In the birth industry, a lot of us talk about how birth is political. We talk about how birth is a feminist issue, and a human rights issue. Sometimes it’s a little difficult to see what we mean by that. We can explain the disparities in outcomes among socioeconomic groups and racial backgrounds, we can talk about the implications of informed consent in childbirth, but it may still appear like birth is, essentially, all the same. Mother enters birthing space, labours, leaves with a baby. What’s political about that?
When I was pregnant for the first time, I thought a lot about my grandmothers. I thought about my Bubbe, who ended up in textbooks after an agonising two week labour and delivery, when obviously needed interventions never arrived. And I thought about my Nanny. Nanny birthed five babies. She was an iron strong irish Catholic gal, with a husband slowly losing himself to undiagnosed PTSD post war. It’s easy to mistake her for a cold woman. She never seemed to know how to interact with her children and grandchildren. I don’t think that was true. Occasionally, little pieces of herself would slip through. When she’d bake for me on my rare visits to her home, and smile. Or even now, well into her 90s and slowly making the long journey into the fog of dementia. She gets confused, frightened, on the phone. But when my tiny children speak to her she suddenly emerges from the fog. She remembers everything about them and speaks with the confidence of an experienced mother. I don’t think she was ever cold. I think she was overwhelmed.
Choice was a foreign concept, for women like my grandmother. She had little choice in her marriage. In her parenting. In her births. She was a type 1 diabetic, and every 18 months like clockwork, she’d leave for the hospital and deliver an 11 pound child.
Detecting a pregnancy was no small task for my grandmothers’ generation. From the 1947 edition of Expectant Motherhood “Today, thanks to the studies of two German doctors, we have at last a sound and trustworthy test for pregnancy and interestingly enough it is performed on urine. In carrying out the test a small quantity of morning urine is injected into a mouse or rabbit. If the urine comes from a pregnant woman, definite and characteristic changes are produced in the ovaries of the animal within forty-eight or seventy-two hours; if the person is not pregnant no alterations whatsoever occur. This test is accurate in about 95 per cent of cases and in the presence of pregnancy will yield a positive reaction two weeks after the first missed menstrual period, sometimes earlier. It is expensive, however, quite unnecessary in most cases, and is generally performed only when the physician finds some medical reason for haste in making the diagnosis.”
My grandmothers would have had two options. Find a physician willing to kill and dissect an animal injected with urine, or wait until the symptoms of pregnancy became undeniable. There was no morning after pill. No early preparation time.
Choice, when arriving into the hospital, was a rare concept to encounter. Women were subjected to an assembly line style of obstetric care. Rules were strict. Women were often alone, possibly with their husband in a waiting room. Women were stripped of all jewellery and clothing, and forced to ask permission before undergoing the most simple of activities. Like getting a drink, or using the washroom. It was common for women to have their pubic hair shaved off, and an enema given. This of course has zero benefit for women and their babies, and simply gives a less cluttered view for the obstetrician.
Speaking of the view, forget about moving in labour. Delivering flat on one’s back, on an elevated bed, objectively makes delivery all that much harder and more painful. But it prevented the obstetrician from crouching, or bending, so it became standard.
Pain relief had polar opposites. Epidurals had recently entered the scene, but it was mistakenly believed to be inappropriate for all but the rarest birthing circumstances. In all likelihood, your grandmother likely endured one of three possibilities. A cesarean, with a large, painful vertical incision and surgery performed under general anesthesia. A completely unmedicated birth, with no comfort measures or personal choice to speak of. Or a twilight birth.
Twilight birthing is often referred to as one of the great injustices in maternity care. At the time, “twilight sleep” (a mixture of morphine and scopolamine) was presented as a miracle. A completely painless birth experience, perfect for the delicate, modern woman. Unfortunately, those claims proved untrue. Women were often left to labour alone under twilight. They were terribly disoriented, and in horrible pain. Women were often placed in straight jacket like confinement, or strapped to the bed. Often with their eyes covered. They’d be left to hallucinate and thrash in pain. How on earth was that ever accepted? The drug cocktail had an amnesiac effect. Women would have no memory of their days of agony and fear. They’d regain full consciousness with no memory of the event. Their husband would visit, the baby would be retrieved from the nursery and placed in her arms, and the myth of the painless childbirth would continue.
My two grandmothers birthed a combined eight babies during these times. It was their normal. The modern woman birthed unconscious and believed breastfeeding was low class. They may have been happy with their birth options, though it was taboo to discuss and I’ll never know for sure. But it wasn’t enough then, and it’s not enough now. If there’s one thing we can learn from our grandmothers before us, it’s the power of choice. The power of autonomy. It’s what makes birth political. A feminist issue. A human rights issue.