No woman can call herself free who does not own and control her body.
-Margaret Sanger
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.
This post was written as part of the ICAN VBAC Blog Carnival in celebration of International Women’s Day and in anticipation of the NIH VBAC Consensus Development Conference.
{ 10 comments… read them below or add one }
I LOVE that you listed the excuses – and debunked them. Those annoy the living daylights out of me.
I hate it when docs say “well, it’s too expensive for me to consider”. To that I say, “I thought the oath was Do No Harm? That doesn’t mean to your pocketbook.”
Thank you for this post. I’ve spent the last several years being infuriated at the pro-choice movement because they seem to only care about the right to decide to terminate or not. If choosing my own care provider and the place and method of birth isn’t a reproductive right, then I’m afraid I wouldn’t recognize one if it bit me.
Thank you and amen.
Fantastic post.
Well said! Anti-woman is exactly it. I think society spends too much energy on the emotion of an issue, and not enough time looking at the stripped bare version. The naked truth is autonomy over our bodies and *all* decisions regarding our bodies is a fundamental right. We can not give women choice in some decisions on reproductive matters and not others. Period. For then, we never *really* have the right to choose anything, do we?
Great post. While I can tell I am a lot more conservative than you, I also wholeheartedly agree that the excuses used to deny VBACs are mostly ridiculous and those barriers could easily be removed if doctor’s were actually motivated to do so.
Thank you so much for this post, and right on, sister! I am still upset that my OBs led me to what I think was an unnecessary C-section because of too many interventions early on. I was young, naive. The second time around, I really wrestled with my soul about my birthing decision, because they (and society) scared me so much about a VBAC. It was successful despite many odds, and I cannot explain how rewarding it was to take my body back. (I wrote about my VBAC on my blog–anattitudeadjustment.com, titled “Birthing.”)
I've just stumbled on your blog and want to thank you for the great posts. I'm 34 weeks pregnant and a VBAC hopeful who has just been told that my RCS will be scheduled for 40 weeks whether I like it or not. Something's got to give!
Nicola, I hope you get your VBAC. I hope that you're connected with your local ICAN or with people who can help you. Railroading women into repeat cesareans is highly unethical.
A doula I talked to once told me that sometimes they'll hold off if you agree to NSTs so they can make sure the baby is alright. Personally, I don't think that anyone should HAVE to negotiate for their health care, but I do try to acknowledge that doctors think that they're doing the best thing for mom and baby and try to avoid "standoff" situations because they really hold all the cards.
Good luck, and good VBAC vibes!
educate me.
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