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Archive for May, 2010

The imperative of choice

Tuesday, May 18th, 2010

I have been watching Mad Men recently, and quite apart from how fantastic and beautiful it is as a series, it is completely fascinating to see into the (admittedly fabricated) lives of women in the 1960s. It wasn’t that long ago really, and yet sexism was rife, women were only beginning to be liberated and generally you get the sense that their choices were, by design or default, significantly curtailed by the cultural norms of the day. Fast forward 50 years, and we are all superwomen, capable of choosing between motherhood and careers or having both, informed and educated and spoilt for choice. Or are we?

Because the women of New York have just had a huge choice taken away from them ( see article). Last week,  the closure of one of NYc’s most progressive St Vincent’s hospital spelt the end of legal backing for midwives who worked independently. As o that day, there is not a single midwife in New York who can legally attend a home birth. That is millions of women now deprioved of a very basic choice as to whether to birth at home or in hospital. In a country that honours freedom as much as the US does, that borders on the sacrilege.

Not everyone wants a home birth, and not everyone should have one. But for those that do, the lack of choice will feel stifling. The most important thing a woman needs to consider when she is planning her birth is what environment she will birth best in. Security and privacy are two complete essentials - if a woman feesl safe she will birth better. Fact.

For some women, that safety comes from being in hospital, with medical attention only a corridor or two away, and an epidural on hand should she cry out for one. But for other women, safety comes from the comfort and familiarity of their own homes. Research on home birth shows that for risk-free prgenancies birth at home is at least as safe a in hospital, and Holland, where the home birth rate is a whopping 30%, has some of the lowest maternal morbidity rates in the world. According to the science both places are safe for mothers in general, but certain places are better for mothers as individuals. And it is only the women themsleves that can decide what is right for them.

Except in New York they cant.

Birth is hormonally driven, and hormones function best in particular environments. When a woman is denied the right to choose that environment, she is effectively ebing denied the right to a good birth. There is, and should be public outcry about this.

Let us also hope that this particular little development is one that we dont decide in the UK to follow. Birth practice in the US seems to be exported, even when it is found to be faulty. I have never been one for protectionism, but there is a time and a place, and when it comes to choice for mothers, that time is now.