To the “healthy baby isn’t enough” hypocrites

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Whose birth experience counts?

Many midwives would answer everyone’s because a “healthy baby isn’t enough.”

They would agree with this mother mourning her lost birth experience:

I don’t have to feign gratitude, because I lost something that was important to me…

I don’t have to be thankful just because things didn’t end tragically.

I’m allowed to grieve what I lost, even now, because it was important to me, and I lost it.

She had wanted a homebirth:

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His birth was supposed to be peaceful, swimming into the world in our kitchen, surrounded by his family, welcomed with cake and champagne. He was supposed to come out easily and heal me from the trauma of my previous labor and dystocia. His birth was supposed to be a lot of things that it was not.

I do not want to hear, “Well, you’re lucky he’s healthy,” ever…

Those midwives would encourage Edelman to grieve for her birth as she has done because a desired birth experience reflects a woman’s deepest needs and fears. Providing that experience — an empowering experience that allows her to be in control of her body and feel that her providers have really listened to her —is the ethical obligation of every midwife … UNLESS, of course, she wants a C-section. Then she should be ignored.

According to the BBC:

Women at 75% of UK maternity units are being denied their right to choose a Caesarean, the BBC’s Victoria Derbyshire programme has been told.

NICE guidance says women should be allowed to opt for a planned Caesarean even if it is not for medical reasons.

In this midwife led system, providers are denying women who choose C-sections the birth experience they request.

Birthrights, the human rights in childbirth charity, used a Freedom of Information request to ask 153 trusts providing maternity care how they applied the guidance.

Of the 146 that replied:

26% fully complied with the guidelines
47% partially complied
15% refused maternal requests outright
12% did not seem to have a clear position

This is in direct violation of official policy:

Under the guidelines, women requesting a Caesarean with no other medical reason “should be offered appropriate discussion and support – but ultimately, if they are making an informed choice, a Caesarean should be offered”.

But in many cases the denial occurs without listening to the mother’s request.

[Birthrights] said it had been told trusts had even been telling women they would not be allowed to elect a Caesarean, either when they had been being booked on to maternity care or in a letter before they had even been spoken to.

And even when the request is considered, these women have to jump through hoops that aren’t required for anyone else:

Gill Walton, chief executive of the Royal College of Midwives said: “Women must be given the information to explore their views and feelings about Caesarean birth, to enable them to come to an informed decision about their preferred type of birth.

“This information should reflect the individual woman’s current and previous medical, obstetric and psychological history.”

Are women required to “explore their views and feelings about vaginal birth” before being allowed to have one? I doubt it. Are women required to “explore their views and feelings about homebirth” before being allowed to have one? I’ll bet it never comes up.

Apparently, for women who want a maternal request C-section a healthy baby is supposed to be more than enough.

Why the difference? Because idea that a “healthy baby isn’t enough” is a ploy designed by midwives to wrest market share from obstetricians. Since obstetricians place the highest value on a healthy mother and a healthy baby, midwives encourage women to place the highest value on a fulfilling birth experience … but ONLY if that birth experience fulfills midwives’ needs as well.

Does your ideal birth experience include a vaginal birth? That’s fine; midwives will keep those evil obstetricians — who think a health baby is enough — away so they can’t diagnose any complications that might interfere with your experience.

Does your ideal birth experience include a homebirth? That’s the best! It allows midwives full autonomy and requires more midwives. The midwife/patient ratio at homebirth is supposed to be 2:1 instead of 1:many at hospitals or midwifery led units. And not only will no midwife question whether you are making an informed choice, they’ll happily ignore any and all risk factors that make homebirth a dangerous idea.

Does your ideal birth experience include an epidural? So sad. Midwives will try to convince you that unmedicated birth is better and more empowering. And if that doesn’t work, they will drag their feet in ordering the epidural until it is too late for you to get it.

Does your ideal birth experience include a maternal request C-section? Too bad for you! C-sections don’t do a damn thing for midwives’ need for autonomy and control. Therefore you can’t have one. Shut up and be glad you got a vaginal birth that you didn’t want!

In other words, the “healthy baby isn’t enough” crowd is a bunch of hypocrites. It isn’t your birth experience that matters; it’s theirs.

Let’s stop that hypocrisy. Let’s agree:

Her baby, her body, HER choice and none of the midwife’s business.

Because a woman who wants a maternal request C-section should be treated exactly the same as a woman who wants a homebirth — with respect. Every woman’s birth experience counts!