Monthly Archives: August 2009

Rage, rage against the end of unemployment

Tomorrow — finally, 3.5 months after being laid off, 1.5 months after getting offered this new job — The Man goes back to work. And the Boychick and I go back to hanging out alone together during the day. To say I am not looking forward to this would be both a misstatement and a massive understatement.

We got used to having the whole week together as a family, used to going shopping during weekdays, used to waking up with everyone still in bed, used to sharing and trading off parenting fluidly, effortlessly, and often. I got used to being able to sleep in (while The Man got up with the Boychick), blog and study during the day (while The Man distracted the Boychick), go out and run during the day (while The Man played with the Boychick — noticing a theme here?) — just generally have time to myself, knowing my child was in good hands (the best, really).

While I can’t say it was a utopia — especially the first half, when we were all adjusting, all dealing with the stress, not knowing when or whether The Man would get work again (and we would start getting money more than the pittance offered by unemployment insurance again) — in many ways it was ideal, and certainly closer than what we’d had before, and what we’re going back to. We were both engaged in (albeit unpaid) work that engaged our minds and our interests — both of us together and him alone on finding him a job, me on the blog and on school — both home (and out and about) with the Boychick, both parenting equally, both able to hand off primary responsibility when we needed a break, both able to step in when we could see the other flagging. And we got to play, all three of us, as a family, in ways that are in short supply when he’s working out of the house full time.

Perhaps more pertinently, The Man in many ways became primary parent, especially once his job was secured and it was a matter of meeting the dead-tree (aka paperwork) quota to get started, since he then went more out of his way to give me time to blog, to run, to do the things I won’t be able to as easily after he starts. The Boychick is going to be losing a primary parent 40-50 hours a week. He’ll cope, of course, and adapt, because children are amazingly resilient that way. But in my current melancholy, I cannot help focusing on what he’s losing — and what I’m losing.

This, of course, even more than the funk when he lost his job, is so much privileged whining. He has a job, when so many don’t (Oregon has the 2nd highest unemployment rate in the USA right now, and the highest homeless rate). And it’s even a better paying, higher status job. We weathered this unemployment without going hungry, losing our (rented) house, adding much to our debt, or letting go of our pets or our property. We are so very lucky, and I am so very grateful.

But I am, also, scared. I’m scared that the transition will be harder on the Boychick than I’m anticipating (as hard as I imagine in my nightmares). I’m scared that I won’t be able to deal with him, at 2.5, used to near-full-time parental attention, the way I could when he was just-two and used to 40 hours of benign neglect from me a week. And, mostly, I’m scared as I look back because I wasn’t handling it nearly as well as I thought back then; The Man coming home for lunches, sometimes far too long, was a necessity. His working to 5pm was rare; working past it almost unheard of. And yes, that possibly contributed to his lay off in May (though I will point out he survived the first two rounds of lay offs, never had problems with his performance reviews, and there were only 2 people left in his department after his departure). Between wanting to avoid that again, the desire to make a good impression at the new place, and more practically the transportation and parking situation from working downtown, it’s highly unlikely we’ll be able to take such liberties at this job.

My heart hurts just thinking about it.

I am, when it comes down to it, afraid of going insane again. I’m afraid of losing my emotional stability. I’m afraid that I’ll get sick (being bipolar is who I am, and I’d never wish it away; having active episodes of bipolar is an illness from hell, and I wouldn’t wish it on anyone), that the new insurance won’t cover the things that will make me well, that all the “extra” money will go toward trying to survive the dark days with hot drinks and dinners out, rather than paying down debt. I’m afraid of slipping back in to a black pit I feel at times so far away from, and at times so frighteningly close to. I’m afraid I’ll spend all my time trying not to yell at, shove, be violent with my precious baby Boychick, and too much of the time failing.

Except for those rare few with specific aptitude for it, and the necessary support network surrounding them, solo stay-at-home parenting isn’t easy for anyone, in this misogynistic kyriarchal culture. But what I hear from my friends (not all of them, but too many) when I try to discuss my ambivalence, my fears, my dread even, is “Oh, you’ll do fine!” or “You’ll get back in your groove in no time,” or “I should be so lucky!” From women who stay at home full time with their children, there’s an attitude of “well what’s the problem? you had your playtime, now it’s back to work.” From the women who work out of home full time, there’s one of “sure that was nice, but you still have it so good,” often with a heaping side of “I wish I could be SAHMing, and you should enjoy it because I can’t.”

