No woman can call herself free who does not own and control her body.
You see, I trust women. I’m not fooled by people who diminish women’s choices and the process by which they make them by saying that they make their choices out of vanity, convenience, or hedonism. I believe in women to make the right decisions for themselves and for their families. Sure, we get it wrong sometimes, but I also trust women to know the risks and own their mistakes.
I’m a mother, a feminist, and an advocate for reproductive justice. I care deeply about the threat of women being forced to carry pregnancies to term against their will, I worry about women being forced or manipulated into sterilization, my heart aches and my belly burns because women still don’t have universal access to contraception without question, burdensome cost, or judgment. I’m sick at the thought that women are arrested for being pregnant and addicted, and I’m goddamned furious that they are locked up for being honest about their ambivalence about motherhood and commanded by the law to do what’s “best” for them as though they were recalcitrant children. It is only natural, then, that I feel that VBAC is a vital matter. Not just vital, a write-your-congressman, call-the-media, picket-in-the streets matter!
Having been raised Catholic, I think of hospitals primarily as charitable institutions, the inheritors of St. Jude and St. Vincent de Paul. In my mind, hospitals take the sick and the broken without question, without judgment, and without discrimination. They are supposed to serve the afflicted, whether they have the flu or got caught in a combine, so for them to effectively tell a woman that what she is doing is far too dangerous for them to let her through the doors unless she consents to surgery is not only absurd, it is discriminatory. So-called “VBAC bans” send a clear message to women: we don’t think that you will make the right decision, we feel that you are putting your own birth experience over your child, and we will therefore take matters out of your hands. Women with uterine scars, you are not welcome here unless you do what we tell you, because we know what is best for you.
The resoundingly paternalistic and anti-woman message is all the more clear when hospitals try to make excuses.
- But you will sue us over a less-than-perfect outcome. The funny thing about malpractice is that plaintiffs don’t win unless there is actual malpractice. And you know who gets to set the standard? Other OB/GYNs. You’ve got most of the cards here, there must be a way to create guidelines for safe VBAC that ensure access without forcing women to sign away their right to legal vindication if a doctor commits malpractice.
- But it costs far too much for us to insure our facility/practice. So now the financial bottom line is more important than the lives and health of women? I’m sorry, there is a lot wrong with my profession and we fail to serve a lot of people in a lot of ways, but I don’t see throwing up my hands and turning the other way as the solution. If my profession is failing the people we are supposed to serve, you can bet your cookies I’m working to change it. I know doctors care! I’ve seen doctors picket and speak out against laws that restrict women’s healthcare decisions and insurance practices that leave Americans in the cold. VBAC is no different! If you care about the women you serve, grab your stethoscope, roll up your lab coat sleeves, and join us in the trenches because we need your help!
- But our hospital is not equipped to handle VBAC! This is perhaps the most frustrating of all the excuses, because it is an admission that the hospital is not equipped to handle any labor. If we accept the technocratic paradigm of childbirth, which focuses on the possibility of catastrophic consequences, every birth has the potential to end in disaster, every birth should have an anesthesiologist and an obstetrician on the premises at all times. If a maternity ward can only handle emergencies scheduled between the hours of 9 to 5, they need to seriously rethink the message that birth in a hospital is safer than birth anyplace else.
What I see even intelligent people around me fail to grasp is that when we talk about “lack of access to VBAC” we are not just talking about lack of access to the latest fad in cosmetic procedures, we’re talking about forcing women who want to deliver in hospitals to choose between unwanted and possibly unnecessary surgery and not procreating. To a feminist, and to a birth activist who wants to see women be able to safely deliver their babies in a variety of settings, this is not an acceptable choice. VBAC is indeed a vital option, and until it is a viable choice that all women can make without fear of manipulation, coercion, or reprisal from doctors and even the child protective system, women are not fully equal.