It’s no secret by now that maternity care is in crisis!
In a lot of hospitals in North America as a whole, the rates of cesarean can range anywhere from 1 in 4 births to 1 in 2, and that number can shift depending on which doctor is on call in the hospital that day.
Many of these surgeries aren’t planned, or they are presented as the only choice.
Breech and twin births are increasingly labeled “high risk” and care providers automatically schedule a cesarean with no discussion of waiting for labour to start or attempting a vaginal birth.
You may not be told all the options for a vaginal birth with your next child if you had a previous cesarean, or your attempts at VBAC could be undermined by hospital policies that don’t support the physiological birth process.
If you manage to avoid a cesarean, chances are still pretty high that your birth will be messed with in some other way.
You might be induced because you “aren’t showing signs of labour” before 40 weeks, or because they don’t “let” you go a certain number of days past your due date.
You might manage to be one of those lucky moms who does go into labour before 41 weeks (average gestation for a first time mom is 41 weeks and 3 days) but then you don’t progress at 1 cm per hour and so they break your waters or speed it up with Pitocin. They might call it ‘oxytocin’, but that stuff isn’t even close to being the same thing as the hormone your body makes on its own!
The result is often a much more painful and traumatic labour and birth than the one you pictured when you were reading up on planning a natural birth, or when you were taking those birth classes with the nurse at the health unit or hospital.
You’re left reeling after the experience, wondering how it all went so wrong when you did everything you were supposed to do.
Why Does This Happen?
You may have had one class on interventions and what to expect, but you probably didn’t pay much attention because that wasn’t the kind of birth you were planning to have.
You trusted your body, and at the same time you were told that you “failed” to progress and you “don’t go into labour on your own”.
If you had a cesarean, you may feel that you “failed” at birth.
But you didn’t.
The truth is that the system failed you.
A lot of advocates will tell you that the system is “broken”, but I have since realized that the system isn’t broken at all. It’s working exactly the way that it was designed to work: the goal is to extract a live baby from a live mother, and do so in the most efficient and cost-effective way possible.
Hospitals and maternity care are a business!
That means that your experience isn’t something they can measure, and it’s not important to their bottom line.
If you survive birth, and your baby survives, then they did their job and they pat themselves on the back for that.
Those of us in birth work who understand the intricate design of our birthing bodies and what is needed for a respectful, empowering, physiological birth can often see the outcomes and the resulting traumatic births before they’ve even happened.
We’ve seen the same patterns, heard the same words said by many clients who come to us after previously traumatic births, and we know what awaits those moms who don’t know their rights, options, or how birth and their bodies actually work.
We know what awaits them inside our Patriarchal maternity care system.
And the worst part of knowing is that we are often powerless to do anything about it.
We can’t sit in on your prenatal appointments with you and tell you that your chosen care provider is setting you up for trauma.
We can’t tell you what to do, nor do we want to.
We believe that you are your own best decision maker, but when you aren’t being told everything you need to know and your doula isn’t allowed to tell you everything either for fear of getting in trouble, or we get to your questions in the mommy shaming groups too late, then how are you able to even make a truly informed decision?
When everyone around you is telling you that birth is dangerous and a healthy baby is the only goal, then how are you going to feel confident in going against that advice you don’t want to take?
Why Birth Professionals Can’t Fix This Alone
Even your midwife or care provider is (figuratively) bound and gagged within the confines of the system.
There are doctors and midwives who are extremely skilled at supporting a vaginal breech birth, homebirth, and VBAC. They would love to support you in the birth you want, but they aren’t allowed to. If they do, they risk being punished by their colleagues, the organization they work for, and even the local hospitals they have privileges at.
Basically, that means that by telling you that you can say no to the policies and recommendations passed down from a governing health authority that doesn’t even understand birth, they risk their careers.
They can’t fight this battle from the inside. For decades they have worked hard to try to change this system, and it isn’t working.
Instead of making things better, often it’s the outspoken birth advocates in the healthcare professions who get fired or discredited in some way.
Midwives have gone to jail for supporting client autonomy.
Most midwives burn out after 7 years.
A lot of doulas burn out after 3 years.
Some last longer, some burn out sooner.
Many carry trauma from the births where they had to watch helplessly as the system pushed another of their clients to make choices that led to more unwanted interventions. Or they witnessed outright assault of their clients by doctors or nurses, or both in retaliation for going against the “rules” of the organization or institution.
They know that those births could have been so much better had they had more power in that environment.
There are doulas and midwives who only attend homebirth, because the hospital setting is too triggering.