Which is a horrible exaggeration and mischaracterization, but I can’t help but hear that in so many of their pat, trying-to-be-nice answers. There there, dear, you’ll do fine, no cause for worry. Except there is. I hope — when optimistic I believe — that the risk for my insanity, my pathological, problematical instability is small, but it is, regardless, real. It cannot be dismissed with a wave of the hand, it should not be disregarded as a triviality.

And further, even without my particular situation as a person with bipolar disorder, I have every right to grieve this loss. I am lucky, yes, compared to so many, but I am still a woman, a person, under kyriarchy, and so I am damaged, I am constrained. This is not the life I would choose if I had full free will, denied to me by the corporate capitalist kyriarchical society I live in. I should have close community, allomothers galore, my partner should have work that does not drag him away from me, from his family, his child, for a majority of his waking day — and so should I. We shouldn’t need to work so hard, earn so much, to pay off debt (at crippling interest) we acquired from illness and unemployment, from trying to stay sane in an insane society, from trying to get education enough to get money enough to get out from under the burden of debt.

This grief I’m feeling? This fear? This rage? Don’t tell me it’s nothing. Don’t tell me I’ll get over it, get used to it. Because you’re telling me to accept my oppression, accept the cage kyriarchy has placed me in.

I will, of course. I’ll go back to slogging through, dealing with daily mundanities, accepting the new normal. I will because I have to — have to divorce myself from my pain, tamp down my rage, bury my grief — in order to survive. We all do; we all have to swallow shit at times.

But now, in these last hours before the new reality sets in, don’t hasten to shush my scream of rage and fear and grief because it discomfits you to hear. It may seems such a small thing, such a good thing, to you, having my partner go back to work. And it is, as well. It is. As much as good can be had in kyriarchy, it is good. Forgive me, though, if I wish to yell about how fucking huge that caveat is, before I sleep, and wake to a half-empty bed and an empty house and a child demanding his father, and smile because I must, because screaming then will only make things worse. Let me scream and cry now, because tomorrow, life goes on.

WFPP Guest Post: Back to school: solidifying the cerebral

This entry comes from Jenn Crowell, a student, novelist, and dear friend with whom I share far too much in common.

This piece, on explaining to her young daughter the nature and importance of her work/school studies, resonates strongly with me, as I’ve dealt with similar concerns over work, school, domesticity, and trying to make sure the Boychick understands that I have a life and aspirations of my own. She describes going back to a non-traditional grad school — at the “late” age of 31, as her child enters school for the first time — and the forces that pull on her and weigh on her as she struggles to make her work seem “real” to a child who can’t yet conceptualize the cerebral quality of her pursuits.

Jenn’s story is a humorous and insightful piece on the way one woman navigates the treacherous maze the kyriarchy sets before her.

Back to school: solidifying the cerebral

When my daughter and I both went off to “school” this year (she to a pre-K program at age 3; I for a long-overdue MFA in Creative Writing at age 31), I knew in advance that student parenting would present me with challenges. I was not prepared, however, for one challenge in particular: how to explain, much less validate, the amorphous-appearing nature of how I occupy the hours of nine through five, Monday through Friday, when speaking about my unconventional workaday life with my toddler.

These difficulties, of course, preceded my foray back into academia. For her entire short life, my daughter has always known that Daddy goes off to some important-sounding “work” on a train, his home/employment boundaries clearly demarcated, while, depending upon our childcare budget at any given moment, Mama alternates between chasing her around and frantically typing on a computer keyboard, all under the same integrated (ish) roof.

To be sure, the ratio of chasing-to-typing has always been pretty skewed. By the time she was two, anytime she saw a picture of someone writing (even an anthropomorphized duck in a children’s book), my daughter would gleefully shout, “He type just like Mama!”

You can imagine how this warmed my authorial heart – until I realized that my daughter had absolutely no idea what I was typing. For all she knew, I could be digital scrapbooking or dinking on Facebook. Not that there’s anything wrong with those time-tested methods of procrastination, of course (and not that I’ve ever used them, mind you!), but it felt disconcerting, even troubling, that my daughter had no concept of my key-clacking absorption as “work.”

