Caesarean sections – a feminist issue?

A Canadian doctor has provocatively argued that women should be able to choose to deliver their babies by planned caesarean section. (Normally women are only offered a planned section if they have particular obstetric problems that would make it dangerous to deliver vaginally.)

Dr Magnus Murphy treats pelvic floor dysfunction – bladder and bowel problems often caused by a vaginal delivery. He is quoted as saying: “There are a lot of women who do feel that the feminist movement has dropped the ball on this.” Murphy adds that the feminist movement has allied itself to the movement for natural childbirth, abandoning women who might want a caesarean section.

Is he right? Well, last month the outspoken Australian obstetrician Hans Peter Dietz presented research at the International Continence Society in Montreal showing that “between 20 and 30 per cent of first-time mothers having a vaginal birth will suffer severe and often permanent damage to their pelvic floor and anal sphincter muscles”.

Dietz notes that in New South Wales, the rate of forceps birth has doubled in 10 years as the result of attempts to reduce the caesarean rate – with the result that women experience much more physical damage.

His colleague Elizabeth Skinner interviewed women who had suffered traumatic vaginal deliveries and found that two-thirds suffered PTSD symptoms. She, like Murphy, believes that feminists need a change of heart: “Previously feminists fought to return control to women giving birth. This is still true but the new 21st Century feminist issue is ensuring that women are correctly assessed for their risk of complications and given full and frank information to prevent such injuries.”

For a very long time, women in the 20th century fought to regain control of childbirth from the medical profession. Childbirth was as a medical process in which doctors were in complete charge: instead of being allowed to give birth naturally, to walk about, to squat, to give birth in their own time, women were strapped to delivery tables with legs in stirrups forced to have episiotomies and epidurals, hooked up to monitors, passively waiting for their baby to be delivered by an obstetrician. Feminists did an important job in rescuing childbirth, in making sure that women could give birth unfettered, undrugged and free to move about as they wish. It has, for many women, been an empowering experience.

And yet, could Murphy and Dietz be right? Babies are getting bigger, and for some women childbirth is a long, arduous and painful experience. Having to deliver a baby in a way that permanently damages your pelvic floor and may even leave you incontinent doesn’t seem like such a great victory for feminism. Neither does it seem particularly “natural” or “normal”, epithets that are often applied to the process of vaginal birth.

When you’ve fought to take control of birth back from the medical profession, caesarean sections, which put the process entirely in the hands of surgeons, can feel like a retrograde step. And yet if it is a choice freely made by a woman who doesn’t want to risk long-term injury and incontinence, isn’t that a choice that feminists should be fighting for?

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2 thoughts on “Caesarean sections – a feminist issue?

  1. Absolutely.

    I have been fighting for this since 2004 when the UK’s NICE Caesarean Guideline recommended that maternal request on its own is not an indication for a caesarean (this recommendation was changed to one of support in November 2011).

    If you’d like to know more about this, and haven’t read it already, you might be interested in the book I co-authored with Dr. Murphy (published in 2012) called, ‘Choosing a Cesarean, A Natural Birth Plan.’

    Editor, electivecesarean.com and cesareandebate.blogspot.com

    Like

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