Wednesday, March 31, 2010


Many recent events have all been pointing towards how women in labour are “monitored”. Many midwives do not do vaginal examinations because they are intrusive and painful and there are other ways of monitoring progress. This is all a very good thing, but I would suggest it doesn’t go far enough. The whole concept of labour progress is assessed using a male mindset. What I mean by this is that men and women think differently. It is scientifically proven our brains function differently and there are different connecting pathways between right and left hemispheres for men and women. Now all of this I say to point out that we are different – in no way do I imply one is better than the other – just different. And nothing is black and white; there are variations and scales within male and female. I am also not saying that science is purely a male domain – I love science, but how it is applied is usually different for males and females.

Since medicine first took over birth as their domain, it has looked at the whole issue with a male-mind. Progress of labour was assessed and monitored, categorised and boxed and put on a time line with a clear beginning, clear progression and clear end. And then they told women how it should be done according to their understanding. And women tried their hardest to ‘fit’ their models. One look at our atrocious birth statistics and trauma will tell you that women cannot fit into these boxes no matter how hard they try.

In reality, birth is purely a feminine phenomenon and we cannot understand it with a male mind. We have the body – the equipment so to speak – and the innate wisdom – to birth. And it does not involve monitoring and fitting into neat little categories. So as midwives avoid the actual physical measurement (VE's) to monitor progress, and come up with lots of external ways to know how a woman is progressing, we give no thought to the fact that we are still using a male-minded yard stick for alternate ways of measuring as if it is the valid way of thinking about birth. It is not just the how of measuring it is the measuring itself.

As women we are all very well aware that life is not like a straight line progression - relationships are not like that and birth is certainly not like that. A women telling a story will leave the progression of her story line for a bit and go back and tell you a side bit, or a piece of history that will make your appreciation of the story more comprehensive - progress is not definitely a straight line. Birth is a beautiful dance where a woman is mostly telling her life story. Let her do it her way, and progress as she feels she needs to - completely unhindered. If she feels she needs to check her “progress” on the male minded scale than something has happened to hinder her self expression and she is doubting herself. What she really wants to know is “am I ok?” Even though she may ask how far dilated she is, she is only verbalising like this because it is set in our cultural concrete that dilation measures progress in labour. What she really needs to hear is “Yes you are fine. You are getting closer. You can do this. YES – you do have the strength. Dig deep – the power to do this is within you.”

Don't get me wrong - all of these external signs are interesting and fascinating - and I watch and observe women, but I do not let the expectations of my observations change my assessment of where she is. I care about how she is and how the baby is. What matters is - how is she? How can I support her best? What does she need? Not "how far is she along the path?" she is either moving toward pushing her baby out or she is pushing her baby out. Who cares how close she is so long as she is listening to her body?

So my aim is to re-educate women into believing instead of the 3 medical (male minded) stages of labour there are really 5. (Well, I think I might reassess this and make it 6 to include the pre-labour stage as a valid stage of labour, because often what women are feeling during this stage is completely invalidated and dismissed with a “well you’re not really IN labour”. Don’t forget – the definite “beginning of labour” at 3-4cm is also a male mindset.) But once a woman is in labour, there are only 5 stages that matter. . . coming soon coming now out and needs to be left alone.
4. ohh look there's the placenta
5. don't you dare disturb mum and bub or I'll rip your arm off