When I entered graduate school, these feelings intensified. Wanting to assuage them before I flew to LA for my first ten-day residency (*cue self-flagellating whip-crack of maternal guilt here*), I explained to my daughter that Mama was going on an airplane — not to Grandma’s, this time, but to school. She understood that concept surprisingly well (and coped way better with our inaugural separation than I did, let me tell you), but once I got back, the poor child seemed utterly confused by the whole “Mama’s back, but she’s still in school” aspect of my low-residency program.

The main reason for her bewilderment, I think, was that, even though she was going to childcare eight hours a day (*crack* dang, that whip hurts!), she had absolutely no reference point, no concrete sense of what I did all day. In the mornings before preschool, she saw me emptying the dishwasher and packing her lunch; in the evenings, when she and her dad came home, she saw me cooking dinner. (Before y’all get twitchy about the division of labor in my household, rest assured that my decision to cook most of our meals is my own, made to provide myself with a badly-needed mental transition between “work” and “home.” That, and I’m just a big ol’ hopeless foodie. I blame my Anglophile crush, Nigella Lawson. Woman could crack my marriage just by crackin’ an egg, but that’s a whole other post entirely.)

As cute as it was my first weekday back from LA, watching my kiddo jump up and down with glee that “Yay, Mama have dinner ready when I come home school!” (not so much a commentary on her dad’s cooking, I think, as one on her delight at me being back), I found my disconcerted feelings increasing, as well as a niggling need to address them. The last thing I wanted my child to think – particularly my girl-child, for whom I desperately desired to model economic and creative self-sufficiency — was that I sent her off to preschool every morning, and then came straight home and metamorphosed into June Cleaver, when in reality I was annotating Great Works o’Literature, and planning field studies, and pounding out new chapters on my own novel for eight hours a day.

Lest this statement inspire yet another misconstrued Mommy Wars smackdown, let me be clear here: I don’t think there’s anything inherently wrong with a life devoted to domestic pursuit, if it’s a freely-chosen source of fulfillment (though, mercy, that’s a ginormous caveat, innit?). I just didn’t want my child to automatically assume that domesticity was the life I had chosen for myself, simply because of my Nigella Lawson fetish and/or my compulsive need to tidy the kitchen in the morning before getting down to literary bidness.

And so I began to talk to her about what I was up to. Nothing too somber, or didactic, or melodrama-laden (“Mama is racking up student loan debt, honey, so she can pursue her passion and have a future!”), just a simple “Hey, did you know that while you’re at school, running around with your friends, making a mess with the glitter glue, Mama is working on her school at home, too?” kinda conversation.

Not only did my girlie get it, she thought it was pretty neat, this idea of she and Mama engaged in parallel lives. Pretty soon, she started reminding us, with her three-year-old’s firm penchant for categorization, that, “Daddy go work, I go school, and Mama go school, too!” It was just a matter of time before she had her teachers convinced I “worked” at Starbucks, thanks to my coffeeshop-frequenting marathons while on deadline.

The day I heard that out-of-the-mouths-of-babes quote, I dropped her off and walked all the way up the street to my overpriced caffeine with a messenger bag full of new ideas, a grin on my face, and a somewhat-calmed feminist pulse. (I say “somewhat,” because it’s still elevated over the fact that my non-governmentally-subsidized childcare costs as much per year as my MFA tuition, but that, like my transatlantic lust over Nigella, is Another Post Entirely.)

Jenn Crowell is a freelance editor, author of the novels Necessary Madness and Letting the Body Lead, mother of a 3-year-old girl and a spoiled longhaired dachshund, and a full-time graduate student in the Creative Writing MFA program at Antioch University. She’s currently at work on a novel in which both her crush on Nigella and her righteous indignation at discrimination against mothers with mental illness figure prominently.

What timing! ACOG releases asshat statement

I do believe ACOG must stand for American College of Obtuse Gynohaters. (Other suggestions from Twitter friends: Appalling Care, Obvious Garbage; Aberrant College of Greed; American College of Oppressive Gits*. Feel free to add your own suggestions in the comments!)

