Reproductive slights

Two days ago, feministing (a site I generally love) weighed in on Joy Szabo's VBAC battle, which is the most recent case to push women's birthing rights into the spotlight. The case itself is well-covered by other bloggers and mainstream news sources as well, so I won't rehash it here, and the feministing piece itself is fairly straightforward, in the sense that it asks the same questions many other people are asking about birth rights, VBAC safety, and women's autonomy.

It was the comments that got to me. The furied pace of the posting has died down by now, but I'm left with an extremely bitter taste in my mouth. Public Health Doula's blog was the one that first alerted me to this (you'd better believe that I, too, am a card-carrying feminist). As she says:

It just raises my hackles when women who in many other contexts would aggressively question medical/legal authority and advocate for a woman's right to make choices about her own body go off on the "Well, if her DOCTOR says it why would she put HERSELF and everyone else at RISK" line. As if your reproductive autonomy ends when you choose to continue a pregnancy, and you must willingly hand your body over to the medicolegal system. As if VBAC access in no way equates to abortion access. As if it's OK for a hospital to threaten to get a court order for unnecessary surgery, because "She's the one who decided to get pregnant and decided to have a VBAC, so she's got to live with the consequences. The hospital has to protect themselves". I'm glad there are other commenters who see the irony here, but shocked that there are those who do not.

There are indeed those who do not get it, fellow feminists who show up to fight off Operation Rescue protesters when they decide to descend upon a clinic, women who would gladly go underground to help provide safe abortion should it ever become illegal again, activists who are passionate beyond words when it comes to the sovereignty of a woman's entire being. Yet when it comes to birth choices, all the way from the more paternalistic nuances of many hospital policies to the more specific issue of VBACs versus forced repeat cesareans, the apathy and sometimes antagonism of some feminists (certainly not all) is stunning to me.

Over at feministing, a "Lilith G" wrote:

I'm sorry, but money IS a factor for the hospital, as are their concerns about liability. It's wiser for the hospital to say beforehand that they can't do certain procedures than to reduce the quality of care throughout the hospital due to increased financial strain.

Just one example, of course. Others reflected variations on this sentiment. Enabling doctors' fear of legal liability suddenly takes precedence over a woman's right to decide for herself. I couldn't help jumping into the melee myself, though by the time I arrived it was starting to abate. Someone invoked the Hippocratic oath, someone else called bullshit, and I added:

Oh, but didn't you hear? It's been revised to "First cover thy ass, THEN do no harm, as long as it's still economically advantageous," if I follow the logic being thrown around here.

Cesarean birth carries significantly more risk than vaginal birth, and the risk increases with each subsequent cesarean. When necessary, they are lifesaving, it goes without saying. But to force one on a woman for any reason other than an emergent life-threatening situation? Outrageous, and I'm honestly astonished that more feminists aren't taking to the streets to protest these outrages.

There are some great responses being given there, too, by other fellow feminists. but I'm still amazed. One poster - a self-described "future doctor" - even said that a woman who refused a cesarean and unfortunately had a poor outcome (citing exactly zero details of the case) should be punished. for. her. choice. Think about that.

These situations are complex, to say the least, don't think I'm saying they aren't. I know that wishing liability and economic issues didn't play such a huge part doesn't make them go away. I just feel so strongly that women's rights organizations like NOW should be playing a much, much bigger role in helping to promote real choices in childbirth, so it's astonishing to see some feminists not only ignoring but actively fighting the inclusion of BIRTH under their definition of "reproductive rights". For some, that really does only seem to mean access to abortion.

Jennifer Block wrote about this perplexing apathy from the mainstream feminist community in "Pushed: The Painful Truth About Childbirth and Modern Maternity Care" (which, for my part, if I could get every woman in America to read just one book, that would be it):

Although informed of this issue, women's rights groups have taken no action. Barbara Stratton called every women's health, reproductive rights, and feminist legal organization she could find to take on the issue: the National Organization for Women, the Center for Reproductive Rights, the National Women's Health Network, Planned Parenthood, NARAL, the list goes on. Not one group offered to platform the issue. Some had never heard of VBAC. "Groups say they're about reproductive rights, but it's really not about the full spectrum of reproductive rights; it's all just about abortion," says Stratton . . . The National Organization for Women did pass a strongly worded resolution on VBAC in December 2005, after much lobbying by Stratton and other members of ICAN, but there has been no other sign of NOW's commitment to the issue.

This all reminds me the most of one of the things pro-choice groups and individuals alike often object to about some pro-life activists, and rightly so, in my opinion*. Many (though not all, of course) pro-lifers fixate solely on the act of abortion itself, to the exclusion of either working on preventing unwanted pregnancies in the first place OR, even more appallingly, trying to help care for and support those pregnancies once they transition into being real, live babies, often into impoverished circumstances. (I won't even get into the issue of violence against abortion providers.) Their sole mission is to get the baby born. Then they're on their own. Buh-bye! Feminists rallying for choice absolutely RAIL against this hypocrisy.

And yet, once a woman decides to carry a pregnancy to term, unbelievably, some "pro-choice" women turn their backs in the exact same way. The complicated relationship of various streams of feminism to motherhood, and the particularly testy relationship to the experience of pregnancy and childbirth, surely plays a part in this. Again, I'm aware that it's a complicated issue, but I still fail to understand how feminism as a whole hasn't embraced birth advocacy. And it's not just about VBAC, it's about birth rights, period. But as Jill of Unnecesarean puts it, "Never underestimate the desire to preserve one's view of the medical hegemony by continually defending and privileging medical authority, even if it means selling out other women. Never underestimate the furor of the subset of feminists who view mothers as inherently selfish and childish. Vaginal birth is, of course, a selfish preference based on one's moral code."

Block again spells it out:

Women are given ultimatums. Not only women seeking VBACs, but all obstetric patients are told, in essence: you can give birth here IF you don't go too far past your due date, IF your water hasn't been broken more than a few hours, IF your baby is head down, IF your baby looks small enough, IF your pelvis looks big enough, IF your cervix is dilating fast enough, IF you'll wear this monitor and stay in bed, IF you'll have some Pitocin, IF you'll let us break your water IF you'll lie on your back and push when we tell you to push.

I don't get how any woman who calls herself a feminist can read the above and not feel a rallying cry build up within.

*Though I am pro-choice, I mean no disrespect to people who consider themselves personally pro-life.