Passing judgment - prejudices about the birth process

Passing Judgment

Over the past 20 years we have seen a tremendous evolution in birthing practices, from fairly barbaric to relatively humane. Sixteen years ago, my husband stood helplessly outside the delivery room door as our first child was born. We had desperately wanted a homebirth but were unable to find assistance. Now, however, women and their families are better able to optimize their birth experiences. More women are choosing to be undrugged and fully participatory, and to have undrugged and quietly welcomed babies who are never separated from their parents. This is ideal.

But what if this ideal is not met? What impact do "failed" birth experiences have on us as women and mothers, or on those who are assisting us? A feeling of failure can affect one's self-esteem and confidence in caregiving. After many years of experience as a mother, educator, birth attendant, and midwife, I have become increasingly concerned about our tendency to judge ourselves and one another, often quite severely, when birth outcomes fall short of expectations.

We have fought hard for the right of self-determination in childbearing. Having been told "no" time and time again, we have struggled to address the rationale. In defending ourselves, we have often forgotten our most fundamental goals, created unrealistic expectations, or assumed that making decisions implied making concessions. By reacting to the status quo in these ways, we have defined what we do not want, but we have not yet clarified how to attain our desires. Only now are we beginning to integrate our ideals with our ability to stand on our own feet; only now are we learning to define ourselves not in relation to "them," but in relation to birthing itself.

Birthing families are slowly becoming part of an international movement that will not be turned back. In recent history, we have attached ourselves to various extreme positions in an effort to establish an identity. Leboyer's view was initially enlightening; however, many of his claims ultimately proved to be oppressive. For example, we were told that a mother must be quiet at the moment of birth and must massage her newborn just so because birth is "painfully traumatic" for babies. More recently, Michel Odent espoused laboring in isolation and birthing in the upright squat position--OK for some, but clearly not for everyone. Underwater birth, touted as the key for increasing a newborn's intelligence and smooth transition, has intrigued and frustrated us with its logistic difficulties, and artificiality.

Nothing is intrinsically wrong with these methods. Their originators were sharing insights (often personal and poetic) for us to consider and incorporate into our own experience. The immaturity of our vision, however, compelled some of us to cling anxiously to form rather than content, or else miss the point altogether. Individuals in a reactionary phase typically fixate on principles rather than assimilate or evaluate information in the context of personal experience.

Beyond the

Reactionary Phase

Our identity will mature in direct relationship to our ability to phase out certain residual behaviors--most notably, our passing of judgment. What does "passing judgment" mean? The word "passing" presumes that we are merely moving something along, not originating it. Think on this for a moment. Consider all the judgments that women struggle against in a male-dominated culture as we nurture and balance our feminine and masculine qualities. Societal judgments have denied our most basic rights--to vote, to work, to define our own sexuality. Unable to accept these judgments that limit our fullness as human beings, it is no wonder that we react by passing them along to others!

The old idioms of birth are a prime example of this. Why refer to a woman as being "good" in labor, or label her a "good girl"? Why say that a baby is "good" if he or she does not cry? And what exactly is a "nice" birth? A Chinese midwife once told me that in her country, a mother must express both her positive and negative aspects in labor: "everything down and out." If she holds back and attempts to conform to her own or her attendants' ideas of good behavior, it is believed that her negativity will be retained and passed on to her child.

The struggle for "perfection," another reactionary behavior, must also be phased out. It is, after all, an often-foiled effort to prove that we are right. As a midwife, I am humbled time and time again when my preconceived notions are swept aside in favor of a greater plan, a bigger picture. The most relaxed and informed homebirthers sometimes require transport to a hospital, whereas more anxious women often have remarkably smooth births.

Obviously, birth is part of a larger configuration, beyond the comprehension of friends or attendants. Birth is a pinnacle atop a lifetime of conditioning, relationship dynamics--both exhilarating and disappointing--sexual encounters, family interactions, and one's own experience of being born. Giving birth is an intimate and altogether individual event that fits no preconceived image or ideal. To attempt to reduce or formulate a woman's birth experience presents a set-up for frustration, a betrayal of her humanity, and a limitation on her perceived potential for growth and change.