Unbeknownst to me, just days before I published Just like athletics: exploring a childbirth analogy, the American College of Obstetricians and Gynecologists was releasing a policy statement that “relaxes” restrictions on fluid intake during “normal, uncomplicated labor”, and would “allow” women in labor to

drink modest amounts of clear liquids such as water, fruit juice without pulp, carbonated beverages, clear tea, black coffee, and sports drinks

– as opposed to the even more unfathomable current policy which restricts women in labor to ice chips. Ice chips! (By the way, if more than 1% of American obstetricians have seen a truly physiologically normal labor that they haven’t managed to unnecessarily complicate somehow, I’ll eat The Man’s angora Stetson.)

Today The Big Push for Midwives released a sufficiently ridiculing reply to ACOG’s statement (which includes another comparison of birth to marathon!), though I wish they had gone into the evidence more.

The rationale for denying solids in labor goes something like: Once Upon a Time, long long ago, when OBs routinely knocked women out during labor (ok, so sort of at our own request) and anesthetics were in their infancy, aspiration of stomach contents was kind of a serious problem. And, of course, since women were knocked out anyway, they figured we didn’t need frivolous things like fuel or energy, so they might as well reduce the risks by dictating Nil Per Os (nothing by mouth), right?

Only, anesthetic techniques have gotten half a century better (see? I do have good things to say about ACOG. oh wait, that’s the responsibility of the American Society of Anesthesiologists. nevermind.), and only a small percentage of the large percentage (but still — for now — minority) of those who need cesarean or other surgery in labor actually go under general anesthesia (which, remember, is much safer), and there’s no evidence that withholding all food or drink actually makes the risks of aspiration and aspiration-related complications safer (though it does make it less messy for the anesthesiologist to clean up), so that’s pretty well an unsupportable policy.

When I talked with my friends in Canada, Australia, and the UK about the ice-chips-only restriction (and this “relaxation” of rules), the reaction was universally a variation on “wait, what? hospitals actually DO that?!” And yet, all three of those countries (and, oh, almost 40 others?) have better maternal mortality rates than we here in the good ol’ USA do.

So if not based on silly things like evidence, or reality, or actual maternal health, how do we explain these seemingly-inexplicable restrictions?

Oh, I am so glad you asked that.

The name of the game, ladies and gentlepersons, is control. About thirty or forty years ago in the US, women started going “Wait, wtf? I’m not sure I want to be knocked out for this childbirth thing. I think I’d like to try to just, y’know, do it. I don’t really need or want you to shave my snatch, stick a bag of soapy water up my ass, cut my cunt, or dope me up. In fact, I think I’d like my husband/lover/friend to be the first to touch my baby as s/he enters the world. So… What are we paying you for again?” And so, slowly, grudgingly, American OBs stopped requiring we be shaved, stopped ordering enemas, and welcomed all and sundry into the birth room (though they’ve yet to stop mutilating our genitals). And the epidural and cesarean rates skyrocketed. At the risk of sounding like a conspiracy theorist, this was not a coincidence.

In the face of women demanding concessions in some areas (enemas, atmosphere, attendants), ACOG had to regain control of birth somehow. The perfect way, when what women were trying for was “natural” labor? Sabotage: set up so many barriers in our way, deny us the fuel necessary for such a strenuous endeavor, that they’d be able to (we’d be demanding them to!) swoop in and “save” us. This is all about misogyny, all about undermining the strength and power of our bodies, undermining women, making sure that (usually white, rich, cis) men have control in the one area that those with functioning uteri and those without are simply, absolutely, different.

(This is probably a good time for the obligatory interlude in which I make clear that I am talking about organizations, and cultural forces that often go unrecognized. Individual obstetricians are generally perfectly decent people. Most OBs really do want to help women and babies, and think what they do is good for us. I have an anesthesiologist relative who, in addition to owning a house that would make Solomon blush, is quite a lovely person. The problem is that most evil is done by persons who are basically good. It only takes a few “we know best” people making decisions, legions of “just doing my job ma’am” pencil pushers — or episiotomy cutters — and a culture saturated in sexist beliefs and imagery and rules, to the point we can’t even see them anymore, to create a birth culture in which blatantly misogynistic unsupported-by-the-evidence practices can be near-universal and none of the intelligent, well-meaning people inside the institutions question it.)

