"Best of" Week: Birth Activist's Jennifer Zimmerman
“Women Need to Educate Themselves”
I often hear this phrase from childbirth educators, doulas, and birth advocates. It is said when these women speak of the increasing cesarean rates, or when they hear of a woman or a baby who was treated cruelly during birth, or when they find out that yet another woman has scheduled her induction or c-section for a reason that seems less than medically legitimate.
As a mother who has given birth, I find this phrase emotionally charged. It may be well intended, or perhaps spoken out of the almost hopeless frustration that can be caused by working so closely with women who often make choices that seem to be the “wrong” ones. Regardless of why it is said, it stings when it is implied that you were such a mother who didn’t school herself in childbirth knowledge sufficiently.
The problem with the current maternity system is so much bigger than women not being smart enough to navigate it. Birth education is not like math or science. There is no agreement even within certain groups. For example, take the natural birth movement. Will you do Bradley, Lamaze, or Hypnobabies? Will you deliver in a hospital, birth center, or at home? Will you hire an Ob, Family Practice Doctor, Midwife or have an Unassisted Birth? Will you hire a doula, invite your mother, sister or best friend, have only you and your partner, or give birth completely alone? Will you plan a water birth, squat, or assume a hands and knees position? Will you cut the cord after it stops pulsating, after the placenta is naturally expelled, or wait for it to fall off on it’s own? Will you try to breastfeed in the first 10 minutes, within the first hour, or allow your infant to crawl to the breast in it’s own time? There are hundreds of more questions I could ask all pertaining to natural birth. There are no right or wrong answers to these questions, there is only individual choice based on the current knowledge and feelings of the participants in the process.
Are first time mothers really not educated about childbirth? Do women have some sort of aversion to learning about the process of giving birth? Perhaps in some cases, but I don’t think that is true for most women. I think women do educate themselves about birth when they are pregnant with their first child. How do women do this though? From what I have seen, they watch TV shows about birth, they read books about it, they talk to the women in their lives who have already given birth, they ask their care providers questions about it, they attend childbirth classes through their hospital or take additional classes, and they go online to discussion boards for women who are due around the same time as them and share information. These are valid ways of learning about a subject, and these women do get an education this way. However, I think when these people state that “these women need to educate themselves”, they perhaps feel that the education that these women have received is not a good one, and that these women should have somehow realized this and searched further until they came across the correct information.
Is the current state of the maternity system the woman’s fault though? Should we really insinuate that the increased c-sections, the intervention cascades, and the birth traumas, and all of the problems associated with giving birth in this country are because women have not educated themselves about childbirth? I don’t think so. I think the fault lies with the system. There is a great lack of transparency when a woman chooses who will be on her birth team. Is this a good hospital, a good midwife, a good doula? Will this hospital give me what they promise, will the nurses be supportive of my wishes, will this homebirth midwife try to speed up my labor with so called “natural” augmentations? Will I be listened to, will I be pressured into doing things I don’t want, will I be hurt, will my baby be in my arms after it’s born? There is no way to educate yourself enough to find these answers because the information is not readily available to us. Things like rates of interventions, or satisfaction with a certain care provider, or how often a woman felt she was not in control or her own experience are not things that they print on the hospital brochures or are advertised on the midwifes websites.
I don’t think it is possible for people who have tried hard to learn about a subject to know that there is more to learn. If things go wrong and you are dissatisfied with your experience, such as having a c-section that you don’t feel was truly medically indicated, or being mistreated by your care provider, or being separated from your baby for lengths of time with no apparent reason as to why, or having a procedure done that you never consented to or didn’t want, or getting bad advice about breastfeeding and finding yourself having problems nursing because of it, you may hear the phrase “this is why women need to educate themselves”. I heard that phrase several times after my birth experience turned into a traumatic ordeal and I complained about the treatment I encountered at the hospital I gave birth at. At first I tried defending myself, as I had thought that I was pretty educated. I had read books, taken a childbirth class, watched “A Baby Story” on TV, and frequented “babycenter.com”. But I even dug deeper than that, and I read books other than “What to Expect When You’re Expecting”, and I researched hospitals on the internet and picked one with a birth tub, birthing suites, and midwives. I even hired a doula and asked my midwife several questions about the upcoming event making sure she made notes in my chart about my preferences. I was educated! I was prepared! And I was horribly mistreated, had procedures I didn’t want forced on me, and my baby was taken from me seconds after he was born not to return for over 20 minutes, not to breastfeed for 3 hours after the birth. It was not the wonderful natural waterbirth I had planned for. And when I told my story and people pulled out the “education” line, I fought back with my list of things that I had learned about birth and had tried applying. I was then countered with different questions, questions to prove that I lacked a real education about childbirth. According to my inquisitors, apparently I had read the wrong books, taken the wrong childbirth classes, and chosen the wrong type of care providers. I didn’t hire the right kind of doula, or watch the right TV shows, or visit the right websites. If I had educated myself properly I would have known that having the midwife make notes in my chart was inferior to having a birth plan, and that my husband should have been properly trained in being my personal bodyguard, and that we both should have learned the common manipulations that hospital staff use to get patients to comply. How can a woman know that there is more to know when she has never given birth before? Even I, who I suspect knew more than the average woman, didn’t know enough for some people to be satisfied that my own ignorance is what caused my birth trauma from happening, and a good education would have prevented it.
So you see, this phrase may seem well intentioned and it may seem obvious and true to the speaker of it. But to me, just a woman who gave birth, who tried her best and failed to get the birth she wanted, it feels like blame. Blaming the woman for not changing the maternity care system is barking up the wrong tree. Lets place blame squarely where it belongs. Lets support women and be kind, knowing that “when you know better, you do better” (Maya Angelou). Knowing that childbirth is not simple to navigate in this system of being made to blindly choose providers and birth settings. Knowing that women are trying to educate themselves, but often don’t know what to do with the enormous amounts of conflicting information out there about childbirth. Also realizing that there is no one size fits all in birth. There is no perfect type of provider or birth setting, there is no correct answer to every question that arises in birth. There is just doing the best you can do with the knowledge you have at the time and hoping that you get lucky and you are treated with kindness and respect on the day that you have your baby.
This post originally appeared on Birth Activist on January 17, 2008 and was submitted by the author for “Best of” Week.
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Jennifer Zimmerman is an advocate for informed consent and refusal and mother friendly maternity care. She blogs at Birth Activist and also volunteers for the organizations Solace for Mothers: Healing After Traumatic Childbirth and CIMS The Birth Survey. She enjoys activism, art, writing and learning, especially the lessons her son teaches her.