|
How Beliefs and Practices Evolve
The final session of Maternity Care Coalition’s (MCC) 2005 conference series, entitled Childbirth at a Crossroads: How Beliefs and Practices Evolve, was held on May 12, 2005, at The Downtown Club in Philadelphia, PA.
Welcoming Remarks
Councilwoman Blondell Reynolds Brown congratulated Maternity Care Coalition on its 25 th anniversary, and commended us for paying special attention to vulnerable families. She encouraged the audience to stay enthusiastic and to inform City Council of families’ needs.
Ruth Wilf, Pennsylvania Hospital a midwife, women’s health activist, and long time friend of MCC, challenged us to examine how each of us can improve maternity care. Ruth spoke of the need to celebrate our past, present and future. Ruth sees the rise of doulas as a positive movement, and she took pleasure in recognizing all of the mother-daughter pairs.
Loraine Ballard Morrill, Clear Channel Radio was the moderator ofthe program. She introduced each
speaker and shared some of her own experiences that shaped her views on women’s health. “I think we tend to forget that women have been giving birth forever and it has only been in the past century that childbirth and pregnancy has become seen as an illness.” Loraine shared her personal experiences with Our Bodies Ourselves, and she described it as not only a book, but a movement.
Birth as an American Rite of Passage Revisited
Robbie Davis Floyd, PhD, University of Texas at Austin
In her book Birth as an American Rite of Passage Robbie Davis Floyd looks at American birth a decade ago, today, and the global context. In her presentation , she began by briefly describing the history of Western cultural evolution. The primary mythology of human evolution is that technology developed through and for man, the hunter and killer. Man is portrayed as upright and tall while woman is portrayed as down and low.The hunter is portrayed as the breadwinner, while in reality it was the gatherers, the women, who brought home 80% of the daily fair.
Robbie introduced the technology imperative, which is the belief that if the technology exists, we must use it. This leads to our belief that using technologies constitutes “the best care,” and n ot using them constitutes inferior, negligent care. By joining these ideas Robbie presented the industrial model of birth: the female body is a defective machine, the hospital is like a factory, and the baby is the product.
The rituals associated with pregnancy and delivery have huge impacts on normative care. For instance, the beeps of electronic fetal monitoring have become a ritual for many medical professionals. From a nurse: “I know it’s irrational, but after a mother is on the monitor for a while, I get afraid to take her off because I get the feeling that it is the machine that is keeping the baby’s heart beating.” From a mother: “As soon as I got
 |
Robbie Davis Floyd |
hooked up to the monitor, no one even looked at me any more, and then I started staring at it too. Pretty soon I got the feeling that it was having the baby, not me.”
Our cultural evolution has lead us to believe “up” is best, so doctors have women lie on their backs to deliver, hooked up to an IV, the symbolic umbilical cord to the hospital which makes a laboring women dependent on the institution and keeps her “in her place.” These practices go against centuries of tradition and practice based on the anatomy of labor and midwives delivering babies from below a standing woman.
The majority of routine interventions in birth are not evidence-based. The first major rise in US cesarean rate since the 1970s is now taking place and the rate of VBACs (vaginal births after cesarean) are down. Cesareans are the ultimate form of control of women, with a doctor positioned over a woman and literally lifting the baby up out of her. Robbie argued that midwives should be the primary attendants at birth, but in the US today midwives attend only 9% of births.
Typically obstetricians standardize pathology and midwives normalize uniqueness. Robbie supports a holistic model of medicine, which views science and technology at the service of the individual and places authority and responsibility with the person. In this model there is not a standardization of care; care is based on the individual and there is a normalization of the uniqueness of individuals.
Today we are fortunate to be able to combine the best of technocratic medicine, a humanistic philosophy, holistic modalities, and the knowledge systems of ancient and indigenous cultures. With this we can transcend the limitations of paradigms, creating new rituals that enact the most comprehensive and effective knowledge system about birth to keep open the full spectrum of choices in childbirth for women!
Our Bodies, Ourselves in a New Era
Judy Norsigian, Executive Director, Our Bodies, Ourselves
Judy Norsigian began by congratulating Maternity Care Coalition as one of the country’s great resources for talking and thinking about positive birth experiences.
One of the new things in this 8 th edition of Our Bodies, Ourselves is the inclusion of younger women in the
 |
| Judy Norsigian |
leadership of the project. There is also a new companion website at www.ourbodiesourselves.org.
