Childbirth has become a battleground of opinion. Any discussion about birth can quickly descend into a polarised debate; natural childbirth vs technological birth, home birth vs hospital birth, your view vs someone else's view on what is the safest or best way to give birth.
I believe underpinning all these issues is respect for a woman's right to make decisions about her own body. When I started making the documentary film FREEDOM FOR BIRTH with my partner Alex Wakeford, we (naively) thought how could anyone argue against a woman's fundamental Human Right to choose how and where she gives birth?
FREEDOM FOR BIRTH features academics, lawyers, doctors and midwives all calling for women's rights in childbirth to be respected and women to be afforded real choice in birth. The film highlights how, in some countries today, women who want to have a normal vaginal birth are sometimes forced by judges to have c-sections or are threatened with having their child taken away by child welfare services. In some countries, if a woman wants to have a home birth supported by a midwife, those midwives face criminal prosecution. Some midwives like Ágnes Geréb in Hungary have even been imprisoned.
We launched the film on 20 September this year with over 1,000 screenings in 50 countries in 17 different languages. We estimate that up to 100,000 people worldwide saw the film on that day. After the screenings, we had thousands of supportive messages from people appreciative that we were raising awareness of this as an important global issue.
There were also some objections. Australian obstetrician and former Australian Medical Association President, Dr Andrew Pesce, said the film was not relevant to Australia as it was "a long bow to draw" to compare the experiences of a jailed Hungarian midwife and Australia.
Recently an article about planned home birth called 'Planned Homebirth: The Professional Responsibility Response' was published in the American Journal of Obstetrics and Gynecology. In the section addressing "respect for women's rights", the authors concluded,
"from the perspective of the professional responsibility model, insistence on implementing the unconstrained rights of pregnant women to control the birth location is an ethical error and therefore has no place in professional perinatal medicine. An editorial in Lancet succinctly summarized this point: "Women have the right to choose how and where to give birth, but they do not have the right to put their baby at risk.""
The obstetrician Dr Amy Tuteur recently wrote a blog-post criticising the film (which she hasn't seen) and the Human Rights in Childbirth conference which took place at the Hague earlier this year (which she didn't attend). Dr Tuteur's main objections were that the organisers of the conference and myself are well-off white Western women holding conferences and making films for well-off white Western women. That we don't focus on abuses happening in developing nations and hence the use of the term "Human Rights" to describe violations in rich industrialized nations is "morally grotesque."
It's true, the film exposes routine Human Rights abuses happening in the developed nations. If you total up populations, that's over one billion people. This includes the 800 million citizens living within the jurisdiction of the Council of Europe who are directly affected by the European Court of Human Rights holding (Ternovszky vs Hungary, no. 67545/09, 15 December 2010) saying that a woman has the legal right to choose the circumstances of her birth.
Horrific abuse in childbirth happens every day in developing nations where women and their babies are often denied access to life-saving obstetric care. In fact, we intend to focus on this in a future film.
I believe that just because "worse" Human Rights abuses are happening elsewhere doesn't mean that a film shouldn't draw attention to what is happening now across Europe, the Americas, Australasia and beyond. With the incredible wealth and resources of industrialised nations, you might hope that these countries would get things right, that women's rights would be fully respected, that these countries would set a positive example.
Generations of women have fought for the right to equality, for the right to make decisions about your own body, for the right to have full informed choice and for the right to be respected, yet it seems when it comes to childbirth, some people believe those rights should be surrendered.
We are about to release a free-to-view 15 minute abridged version of the film. We want people to watch it and make up their own minds. We made the film not just because we wanted to reveal a difficult truth but because we wanted to start a conversation with all sides that will bring these issues into the mainstream. We want the film to spark a debate and for that debate to lead to change.
We want all women to be afforded real informed choice as to how and where they give birth, for all women's rights to be fully respected by all care providers and for Human Rights violations to end.
Can anyone argue against this?
