I’m surprised to see “Pregnancy is not an illness!” (Solidarity 3-175) in a rational newspaper like Solidarity.
- We should question medical opinion, Solidarity 3/177
- Pregnancy is not an illness!, Solidarity 3/175
Surely the author realises hospital obstetrics is geared up for worst case scenarios and the intervention that flows from that? All hospitals feel alienating to patients, as every device there is almost completely foreign and they have no control over when they eat, sleep or see their relatives. But if the author had ever seen a delivery go wrong and how quickly it goes downhill and how in less than a minute a hypoxic brain injury can occur, she’d presumably revise her views.
I also don’t agree at all with making a virtue of the pain of labour: that’s what an epidural is for. There’s nothing virtuous about not using all the accumulated products of human knowledge available as they are manifested in modern medicine. This article is typical of people who are essentially well: they believe in the “natural way”, which is great because it lessens the unnecessary burden on GPs, but doctors will be seeing them when there’s something really wrong.
And, really, what a load of rubbish at the end saying women are physically assaulted through the surgical procedure affording easier repair provided by an episiotomy. Where are these facts that this process is “often carried out without the woman’s knowledge or consent”? Of course there will be cases where this has happened under anaesthesia, but this presents it as a routine occurrence. I know the hospital system in the UK is different to Australia, but I find that hard to believe these days.
I appreciate the feminist sentiment behind the article, but it’s entirely the wrong type of feminism for socialists.
It irritates me that an anti-medical article like this make an appearance in this newspaper. I could cop it on the chin with the anti-psychiatry article presented in an earlier edition '”Mad cabbie protest”, as psychiatry is obviously a lot more contentious, being about fitting into this society for maximal psychic functioning, but this new article is going too far.
Melissa White, Brisbane
I have some sympathy with some of Melissa's points about Rosie's article, but Melissa's assertion that Solidarity should not have published it is, I think, very wrong - as is her argument that Rosie's point of view is "entirely the wrong sort of feminism for socialists".
Solidarity should publish articles that prompt discussion, including articles about issues and experiences in women's lives, without them having to fit a pre-ordained 'line'. And how would we establish what that 'line' should be without an open debate, which involves publishing different points of view?!
I would like to start by saying I am not anti-medical. I am a paediatric nurse, currently working as a health visitor. I worked on a heart and lung ward and I know how modern medicine transforms the lives of children who, even 30 years ago, would not have survived. Also, I am well aware that women and children used to die in childbirth, something which is now (in this country) a rare occurrence. This is a good thing, and I am glad that we have an accumulation of knowledge and skills to make pregnancy and birth safer. However, my point is that medical intervention has become routine, even when it is not necessary. When this occurs it can start a chain of interventions that result in a more uncomfortable labour for the woman, assisted delivery, or (in about 15% of births these days) an emergency c-section.
My main point is that women are not treated as equal or senior partners in any discussions/decisions regarding their health but are treated paternalistically and expected to just follow the instructions or advice they are given – I say again, that we are treated paternalistically, which mirrors treatment of women in society in general. I am also attempting to look at why women make the choices that they do. Women go into the process of having children carrying their own accumulated life experiences which will affect how each woman handles being in such a vulnerable position. Choices we make are not made in a vacuum they are influenced by our surroundings, our circumstances, information we are provided with, the support we have and the way we are treated. This is true of many choices we make, including whether we “choose” to have an induction or an epidural etc etc A lot of women prior to labour intend not to have any interventions, end up having them and have very negative feelings about their experience afterwards. It is not enough just to say ‘suck it up at least you and your baby are alive’. I think there are problems in the medicalisation of childbirth that can make birth more difficult and traumatic than it needs to be. Now I value medical opinion, but it is just that – an opinion. I reserve the right to have my own opinion, do my own research and make my own decisions. Medical staff and midwives are not infallible and many common practices carried out on labour wards are highly questionable.
Epidurals are becoming routine and in some cases women really need a break from the pain of along labour, but they are offered too casually. I say this not because I want to make a virtue of the pain of labour! It is because all research suggests that epidural use carries risks, including greater risk of assisted delivery and caesarean and so to the wellbeing of the woman and baby. If a woman decides to have one that is her choice but it should be an informed one and she should have other options such as a birthing pool– but funding dictates there are not enough of these.
Induction of labour is also now routinely offered – women are just booked in for an induction about 10 days post due date without real discussion about their alternatives, i.e. waiting for labour to start naturally. I am not making a virtue of the ‘natural way’ for its own sake – again it is because research and evidence show that labour is more painful, progresses more slowly and is more likely to end in medical intervention if labour is induced – i.e. there are (again) risks to the wellbeing of the woman and baby. Women are often put in beds on their backs (especially if induced and they are being monitored) which makes labour many times more painful and slow to progress. Also, I feel obliged to say that episiotomy does not ‘afford easier repair’ than a natural tear in most cases. This is broadly accepted by most midwives ‘in this day and age’ yet doctors continue to carry it out usually to aid them in managing a delivery. As to my assertion that it is done without knowledge and consent – this happened to my mum in the seventies and my sister 3 years ago, neither under anaesthesia and both against the advice of the attending midwife. The rate in England is 15%, USA 50% and Eastern Europe 99% (NCT 2001). Obviously I could go on and on about poor practice in birth management. But Melissa’s assertion about episiotomy highlights my point – it is presented as fact that episiotomy affords an easier repair when this is not fact at all – it is an opinion.
Modern medical advances are, I repeat, not infallible. Let us look at the use of incubators for low birth weight or pre-term babies. Great advances have been made in caring for premature babies in neonatal units. Yet the way they are set up has resulted in the forced separation of mother and baby after birth. Common sense would seem to indicate that this was just an unfortunate necessity. However, in South Africa due to lack of funds to have sufficient numbers of incubators they discovered that low birth weight and premature babies do better than those in incubators if they are kept skin to skin with their mother (Kangaroo Mother Care). Their breathing, heart rate, temperature and stress levels are all stabilised through this closeness to the mother and breastfeeding success is significantly improved. Babies can be cared for this way even while being ventilated. The evidence for this approach to care is very convincing, yet in this country mothers and babies are separated after birth if the baby needs to go to special or intensive care. My point here is that modern medicine doesn’t always have the right or rather, the whole answer. It is not being anti- medical to question things and pose alternatives and the natural way isn’t just some hippie pre-occupation.
Modern medicine can save lives. I am not some woolly headed herbalist who thinks that petals can cure cancer. If I am seriously ill then damn right I want good quality medical advice and treatments available. But I don’t think this means I have to surrender the right to question and have knowledge and control over my body and health, in pregnancy or at any other time. The question of a woman’s right to have knowledge of and control over her own body is central to feminism.
Finally, although medical and scientific advances are good I think there is a problem with the knowledge that is generated through research and practice. Firstly, conclusions cannot always be trusted; medical research can be funded by various organisations with profit motives. Secondly, medicine is very elitist. I am for the ‘democratisation’ of healthcare; we should seek to level up awareness of health issues, treatments, drugs etc. We should aspire to a situation in which health care is rooted in communities and more people in general should possess medical and health care skills.