In 2000, I first built the Birthing Naturally website. I wanted to provide an internet source of natural childbirth information. I included a list of my birth philosophies on that website and every version since. Here is the first statement from my philosophy:
No woman chooses the circumstances of her labor and childbirth. She only decides how to respond to the circumstances she finds herself in.
Have I changed my philosophy?
I agree more strongly with this statement now than when I first wrote it. Why? When I first wrote this I had a vague understanding that sometimes birth didn’t go as planned. That understanding revolved around the idea that sometimes contractions just don’t work or sometimes the baby has a problem and cannot handle labor. I still think these things are sometimes true, but now I would add to these other circumstances the mother needs to respond to. For example, in my state we’ve had 7 rural hospitals close their obstetric services in the last 10 years — leaving rural women with few good options for antenatal and delivery care. My state is not alone. Some states still have family practitioners providing delivery care, but in a 2012 survey of hospitals in my state, we learned there were none.
We can talk in generalities about the options women can choose. But for any particular woman, unless she is willing to leave her community to give birth, she is dealing with the circumstances in her community. This may mean she has several hospitals to choose from, or she has one. She may have access to doulas and midwives, hydrotherapy for labor, or she may have a two-hour drive to the nearest maternity services and accept whatever they have to offer.
I would like to improve the community circumstances for women. I would like to keep antenatal and delivery care local because we know the further women must travel for care, the higher the risk to her and her baby.
What do you think? Are there other circumstances that come to mind when you think about the things a woman cannot control about giving birth.