I used to write for a homebirth magazine in my local area. I did this because I think it's important, I like to support homebirth groups, I think I have something important to say and all those kind of activist reasons that one might offer one's time for free to so many groups.

Interestingly, this article was knocked back because it supposedly dismisses women's concerns around birthing after previous surgery. Obviously only someone not very bright would think that or perhaps someone with an agenda other than offering information to birthing women? But further, I happen to know that other women have said the exact same thing in their submitted (and accepted) articles as I said and that was somehow deemed appropriate. Go figure. What possible conclusions could one draw from that then, hey?

Welcome to birth politics where what tree I pissed on, and who my friends are, is more important than the work I do. Where Sheila Kitzinger's words are greeted with sage nodding and mine with exhortations to get Over It and stop Being Angry. Hmmm. Underneath this short article is one I wrote in 2005 thus demonstrating that this is not even new thinking on my part.

On Birth – and with due deference to Nancy Wainer whose revolutionary thoughts helped so many of us frame our own.

I propose that we reclaim birth. Our first step can be the removal of labels from birthing. Birth is birth. Women are women. We’re not mothers, wives, primips, multis or “the VBAC in room 3”, we’re women. We’re women at work, women in the home, women in the revolution and women when we birth. And birth, is just birth.

If a woman has had five previous surgeries, this homebirth is still just a birth.

The woman-hating surgical discourse has colonised our once great nomenclature and turned it on us, pathologised it, made it an unattainable, risky, undesirable managed process designed to “fail”. And let’s drop “successful” and “failed” from our descriptions of reclaimed birth. Birth doesn’t fail although often the system does.

Alternatively, if we reclaimed our lives, maybe birth would naturally follow on? Now there’s a radical thought!

A survivor of birthrape birthing again, is just birthing.

A woman with a “big baby” is just birthing.

Let us leave the acronyms to those who seek to remove our humanity and have the power in naming our own births. No more FBAC, VBAC, HBAC, EBAC, UBAC, BAC, whatever. Don’t give in to the powermongers, and fearmongers, just give birth.

Give birth at home. Give birth with friends. Give birth on your own. Catch your own baby as she plunges from your yoni and inhale deeply. That is the true scent of freedom. Give birth screaming, give birth whispering the meaning of the universe. Give birth nestled into your lover. Give birth holding the hand of your chosen wise woman. Look into her eyes and see the line going back to when we first walked upright and our bodies adapted to birthing that way. Give birth in a rented deflating secondbest pool in your study, hey, I can recommend that personally!

Give birth in the living room, after your previous surgery. Give birth on the roof this time if you feel like it. It’s just a birth. Give birth in the garden. Last time you had surgery, this time you’re giving birth. Not a big deal. Just a birth. Give birth at your kitchen sink in ironic tribute to your inner housewife.

Give birth to yourself, embrace yourself, throw off the shackles, womankind arise! Even suffragettes just gave birth. (And most of them at home.)

Give birth to boy babies that they may be loved onto earth and cherished from birth, not brutalised to fit society’s demand for drone-like men. Give birth to girl babies that they may continue the line and know the power of birth and the power of women themselves, all their lives.

Birth, birth, birth, that’s all it is. What our greatgrandmothers did at home, alone or with friends and sisters, just birth.

Reclaim our birthright to name our births, own our births and choose woman-centred baby-loving birth.

Birth after surgery = just a birth.

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Giving Birth After Caesarean? The Good News Is It's Just A Birth!

Written to mark National Caesarean Awareness Day, 2005.

I recently came to a decision about my next birth. I’m not planning a HBAC, I’m not planning a VBAC, I’m planning a birth.

To quote Henci Goer, “Frankly, VBAC should be a nonissue by now. You should be no more choosing whether to labour this time than you did before you had a caesarean. Based on 2 decades of studies, totalling many thousands of women, the consensus of experts [both of the medical model and the midwifery model] is that in the absence of a specific reason for caesarean section, the routine policy for women with prior caesareans ought to be labour.”

Certain groups central to the pursuing and upholding of the medical model are changing their view on this, despite the unchanging evidence, and this seems to be where the problems lie.

Now the logical, academic side of me feels terribly confused then by what I see happening in our hospitals to birthing women, and not only those who have had prior caesareans. We all know that vaginal birth is safer for babies, the evidence is well documented and persuasively presented by many people.

Spontaneous labour, followed by normal physiological birth, ie the midwifery model, produces the best outcomes regardless of prior surgery. But in Australia, fewer than 1% of women access this optimal care.

Even those who could afford it without much difficulty, mostly choose to hire a careprovider from the medical model despite the worst outcomes being associated with disastrous notions like active management of labour and elective repeat caesarean with no actual medical indication for it.

Of course, if you were to survey most of the people walking past in the street today, no doubt a large percentage could tell you that birth is dangerous and difficult, best confined to the walls of hospitals, and almost certainly requiring the services of a surgeon in some capacity.

The advertising of their business by those who promote the dangerous and poorly evidenced medical model is thorough and buys into larger myths in our culture around women and women’s bodies.

