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Foreword
Barbara Katz Rothman
Professor, Department of Sociology & Anthropology, Baruch College, The City University of New York (CUNY)
Article Text
The thing about being an American, who cares about birth issues, is that the grass really is greener everywhere else. Around here, the big debate is about whether there is any reason to offer women vaginal births at all. If you listen to the medical folks, you'd be thinking that women in droves are requesting cesarean sections to avoid the trauma of vaginal births, and if you raise an objection to 'elective cesareans' then clearly you have lost your feminist vision of choice.
It is, rest assured, not the case that American women have gone mad or somehow decided that having abdominal surgery is nicer than giving birth. Recent research (Beate Schucking, unpublished) in Boston - a high tech birth area if ever there was one, shows that more than 95% of the primiparous women do want vaginal births, and those that would 'choose' these medically uncalled for (even by current medical standards!) cesareans are a small subset of socially marginalized, depressed and anxious women. But the story one gets from the current media is quite different: women are demanding cesarean sections and, poor doctors, how can they deny women choice?
And it's not just random choice: it's about health, saving innocent babies. Checking the headlines this morning on my computer screen, I found this in the 'health headlines': Ore. (Oregon) Dad Saves Newborn after Home Birth (Netscape Health, August 24, 2006). Of course I read the story - no, it wasn't a planned home birth. A woman had a quick labour and pushed out a baby who didn't pink up instantly. Thank god the husband called 911 and they told him to clear her breathing passages, give her a few puffs of air, and - serious medical intervention - tap her feet. Miracle! The baby survived. Score one for medical science, zero for home birth. Birth is SO risky, see? And normal people would never think of, oh, jiggling or puffing some air into the baby, or tapping its feet.
It's not that things look all that great on the other side of the world - medical risk factors overwhelm all other considerations in Australia, New Zealand, and Laos too, as we see in these papers. For example, what looks like 'support' for birthing women quickly turns into surveillance in the interests of the innocent newborn. And the ways that people have managed birth for themselves, even the ways that work really well, get trivialized as 'comfort aspects' acceptable, maybe even important, to maintain while the larger biomedicalizing project goes on. The 'fluidity' of power, the 'choices' women make seem, to my jaded eye, too often like the flitting sideways movements of fish being carried along a strong current. But still: midwives are serious players in the discussions, there is concern about a rising cesarean section rate, and conferences like this one take place.
So standing way over here, and reading the papers produced out of this wonderful workshop, I feel faint stirrings of hope. Serious scholars, who are grappling with these issues, do understand that the risk society has specific consequences for birth, and perhaps we should be doing something about it.
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