Tuesday, October 6, 2009

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.


  1. Amen! I was almost a little sorry to see the debate start winding down (my homework was not) just because I felt like these are important issues that we need to dig into, so let's get going.

    I will say I was excited to see NOW's participation (at least at the state level) in the Worst to First campaign in NJ. I want to think it might be the harbinger of a turning tide. Unfortunately I think many young feminists see pregnancy, birth, and other biological parts of motherhood (like breastfeeding) as inconveniences, handy tools of the patriarchy (Hanna Rosin's "other sucking sound"), and so think little of anyone who invests them with any meaning beyond hoping to get them over with as soon as possible. Maybe that's too cynical?

  2. Excellent post. You really hit the nail on the head. It is precisely the issues surrounding motherhood and birth that make me a non-feminist. While I respect that the feminist movement did women of my generation a great service by pushing for equality, they focused on career women at the expense of mothers, abortion rights at the expense of mothers-to-be. Why is there no fight for birthing rights? Why is there no fight for better maternity leave? Why does the feminist movement leave out 80% of the female population who have at least one child? Ridiculous.

  3. Public Health Goddess, I know! I kept checking back, hoping to engage a little more, but no. Maybe we can have a little more discussion here.

    I think you're right about the young feminists. Why? Because *preps a nice big hunk of humble pie a la mode* I was one of them. Really. I remember SERIOUSLY thinking that once you chose motherhood, well, you made your bed, now you lie in it. GOD, I'm so embarrassed to admit that. Now, I think I got over it fairly quickly, especially once my friends started having kids, but even then, I also recall being bored out of my mind in Women's Studies when we talked about domestic labor issues (to take us slightly off-topic). I wanted to get into the much more exciting things, like Take Back the Night, and the philosophical labyrinth that is sex work and, yes, leading the charge at pro-choice rallies. Now I totally get it. It's absolutely fundamental.

    I'm glad to hear about NOW starting to get involved with Worst to First! I, too, hope it's just such a harbinger.

    Thanks Lori! I hear your frustration, totally. "They focused on career women at the expense of mothers, abortion rights at the expense of mothers-to-be." I agree with this, and it was and continues to be a huge mistake, I feel. I will still hope for change - what PHD mentioned above is a good sign, if just a small step.

  4. I consider myself a post-feminist. I support women's freedom, of course; I support our rights to independence, bodily autonomy, and the vote. But the modern feminist movement has dedicated itself to abortion and gay rights at the expense of everything else. The right to work outside the home has become the obligation to do so. Wives and mothers are completely ignored and even openly disparaged.

    I used to be a young radical feminist too - I think we all were, right? But these days I feel like the movement took a sharp left turn off the path. For whatever reason, NOW no longer speaks for me.

    It's a shame, really. There's so much we could've done.

  5. I want to add some astute further commentary Jill (of Unnecesarean) has made:

    I have been thinking about it. I don't know that it's fair or accurate to say that the attitude belongs to a subset of feminists, like there's an official club of Feminists Who Hate Women Who Have Babies.

    It's more that it's still always surprising to hear women who identify as feminists argue against certain women with their minds completely closed to even the mere possibility that there could be oppression in medicine just as there are in all areas of society. It would be like saying that the U.S. is a racist society, but racism doesn't exist in schools because schools are good and therefore not racist.

    The thing that gets me is that it's not just the cluelessness about the motherhood experience from women who are child-free... it's the glaring contempt for women who make a step toward reclaiming something uniquely female and the continued lack of willingness to listen.

    The other thing that's kind of funny to watch is women argue with other women that if they don't get an epidural or a neat and tidy elective cesarean (yep, I've read it), they are putting themselves through pain for no reason and subjecting themselves to Eve's curse as some sort of moral crusade. This argument is founded in the patriarchal attitude that women are cursed to horrible births. So really, they are arguing in favor of traditional patriarchal attitudes about childbirth and unwilling to hear otherwise.

  6. I forwarded the story on from Unnecesarean to Feministing because I was surprised that they hadn't yet posted the story. I, like you, did not expect to see such a host of comments about how women don't and shouldn't have the option of making decisions about their child birth. Even personal friends of mine don't see how this is really a problem. They see an inherit right for medical providers (hospitals and doctors) to deny medical coverage of any kind. It just saddens me. I still hold on to a hope for a better future but with so many women suggesting that Joy is really not in a terrible position (after all she can just go to some other hospital...sarcasm); how can we be moving forward in the current health care debate. When I met with my Congressional Representative (Cliff Stearns) recently, he flat out told me in front of an audience that he thought Congress already put too much focus on women and that my question of "What is congress and what are you doing to make sure women have an adequate array of options when it comes to their health care? What are you doing to help women have more access to midwives or lower c-section rate hospitals or better prenatal care? According to the Atlantic, child birth represents one of the primary reasons that insurers charge more for women so what are we doing to lower those costs and provide BETTER care? He just noted, "Congress gives money every year to breast cancer research. Congress never focuses on just men but does focus too much on just women." And the crowed cheered for him. I later contacted his office to let them know that in 2005 (most recent CDC numbers) less than 190,000 women were diagnosed with breast cancer but over 4 million women that same year had children. His office took the statistic but told me not to expect a reply. I had several women quietly thank me for my questions after the "town hall" but consigned themselves to the fact that our country doesn't care very much about them.

  7. ^^ AUGH! That is absolutely infuriating. It's right up there with the recent "Well, *I* don't need maternity care" debacle.

    Last I checked, pretty sure that in order to exist, everyone has to BE born in the first place. Everyone. Why we don't honor the very SOURCE of that more remains a complete mystery to me.

  8. I was a radical feminist in college and I consider myself a radical feminist now. I am a wife and a stay-at-home mom, which is not the "mainstream" feminism, but if I identify myself as a non-feminist or a post-feminist because I don't agree with what some other feminists believe, then how will anything ever change? I am a feminist and I had a natural (non-medicated) childbirth because I believe in the power of my body. I am a feminist and I raise my daughter at home because I believe that the best way to raise a feminist is to be there for her and show her what a feminist is instead of let mainstream society tell her what feminism is (and really isn't.) I am a feminist and I believe that childbirth is as much a feminist issue as abortion.

  9. Punished if she had a bad outcome after refusing a c-section? Then can the doctor be punished for a bad outcome with one? Likely not, likely the opposite. Oh thank you great one for doing all that you could! Could they also be punished if the mother has a stillborn baby in a subsequent pregnancy?