So much for the history lesson: back to the present, in which we are offered this “relaxation” of restrictions, and told:

As for the continued restriction on food, the reality is that eating is the last thing most women are going to want to do since nausea and vomiting during labor is quite common.

Oh William H. Barth, Jr, MD, of Massachusetts General Hospital in Boston and chair of ACOG’s Committee on Obstetric Practice, how you make me laugh. While it’s true that most persons in labor would frown at a four course meal, and many of us do indeed upchuck quite frequently (if not copiously), most DO choose, when presented with the option, to consume something in labor, from toast to soup to pasta to pepperoni pizza (to name a few that were mentioned on Twitter). Further, the idea that because most do not want much means that none should be “allowed” any is… well, completely kyriarchal.

But hey, it’s a step forward, right? At least it’s something, right? A move in the right direction? From the policy release: “Allowing laboring women more than a plastic cup of ice is going to be welcome news for many.” That’s true enough, so this is sort of a little bit good… Right?


What it is is a morsel, a scrap, a teeny tiny tidbit that is supposed to make us feel grateful, that serves only to tie us closer to them, like when a nurse or nurse-midwife slips us a sucker in the sly, and says “Shh, don’t tell, because you’re only supposed to have ice”, but we are so grateful to finally have something of substance in our mouths, something with energy, no matter how little, to get us through, something to settle our churning stomachs, we are so grateful… that we forget that it’s their fault we’re starving in the first place.

To my American hospital-birthing friends: you know this matters to you, whether you wanted food in labor or not, whether you were at an enlightened hospital or not; know also that it matters to me. To my American homebirthing- and birth-center-using-friends: it’s not enough to just escape the system. We aren’t all that lucky (approximately 12% of intended homebirths transfer in labor), and we don’t all want to. The system has to get better for when we need it, for when our sisters need it, for when our sisters want it. To my non-American or non-birthing friends: Birth rights are reproductive rights are human rights. What happens to one of us happens to all. As voz_latina says: “There can be no equality until all women have control over all aspects of our bodies. Birth, transition status, personhood.”

This may seem like such a small thing, a tiny drop, hardly worth getting bothered about; but in a million such drops we are drowning. ACOG wants to be seen as our benevolent allies, offering us tea and juice and soda, but they’re only pouring more on while we sputter for breath.

There are whole aspects to this I’m not addressing: the fatphobia slipped in toward the end of the policy statement (“Pregnant women who have additional risk factors for aspiration, such as morbid obesity… may need to be restricted from fluid intake on a case-by-case basis.”), and the undeniable racist disparity in maternal mortality rates, based largely but not wholly on the heartbreaking difference in quality of care based on class. And I hate to tag those intersections on at the end of a post like this, but I’m simply not up to juggling that many pieces today, and I beg your indulgence and forgiveness.

* “Git”, incidentally, is actually derived from “get” or “beget”, and refers to a person born out of wedlock. Thus, this will likely be the last time you’ll see it on this blog, as I do my best to refrain from misogynistic, kyriarchal language. (Which also happens to insult a group which includes my own child, though that shouldn’t matter. But it does.)

Just like athletics: exploring a childbirth analogy

One of the arguments used against “natural childbirth” is “we don’t allow people to be in pain in any other circumstance: why would we allow women to hurt in birth?” But it simply isn’t true, and the disproof brings me to one of my favorite childbirth analogies: athletics. The metaphor of birth as marathon has certainly been done before, but if you will indulge me, I wish to explore some of the specifically misogynistic implications of this particular assertion using this particular analogy once again.

(My other favorite analogy to dispute this assertion is sex, as it also potentially dances most deliciously along the pleasure-pain divide: however, for the sake of accessibility for the squeamish, and to divorce this discussion from the shame we also apply to sex — particularly to highly vigorous sex in which women enjoy themselves thoroughly — I will stick with the old stand-by of athletics.)

In athletics we certainly do “allow”, and even celebrate, people enduring pain (sometimes referred to in athletics as physical discomfort) in pursuit of some goal — often a goal much less worthy or significant (dare I say important?) as bringing a new person into the world. We do not consider that pain to be suffering, because it is chosen pain (or at least the pursuit is chosen, and the pain is considered an acceptable cost of the pursuit), “good” pain. Is not the pursuit of birth at least as worthy?

