Last week, I wrote an article called “A Healthy Baby Isn’t All That Matters.” It was about our opportunity for a higher standard for birth in the U.S.: “safe, respectful, family-centered birth,” in addition to a health baby and healthy mom. I also talked a lot about the need for respect of women in birth.
A couple of days later, a comment was posted to the article that included these words: “Get over yourselves” and “Get off your high horse.” It’s disheartening to see a response like this to an article about respect for birthing women and their choices—especially coming from someone who identified herself as a care provider.
But it’s a great example, too. What exactly do you do when your request for respect is met with disrespect? I think sometimes our first instinct is to look inward to see what we might have said or done that would explain it away. Instead of cutting to the chase, we tend to make excuses for the other person.
There is no excuse. A lack of respect is not a starting point for conversations or progress or building bridges–and it’s certainly not appropriate between a pregnant woman and whoever she has hired to care for her and her baby. It is a deal breaker. It doesn’t matter what someone says to us—how correct they are, how valid their point is—if they can’t do it respectfully in a place where respect is valued. And in birth, respect is all-important. At Improving Birth, it’s one of our organizational principles.
So, in this case, I respectfully draw the line. As I would say ever so gently to my young son, “I can’t let you do that. You may not be disrespectful to Mommy.”
There’s another element in comments like these, though. It’s an element of “I decide how much respect I give out, and who are you to question it?”
Therein lies the big, big problem. As birthing women, the conflicting messages we quite often receive are:
You make decisions about your body—except when we do.
You are responsible for your baby—until someone more qualified thinks different.
You are in charge of your birth—until you’re not.
In so many ways, many of us are given choices in birth and respectful treatment only within a framework. We may choose from among the choices we are given, not from a full set of choices. Step outside those lines—assert that we are the final decision-makers on what happens with our bodies and babies, or that we are deserving of respect regardless of whether our providers think so—and we’re told to “get over ourselves.”
True choices and true respect include deference to us at each step of the way, fully informed consent, and support instead of coercion or pressure about our decisions.
The sad truth is, for most women in the United States, maternity care is simply a gamble. The numbers bear this out: a steadily increasing c-section rate, the use of drugs to force or speed up labor in more women than not, and a rising maternal mortality rate. When our well-being and the safety of our babies is so unpredictable, respect for our bodies and our decisions is more than a silly cliché—it’s a necessary protection. It isn’t a compromise for safe, healthy birth, but an essential part of it.
At the end of the day, we may not know with any certainty what the “right” thing to do is in the event of a complication. But we know what respect feels like and we know what disrespect feels like. You know how your provider makes you feel.
So, again, I encourage you to walk away from providers who don’t treat you and your decisions with respect, and seek out those who do. There are wonderful, caring, skilled providers all over this country who deserve your business.
While so many of us are working toward that “safe, respectful, family-centered” ideal for American maternity care, we’re going to come up against a lot of get-off-your-high-horse-s.
It will be up to each one of us to say respectfully, “I can’t let you do that. You may not be disrespectful to Mommy.”
Author Cristen Pascucci, a political and communications specialist, recently joined Improving Birth’s executive board.