Are you a feminist? I'm not going to lie, I was never truly sure what that meant and so never felt confident enough to call myself one. But since the rise of Barbie, I am beginning to get a better understanding on the subject!
And then the term 'patriarchy', I didn't quite know what that meant either! I know what you are thinking, educated woman and at an all girls private school to boot! Yet somehow these terms passed me by! So since watching the Barbie movie I have googled, as you do!
Patriarchy 'a system of society or government in which men hold the power and women are largely excluded from it.'
So basically it means the men are in charge.
Well what does that have to do with your labour and birth?
Did you know there are 5 main ways, men are still holding power over your birth, without you even realising it?
1. HIGH BMI?
Your BMI calculation can dictate your birth place recommendation and also be used as a reason for not allowing a water birth in the AMU. But... the BMI calculation was created in 1832 by mathematician Adolphe Quetelet who was obsessed with figuring out 'the average man'. He created the BMI calculation as a quick way to determine the 'ideal' or 'perfection'. To do this he collected data from white, European MEN. BMI doesn't take into consideration muscle mass or bone density, let alone ethnicity or gender... or the fact that you can have a high BMI and be PERFECTLY HEALTHY!
2. Due Dates
The 'due date' is used as a measure of when the baby should be born, and is often used as a deadline for induction. However this calculation was created in the 17th century by a German professor called Nagele, was based his formula on research done by a Dutch professor Boerhaave. His research only looked at 100 white European women. The calculation assumes that all babies are ready to be born at 40 weeks, that everyone's menstrual cycle is 28 days and that we all ovulate on day 14. It also doesn't consider ethnicity, and it is far from accurate, given the number of women who go passed it!
3. Vaginal Exams during labour
The Bishop Score was invented by Edward Bishop. He created the score in 1964 to help predict the success of an induction. Basically during a vaginal exam, a midwife will use this score to see how 'ready' you are to give birth. It can be a good predictor if a sweep will work. It looks at your cervical dilation as well as baby's position in the pelvis.
However - it can only be determined through a vaginal exam, which is invasive, uncomfortable and despite being 'routine' is medically unnecessary. Whatever your score, ultimately it is only relevant during that minute of an exam - it only provides a snapshot of where you are in labour. It does not predict how long labour will last, and as labour can progress at different speeds for different women, it is irrelevant minutes later. There are other ways to predict labour progression without having fingers shoved up your vagina!
4. Friedman's Curve
Dr Friedman developed a line graph, a curve for how your labour should progress in the 1950s. He based this on the average rate for dilation over time. However this curve is based on research that included both spontaneous and induced labour. Natural labour and labour with the drip. Breech babies and not breech. The curve is still used to determine 'failure to progress', indicating the need for interventions such as synthetic oxytocin to speed labour up. Standardising progress has its problems as not all births progress at the same rate and you should be treated as an individual.
5. Birthing on our backs
The lithotomy position was popularised by French King Louis XIV who had 22 children and reportedly had a perverse desire to watch the process of birth. He insisted his wives and mistresses birthed on their backs, not upright, so he got a better view and didn't have to get down on his knees to see. Surgeons at the time then normalised this position and it became the standard position for birth in modern medicine - as it is the most comfortable for the doctors helping you. Lithotomy is not the easiest position to birth in, it loses the benefit of gravity and it traps in the sacrum in your spine causing immense discomfort. This position is for everyone else's benefit - not yours!
So come on Barbie, it's patriarchy! What can we learn from this:
Your BMI, high or low, should not dictate your birth choices.
Your due date should not be used to dictate an induction.
Your Bishop Score and more importantly, vaginal exams, are not necessary to determine your progress in labour - there are other ways!
How long your labour lasts, should not be standardised against a 'curve' but at your own individual rate, and not used as a reason to 'speed things up' by breaking your waters or using the drip.
You do NOT have to birth on your back - please get off it! Epidural? Lie on your side!
Am I a feminist? I think I might be! And I am definitely OK with that!
Want to know more about how you can take charge of your birth? Head to the button below and book yourself on a course - there are so many more ways you can control your birth experience, booking a course is the first step in this!