Just like in athletics (thinking here particularly of amateur and charity races), there are different types of pain in birth: most is the “normal”, expected pain (which can be anywhere from negligible through, shall we say, highly noticeable) of a body hard at work, stretching, moving, doing. In birth and in athletics, we can be overwhelmed by this normal, physiologically healthy pain, if we don’t have the means to cope with it or it is unexpected. The pain of birth might be inescapable for most, but suffering is unnecessary: in athletics, it is framed as discomfort, we are taught to expect it, and told it is normal, not an indication of anything wrong; and we are cheered through it, exposed to dozens of ways to cope, from improvements in form and pace to mindfulness meditation, music, and massage. Why do we expect women in labor to engage in that physical endeavor with any less? (It should come as no surprise that I blame the kyriarchy, as will become clear.)

There is also, rarely, pathological (problematical) pain, from something going wrong: a muscle is pulled, a ligament tears, a blood vessel ruptures, or a body is simply pushed past its limits. In those cases, in both birth and athletics, we of course have medical assistance available, from something simple like oxygen or oral analgesics, to anesthesia and surgical intervention.

And, just as in athletics, there is no shame in choosing not to finish, in needing assistance, in choosing to skip the experience altogether. Only the kyriarchy and those under its influence say otherwise, in an attempt to control and shame us, and such beliefs should be shouted down as roundly in birth as in athletics.

Rather than coerce with stick or carrot, what we do in athletics (again, thinking especially of charity racing; a particularly apt comparison to birth as it is physical effort that benefits another) is cheer, support, encourage, commiserate. No one stands at the sidelines of a charity marathon yelling “give up! it’s not worth it! stop trying to be a martyr! you’re not going to win a medal!” Nobody whispers in their ear when they’re doubting, “take these drugs [that will actually make running harder], let us drive you to the finish [we'll tie you behind the car], finish in five minutes or we’ll whisk you away for surgery [for a torn ligament you don't actually have].” No one tells an athlete she can only have a “trial” of running if she has no food or drink, if she’s hooked up to machines that purport to measure how hard her muscles are working, that take her blood pressure and heart rate and temperature and send it all to the medics’ station and meanwhile are hindering her movement and reminding her she’s on a clock and she’s not running fast enough (or running too fast and they’ll “have to” stop her “for her own good”).

Who would be surprised if the rate of marathon completion plummeted if all those conditions were placed on athletes, all those hurdles erected in their way, all those unkind and untrue statements flung at them? And yet we expect the laboring woman to function under those circumstances, and shame her when she doesn’t “succeed”, or tell her it wasn’t really worth it anyway, and use the “failure” rates to “prove” it’s an unrealistic expectation.

And why is it worth it? Leaving aside that unhindered birth is, barring medical conditions, unequivocally better for the baby and birthing woman, there is also value in the sheer physicality of it for the woman undertaking it. Everyone has heard of and no one doubts the existence of “runner’s high”, so why do we start plugging our ears and rolling our eyes and flapping our tongues when we speak of “birthing high”? Just as in athletics, in the absence of intolerable pain and unnecessary interferences (the latter of which is all too often responsible for the former), birthing has the potential to produce the most delicious chemical cocktail which feels good. (Divine even: I certainly felt like a birthing goddess afterward.) Even discounting that, or in its absence, there is potential for pride and a sense of accomplishment: something we value so much in athletics, yet scoff at in childbirth, where our effort benefits both us and another. We deny women that pride in accomplishment (for which support of athletics is so vital to girls’ sense of self and women’s equality), that boost in self-esteem and feeling of competency, right when we need it most: at the start of parenting, one of the most demanding journeys a person can undertake.

Again, there is no shame in birthing with the assistance of medications or medical intervention, whether by choice or necessity — much less in choosing not to birth at all — but so much value in birthing autonomously, so much value even in trying.

