Power, status and control...

So, I was reading this http://www.bestdaily.co.uk/your-life/news/a567116/i-was-not-allowed-the-words-that-steal-our-birth-power.html

Which I started by wholeheartedly agreeing with.

the message has simply not got through that we have rights in birth just as we have rights in our workplace, in our marriages and in every other aspect of our lives. We're stuck in a 'doctor knows best' mentality, that finds us failing to question 'expert' decisions – some of which might be very helpful, others less so.

All too often women accept what the doctor says and fall into the doctor knows best trap. However, I think it is dangerous to reject this notion outright and don't agree with the sentiment in the article:

This is not just my 'personal' view. It is enshrined in law: the European Court of Human Rights decided in 2011 that it is the woman who is the ultimate decision maker, and that every woman has the right to decide where she gives birth, and how she gives birth.

And guidelines from the GMC on medical decision making are quite clear too, that this is a mutual process in which the medical professional must set out all the options, including 'risks, benefits, burdens and side effects', and that, 'The patient decides whether to accept any of the options and, if so, which one. They also have the right to accept or refuse an option for a reason that may seem irrational to the doctor, or for no reason at all.'

It is completely about power, status and control though. In the ante-natal and post natal world mothers are seen as big bundles of hormones incapable of making rational and logical decisions about their own bodies... or are they?

I have to look away from the feminism argument to find my answer and towards disability studies. Within disability studies and activism there is a big push against the medical dominance on peoples bodies and daily lives. The social model rejects the medical models ideology that disability is located within the individual and places it firmly within the societal barriers that exist to disable people. Alongside this there is a rejection of the power of the medical professionals over disabled peoples lives and reclaiming bodies from medicine is a "big thing".

However, out of this there has come more of a middle ground. These people argue that rejection of the role of medicine is a dangerous thing to do as ultimately there is an importance and a need of having this intervention in some disabled peoples lives in order for them to remain "stable". I tend to agree with this argument and its my belief that in order to counter the dominant medical culture we don't need to reject it but to engage and work with it to achieve the outcome we need. It centres around the ideology of nothing about us without us.

Ultimately it has meant (re applying it back to ante-natal and post-natal) that in my pregnancy I have often asked the question why? or how? or similar. I have not wanted to reject the knowledge and expertise that I have at my disposal and trust my body or make my own decisions against medical advice but worked with this knowledge as an equal participant. It is not about dominance, whether that be on the part of the mother or the "doctor" but about partnership.

If there is a decision to be made about my care I will not blindly accept the status quo or even reject it on principle. I will seek, with the help of the professionals the knowledge I need to make an informed and balanced decision that is both empowering to me as it takes my needs into account and the needs of the medical professionals to be responsible for my care. 

I agree that all too often there is a permission culture within maternity care, but I honestly believe there is a better alternative than seeking dominance in order to reclaim our bodies. Empowerment and control can be reclaimed through collaboration with professionals and choices can be made to accommodate this.

It is time to change the culture from I'm not allowed but not to I am allowed, even against medical judgement. It should be changed to it has been agreed that this is the best outcome for all. It can be very difficult to do this at certain points in pregnancy and especially in labour, but I genuinely believe it is the best way forward. It is about midwives, doctors and professionals giving a bit of their power away to the mothers by enabling them to chose and decide for themselves. It is about changing the language of control to a language of collaboration rather than subservience.

In the same way that mothers are not there to serve the needs of the doctors, doctors are not there to serve the needs of the mothers. There has to be a recognition and a balance of mother knows best and doctor knows best, because ultimately, they both do.