My body my choice: Human Rights in Childbirth
Last week I set out for The Hague to attend the world’s first Human Rights in Childbirth conference. Organised by the Hermine Hayes-Klein of the Bynkershoek Institute, it’s aim was to gather leading thinkers, professionals, practitioners and others from across the world and across the disciplines to discuss and debate the question: What are the Rights and Responsibilities of Birthing Women?
I could blather on for months about the incredible speakers (from Ina May Gaskin to Anna Ternovsky, Jennie Joseph to Raymond de Vries), or the intense discussions, the atmosphere of passion and desire for understanding and change, or the impact of some of this will have on my work as a doula. But I’m not going to. I will direct you, at the foot of this post, to some other bloggers’ round-ups of the event who do all of that far better than I ever could. What I want to focus on is very basic and quite personal.
Before I surprised myself by veering career-wise in to the birth world I worked for a human rights organisation. I spent time during my Masters focusing on human rights in the context of wartime. Human rights were something I felt drawn to investigate and felt strongly should be protected.
When the Human Rights in Childbirth conference was announced I was delighted: a chance to look at two of my greatest areas of interest at the same time. It turned out I was completely wrong. I wasn’t there to discuss two separate areas of interest – just one. You see last week taught me that I didn’t change career, I didn’t stop thinking about one idea I believed in and switch to another, I have always been focused on one thing – I just didn’t realise.
Without trying to get too technical, too theoretical, too pompous or too out of my depth I, like many others, hold a firm belief that all humans have a set of inalienable rights. These rights are set out in domestic and international law, in the Universal Declaration of Human Rights and less tangibly, but arguably more profoundly, in the series of moral, religious and societal codes by which the vast majority of us live.
These rights are fragile, connected together by an unseen web, dependent on each other for their survival. Chip away at one person or one group’s rights and we leave everyone vulnerable. Decide that a particular right doesn’t apply any more and risk all the others. The more I learned about the rights I took for granted as a student the more I, like so many others, realised that they need to be protected, upheld and understood. And not just by those who have lost or are about to loose them but particularly by those of us who take them for granted.
The majority of those participating in last week’s discussions in the Netherlands seemed to agree that full access to these rights begins at the moment a child, and therefore her parents, are born. Birth then, is the moment of setting a match to a fire you laid last week. It has had potential for days and suddenly springs in to life, altering its surroundings, changing things and burning until someone neglects it and lets it go out or throws a large bucket of water over it suddenly extinguishing it.
Birth, to my mind then, is the very frontline battleground for human rights. Nothing says more about a society, a culture or an individual’s attitude to the rights of those around him as his attitude to the rights and responsibilities of a birthing woman. If the moment where our human rights begin as a newborn baby is set against a gruesome backdrop of our mother’s subjugation to the deliberate, even criminal, withdrawal of some of the very basic rights we all expect, what chance have we [the baby] of living a life where our own rights are respected?
Sound a bit dramatic?
Well I imagine most of you would agree that it is ultimately up to you to decide what it best for your body. You will decide whether you have an operation, whether the risks of a particular course of action outweigh the benefits. You will be the person to decide if and when you consent to an invasive procedure. You will be the individual who carries the burden of responsibility for making the right choice for you, accessing good information and support in order to do so. And you’d expect to be able to make the same choices for your unborn baby: you the woman who carries him. You whose body is affected by the choices you make for your baby. You whose body is currently giving him life and you whose life sometimes hangs in the balance based on the choices you make.
And yet, right here in EU member states and other developed countries like the US – countries have a responsibility to uphold the human rights of their citizens based a range of international and national laws – there are cases of women being forced to undergo caesarean sections against their will. These are women who feel another course of action is best for them and their baby who are taken from their homes, anaesthetised and given major abdominal surgery against their will. In the EU there are countries where domestic law classes with the European Convention on Human Rights stating that medics can intervene without a woman’s consent if they fear for the safety of a 24 week old (or older) foetus.
When you think about this closely it is terrifying. I have been at plenty of births where one doctor, one midwife thinks plan A will be best for the baby, parents aren’t keen so they ask for a plan B. After weighing up the risks and benefits of both they decide plan B is best for them and respectfully decline the recommendation. Another midwife, another doctor may suggest plan C, another plan D while one will concur with the parents. What if plan A is a planned caesarean for a breech birth and plan B is a vaginal breech birth? Despite the information being far from clear, their are many doctors who believe a vaginal breech birth will put a baby at risk. Should there be legal recourse to take that woman to court and force her to have a caesarean against her will? A caesarean that increases her own risks of death just because her baby is breech?
There will always be ethical debates, grey areas involving the unique state of pregnancy. But, as a razor-sharp human rights Barrister reminded me last night, the law is crystal clear. If you do something to a woman without her consent: be it a vaginal examination, an episiotomy or a caesarean it is criminal assault. I want to live in a world where everywhere (but for the time being at least in EU member states and the US who purport to uphold the rights of their citizens) my body is my own. Mine to make decisions about, mine to hold responsibility for and mine to safeguard in the way I believe best. I want the right to choose where, how and who is there when I have my babies.
I want to live somewhere that women’s bodies aren’t continually a place to battle politically. Where they aren’t somewhere to play out power struggles, or become by simple accident of sex something that others feel they have the right to control.To policy makers, women, men, doctors, midwives, lawyers, politicians and my own daughter, I ask you to read some of the articles from the Universal Declaration of Human Rights and use them to inform your attitude to the rights and responsibilities of birthing women: be those women yourselves, your partners or women in your care.
To those of you who gave your time last week to push this vital project forward there is nothing I can say but thank you.
Universal Declaration of Human Rights (excerpts)
All human beings are born free and equal in dignity and rights.They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood
Everyone is entitled to all the rights and freedoms set forth in this Declaration, without distinction of any kind, such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status. Furthermore, no distinction shall be made on the basis of the political, jurisdictional or international status of the country or territory to which a person belongs, whether it be independent, trust, non-self-governing or under any other limitation of sovereignty.
Everyone has the right to life, liberty and security of person.
No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.
Everyone has the right to recognition everywhere as a person before the law.
No one shall be subjected to arbitrary interference with his privacy, family, home or correspondence, nor to attacks upon his honour and reputation. Everyone has the right to the protection of the law against such interference or attacks.
Other Bloggers Thoughts on the Conference:
Dr Rixa Freeze
Dr Amali Lokugamage