I didn’t discover this side of maternity care until I became an advocate and started sitting in on the birth network meetings. Hearing the stories from midwives, doulas, and nurses, I learned just how little they were really allowed to use their voices to change the system.
I learned that the power we really needed to change things had to come from the moms who were most affected by the policies and guidelines.
The midwives, doulas, nurses, and few doctors who want to support physiological birth are being silenced in the institutions and organizations they are a part of.
They won’t have a voice until we give it back to them.
Why Empowering Moms is the Answer
So what can you do?
We need you to educate yourselves on how your bodies work, your rights, and what is happening in our maternity care system. We need you to understand that in order to change this system, we have to dismantle it.
Mothers and birthing people need to be the ones at the top of the hierarchy, not the healthcare administrators.
Until enough of you force the system to change by refusing to take your business to those care providers who keep that system running and instead choose to hire the “underdogs” who believe in your abilities to birth your babies your way, the truly good care providers will continue to burn out or get pushed out of the hospitals and clinics.
Until you flat out refuse to attend birth classes that treat you as the “patient” who will do as expected, then those classes will be the ones that continue to dominate prenatal and birth education.
Until you toss out the birth books that say “don’t write a birth plan, and go with the flow” and start putting your money into purchasing the better birth books out there, then guess what will crowd the shelves and limit the other books to one copy—or none at all?
I have a phrase I’ve used a lot in the past when I discuss this with my fellow birth workers and advocates: “Change, or GTFO of Maternity Care.
This is something I am convinced needs to happen.
We need to inspire that change to happen.
If we all stop birthing in hospitals that have high cesarean and induction rates, then those hospitals no longer make money off our births.
If we stop hiring doctors who believe they are the ones who make the decisions for us, then they don’t have any clients.
If we stop buying a certain book that is inexplicably popular with newly pregnant moms despite its horrible advice and scaremongering in every chapter, then that book will stop being published in such mass quantities and we’ll be able to make room for other books on the shelves.
If we stop attending the birth classes sponsored by the hospital and instead enroll in the ones taught by independent childbirth educators, midwives, and doulas, then those hospitals birth classes don’t make any money and the independent educators make a decent living and may be able to offer more classes more often.
By changing what we choose to purchase, enroll in, or whom to hire, we put the power, money, and resources in the hands of those who can actually serve us.
The patriarchy isn’t some big bad boogeyman in the sky casting spells on us or slamming a fist down on anyone who speaks up.
It’s just an idea made up over collective generations and perpetuated by society.
It’s only upheld as long as we value the things that the patriarchy values.
So if we want to take our sledgehammers to it and break free, then we need to recognize our power.
We can choose not to support or fund anything that takes our power from us.
Much like we have decided in this century to no longer tolerate mansplaining, rape, sexual harassment, or sexist ideas of how women show up in the media, we can also decide that we will no longer tolerate care providers telling us what we are “allowed” to do with our own bodies.
We can decide that no amount of birth trauma is ever justified or okay and demand better.
We can criticize the media for portraying birth as inherently dangerous and traumatizing.
We can inform the market what we really want for our births.
If you want to change the system, then you do have that power.
Why You Need to Be a Powerful Consumer
Now that you know that you have more power than you thought, you’re probably wondering how you can help. Luckily, there’s several easy ways to do that and none involve becoming an advocate yourself (although if you want to join in this work send me a message because we in birth work would love to have you).
#1) You can support this website and all the other amazing websites created by birth workers and advocates who are fighting to change the system and educate you on your rights. Many of these sites are even housed inside the Empowered Birth Library. Tell people about these websites, direct traffic to them, and if you can make a donation to help keep them running then that helps too.
#2) Follow Empowering Moms and the other advocates, birth workers, bloggers, and educators on Social Media. The more exposure we get, the more our stuff shows up in the news feeds and the more attention we’ll get from the actual media. Birth Monopoly, Improving Birth, The Positive Birth Movement, and Evidence Based Birth got as big as they did because they grew a huge following. I was sharing their stuff everywhere before I started creating my own content. Social media is powerful, and women are more of a presence on it than men and more likely to share content that is meaningful and educational. You can Pin, Tweet, Repost from Instagram, Subscribe to YouTube Channels, and Share all the content every time it comes across your news feed, and the more you share, the more you’ll see it.
#3) You can choose to only purchase books on birth that recognize that you are your own best expert in your body and your baby. You can stop buying the kinds of books that perpetuate the idea that birth is a medical emergency or that making a birth plan isn’t important.
#4) You can hire the right care providers, and fire the ones who tell you repeatedly that you aren’t “allowed” even after you’ve politely reminded them that you are the client, not a patient.
