holding down the holistic end of the spectrum, questioning protocols that are not evidence-based, expanding knowledge about natural childbirth methods, and adding a huge dose of love, gentleness, and respect to the equation. I’ve met many people who share these values. Some were wearing vegan sandals and some were wearing white coats.

I’ve been a childbirth educator and doula since 1982, during which time the US cesarean section rate has skyrocketed. Everybody should know that in 1965 it was 4.5%, and now it’s 32% and climbing — without a corresponding improvement in outcomes.

In my work, radicalism means plugging away, year after year, educating pregnant people, forming alliances with holistic midwives, nurses, and doctors. It means offering doula and childbirth education services to everybody — whether they are richer, poorer, younger, older, straighter, queerer, single, partnered, or incarcerated. It means looking at the global picture, working to reduce maternal and infant mortality and morbidity.

I have to say that statistically, it’s not going very well. Capitalism maintains health care inequities. Some things just don’t make sense — like insurance that pays for hospital birth but not home birth with qualified midwives, even though the latter is equally safe and vastly more cost-effective (and, in our family’s case, much more fun). Economic and time factors and the fear of malpractice lawsuits contribute to the cesarean problem. The ubiquity of interventions like continuous electronic fetal monitoring and epidural anesthesia contribute to the famous “cascade of interventions” scenario.

And there’s one other factor that must be addressed: culturally, we are afraid of childbirth. This is exacerbated by TV and movies. It turns out that more pregnant people watch “reality” childbirth shows than attend childbirth classes. In my work, I’ve seen a change over the years — as more and more people get their information from TV, they come to believe that birth is dangerous, fast, and undignified. They think that “normal” birth involves medical rescue, while natural birth is for hippies, weirdos, aliens, and old-timey pioneers.

That’s why I focused my master’s thesis (Anthropology, University of Massachusetts) on TV and movie birth scenes. Now that my radical little kids have grown into radical awesome adults (yes, I’m proud), I’ve had the energy to update that thesis and turn it into a film that’s being distributed all over the world: “Laboring Under An Illusion: Mass Media Childbirth vs. The Real Thing” (www.birth-media.com).

Making the film, I didn’t just want to whine about how unrealistic and terrifying TV birth scenes are. I wanted to juxtapose them with scenes from empowering natural childbirth documentaries, partly to highlight how ridiculous TV is, partly to keep from reproducing the very thing I was complaining about, and mostly to offer viewers an inspiring antidote. The natural childbirth films I excerpted are all worth watching in their entirety, and I hope that viewers will seek them out.

There was a silver lining to looking at birth through the lens of mass media. Since it’s our shared popular culture, the film came out very accessible, and it’s hilarious. I’m having a lot of fun with it.

I’ve been amazed to find that people are showing the film in Uganda, Greece, India, Malaysia, Australia — apparently the US exports so much of its culture that its movies and TV shows are familiar all over the world.

I designed the film as a tool for pregnant people/partners, care providers, teachers of health, sex ed, and media literacy, and screenwriters who want to do a better job (check out our new resource for Hollywood called REEL CHILDBIRTH: Script Consultants Deliver The Facts).

Now that I’ve broken even on the project, I’ll be dropping the price and trying to get the word out there in cyberspace so that anyone who might find it useful will stumble across it. If anybody wants to review it, tell me where to send a review copy.

As antidotes to the culture of fear, I also recommend short films called “It’s My Body, My Baby, My Birth” and “Birth Day,” both available at the delightful websites www.whatbabieswant.com and www.sagefemme.com. I recommend books by Ina May Gaskin, Penny Simkin, and The Boston Women’s Health Book Collective.

Keep an eye out for these: There’s a new film coming out called “No Woman No Cry,” about global maternal and infant health issues. Also the film “Babies” is fascinating. It’s about the lives of four babies in Mongolia, Japan, Namibia, and California.