Was the art of independence lost in the shuffle? Or forced out in labor and delivery rooms?

By Jennifer Antonik                  

Our daughter is in that lovely stage of life where everything has to be a struggle or it isn’t worth her time it seems. She’ll be three soon. (I can see many of you emphatically nodding your heads in empathetic understanding.) Truly, I love that age though. It’s magical.

She is quite the independent little princess. I say princess because I told her she was beautiful the other day and her response was: “No, Mommy. I’m not beautiful. I’m a Princess!” Well okay then!

I couldn’t imagine having children who were not independent thinkers and free spirited. We try to embrace and help foster their (we have two right now) spirits and independence as much as possible. But sometimes, it just gets in the way of what us grown and somewhat boring adults decide is best.

You know, like the moment you have to go to a very important meeting, and you decide you need to leave RIGHT NOW. But the child needs a(nother) round of toothpaste RIGHT NOW, and then decides (after you’ve put the toothpaste on) that she doesn’t want toothpaste after all. Just to change her mind again, after you remove said toothpaste. So much for being on time! And all you can do is lean your head back and groan; and think of some crazy excuse as to why you were late. Possibly again.

I hear stories like this a lot in terms of maternity care, too often. Mom sees her care provider, but care provider decides mom isn’t doing something just how he or she desires. Now, instead of reacting with respect and compassion, he or she reacts with an entirely different beast called perinatal violence which can include physically forcing a mom to cooperate, emotionally forcing her to do so through coercion, impeding early bonding and/or breastfeeding or a host of other scenarios.

Perinatal violence and informed consent issues are becoming commonplace which, to be honest, boggles my mind. We expect our children to grow up as independent thinkers, but as soon as they become “old enough” to do so, we shut them out and tell them to sit down and take it? “You must follow society’s ways,” we hear.

When I gave birth to our resident Princess, the doctor didn’t respect my independence, my informed refusal of a procedure. It wasn’t a life or death situation, there was no emergency. Yet, he decided he needed to give me an exam anyways, right then and there, against my wishes. Literally moments later, after arguing with this doctor while his fingers were inside of me, I pushed out our daughter.

I suffered from PTSD for a long time after her birth. I used to say “Boy, I can’t wait to go to his disciplinary hearing through the medical board and hold a sign which reads, ‘I think about you when I have sex with my husband. Was that your intention?’” Probably two signs, one right after another. I couldn’t step foot in a doctor’s office without triggering a PTSD episode and had to make two attempts at removing my IUD. My husband and I struggled as a couple because of her birth in many ways.

The point, though, is that along with informed consent comes the right to informed refusal. My daughter makes the decision of informed refusal nearly every night when it’s bedtime. Before you judge my parenting, know that she takes a nap most days while her brother does not. So usually, brother goes to bed at a decent time, Princess stays up until she passes out somewhere and we carry her to bed.  Because it’s either that or tantrums for hours. We choose sanity. But she does that because she’s telling us she’s just not ready for bed yet. So, we try to help her get ready, of course. Lights down low, stories, songs, etc. But ultimately, we can’t force her. She has to make the choice to go to sleep, or refuse sleep.

Just like we are the ones who have to make the choices, or refusals, during our births. Care providers need to understand and respect those two aspects of care, or else it really isn’t good care. When a care provider doesn’t respect informed consent and informed refusal, it becomes that beast all over again.  Coercion. Violence. Something that maternity care should never become.

When did we lose our focus and independence? Autonomy, Independence, a principle we should be able to agree is a fundamental human right, is lost in so many of our birth communities, labor and delivery rooms and OR’s. Just gone. Where did it go? Why is it that some activists think it’s one way or the highway? My decision to birth at home this time around (yes, we’re pregnant, again!), is just that. MY decision. My belly bump friend down the street has decided to birth in a hospital. And that’s just as valid of a choice! Why is there stigma surrounding either choice?

Why is ACOG only *just now* finally acknowledging that women’s bodies are not just one size fits all?  Yes, of *course* some women labor longer than others! Is this really news? Do we really need a giant labor organization to tell us that some women labor differently and deserve the same respect as those who labor right on par with “standards?”

I’m not sure I understand the lack of independence or informed consent and refusal in today’s world.  Because there’s no way you can spin that argument to make it sound like a person should lose their autonomy. What I do know is that we need more bodies standing up for the rights of childbearing women and their babies. I began my fight after I found out just how non-evidence based maternity care could be through our first born. Then with our second, I discovered just how nasty it can be in terms of violence and lacking in the areas of informed choices and refusal.

I know after a traumatic birth it takes a little while to get to that point where you’re ready to rock and roll and change the world! Some never get there, and that’s okay, too. Some want to help, but quietly. Our movement needs people at all stages and all levels of commitment to continue making strides towards better care and independence in all settings.

Jennifer Antonik is a mom to two surprises with another on the way. After her own traumatic births, she founded the Momma Trauma Blog & Community which continues to thrive as a blog and on multiple social media platforms. She recently also founded the Birth Advocacy Coalition of Delaware and is currently working on legislative efforts to increase access to midwifery care and safer, healthier birth options in all settings.  Visit both efforts at www.MommaTraumaBlog.com and www.BirthAdvocacyDelaware.com; both can also be found on Facebook and Twitter.