#5) You can write in to the hospital you have chosen not to birth at, to tell them why you aren’t setting foot there. Inform them that their policies don’t support physiological birth and that it’s not okay with you. They won’t know why people are leaving unless you tell them.
#6) You can spread the word about the Empowered Birth Work Shop and sign up! You can support the work of independent childbirth educators by attending their workshops and investing in their programs too. One of my students in my program also invested in the VBACFacts course for families as a complement to what she’s implementing in the Take Charge of Birth Program. You can tell your friends, when they inevitably ask you “should I take a childbirth class?”, that yes, they need to, and then direct them to the Empowered Birth Workshops and our Facebook Group for Empowered Moms.
I know what you’re thinking about that last point. “Birth education should be free; doulas and educators shouldn’t charge so much for their important services because we need them so much”.
I used to feel the same.
But I want you to think about this for a minute.
The work of women is often devalued in our patriarchal society; especially caring work.
This is why there’s a gender pay gap in the first place. Women do a proportionally higher amount of caring work, paid and unpaid.
Here’s the problem with that: It’s not serving any of us, and allows the Patriarchy to remain unchallenged.
The reality is that if you don’t choose to invest in these independent programs, services, classes, books, and websites, it can be very hard for the owners and creators to keep them running long-term. So when you choose to invest your time and money into the right education and support, then that allows those of us who are passionate about birth work and your rights to autonomy to continue to show up for you, create more value for you, and ultimately attend conferences where we can add our voice and speak up for you.
Many of us are women and many of us have children.
We work tirelessly to show up to support and educate you because of how much we care, and we also burn out doing it.
Rebecca Dekker, Cristen Pascucci, and Jen Kamel were able to get as big as they did because they started charging for their work. They have membership sites for birth professionals and courses for families. They have merchandise and books. That didn’t happen by chance, it happened because they charged what they are worth.
So while I teach a lot of content for free, I learned from these powerful women that in order to truly make an impact, I needed to build the Take Charge of Birth Program in addition to my free Empowered Birth Workshop and this website.
And ultimately it will be the funding gained from my paid services and program that will allow me to add my voice to theirs, and fight for you and have your back.
The birth workers in my community also often add classes on top of their typical services because they know that by offering these classes they can fund their own work, whether that’s a blog, a documentary, a book launch, or attending conferences.
The more people hear about our services and invest in us, the more we can invest back into the community and fund larger projects like independent birth centers and birthing houses so that there are more locations available for families when it comes to choosing where to birth.
If the Patriarchy controls everything right now, it’s only because all the wealth is being controlled by those who wish to maintain its hold on society.
To destroy the Patriarchy, we simply stop investing into it.
We invest in a Matriarchy instead, because moms get shit done and we don’t step on everyone else to do it.
The Bottom Line
Nothing will change if nothing changes, and money is power.
But it’s not those up at the top that control the market.
As consumers, we pay them.
Nobody gets rich on their own. It takes market demand and what people will pay for.
This is what happens when you become a consumer of maternity care, and you learn how to use your power effectively.
You get to vote with your wallet.
Rachel Rogers talks about this in her new book “We Should All Be Millionaires”. It’s not about birth, but she is a mom and she’s also a badass woman intent on taking her own sledgehammer to the Patriarchy.
She knows that the way to put power back into the hands of women is for us all to get really rich and vote with our wallets, and I believe that in birth we discover our own unique power and find our calling. Whether that’s changing careers, creating your own business, becoming a philanthropist, or becoming an advocate, we all learn just how capable we are of greatness after an Empowered Birth. Is it any wonder why the Patriarchy keeps traumatizing us?
Even if you don’t have a big wallet just yet (go read Rachel’s book, and you’ll get one), your voice is just as important because you get to tell others where they can invest their time and money.
The more word spreads, the more the market shifts, the more the culture changes, and the harder the patriarchy will fall!
Alone, it can feel like we are the only ones fighting. But it’s not true. A drop in the ocean creates a ripple. Many ripples create waves. And enough waves can change the tide.
What ripples and waves will you create?
Carly Bonderud is a birth educator, advocate, and coach who specializes in helping moms/birthing people achieve an empowered birth and postpartum. She has been an advocate since 2014 and started with Improving Birth in her home community of Abbotsford, BC, and quickly gained recognition by the greater birth worker community in the Lower Mainland, Fraser Valley, and even other parts of Canada, the U.S., and the U.K.
She is the founder and CEO of Empowering Moms Pregnancy & Birth Coaching and also runs the Facebook Community for Empowered Moms: Empowering Moms in Pregnancy, Birth, Postpartum & Beyond