A few weeks ago, Dr Denis Walsh caused no end of outrage both here and the UK for suggesting that women should endure the pain of labour without anaesthetic drugs - in particular, epidurals - because they undermine the mother's bond with her newborn baby.
Firstly although the man in question was an Associate Professor of Midwifery and probably knows more about childbirth than the average blogger, there was something about a man telling women how to give birth that really annoyed the hell out of females. I'm pretty sure that if the expert in question had been a woman, we probably wouldn't be so up and arms about the opinion even if we disagreed with it.
So I'm going to say that comments such as 'well you trying pushing something the size of a watermelon out of something the size of a lemon' probably aren't that helpful in birth politics.
And what a hornet's nest birth politics are. I think in our efforts to have the perfect birth, we forget that everyone wants the same thing, healthy babies and mothers at the end of it. I'm pretty sure that many mothers would happily have a good birth (one in which everyone lives) rather than tying themselves up in knots trying to have the perfect birth.
Also let us not forget that while birth is important it is not the only part of what makes a mother. Drying away tears, defusing tantrums or picking up your wayward teen from a party where they had too much to drink all seem to me to be just not as if not more important part of parenthood that the act giving birth. Because after all, at worst you labour takes a few days, raising your children and actually being a parent takes a commitment of at least 18 years. Some parents would argue that it never really stops until you cark it.
14 comments:
I feel really sorry for Dr Walsh - firstly his article was misrepresented (it's not yet even published, but is undergoing peer review; http://rixarixa.blogspot.com/2009/07/burn-male-midwife.html), and then he was ripped to pieces for being a male midwife, despite having spent his career calling for evidence-based practice and support for women-centred care.
From what I've read of his writings, Dr Walsh recognises, as most midwives do, that some women will need an epidural, he just also recognises that we do women a HUGE disfavour if we provide no non-pharmacological means to deal with pain in labour, since epidurals aren't without risks.
So much of our rhetoric around birth is fear-based, and choice stemming from misinformation and fear isn't much choice at all. Yes, a healthy mother and baby is the most important thing... if, and only if, we take a view of health that includes social, mental and emotional wellbeing in addition to physical. The most perfectly physically healthy mother still isn't off to a great start with her parenting if she feels like she had no agency in her pregnancy or birth. We risk doing that (for some women) if we tell them from the start that they only way they'll cope is with the help of medical intervention.
I probably risk quite a bit of backlash by saying I think vaginal birth, may be over-rated (having watched my sister agonise through her first one)and not necessarily realistic in all cases (having watch my other sister's son's and her life being saved in an emergency ceasarean). Wonderful if 'natural' birth happens the way you planned. In my case, I planned to have a ceasar, for carefully considered reasons, and it was perfect for me and my baby. No bonding issues at all, breastfed for a year, and am still utterly besotted by my now 6 year old. Let's just be open, and supportive of choices, and yeah look at the bigger picture which is life after birth....
I wish there was this level of outrage when obstetricians talk about elective caesarians (pretty sure I spelt that wrong..) or controlled timed birth.
Here is Australia the maternity system is very much geared around the idea that you are 'sick' and you need to go to hospital to get 'fixed'. And if you try and assert your rights to a natural healthy birth you will run into at least one obstetrician who will try and talk you out of it.
Hell, they're even trying to outlaw midwife assisted homebirth. So if you want to have to have a baby in your own home, you can't have a midwife there. Sounds like responsible health policy to me - NOT!
I'd say that a woman who has given birth even once knows more about birthcare than any man, no matter how many books he's read. Practice beats theory any day. If Mr Walsh really wants to learn about birth, maybe he should listen to some women?
@ Anonymous
I'm a student midwife who has not had children of my own (I hope to one day, but I'm not going to let it stop me in the meantime). Your comment equally applies to someone like me.
Birth is incredibly varied. Every single one is subtly (or not so subtly) different, and I fail to see how having had one, or two, or six births of one's own, makes a person more knowledgeable about the physiology and patterns of birth than someone who has facilitated women to give birth 30, or 300, or 3000 times. It's a dangerous midwife who makes all his or her clinical assessments according to their own personal experience.
Dr Walsh has not simply based his knowledge on reading books, he's attended births for 23 years. I think that deserves some recognition!
I have given birth naturally three times, that sure as heck doesnt make me an expert, but it does give me insight into how my body will react when I have my 4th child in november. for me natural vaginal birth is my preference but I arent going to bag any women who doesnt have that choice or who chooses to birth differently.
my last midwife is single and doesnt have children yet she was amazing when I was in labour, there are some very well respected male midwives practicising in NZ... being male or not having had children should not preclude people from having an opinion on childbirth,
Even if a woman has had no children and never plans to, she still knows that one day she might. For a man it's an entirely cold-blooded and academic exercise - he has no personal investment in what he practices. It's just a profession to him.
@ Azlemed
I totally agree that it gives you insight (and I think some expertise too) on your own body! That's part of a midwife's job I think, to help women recognise their own insight, but I think that one part of that is having someone who can confirm that what you're experiencing is normal - or not - and make suggestions as necessary. It's the suggestions, and the massive scope of "normal" that we spend all our time learning, and that does take reading, and lots and lots of experience.
Now that I think about it, it's a bit alarming that, despite the fact that only 2% of midwives are men, this school of midwifery Mr Walsh is in has a man in a very senior position. I wonder how he got his job?
@ Anonymous
There are people in caring professions all around the world who haven't personally experienced the type of care they provide. It is possible to be both professionally stimulated by a job, and empathetic towards the people requiring your care or expertise, providing you have the capacity for empathy in the first place (and since that is not a character trait restricted to women, I fail to see why a man's interest is definitively "cold-blooded").
I'm not very comfortable with the argument an anon is making here that men should basically never be midwives and also that they cannot possibly have an emotional investment in birth.
At the one birth I've been present at the father was incredibly personally invested in the whole thing. And the impression I got from all the staff was that they weren't entirely cold-blooded about it either - everyone seemed pretty caring to me, both the female surgeon, the female midwives and nurses, and the male anaesthetist and his male assistant.
If we say men can't/shouldn't do something then we're effectively saying only women can do it. Is that really what you mean Anon?
I think the thing that irks me the most about Dr.Walshs comments is the shaming aspect to them. Its almost like he is taking away choice. I think the most important thing to remember in birth politics is that woman should be informed of all choices and not shamed either way. Epidurals are necessary for some women, everyones pain thresehold is different and they shouldn't feel bad about it. I myself have experienced feeling like a failure after having an epidural during my sons birth. It is not healthy or helpful to feel this way. Sure natural birth is wonderful and I hope for a natural home birth next time but putting undue pressure on women to ALWAYS go natural can lead to shame, guilt and feelings of failure. PND can lead to problems bonding with your baby too.
This post is an interesting contribution to the debate. I don't agree with a fair proportion of the author's views, but they're certainly worth reading. I think of all brands of feminist thought, the rationalist variety is the least formally represented in the health and childbirth fields.
I don't mind anonymous's argument that no-one can have a valid opinion about anything they haven't personally experienced. I just read it as someone saying "I have no idea what I'm talking about and you should ignore me". In this case, since it's never been a male midwife it's argument is that it's opinion is invalid and should be ignored.
It's not a paradox, it's a simple and obvious argument.
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