The system is broken if it doesn’t leave people whole – Part 1

The medical model of childbirth. Don’t doubt that it is broken, perhaps from the very beginning, right to the core.

When I was just getting started with this birthing thing I was pretty enthusiastic. I did a lot of reading. I wrote optimistic essays about birthing choices for my shockingly bad website. I tried to be a doula, though I’m not sure I was ever a particularly good one. I went to conferences and training days by the dozen. I believed that I could make a difference. I believed that positive change was inevitable, that the facts were lining up and soon everyone would have to agree on the appropriate approach. All we had to do was be firm, keep tabulating research, and make it available. Wait the change out and it would happen.

But as I say, I was a perhaps not very good doula, and in the main the births I ended up attending were those of strangers, often strangers that I hadn’t met before I found them in the labour and delivery room at a local hospital (ah, the free referral service of the local doula organization), and by the time I got there things were already on their downward spiral. The induction was on and it was only a matter of time before someone became exhausted and bored and suggested a c-section. Hapless women of colour with poor english and their equally hapless husbands and partners were funnelled through to the operating room and for all my enthusiastic soothing and panting and rocking and walking and changing positions there was nothing I could do to change it.

In all the births I attended at that time, there were only two decent ones, one a homebirth, the other a hospital birth, older white mothers full of determination. They knew what they wanted. They fought for it, and they were very clear about what they wanted from me. So, it worked, you see. They had the education, experience, determination and white privilege to get what they wanted, a birth that wasn’t abusive or horrible. It certainly helped that they were women having second babies, as second babies are always more responsive to the arbitrary timelines of the medical model. It was a gift to be their doula, it really was.

In between births I did postpartum doula work, some volunteer, some for a pretty good wage. Here too I could see how damaging the medical model was. One young woman I was helping for free was in Canada alone, her husband in Malaysia waiting on his visa application. She’d given birth alone, a young non-white woman with no apparent partner and poor english. She’d had a good nurse, she felt, but the doctor, a woman, was rough and impatient with her, and had performed an episiotomy that resulted in a fourth degree tear, very painful and with a difficult and perhaps surgical recovery.

Another woman I served for a few weeks, helping out through the nights, had been pregnant with twins. Her babies were delivered via c-section, for no other reason than that they were twins. She was struggling with the continuing pain of her incision, not being able to breastfeed her son, who wouldn’t latch and would only take a bottle, and pumping around the clock to supply them both with breastmilk. She was exhausted.

Another woman was in Canada from England, but was not yet covered by MSP. The doctor she saw would not permit her to attempt a trial of labour after her previous c-section, so she was forced to undergo another surgery and pay for the entire thing out of pocket as well.

I was called to help with breastfeeding with another older couple, who gave birth at home with registered midwives. She had a tear which required stitching and while the midwives were stitching it up they kept the baby in another room away from her. For an hour and a half. The first time she tried to breastfeed after her birth her baby was already through its wide awake period and slept instead. Two days later, still not nursing.

All of this is a very long-winded way of saying that after a few months of thinking about birth! and babies! with stars in my eyes! and then attending a weekend workshop in which women imagined awesome births and inspirational stories were told by the doula instructors of how they had saved women’s births and so on, I somehow plunged headfirst into the deep end of how awful and how broken the medical model of birth really is.

Next: Part 2: Statistics
Part 3: Illustrative Non-Fiction
Part 4: The more things don’t change
Part 5: The system is broken. What next?

2 Comments »

  1. Janet Fraser said,

    February 17, 2010 @ 12:03 am

    I love your blog! Thank you for such great writing and thoughtful insights.

  2. Jane Palmer said,

    April 16, 2010 @ 3:10 pm

    Dear Kenzie – what a fantastic blog. I was wondering if I could reproduce your blog – “The System is Broken if it doesn’t leave people whole” parts 1-5 on http://www.pregnancy.com.au I’d love to share it with my readers and I would of course link back to your blog. I am hoping you will consider my request – Jane (mother, midwife and childbirth advocate)

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