When I became pregnant, a whole new world revealed itself to me: the realities of childbirth. I was faced with new and daunting decisions regarding how and where I would give birth, and who I would choose to be my primary caregiver. Out of habit, the first person I met with was my gynecologist. We sat and discussed my care options and I left that first meeting with a sense that this was not the care option that would bring me a sense of ease. Ultimately, my partner and I decided that we would have our baby in a birthing center run by a midwife and a doula, incorporating little to no intervention.
My decision was met by many with skepticism and sometimes even with outright hostility or ridicule. After a while I stopped caring, but it did begin to open my eyes to the politics of giving birth. For the first time I began to question the birth practices that I had come to see as normal: hospitalization; the use of drugs; Caesarean sections; episiotomies…all of these are the terms that I could have come to associate with childbirth. I had come to see midwifery and home birth as irresponsible, dangerous and archaic; and the use of technology as the most efficient guarantee of a safe birth.
Globally, a climate of health care is emerging in which the management of birth through technology has resulted in medical intervention at all stages of even the most "normal" pregnancies. Societies have moved away from birthing practices that focused on the delivery of a healthy infant, but importantly, also privileged the spiritual, physical and emotional wellbeing of the mother. With the increased use of technology at every stage of the delivery, along with increased state intervention into childbirth, an important element has been compromised: women's experiences in becoming mothers.
Giving the seeming naturalness of birth, how does this become a political issue? In short, states benefit from women's maternal "labor" (pun intended). With every healthy baby that is born, states receive future members of society that will predominantly contribute to its economic and social development. Women's bodies – and in particular women's reproductive roles – are therefore central to the functioning of our societies.
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Childbirth is usually addressed solely in the capacity of maternal health care, which is generally concerned with indicators such as infant and maternal mortality. While these are key areas of concern the sole focus on these indicators potentially silence women's voices, as countries with low maternal and child mortality rates can unquestioningly assume that their approach to childbirth is a successful one without taking into consideration women's experiences with becoming mothers. This becomes particularly problematic in smaller, developing countries with limited financial and human resources, who may be even more unwilling (or unable) to expand notions of maternal health beyond the current indicators.
By politicizing childbirth we can center women's bodies and female experience. If we call for policies that privilege the importance of women's experiences – of our desires, fears and challenges – then we can move towards integrative approaches to childbirth, approaches that focus not only on mortality rates, but also look at the harder-to-measure indicators such as "satisfaction" and "empowerment."
Given the key role that women play in the reproduction of society, governments – the main beneficiaries of our maternal activities – not only have a responsibility but also a vested interest in ensuring that women experience childbirth as a source of power. A sole focus on the delivery of a healthy baby by a healthy mother stops short of a holistic view of what we mean when we speak of health.
We need to politicize our own understandings of and expectations for our bodies and then to demand birthing practices – whatever they may be – that honor our right to give birth in ways that affirm our senses of self.