If you’ve heard even just a handful of birth stories, this probably sounds familiar: “Mom and baby are both healthy, and that’s all that matters.” If you’ve been pregnant yourself, you may have heard people say that your health and the baby’s are all you need to worry about. And if you’re like me, hearing those words seems like it SHOULD feel good, but it doesn’t. And there’s a reason for that.
A healthy mom and baby is NOT all that matters, despite being the apparent goal of many providers and facilities. Birth experience matters. Bonding between parents and their baby matters. Treating the family and especially the birth giver with dignity and respect MATTERS. Of course, good health outcomes are essential. But these should be the bare minimum standard that we reach for, NOT the single measure of whether everything is ok. The needs of birthing people are complex, and failing to acknowledge them starts us on a path of outright ignoring them.
Disregarding these complex needs does more damage than over-simplify one of life’s most miraculous processes. It paves the way for more overt disrespect, the silencing of birthing people, and even abuse. If that sounds extreme, believe me, I understand. I used to think that the abuse of birth givers included only the most reprehensible behaviors. Over time, however, I’ve realized that actions which may seem normal at first are in fact unacceptable forms of manipulation and abuse.
I recently took a Yale course in Quality Maternal and Newborn Care, where I was introduced to this image by Birth Monopoly:
Take a look at some of the items in the bottom section – Normalization. Birth horror stories, jokes about birth plans leading to c-sections, failure to ask for consent before touching a pregnant person. . . These are common behaviors in the US. There are even t-shirts you can buy advising people NOT to touch your belly. That’s how normal of a behavior it is.
Next, let’s look at the middle of the pyramid – Degradation. Here we have actions that overtly disregard the wishes of birthing people and aim to intimidate them: ignoring a birth plan, repeatedly pushing for declined interventions, making threats about the baby. Even these behaviors are not unusual in birth stories from the US.
Finally, the top section – Assault. Something like “use of physical force” may sound dramatic, but re-frame that into behaviors you may have heard about, like physically moving a birthing person into a different position, lifting her feet or spreading her knees apart without asking permission. This is physical force! How about “procedures without asking?” Again, this may sound like extreme procedures like a C-section or vacuum-assisted birth. But “procedures” includes less invasive practices like placing an IV, doing a pelvic exam, even taking a blood pressure reading. Birth givers have the right to consent to or refuse procedures, and performing them without asking disregards that right and is, in fact, assault.
That’s not to say that placing an IV or measuring blood pressure is a assault when the birth giver understands the procedure and consents to it! I don’t want to give the impression that any form of contact between a provider and birth giver is inappropriate. The crucial element here is ASKING FOR and RECEIVING informed consent – but that’s another blog entry.
Notice the circled quote to the left of Birth Monopoly’s pyramid, because this is the underpinning of why a healthy parent and baby isn’t enough: Tolerance of the behaviors at the bottom of the pyramid supports and excuses the behaviors at the top. Seemingly innocuous language creates a safe environment for abuse. So if you believe birthing people have a right to be treated with dignity and respect, consider removing the “healthy mom and baby” standard from your thinking. If you hear that “mom and baby are ok,” consider asking how both parents felt about the birth experience. If your provider hints that their only priority is yours and your baby’s safety, consider telling them that your standards for birth are more complex than that. You deserve to be treated well, and you deserve a birth experience you will cherish.