What makes birth “safe”?
The answer to this depends on so many things…who is answering, what their beliefs may be and how they see the world.
It’s that controversial; and the answers to this question have created fear in some women, empowerment in others. It is the question that has led to the licensing of midwives, and the governmental control of Birth as an industry. It is also yet another divisive argument between caregivers of all kinds that work with women and birth.
To me, it’s a trick question. Because nothing makes birth safer than it already is. In it’s truest form, of course. The delicate dance of mom and baby, to complete a sequence that is normal and physiological. It’s already “safe”; at least, as safe as anything else that our bodies are programmed to do. Eating, sleeping, eliminating. We don’t question that these processes are “safe” for the average person. They just are. We don’t ask “what” makes them what they are.
But things are not this simple in the birth world. The medical world argues that certain PEOPLE make birth safe. And to make it even more complicated, they want to also specify WHO make birth “safe” and label them as for us.
It’s just all backwards. The normal, healthy pregnant woman does not need all this. She may not know that, because for as long as she can remember, she’s been told that birth is dangerous and that it cannot be accomplished without an “approved” handler present. Does that not sound SO ridiculous?? Do we get a recommendation for an “approved” neurologist to make sure that we are sleeping safely? Or from an approved gastroentorologist to make sure we are digesting normally? The average person does not.
The problem is the thought that birth NEEDS to be made any safer than it already is. But it’s actually not “safe” that many people are after; it’s birth being infallible.
How is this possible? How can we erase the possibility of death from birth? We cannot. They are two sides of the same coin, but this is an uncomfortable subject and not addressed by those that think other humans or special machines can save every baby and every mama. That is not real, and that is not life, unfortunately. There is an element of risk in everything we do in life; whether it’s crossing the street, or driving our car. Birth is no different.
But if I HAD to answer it, birth is safest when left to the natural order of things. We know this to be true in the animal world, and so it is with people, too. A healthy woman that feels safe, loved; no matter how much she “knows” about birth intellectually, will birth her baby her way, on her terms. It may be easy or difficult, it may be an awe inspiring experience or just another day for her! But the mechanism is there for birth to work.
And as far as the WHO is “safe”; well, I don’t think it’s any of our business to determine this for ANY woman. There is no way to quantify risk, TRULY, for another person. We cannot know what a woman is weighing as HER risks and benefits to choosing a breech vaginal birth, or a home birth with a preterm baby. There is no research in the world that can take into account the emotional and psychological and spiritual assessment that each woman will do to make the proper choices for herself and her baby.
We do not need third parties looking in and deciding this for us; I refuse to participate. I truly trust that birth is safe; and even if I didn’t, I truly trust each woman to make the choice that she needs to make. I can offer education, research, or just be her sounding board. But when she chooses an unassisted birth after several cesareans, for example, I am confident that SHE has done her own risk assessment and assessed herself in a way that no one else ever could. She may or may not want input, information, research from me to make her decision. What this woman (and any woman needs!) is support. I am here with you. I will stand by you. I can’t see the future or guarantee you a specific outcome. But I respect your choice and I trust in the inherent safety of the birth process. I do not control life or death. No one does.
But it’s not just the obstetricians that have decided when and with who birth is “safe”. Now midwives, the “guardians of normal birth” are arrogantly assuming the same thing. A doctor insisting that birth is safer at a hospital with a surgeon in charge is no different than midwives believing that only certain midwives make birth safe, and that just having a midwife makes birth safer than not having a midwife! Has anyone realized the irony of this stance? We say we believe that birth is normal, but then suddenly, it’s only “safe” if we are there to save it. Not every birth is uneventful or perfect, but many caregivers end up creating the problem or complication they were afraid of in the first place.
So, let’s end this on a positive note. Walking with women is the TRUE job of a midwife. And this walk is done differently from midwife to midwife. Ideally, all midwives would be educated, compassionate, up on current research, a wonderful counselor, etc. But even when not, we must trust that a woman will choose who she needs to accompany her on her journey. It does not matter what anyone else thinks, and birth is not less safe when this choice comes from her heart.
Birth is just as safe as it always has been, and will continue to be, if we allow women to lead.