FREEDOM FOR BIRTH will be released on youtube on 17th December. http://freedomforbirth.com
For information about Human Rights in Childbirth - http://humanrightsinchildbirth.com
Join us on Facebook: http://facebook.com/freedomforbirth
Follow Toni Harman on Twitter: www.twitter.com/oneworldbirth
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That baby's death was just thrown away by this film, a choice that I find absolutely horrifying. If Ms. Gereb botched a delivery that badly, why on earth should she be lifted up as some sort of heroine by the natural childbirth movement? Completely unacceptable.
Anyway, one of my points is that home birth is considered the perfect option by people in countries where hospital delivery is standard. But I can say coming from a country where home-birthing has been the standard since forever that it's not the perfect solution or necessarily "better" than hospital births. I would say leave it up to the woman giving birth what she wants to do...
My personal birth choice was a planned cesarean, and I was lucky in that I found a supportive obstetrician. Too many other women are not as lucky, and either have to fight to have their birth plan preference respected and supported or are forced to have a trial of labor against their will.
Hopefully a future film will include the voices and rights of these women too because, as it stands, I'm afraid it represents a rather limited call for 'all' birth choices.
When procedures are routine, birth is rushed, and babies are taken away from their mothers, the normal, physiologic birth process is disrupted. This is evident in obvious things, like breastfeeding issues, to not so obvious things, like maternal anger, disappointment and possibly emotional trauma.
Many care providers, many obstetrical practices, are not evidence-based. This is not only disheartening, but in some cases, dangerous for mother and/or baby.
This film is important. It's important for mothers to see, for care providers, for insurance companies...
Women are not second class citizens. We deserve to be treated with respect during pregnancy and birth.
USAID's report, "Exploring Evidence for Disrespect and Abuse in Facility-Based Childbirth" (http://www.tractionproject.org/sites/default/files/upload/RFA/Respectful%20Care%20at%20Birth%209-20-101%20Final.pdf) uncovered human rights violations in over 18 countries, from beatings to coercion and shaming. These abuses drive women away from facility-based birth, and are a barrier to the Millennium Development Goal of decreasing maternal mortality by 75%. From this report, the White Ribbon Alliance for Safe Motherhood synthesized a charter, "Respectful Maternity Care: The Universal Rights of Childbearing Women." (http://www.whiteribbonalliance.org/WRA/assets/File/Final_RMC_Charter.pdf) These rights come from international human rights instruments that apply to all people.
The fact is that disrespectful care and threat of unconsented care drive women away from facility-based birth. There are women the world over who are pushed out of the system because they fear that they will be coerced or disrespected. Rather than derisively laying the blame the feet of parents making decisions in an imperfect system, we need to look critically at what can be done within systems and facilities to protect the rights to the highest attainable level of health, informed consent, liberty, and dignity.
How dare you imply that 'high risk women' are free to choose to birth at home at the expense of their child's health! No mother in her right mind would actively make a birth choice that exposes her child to unnecessary risk. Childbirth carries a small but inherent risk of injury/death to mother and/or baby and no amount of medical intervention will ever remove all of that risk.
I encourage you to investigate what actually happens to both parents and Independent Midwives when a child dies/is stillborn during a homebirth. Parents and midwives are treated appallingly in these circumstances with one mother I know whose daughter was stillborn at home being denied access to her daughter's body in hospital because her daughter was being held as 'evidence'.
I encourage you to do some research on the internet and educate yourself on the realities of human rights violations with regards to childbirth in Australia - knowledge is power.
I really do believe in these interventions, they were created for very valid reasons. However, when I mother believes that these interventions are actually MORE risky for her and her baby, she should be able to make that choice, without judgment.
Does that sound fair?
I find it funny everyone wants full freedom of choice, but not the "full freedom of responsibility" that comes along with it.
doctors make mistakes all the time. that's why they don't, in general, have power of attorney over you as son as you become their patient.