Yesterday, I gave a talk called “Obstetric Tradition vs. The Modern Woman” to a university class.  I described to these college students how differently I was treated as a person in regular life and as a pregnant woman in her health care.


During pregnancy, the messages I received over and over again from my healthcare providers and people in general boiled down to a couple of things: this is too scary for you to really want to know about, and this is too important for you to participate.


One well-meaning doctor said that very clearly when I asked exactly how I should be preparing for birth.  “You just come in when it’s time, and we’ll take care of everything.”


We talk all the time about evidence and rights and all of the complicated issues that go into the way healthcare – particularly maternity care – is delivered, but, to a birthing woman, that all just goes into one big pot of, “Why is this so scary and confusing?  Why is it being taken out of my hands?  Should it be taken out of my hands?”


For a woman who isn’t willing to settle for “We’ve already done all of the thinking for you, so just relax and follow the rules” (thank you, Emily Oster, for spelling that out) traditional maternity care doesn’t work.  The “don’t worry your pretty little head about it” attitude runs smack up against the relatively new idea that the pretty little heads of women are good for more than just smiling and nodding.


In fact, that’s part of why I was standing in front of a room mostly full of females.  We have already agreed that women get to use their brains now.  But what about the rest of themselves?


Our bodies are made for more than just decoration, too.  We will give birth, one way or another, regardless of the care we receive.  Babies are born, pretty inevitably.  Science is with us on this one.


And as much as we need what others can give us to make that experience safer, we don’t need them to make that experience happen in the first place.  They are there by invitation, not by right.


The students seemed to agree.  In response to the question, “Do you see birth as a medical procedure or a bodily process?” they overwhelmingly said it was a bodily process, and a handful said it was a little bit of both – that sometimes it has to be a medical procedure in rare cases.  I agree with them, but how often does our system?


How different are these two images?  How much the same?  The students used words like “prisoner” and “machine” for the first, and “inhumane” for the second.

Lithotomy Then Lithotomy Now


Maternity care is one final frontier for the modern woman where we’re articulating, yet again, that we don’t need anyone to save us from ourselves – from our bodies, from our brains, from our biology.  We don’t need management.  What we need is information and support to do the thing we’ve been doing for millennia, for better or for worse.


I felt a little sad and a lot hopeful talking to a class where a little under half of the 50 or so students in the room said they thought that doctors have legal rights over the body of a pregnant woman.  If the generation coming up now manages to see through the outdated attitude that women aren’t capable of participating in their own bodies, they’ve got a pretty good chance of having it better than we do now.


If good mothers don’t ask questions, I’d say it’s time we redefine what a good mother is.

Author Cristen Pascucci is the former Vice President of ImprovingBirth and is the founder of Birth Monopoly, co-creator of the Exposing the Silence Project, and executive producer of Mother May I?, a documentary film on birth trauma and obstetric violence.  She is dedicated to promoting the rights of women in childbirth.

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  1. Martha D. says:

    I had four of my five babies in a hospital with nurse-midwives. I believe I had the best of both worlds: I had respectful medical caregivers who respected the labor process, allowed it to proceed as naturally as possible, and included me in every decision that had to be made; and I was in the hospital so I could receive the best medical care if anything went awry. I also educated myself about labor and birth through childbirth classes and reading, so I was equipped to take part in decisions. It saddens me that more women don’t have the option of using nurse-midwives (or don’t know about that option). (And, by the way, good mothers ALWAYS ask questions!)

  2. G says:

    Everything about motherhood is empowering! Conception, pregnancy and childbirth leads us into motherhood. These things are physical. We are the ones in control of our bodies (or at least should be). Each and every other person who wishes to participate in this endeavor needs to have permission to touch us. This is why so many women find themselves feeling violated when they labor and deliver in a traditional setting. They have physical contact forced upon them way too often. It should be required for there to be respect for the woman, her body and the body of her infant. This is her experience and every thought and choice needs to take this into account. Each mother has the right to experience this respect. She also has the right to command it from those in attendance and an obligation to express this requirement.

    I chose to deliver my youngest children at home with the wonderful support of my husband, family, friends and a midwife. The experiences were all I could have hoped for. Those daughters are now grown and have children of their own.

  3. Lauren says:

    I was grateful to be able to give birth in a hospital, with pain management. However, I would have liked to feel that I had the power to say, “No, you cannot check my cervix during a contraction,” or, “Please cover me up while people I haven’t met are wandering in and out of my room.” It is inhumane to treat women giving birth as just a patient, or just a subject. There are many things that can be done in a hospital setting to make women feel more in control of the situation.

  4. Cristen Fischl says:

    Women should know what is going to happen and be in charge of making decisions. I am thankful for good doctors, I would not have survived a home birth. Now pregnant with twins by IVF I am thankful for the guidance of my OB. Some births just need some assistance to have a good outcome. That’s why we have the technology that we do, to make life better. We are foolish if we ignore the research and expertise of trained professionals in the name of independence. We are also foolish to follow them blindly.

  5. I’m curious where you found the top left photo – I’d like to use it on my FaceBook fan page in my history of childbirth photo gallery. 🙂

    1. Cristen says:

      I used my iPhone to take a picture of that photo from the 1947 obstetrics textbook “The Pathology of Labor” (I’m pretty sure that was the name of the book). Go ahead!

  6. b says:

    As a mental exercise, if you take either woman and place them somewhere other than the hospital, or put the medical staff in street clothes in the modern picture, it becomes very obvious how terrible the situation shown really is.

  7. Martha says:

    I’m glad I had a homebirth. Hospitals are for sick people. Not healthy pregnant women.

    1. SWM says:

      Maybe a better wording than “hospitals are for sick people” would be “hospitals are best suited for those with an emergency situation/requiring advanced medical care”.

      True informed concent is such an issue in the medical field, imo. Questioning things doesn’t seem to make you smart or intelligent but ignorant that you dare queation the mighty degree and experience before you.

    2. Tiffany C. says:

      I am a healthy, pregnant woman who just happens to have COMPLETE placenta previa. Hospitals are not just for “sick” people. While I agree with what the article is saying, I think it’s also important to remember that not everyone gets to have a picture-perfect pregnancy and birth. Yes, we can still be educated and help make decisions for our care, but let’s face it, without doctors and surgeons, women like me would die in childbirth.

      1. Michelle D says:

        I notice also with some doctor’s and surgeon’s women die too. I guess its 50/50 chance huh! Not all doctor’s and surgeon’s are (good) or bad! But, I seem to have met those bad one’s. I think the hospital should be for emergencies….but that’s my opinion. Other than that…nope I will take care of myself and children (I am not so dependant on modern medicine and drugs for every thing)! Hospitals are risky too and they don’t always save lives! Doctor’s are not perfect! Neither are surgeons. I dont put my faith in man and I don’t trust everything people tell me. But, I am glad that there are those docs that are there for the people and that truly care. That means a lot to people. Compassion, (hospital)ity, and empathy should be in hospitals….you never know when you will be in need! That goes for every one.

      2. Cristen says:

        Tiffany, that’s a problem that requires a hospital. I’m glad you got the care you needed! I don’t see a conflict whatsoever between “helping to make decisions for our care” and “without doctors and surgeons, women like me would die in childbirth.” The decisions about our bodies are ours to make, with the assistance, expertise, skill, and advice of healthcare providers.

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