Overcoming perfectionism is essential to both birthing families and practitioners. As a midwife and home-birthing mother, I was astoundingly surprised to have my third baby in the hospital. I dilated rapidly to 5 centimeters and stopped my posterior asynclitic baby did not descend. We tried everything--herbs, positioning, and manual maneuvers. After 16 hours of hard labor with no further progress, I was to be transported to the hospital by my midwives. However, I insisted on more time, and I also suggested that if nothing changed in the next few hours, I would not only go to the hospital but would also like pain relief (although I had had none with my previous births, including a posterior presentation of a baby weighing 1 pound more).

After a bit of rest (via alcohol sedation) and a fresh round of strong contractions, my hopes rose once again...but no go. A vaginal check in the hospital revealed that my cervix had become edematous, making a cesarean a distinct possibility. I requested a low-dose epidural. My subsequent loss of pelvic tone and the final give of my bones permitted the baby to descend occiput posterior. I birthed joyously and without further assistance.

Just for fun, reread the above account and note each place where you found yourself passing judgment. This sort of exercise is crucial for anyone currently involved with or planning a career in birthing. My midwifery students' first assignment is to identify both their positive and negative prejudices (shoulds and shouldn'ts) regarding the birth process and to consider how these might invalidate another person's experience. I emphasize that our role is not to help women have the "perfect" birth, but to provide information so they can make their own decisions. Nonjudgmental assistance empowers birthing women and their families.

The story of my birth traveled like the telephone game we played as children. Various students and colleagues took different portions of the story and retold these with their own interpretations. (Perhaps we fragment life in order to make it comprehensible?) At first I felt proud of this birth, grateful to have had the wisdom to surmount a tough experience, but then I began to feel guilty, to doubt myself. I soon discovered that I could never give enough information to avoid being judged. Fortunately, a good friend told me to stop telling the story and let it be.

A Call to Midwives

The tendency to pass judgment must particularly come to an end in the midwifery community itself, where the willingness to judge one another is regretably prevalent. Midwives pass judgment on one another's style, practice, or training route. Why haggle over distinctions such as certified nurse-midwife versus lay or direct-entry midwife, when all midwives share the same goal of healthy mothers and babies? Divisions are surely counterproductive. It is time to come together for the sake of professional integrity.

Take a moment to consider the ways we midwives pass judgment on one another. When we see a sister midwife in trouble, do we settle for less than the whole story? Do we question her competence or cite the superiority of our own methods? What words do we use: incompetent? uneducated? incapable of dealing with crisis? irrational? weak? If so; we are still in a reactive phase. Indeed, these terms are borrowed patriarchal labels, many of which physicians have used to perpetuate false notions about midwifery!

Although it may seem easier to turn against each other than to face the tremendous challenges and threats to our profession, we can and must shift our thinking. We can become conscious of our judgments and look for healthy ways of supporting one another. We must allow ourselves room for human error, learn from our mistakes, and use the process of peer review to determine accountability.

We must also allow for times of retreat, reevaluation, and realignment of priorities. Above all, we must recognize that everyone has off-days, rough periods, times in their lives when they deserve support and compassion--not judgment.

During a recent conference on intuitive development, I attended a workshop entitled "The Dark Feminine" and made a startling discovery. The workshop leader showed some introductory slides of dark goddesses

" from many cultures and then led us on a powerful meditation that stripped off the trappings of outer identity and took us deeply inward for meeting and renewal. Then she suggested that we share the most intimate moment of the process. One woman replied, "I don't know about anyone else, but I really don't feel like sharing. This was very personal for me, and talking about it would ruin it somehow."

For me, and for many others in the room, this was a great moment of truth. Indeed, some things are too private, too personal to share! I learned that we must have in our lives a place for mystery--a place for quiet, darkness, and germination. In this place, we must not look for answers, but rather merge with experience. Here, words may sketch and dance, but they can never tell all. This is birth; it remains, in all its power and unpredictability, one of the greatest mysteries of all.

COPYRIGHT 1989 Mothering Magazine
COPYRIGHT 2004 Gale Group