Parent's Right to Choose?

(Preface: As I start to frame this blog entry in my mind, I KNOW that as compared to other countries around the world Morgan and I are extremely blessed in the technology and wide range of birthing options available to us in the United States. I just want to put that out there before I express my frustrations.)

I thought I was keenly aware of regulation of my body. I grew up in a pro-choice home, have an undergraduate concentration in Women's Studies and am very well versed on the history of regulation of women's bodies and sexuality by laws and social norms around the world. All of this background did not, however, prepare me for the laws, hospital regulations and variations of standards of care surrounding the birth process and having a child.

Over the course of my pregnancy I have lived in California, Virginia and North Carolina (where we are settled). We have been planning a natural childbirth from the start, but finding the location for our birth has presented complications along the way.

If we were still in California, I would be having a water birth at home with a midwife. There it is legal and our insurance would have covered the entire cost (which would have been much less for them, like a total of $3,000). As the home birth midwifes in California are legally admissible to the hospital, if there were complications my midwife would go with me and continue to be my primary care provider. Additionally, as midwifes are legally licensed in California they bring oxygen tanks, pitocin for the afterbirth, general anesthesia for repair and other necessary items into your home to provide the same medical care you would get in the hospital.

In Virginia I was introduced to the reality that in some states there are two kinds of midwifes, those who do home births, who are not admissible to the hospital, and those who do hospital births. In the hospital birth scenario the midwife does not give you the individualized care of a traditional midwife-patient relationship, but rather operates with multiple patients at a time, providing quick and unpersonalized care (I am sure there are some exceptions here, but generally this is the case).

Even after exposure to Virginia, I mistakenly assumed that North Carolina would be one of the liberal states and that I would have the same options as I did in California for birthing location. (Note that the states have an approx 50/50 split regarding home birth and midwife legality.) Our first choice was the Women's Birth and Wellness Center in Chapel Hill. This birthing center provided the safety of being in a "facility" which we felt was an important concession to make to our parents, and also provided a place where I could have a water birth which was my top choice for birthing method. My mother in law said early on that I should consider the fact that the success rate at the Birth Center is contingent on the fact that they only accept a very specific group of patients with low risks. I didn't want to listen, and assumed that I would be low risk - no problems, low blood pressure, no reasons for concern - but alas, when I finally got around to submitting my records they did not accept me as a patient because my BMI was too high for their guidelines. Please note that they never even examined me! I cannot even tell you how it felt to be told that I was too fat to have Thriller there. I was devastated.

At this point I was hitting 6 1/2 months pregnant, moving to a new town, no contacts, and no clue what to do. I cried a lot - and Morgan got online and started researching options. Home birth had been our initial choice, and in the absence of the birthing center, seemed like our best option. Additionally, we really wanted a water birth and hospitals in North Carolina will not let you have a water birth! You can labor in the tub but not have the baby in it.

Little did we know that we are now living in one of the most conservative states regulating home birth! It is not illegal for us to have a baby at home, but it is illegal for any medical provider to attend the home birth. There is an underground group of providers that will help you, but their names are not disclosed and if you go to the hospital not only will they not be admitted, but you can also not disclose who was there without exposing them to loosing their license or arrest! We have the SAME INSURANCE as we had in California, but given the laws in North Carolina we would have to pay out of pocket for the home birth. Not to mention that any provider who would attend the birth would not have insurance. Additionally, I am just not comfortable with an underground midwife bringing pharmaceutical supplies and drugs into my home. I don't think it should be illegal for her to have them or administer them - but when it comes to the birth of my child, I want to make sure that the best legal alternatives are around.

Assuming risk by employing civil disobedience, despite my liberalism, is not appropriate when it comes to having a baby.

Luckily my Bradley instructor made a great recommendation for Triangle OBGYN (doctor/midwife practice, very natural birth friendly) and Wake Med Cary (10 minutes away from our house, also very natural birth friendly) - and generally I am happy. The parents are happy and I do not feel like I need to go into the birth with my defenses up.

Despite the fact that I have found a good doctor/midwife practice and am having Thriller in a very progressive hospital I still find my mind wandering back to extreme frustration! It is my body and Morgan and I's child growing inside of it! Shouldn't we be in charge of how it comes into the world? It is SO MUCH safer to bring home birth above ground where it can be legal than have it occur behind closed doors with a hush hush attitude.

Here are some other ways my body and Thriller have been regulated thus far, I'm sure there are more to come:

Testing:

Simply being pregnant and receiving medical care opens me up to having legally required testing for transmittable diseases at the beginning and at the end of my pregnancy. Is there good reason for this, of course! If I have HIV they must know. If I contract HIV they must know prior to delivery as a c-section is required to protect the child. Moms may sleep around, fathers do cheat, etc - But nonetheless I am subject to body regulation without any choice.

But here is the kicker - they test me for every STD in the book prior to delivery but still the law requires that Thriller get an eye ointment to prevent blindness in case I have gonorrhea after birth. Doesn't it make MORE since to not do an unnecessary procedure and preserve the resource if they already know I don't have it? Really?

Alcohol & Drugs:

If I disclosed to my doctor that I was still drinking, or simply said I had ever smoked pot or used illegal street drugs, I would be subjected to routine drug testing, the law there applies to the doctor's responsibility, but it is still my body! In some cases women are even forced to meet with a probation officer and counselor like someone on parole! All this does is make it so women cannot trust their doctors and will not disclose their history to them, which is a real shame. This is not to say that an active drug user should not be subject to testing and counseling - but to be routinely tested after simply saying something like "I smoked pot in college" is a gross over extension of concern.

Vaccinations:

Vaccinations bring up a whole other debate. I have never felt so pressured or truly controlled and violated as I did the day I received my H1N1 vaccine. Was it the safe thing for me to do? Probably. But the CDC issued a statement that said ALL DOCTORS had to advise me to do it, binding their liability, and I honestly do not know that I will ever feel that I had a chance at getting the complete picture. Not to mention that both my mother and mother in law were extremely clear in their belief that I should get the vaccine which added genuine, loving pressure.

And then their are the concerns for the child's vaccines. Again, the CDC presents a schedule and the doctors have a liability issue if they do not follow it. I don't honestly have a problem with vaccines but I do have a problem with the set schedule and doctors who will not modify it based on the patent's (aka MY CHILD'S) needs. And, in some states, I have a serious problem with the addition of vaccines to the schedule.

I know that state and federal regulations governing pregnant women and children were put into place to protect the child. I know that extreme negligence and risky behavior endangers children and we (the collective society) need to protect them from their parents sometimes. But where is the line?

I believe that our society would benefit MORE from having parent education classes and giving parents the right to choose what is best for their birth plan and child. By taking the responsibility away from the parents and letting the state dictate regulation to protect the child from the moment pregnancy is realized we have taken away an integral part of preparing to be a parent.

I had a dear friend say to me last weekend that she had no idea that she had options, she thought you just went and did what the doctor told you to do. This prevalent understanding of your role in medical care in birthing in our society is so damaging to the parents! Have some ownership! Be an active participant! This is YOUR CHILD! Even if you choose to elect a c-section, take all the drugs offered, etc - OWN IT. Educate yourself and your partner to make smart decisions.

Morgan and I are obviously on the educated side, and as it is our nature, we question state regulations. I hope that we make good educated decisions for our child, and believe that we have in choosing health care providers and in constructing our birth plan thus far. I also hope that we can legally have our next child at home and have freedom to choose what is best for us and our family.