And their continuing promotion, through ridiculously elevated levels of first time mothers experiencing unnecessary caesareans leading to further surgery as VBACs are refused, means that they are safely both capturing and creating a market share via an unethical monopoly.

If you doubt that this is a policy, and in collusion with our media, you need only think of the recent release of a very faulty study in Australia which alleged that induction at 39 weeks gestation led to a lowering of stillbirth rates.

In the same week, a study demonstrating yet again, the efficacy of the midwifery model, now largely the domain of independent midwives practicing in our homes, was completely ignored in favour of the footage of women clutching small infants praising their obstetricians early intervention in saving them from the dangers of normal, physiological birth and timely gestation.

The very language we use reinforces this clash between the well evidenced, and the poorly evidenced but predominant culture – Trial of labour, trial of scar, hoping for a VBAC, successful VBAC, failed VBAC, uterine rupture which rather conjures images of catastrophic bursting culminating in a spewing forth of blood and baby.

For most women, any issues with their scar results in a small pulling apart and cessation of labour, provided you haven’t had your labour augmented with chemicals which stretch the uterus beyond it’s normal capacity. And let’s not forget other terms like incompetent cervix and failure to progress.

The United Nations 4th World Conference on Women, in Beijing 1995, said this in relation to healthcare for women. Countries need to:-
"Reinforce laws, reform institutions and promote norms and practices that eliminate discrimination against women and encourage both women and men to take responsibility for their sexual and reproductive behaviour; ensure full respect for the integrity of the person, take action to ensure the conditions necessary for women to exercise their reproductive rights and eliminate coercive laws and practices."

The World Health Organisations, report “Safe Motherhood: a guide for care in normal birth” states that “The uncritical adoption of a range of unhelpful, untimely, inappropriate and/or unnecessary interventions, all too frequently poorly evaluated, is a risk run by many who try to improve the maternity services. And also warns that “Women and their babies can be harmed by unnecessary practices.

Staff in referral facilities can become dysfunctional if their capacity to care for very sick women who need all their attention and expertise is swamped by the sheer number of normal births which present themselves.

In their turn, such normal births are frequently managed with "standardised protocols" which only find their justification in the care of women with childbirth complications.” The report states, crucially that “The aim of the care is to achieve a healthy mother and child with the least possible level of intervention that is compatible with safety. This approach implies that: In normal birth there should be a valid reason to interfere with the natural process.”

Too few women are achieving this kind of care and that is only too evident in our soaring rates of unnecessary surgeries.

So what happens to women and our community in all this? For a start, the money spent by governments on supplying highly priced, poorly evidenced careproviders is money which could be spent more judiciously on programmes preventing violence against women or abuse against children.

Hospitals are performing unnecessary surgeries on perfectly healthy women and leaving women at far greater risk of postnatal depression and, the little mentioned but frequently experienced, post traumatic stress disorder.

Women who have caesareans frequently have difficulty breastfeeding, which not only leads to the high dollar value of formula being used, but the resulting drop in the health of that baby leading to further draining our health budget because we know that formula fed babies are at far higher risk of being hospitalised from illness.

And women unable to breastfeed are also missing out on valuable protection from reproductive cancers, particularly breast cancer, which is in almost epidemic proportions nowadays. There go more health dollars which could have been more usefully and economically spent on midwifery care.

Given that the safety of midwifery has been demonstrated over and over around the world ad nauseam, yet still midwives are asked by obstetricians to demonstrate their worthiness to care for women in normal, physiological labour, something is very wrong.

We need to step up to the community and be proactive with information, to go on the offensive with the superior outcomes and satisfied clients of midwifery care. We need to stop allowing surgeons, ill qualified for the care of healthy pregnant women, to dictate the terms of the discourse because women are losing out to it.

We need to ask obstetricians to demonstrate their safety outcomes and justify their capacity to care for women who require nothing from their impressive skillset as surgeons. As Michel Odent said, “Imagine the future if surgical teams were at the service of the midwives and the women instead of controlling them.”

We need to retain our obstetric services for the few women who need this admirable and life saving technology put to the use for which it was intended. We need caesareans to be treated again as major surgery, and not performed without good reason after a woman has used other less invasive methods at her disposal.

We need for women who have this necessary surgery to have their experience honoured, and not treated as a run of the mill, every day occurrence, with no regard for their emotional state or physical needs.

And those of us who have experienced caesareans need to be firm about our future decisions and base them on evidence and not let the medical model steer us into unnecessary further surgeries.

According to a newly published Canadian study of 308,755 mothers who gave birth from 1988 to 2000 after a previous Caesarean section, maternal in-hospital death was significantly higher in elective repeat caesarean group (5.6 per 100,000) than the trial of labour group (1.6 per 100,000). This means that maternal death is 3 1/2 times greater with elective repeat C/S.

Today is a day for us to honour ourselves and our experiences. We are grateful for the mothers who are with us today, and their children, who might not be if it weren’t for emergency surgery in a developed country.

We are grateful for the journey which our births take us on, because birth is a journey and not a destination. Our courage and experience can lead us into the betterment of birth for all Australian women, if we let it.

References available from the author on request.