The federal government's maternity services review is providing journalists with a good deal of material.
This week SMH has a piece on informed choices, the Age has expressed concern over rising rates of caesareans, and a personal story of caesarean and vbac, and the Australian has Midwives push for Medicare.
I would like to look closer at a statement that caught my eye in the SMH 'informed choices' article:
"Many submissions referred to nature. As one woman wrote: "Give women back their rights to birth, the right that women have had taken from them due to a medicalised world. Reinstate BIRTH as a normal function of life!"
"Birth is a normal function of life but it is also dangerous. Women have been giving birth since the beginning of time but they have also regularly been maimed or killed in the process, and continue to be in countries where women cannot resort to modern medicine if things go wrong.
"The belief that nature intended women to give birth in a certain way only holds if you believe intelligent design rather than science. If you believe in evolution, you will understand that there are competing interests in the way a species develops over time and humans have evolved in ways which make childbirth particularly nasty: we have fat skulls to hold our fat brains and narrow hips so we can walk upright, compromising the ease of pushing out offspring. We use pain relief and surgery when faced with other half-baked products of evolution, such as wisdom teeth and burst appendixes, without feeling like failures, so why not childbirth?"
What a ridiculous connection to make. So we are now to believe that childbirth is one of the "half baked products of evolution" that should be put in the hands of 'science' and taken care of!
When I was young I heard of women who had had all their teeth removed before they got married, so that there would be no dental bills. The 'science' of the day told them that a good pair of dentures would be much preferable to oral hygiene, and the teeth look much nicer than the natural sort. As those women got older their gums became progressively more degraded, and they reached a point where the dentures would not stay in place. Today's 'science' encourages us to protect the natural process, with day to day care of our teeth, and specialist care when disease or decay are present.
When I was young I knew children who underwent elective surgery to remove their tonsils and appendixes. The 'science' of the day told their parents that tonsils and appendices were vestigal parts of the anatomy that were not necessary, and that could become infected. Better to do a bit of housekeeping, and book all the children into hospital to have their useless bits removed. Today's 'science' encourages us, once again, to protect the natural processes, and to maintain healthy tonsils and bowels through healthy diets and lifestyles. Once again, there is specialist care available when disease occurs.
There is a very important reason why midwives are required, by definition, to promote and work in harmony with normal, or 'natural' birth, whenever that is possible. There is NO safer way of childbirth for most mothers and babies than following the complex, unpredictable, and often difficult process of spontaneous, unmedicated birth. If we want to talk science, this has to be the starting point. Every intervention, every drug, every procedure carries its own package of risk. Drugs and surgery can, and I hope will, be made safer over time. Risk management protocols in hospitals can, and I hope will, minimise the number of people harmed as a result of human error. If maternity care providers follow scientific and ethical thinking about safety and wellbeing of those in our care, we can not afford to lose our skill in working with the natural processes in birth and nurture of the newborn.
In addition, there is a deeply significant emotional process in birth. It's no wonder there were so many responses to the maternity services review.
Thinking people find birth important. I am outraged at the suggestion that childbirth should be treated as one of the "half baked products of evolution".