A Feminists Perspective on Childbearing and a Woman's Right to Choose

There are as many different ways of experiencing childbearing as there are women having babies. Our social, cultural, economic and family circumstances affect us, and within those networks we are each an individual. We may be single or married, in our teens or in our thirties. We may have other children, or this may be our first. We may work full time, care for a family, or be in school. The pregnancy may have come as a surprise, perhaps unwelcome; or it may be an event for which we hoped and planned.

Given the broad range of differences among us, there are many things we share in the process of having a baby. At times, we find ourselves preoccupied with practicalities. We may be concerned about losing our jobs or about arranging good care for the baby. We might be wondering what doctor or clinic to choose; how to pay for the birth; whether or where to take classes in preparation for childbirth. And when we have a moment to dream we may wonder what the baby will be like.

Often our preparation for childbirth is marred by fears, misinformation and a feeling of helplessness as we cope with a medical system that can quickly dehumanize us during this most deeply human of experiences. The aim of this article is to affirm childbearing as a dignified and creative act; to educate ourselves both physically and psychologically for pregnancy, childbirth and the postpartum period; to underline the vital importance of good nutrition; to explain the risks involved in such common hospital procedures as administration of anesthesia and fetal monitoring; and to discuss the alternative of home birth. We stress that this kind of childbearing information must become easily available to all women. We encourage women health consumers to work for woman oriented health care and to pressure medical institutions to respond more flexibly to our needs.

It is magnificent to be able to create a new human being. During pregnancy, as we go to work, prepare meals, figure out our budget and cope with the thousands of ordinary concerns that make up a usual day, we may also touch another level of existence from time to time. As we think of our fetus growing in us we may revert to our own childlike and dependent feelings and even wish to be back in a womb again ourselves. We'll think about what motherhood means to us; who our mothers were in relation to us; what kind of mother we want to be. We might have strange and vivid dreams and fantasies. Things we hadn't thought of since adolescence or childhood might come to mind:

What is the meaning of existence, of my existence, of bringing a child into the world? We might want more strongly than usual to make the world a better place for our child to grow up in. We may feel ourselves as one of hundreds of millions of mothers, part of a vast history, living one of the most common and yet unique human events. Labor itself is a vivid example: It can be an extraordinary time, both physically intense, as we experience powerful contractions, and mystical, as we are in touch with the awe of giving birth.

Sometimes it is helpful to think of each year as a period having several phases of change and growth. Before becoming pregnant I am a separate individual. I have ties of varying strengths to others, but basically I am independent. When I first become aware of my pregnancy, I have to incorporate my consciousness of it into my self image. I am no longer myself alone, but myself plus another. At times I will feel my baby as a part of me. Then I feel it move and realize it is going to be separate from me with a life of its own. Later, before I give birth I will prepare for a physical separation, the "delivery" of my child into the world. I will lose a part of my being; it will be apart from my body for the first time- I might feel grief, relief or gladness, or all three. Finally I spend the next year-the next eighteen years, learning how to preserve my connections with my child in the most positive and most loving way, while I also learn to give it a firm basis for becoming independent, and learn to feel my own independence again.

Our society does not have language rich enough for honoring these rites of passage. Rarely are we allowed to experience the dignity and universality of our childbearing times. Our present socioeconomic system refuses many of us the right to be well nourished and well-educated and secure so that we can more fully celebrate the joy of childbearing. (If I have been malnourished for years, work long hours at a difficult job, become pregnant and don't have the money to buy adequate food, can I confidently expect my child to be born in the best of health?Our present medical system, with its increasingly centralized institutions, its abuse of technological devices, and its crisis-intervention mentality, does not cope adequately with the humanness, naturalness and continuity of our childbearing year.

We have needs that are not being met. One great need we have is to experience our childbearing year as a continuum. This continuum begins physically with conception and psychologically with our decision to carry our child to term. It includes pregnancy, labor, delivery, the period immediately after our child is born, and the postpartum adjustment period, which may last a year or more after birth.

We need to receive knowledgeable medical care from one person or set of persons during this continuum. With the present medical system, each phase of childbearing is handled rather mechanically by a different set of "experts." During pregnancy we see a series of doctors and nurses in a clinic or we have a private doctor. We might deliver our baby with a doctor we know or with one we've never seen before. After the birth we're cared for by a new set of attendants and nurses, while our baby has his or her own doctor. When we come home we have no doctor at all. We take care of ourselves or depend on family and friends. An experience that could be a unified one is all broken up.

An example of this fragmentation is the childbirth experience. Childbirth could be as much a part of our everyday lives as pregnancy and child care. Instead, we are removed to an unfamiliar place for sick people and separated at a crucial time from family and friends. We and our children suffer from this sudden removal; to our children it's a mysterious absence. In the hospital we are depersonalized; usually our clothes and personal effects, down to glasses and hairpins, are taken away. We lose our identity. We are expected to be passive and acquiescent and to make no trouble.

We are expected to depend not on ourselves but on doctors. For the doctor's convenience we are often given drugs to "ease" our labor. We often let ourselves be convinced by doctors who have never experienced labor and by our unprepared, frightened mothers and grandmothers that our labor will be too painful to bear. After our baby is born s/he is taken away for an hour, for a day. We pay a lot of money for our hospital space, sometimes more than we can afford.

Obstetricians are trained mainly to deal with complications of childbirth. "Well," we say, "you never know. Something might happen. We need our doctor." We are afraid on many levels. We have been taught to have' very little confidence in ourselves, in our bodies. In fact, 95 percent of our deliveries have no complications. Most of us could very easily give birth with the help of a trained, experienced midwife, in a hospital, a special maternity house, or at home among family and friends if emergency equipment were present or nearby.

During the childbearing continuum we need one or more people to provide personal support from beginning to end. This support could come from a parent, friend, or partner. At times we will have to rely emotionally on someone else. We are going through changes and will have ups and downs. Some of us mistakenly rely on our doctors for this support and are disappointed when he (it's usually a he) doesn't meet our expectations. If we have our baby in a hospital we have a right to have our friends by our side during labor and birth. No other society isolates laboring mothers as we do. And we will need help afterward as we get used to being a mother, or as we work at fitting our child in with our existing family.