This week in Australian Parliament, the member for Canberra, Alicia Payne, addressed a question to the Prime Minister:
““Women from the Yass Valley are currently forced to travel an hour to Canberra or Goulbourn to give birth. As a result, a number of women have been forced to give birth on the side of the Barton Highway. Does the Prime Minister agree that this is unacceptable?” she asked.
With a satisfied smirk on his face, the Prime Minister rose and gave a glib response: “Well, I’m pleased to let the member know that that’s why we’ve committed $150 million to upgrade the Barton Highway…”
His reply was met with chortles from our male-dominated Parliament. Apparently, women giving birth on the side of the road is a big joke to our government. Why express concern and regret that women in Australia are forced into a life threatening situation? Why acknowledge the incredible stress that this must cause all women who have to make that journey, even those who make it to the hospital in time, at a time when women are already nervous and scared? No, apparently women should be happy with the fact that sometime in the distant future they can face the prospect of giving birth on the side of an upgraded, luxury highway rather than having maternity facilities in their home town.
Predictably, Twitter exploded with commentary on the issue. Many people (at least the people I follow) were as outraged as myself that the Prime Minister could be so dismissive of such a serious issue (but hey, its a “woman’s” issue isn’t it? we should know by now that women are of little concern to him), but there were also those who couldn’t see what the big deal is. According to some, giving birth on the side of the road is “unfortunate” but rare, so why have we all got our knickers in a twist?
But as a woman who has gone through pregnancy and labour, I was incensed. Like many women, I was hoping for a calm, empowering experience during labour. The reality, however, was very different. My son went into distress numerous times, he became stuck and could only be delivered with forceps and an episiotomy. I lost three times the normal amount blood and seeing a barrage of doctors and nurses descend on the room as monitors were frantically beeping was terrifying. The whole experience was stressful, scary and quite frankly (in the words of my husband), a blood bath.
I was lucky, I have birth in a highly regarded hospital with professional and experienced staff. However, I am well aware that if I had been one of those women giving birth on the side of the road, there is a high chance that my son and I could both be dead. That is an actual reality for some women in Australia – in 2018, it was reported that 23.3 babies per 1,000 were dying in Queensland towns without maternity services. This compares to the national average of 9.1 per 1,000 births in 2015-2016, according to the Australian Institute of Health and Welfare. These statistics are even more appalling when disaggregated Indigenous and non-Indigenous populations. Indigenous women face neonatal mortality rates up to three times higher than non-Indigenous women. Around the country, women in rural areas are facing a shortage of adequate maternity services. For these women, giving birth on the side of the road is not “unfortunate”, it is life threatening.
Now obviously, there are complex policy questions involved here, including the ability to staff rural services. And if the Prime Minister had answered the question in a considerate and compassionate manner, we soon would have moved on. However, for me, the attitude of the Prime Minister and those who dismiss his remarks as a joke are symptomatic of a wider attitude that diminishes women’s pain and experiences, and in turn consider pregnancy and labour to be no big deal. It is part of a narrative where women are made to feel weak for choosing an epidural, where they are fed the message that by choosing pain relief they are being selfish for bringing their baby into the world in a “drugged up” state. It is the attitude that led to Meghan Markle being torn to shreds for not wanting to immediately to stand in front of the world press after going through what may have been a traumatic experience. It is part of the culture that expects women to snap back to their pre-pregnancy weight within weeks.
The reality is giving birth is the most dangerous experience a woman will go through in her life. According to Save the Children, one in seven women globally will face a complication. In the developing world, according to the World Health Organisation, pregnancy and childbirth complications are among the leading causes of death in women.
Now of course, many women have easy deliveries and wonderful experiences, and luckily in countries such as Australia or the US (where I gave birth) most women these days deliver safely, However, from my experience, this illusion of safety means there is no nuanced discussion about the very real risks women face. When I gave birth, I received more information about how to develop a “birth plan” – how to pick the perfect music, which candles are the most relaxing – than I did about what would happen if there were potential complications.
Now, I have nothing about birth plans per se, I think women should have some idea of what they want so they can speak up and be active participants in decisions made during the process – unfortunately there is a history of the medical profession infantilising women and pushing them into unnecessary medical interventions. My issue is that there is a narrative that birth should be a perfect and empowering experience and anything less is a failure.
This has real-life implications. I have friends who had to receive counseling because they felt so guilty about having a c-section and apparently not giving their baby “the best start”. Research also shows that women who have rigid birth plans that don’t actually go to plan are more likely to suffer postpartum depression. At its most dangerous, it contributes to the “freebirthing” movement, whereby women give birth at home with no assistance. The pressure to have the “perfect” birth can be overwhelming and the guilt when things don’t go that way can be very real.
In my job working on women’s rights, I have read many reports and harrowing stories about women dying in labour, babies not surviving and women being left with lifelong disabilities. I know I am lucky to come from a country where women have access to a range of safe birthing options – whether it be with an OBGYN in a hospital, in a birthing centre with a midwife, or (under certain conditions) at home. But I fear our complacency carries risks. It is a risk to women’s mental health when they are not prepared for when things go wrong. And it is a risk to women and babies lives when our policymakers dismiss the importance of all women having access to maternity facilities close to home. To deny this is an issue in Australia is naive – around the country, in rural areas, maternity facilities have been closing.
When I was first pregnant, I didn’t want to hear scary birth stories such as my own. Just the word episiotomy made me wince. For a first time Mum, that is natural – it is a nerve wracking experience as it is without filling your head with worst case scenarios. However, I know now that information is power. We owe it to women to have frank discussions about birth – the amazing aspects and the real risks. We owe it to women to not diminish the experience of birth and to work to ensure all women can deliver under the safest conditions possible.
Sarah Yvonne 
The term birth plan should be scrapped- it gives the completely false notion that the birth is a defined process only if you somehow try hard enough.
I’m completely with you that knowledge is power. The antenatal preparation in the UK I think tried to minimise anxiety about birth by painting it as a natural, very womanly thing and as long as you breathe properly it won’t hurt and your pelvis will open and the baby will pop out. I found the attitude to any other birth option was toxic. Approaching birth this way means those who have never birthed before still think that humans are evolved to birth without medical interventions, hence such an apathetic response to a lack of maternity ward.
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