The first edition of Our Bodies, Ourselves was written in angry response to the lack of education being provided to women about their bodies. Today the Our Bodies, Ourselves message is reaching around the world. There have been more than a dozen translations or cultural adaptations of the book, and in each instance, the book is an outgrowth of the women’s community in that country.
Judy hopes that with the cultural and linguistic adaptations of Our Bodies, Ourselves a transnational dialogue will begin. Our Bodies, Ourselves has been a springboard for activism and Judy urged that we should all be more active in the communities in which we live. We must help facilitate a collaboration of various disciplines so that we can learn what evidence needs to be collected, and what options women want.
Daughters Becoming Mothers: Feminism, History & Childbearing Options in Our Bodies, Ourselves
Elizabeth Sarah Lindsey, Maternity Care Coalition
Elizabeth Lindsey is 25 years old and identifies as a queer black woman of mixed race heritage, queer. She is of childbearing age, and is author of the on gender identity in the new edition of Our Bodies, Ourselves. Elizabeth’s goal in her presentation was to examine previous editions of the book to better understand were we are now, and how we got here. Our Bodies, Ourselves has provided women an environment to learn more about themselves and their bodies for decades. It is important to recognize women’s experiences in childbearing in the past and how feminist struggles in our communities have impacted the choices that we have today.
In the 1971 edition of Our Bodies, Ourselves the chapter “Pregnancy” raised consciousness about the intense societal pressures women were experiencing to become pregnant. The same chapter also detailed the demands that women should make when deciding to have children. This chapter evolved through the 1970’s
 |
Elizabeth Sarah Lindsey |
to discuss the positive reasons for having children, and were about empowerment and informed decisions. Race was not specifically mentioned in the 1970’s, however, the 1973 edition of Our Bodies, Ourselves did mention lesbians as parents.
In the 1980’s and early 1990’s the chapter “Deciding to Have Children” was removed and “Controlling Fertility” replaced it. The shift in focus from motherhood to reproductive rights was a huge change. The authors knew that childbirth was a right and they were now helping to keep alive the reproductive rights won in the 1970’s. In these editions women of color were also more specifically addressed
The newest editions of Our Bodies, Ourselves in 1998 and 2005 again include discussions around the decision to have children. Women who are entering their childbearing years today are usually not involved in the conversations that feminists had in the 1970’s regarding childbirth. It is therefore a critical asset to young women to have these chapters included in the latest editions of the book.
Childbirth at a Crossroads: A Glimpse at Southeastern Pennsylvania
JoAnne Fischer, Executive Director, Maternity Care Coalition
 |
JoAnne Fischer |
JoAnne Fischer presented Maternity Care Coalition’s preliminary findings for the report “Childbirth at a Crossroads” due out later this year. The report will examine the childbirth environment 25 years ago when
Maternity Care Coalition was just getting started, what we see today, and what we hope for in the future. Some preliminary findings include:
Barriers to Health Care
- Then : Many needy women who were ineligible for Medicaid and too few providers accepting Medicaid. Barriers included long waits for care, inflexible appointment hours, a lack of transportation, and prenatal care being viewed as a low priority.
- Now: The problems persist and are getting worse as employer based insurance erodes, Medicaid is under-funded, welfare imposes work requirement and restrictions, and our communities become increasingly diverse in culture and language.
Providers and Hospitals
- Then : Poor Medicaid reimbursement and too few women were practicing obstetrics. OB was the gateway to hospitals, and hospitals aggressively marketed to consumers.
- Now : Uncompensated care, decreased public funding, high malpractice insurance, fewer practicing obstetricians, staff reductions, low morale, less time and more patients are all problems. The field of obstetrics is now female dominated which has brought its own challenges. Hospitals are market driven and OB is not desirable.
Quality of Care
- Then : Attention was paid to unnecessary procedures and untested technology. There was a simultaneous, consumer driven emphasis on patient education and informed consent as women were learning about their bodies, asserting themselves, and making decisions.
- Now : Shortened hospital stays postpartum and an emphasis on risk management, pain management, and time management. Increasing c-section rate and little to no VBACs. No time or capacity for patient education. Technology has improved but it is over-utilized. Women are more passive, and childbirth is increasingly a planned medical event.
Moving forward, Maternity Care Coalition commits to continue collecting and sharing data from various perspectives, taking the lead in organizing advocacy efforts on behalf of childbearing families, and using the media effectively to highlight the issues.
Buy your copy today!!
Signed copies of the new Our Bodies, Ourselves are still available by contacting Maternity Care Coalition. Each book is $25 and proceeds go to benefit MCC.
Booksigning and Reception
Back to Top
Back to Top
|
 |
|