More to the point I am trying to make with the exploration of this analogy is that as a culture we must value birth, must value and celebrate what our bodies can be capable of. We celebrate and encourage athletic performance, and we pay men millions of dollars for engaging in war games (colloquially known as “sports“), and yet we don’t even give women respect: indeed, often our only “payment” from society for daring to birth “naturally” is scorn — sometimes to the extent of having our children taken away from us. At best, we are praised for performing a “miracle”, and doing the “best thing” for our babies; ignoring or dismissing the entirely human mundanity of the achievement (well within reach of 95% or so of the population possessing a functional uterus and vaginal canal), and removing the focus from us and our process to another. While natural birth is best for babies (or rather, is what babies biologically expect, and lose out on when interference is added unnecessarily), I am not asking that women once again be shamed into martyrdom for the sake of others.

For do not get me wrong: advocacy of pharmacological analgesic in childbirth can be (and at its inception was) feminist, even if I believe it misguided. And surely it is all too easy to construct a pro-”natural” birth position that is deeply misogynistic: for hundreds if not thousands of years in much of “western” culture, the physiological pain of birth was seen as due suffering for the theological sins of women’s ancestress. I am not here trying to say that all natural birth advocacy = feminist = good, nor all medicalized birth advocacy = misogynist = bad, which would be as ridiculous as it would be fallacious.

Rather, I am saying that kyriarchy’s construction of labor and birth as unbearably painful, as unworthy (as opposed to war games or athletics), and women as either too weak or too “advanced” to tolerate it, is inherently misogynistic. Whether an individual woman follows the biological default and has (or pursues) unhindered birth, or elects to make use of the medical interventions available to most of us in developed nations, does not reflect on her moral standing, any more than participating in, or not participating in, athletic events does. But the current cultural construction of birth must change: not by moving backward to a time when women had no options in childbirth, and were expected — even encouraged — to suffer, and in which there were no medical interventions for when they were truly needed; but forward, to a time when our bodies are valued, our spirits are supported, and the work of birth is seen as hard, yes, and even sometimes painful, but within reach of most of us, and oh so worth it: just like athletics.

There should be no moral value placed on individuals’ choices or unchosen courses in childbirth, and although I speak of enlightened athletics as though all cultural messages were as positive as the cheers at the end of a charity race — no more for the first than the last — I know there most certainly are different levels of respect awarded to the “couch potato” and the Olympic triathlete (different again to the star American quarterback). Still, the microcosm of culture surrounding some segments of athletics give me inspiration and hope. As cynical as I may seem about the present, I remain optimistic about the future: we can create a world in which birth is valued as the rewarding work it is, women’s autonomy held sacrosanct, and babies welcomed gently and with joy no matter how they arrive.

And we must.

autonomous birth/unhindered birth

I speak of autonomous/unhindered birth rather than homebirth or freebirth/unassisted birth because what matters is not birth location, or even birth attendants, but birth style and who has the power. I am not sure unhindered birth ever happens in hospitals (which is not to say positive, joyful births do not happen in hospitals), but it is not a given at home, either. Whether a woman has autonomy in labor, whether she is free of violations to her body and her humanity, should not depend on whether she needs medical assistance or would feel safer with the presence of a birth attendant.

I often use autonomous and unhindered birth interchangeably, but the terms have subtle distinctions. Autonomous birth refers to the woman being “in charge”, or at least centered, during labor and birth. This is most likely to happen in a free/unassisted birth, and some people do use the term specifically to mean birthing without a professional attendant, though I do not.

Unhindered birth is an alternative to the less precise, more historically loaded term “natural birth” (which has come to most often mean “birth without prescription pain medications”, and which some even use synonymously with “vaginal birth”, with or without medications). One of my favorite midwives describes it this way:

Unhindered meaning on your own terms, without direction or management by someone else, given privacy to do your own thing.

Unhindered birth is a birth without unnecessary interventions (not just without pain medications), in which the environment is structured to acknowledge and support the mammalian nature of the laboring woman, to not disturb the physiology of birth. It means that procedures are not done because they are “routine”, or to measure or encourage a “schedule”, and when interventions (such as fetal heart rate monitoring) are elected, they are done in a way to minimally disturb the laboring woman. The Mother Friendly Childbirth Initiative outlines the basics of what I consider unhindered birth.

I do not give a strict definition of what is or isn’t compatible with unhindered or autonomous birth because it’s not about a checklist, and I’m not interested in labeling others’ experiences. Rather, I hope to reframe the discussion to center women and respect for our autonomy and our bodies and our power in birth, without shaming women who need or desire medical assistance, while celebrating what most women’s bodies are capable of.