Reproductive choice is a topic that women have been defining, debating and defending for generations, and is a phrase that has developed highly controversial political connotations. The term currently centers on the issue of abortion and pertains to decisions about when and how many children a woman has. However, when interpreted more holistically, reproductive choice incorporates a variety of questions regarding women’s health and empowerment. One aspect of this definition we tend to forget regards the act of childbirth itself, or how and where a woman wants to have her children. Without appreciating the choices part of this crucial dimension in the reproductive process, we are not pro-choice and we are not a mother or child-friendly nation.
Over time, the course of action a pregnant woman follows has become almost universally prescribed. Visit doctor in office, follow his/her directions, deliver in doctor’s care. Frighteningly, this plan has not resulted in improved maternal or child health. Instead, the United States actually produces worse birth outcomes and higher levels of maternal mortality than other developed nations that rely more heavily on home birth midwives and out-of-hospital practices. Clearly, despite our emphasis on technological equipment, we are missing a crucial link in childbirth care. Perhaps access and respect for true reproductive choice is that link.
Though not widely recognized, there are several choices available to women in childbirth, all of which can have better birth outcomes than hospital delivery. These include options for where to give birth and who will provide care during the delivery; decisions that empower the woman and give her control of her surroundings. Unfortunately, as a nation we are often still not supportive of women’s right to choose these things; many of these alternatives are made nearly impossible by systems hoping to maintain the money-making nature of our current medical infrastructure.
Though obstetrical specialists have been recognized as the primary attendant for pregnant women, no matter where you give birth, there are often other options to choose. If you prefer or require a hospital birth, you can still choose a family practice doctor, rather than a specialist. Additionally, nurse-midwives – women trained as nurses with a specialty in the de-medicalized care of natural childbirth – are also licensed to perform hospital deliveries in every state.
If you are hoping to escape the confines of a hospital system, you can choose to deliver in freestanding birthing centers or your own home. In these facilities, you can work with nurse-midwives or Certified Professional Midwives, women trained outside of the official medical system.
In upcoming articles I will provide more in-depth information on caregiver and birthing space options. We must reconsider how we see birth and maternal health in this country. Hopefully, with a better emphasis on holistic reproductive choice, maternal and child health will finally improve.