Touching Further on “Safety” in Birth

I shared my previous post on “safety” in birth in the group for my MamaMuse (un)Midwifery program mentored by Krista Joy Arias and she made a comment that spurred a new thought process. My view point on “Unassisted Childbirth” has ebbed and flowed through various thought processes, view points, and opinions since I first discovered the terminology (and the ever-growing movement) but that is for another post. We had talked some on UC in our class and I had made a comment in regards to UC being counterproductive. Krista asked in regards to my last voiced stand on UC how it related to my post on “Safety in Birth”. This was my response:

I feel that if one can go into a UC (here meaning having no one, midwife or otherwise… i.e. someone other than a midwife more experienced in birth than yourself… at your birth to “assist you” in the instance of an “emergency”) with the frame of mind that whatever happens, happens, and feel that they can be present with that and just let birth BE, that UC may be the best thing for that mother…. However, I still feel that it is counterproductive all around, whether for “safety”/”positive” birth outcome or for spiritual growth/enlightenment/what-have-you, to go into a UC planning to “be the midwife” trying to learn as much as you can and practically train yourself to be a midwife, to be able to recognize complications and be able to handle them, WHILE giving birth and being in a completely different state of mind (or, this weight and responsibility you have put on yourself is KEEPING you from going into that essential, primal, state of mind)… this is the route that I see most often in women who seek UC. I feel that it is OK to have people with you. You don’t NEED to be by yourself, to “prove” that you can do it, that your “natural”, or anything like that. I think that women have been giving birth surrounded by women, for millenia. And yes, even though they had women who were more experienced in birth, whether a great-grandmother and their grandmother and their mother (who all had 8+ children), or a midwife, or all of the above… they still knew that even if something happened and no one there knew what to do, or something happened and someone there DID know what to do, and it still didn’t help or salvage the situation and the baby or mother died, that was accepted as the way of things. There was allowance for acknowledgment in this, and allowance of time needed for grieving. But it was known to be a possibility and was accepted as such…. I think that’s the key. Not seeking safety as the goal, or throwing safety out the window. Not seeking to know as much as humanly possible to keep something from going wrong or throwing experience and knowledge out the window, but instead using what we have to the best of our ability (our skills and knowledge) and if what we had to give was not enough (or the mother did not want what we offered and so we met her in that place and acknowledged her right to chose and her choice), and regardless of the outcome let it BE. Acknowledged it, was present in the moment, and took nothing for granted. That, is the key.

Safety in Birth

As I was traversing Pinterest I came across a blog here on WordPress called “Outlaw Midwives” and while skimming the articles, I found this one: http://outlawmidwife.wordpress.com/2011/03/30/on-safety-and-consent/; shortly there after I re-read an article also touching on “safe birth” by my mentor, Krista Joy Arias over at MamaMuse: http://www.mamamuse.com/2011/05/trust-love/.

They sparked a thought process in my head that I hadn’t considered before. An idea, a philosophy, that so many mainstream midwives, pro-homebirth (*cough* midwife-attended homebirth) campaigners, etc. would be furious at. Especially when it challenges their biggest ideal: “trusting birth”, that birth is “safe”. My thought process was similar to that of the Outlaw Midwife’s, supported by Ms. Arias’s points.

What is “safety in birth”? Why do we seek “safe birth”? Is it just a ploy by pro-midwifery-licensure campaigners to gain more support? They are trying to not “scare” anyone. “See, look! Birth IS safe if you don’t receive interventions!” But that’s just it. We find comfort in “safety”, even if it is just perceived– which can be dangerous in itself. Our culture, our society, fears death. It fears it, and it is taboo to not fear it, to accept it as an every-day Right of Passage. We fear it, so we fight it with medication and technology. We fight it down to our very cores, though there is a place in our souls, in each of us, that knows Death, and accepts it. But we fear letting that part of ourselves, that part of our humanity, out into the light of day.

To me, Death is a part of Midwifery. It is a part of Motherhood. It is a part of Life. There is no escaping it (though we like to think as much). And the rituals and chants, the songs and whails surrounding the Rite of Passage that is Death (and all other Rites as well, really) are being forgotten. But there are those Rogues who are grasping at the slipping rope, trying desperately to pull it back up to the surface before all is lost to the sea of modernization and technological advancement.

Consider the following taken from the blog over at Outlaw Midwives:

“this idea of safety is so ubiquitous that even the controversial ‘trust birth‘ movement says, birth is safe, interference is risky, as if the question on the table is, how do we have the safest birth possible?  do we follow medical protocol, mainstream midwifery protocol, more ‘hands off’ protocol…which one is safer?

but i want to question, why is safety the goal?  why do we first tout how safe a procedure, before we talk about whether the mama has given informed consent?  and why when we talk about informed consent, we often boil down to whether or not the mama consented to this procedure, despite or because of the risk or safety of the said action?  feel me?

what is safety?  being alive?  fitting into the normative ideas of healthy and average?

and how do we determine safety?  through clinical studies?  medical tradition?  anecdotal evidence?  expert opinion?”

Really consider that for a minute…. “What IS safety?” ….. “WHY is safety the goal?”

In the words of Krista Arias:

“So, when I hear someone say, Birth is safe or Trust Birth –your body knows how to give birth, something in me rebels.

“That’s not true,” it says.

“Birth is anything but safe.”

Birth may not be a medical emergency, but that does not mean it is safe. It is a serious and intense rite of passage that can shake us to our depths. Persephone’s trip to the underworld was not safe. Safe is a cop-out in life, and in birth.”

Let me repeat that: Safe is a cop-out in life, and in birth.

I feel that women, midwives, mothers… that they should not focus on “safety” and “what-if” and “Where did we go wrong” or “What could have been done to make it safer”. Instead, they should focus on allowing what is to be, allowing the birth to unfold in the manner of which it is meant to. Even if you attempt to do what you can with what skills and knowledge you have, and the “best outcome” doesn’t happen, accept that. Accept it as it is. Be present, be responsible, and own the part of the story that is yours. Meet mothers where they’re at. Do not hold judgement. Know the rites, know the rituals, know the words and the way of life and death and you can accept it as it comes, and help mothers and families to do so as well.

Another thought from the Outlaw Midwife:

“i guess it is because i think of safety/security as an illusion.  there  are no guarantees in life.  and playing the statistics game (deciding  ones protocol based on what has proven to be statistically safest or  most effective) is a fools errand.  because you can easily find yourself  in a situation where you do all the right things and the outcome is  horrible.  and you can do all the wrong things and in the end everything  turns out just how you wanted.
and if something is 99 percent  effective, and you turn out to be that 1 percent, do you really care  that 99 other people had difft outcomes?  and what if you are the mama  and you lose your babe, because you are the 1 percent?  is your grief  any less? probably not.
but yr grief probably is harder if you were told to go against your own motherwit, because the stats said xyz.
and  if you did follow your intuition, and the outcome is not what you  expected, then at least you can take responsibility for what happened.   rather than blaming mw’s and obgyns etc, ppl who have little  accountability to you, and will go on doing their jobs barely  remembering you existed a couple of weeks or months later.
i dont  know.  i tell mamas, look, everything will not be perfect.  but if you  follow your own sense of what to do, then you are taking responsibility  for your own life and choices.  everybody has to be who they are.
and  from what i have seen if you follow your own sense of what to do, then  you will have more self-respect, self-love, self-empowerment.  and the  more that we value ourselves, the more we are able to value others  around us, including/especially our children.”