Having A Healthy Baby Is Not All That Matters

Michael made the off-handed comment this weekend that “telling Krista all that matters about pregnancy and giving birth is having a healthy baby at the end is a really good way to piss her off.” He’s right.

I’ve been thinking about this a lot lately.

And I cannot come to any conclusion other than this: Having a healthy baby is not all that matters. Having a healthy baby cannot be all that matters if we actually want social systems and norms that are worth handing over to those babies. When we say that having a healthy baby is all that matters, we become participants in a system that says women cannot know themselves, cannot make good decisions, and are worth less as human subjects than they are as carriers of babies. A healthy baby matters, but that cannot be all that matters. Choice, responsibility, and change must become vital parts of pregnancy if we want it to be something other than dehumanizing and invasive. 

Choice

Bugbear was a surprise, hence the nickname.

Bugbear is now loved and very much wanted.

Just as I could not have come to this point without the legal right to choose safe medical abortion (that’s a post for another day), I cannot come to be a parent without being respected throughout that process. Having the choice to make informed decisions, based on knowledge of all my options, is a vital part of this.

If I am not involved in the medical care that impacts both me and my fetus, then I do not have a choice about what is going on. Informed consent is a vital part of any trustworthy relationship that involves choice. Informed consent cannot be consent without real information. Much as we would love infallible information that would make the difficult decisions easy, medicine cannot provide that for us. And so informed consent has to include both positive and negative potential outcomes in order to be informed and make a meaningful choice. This is icky. It means we have to admit fallibility and reliance on procedure more than practical individual attention. Moreover, the choices that come out of information have to be respected, or they don’t count.

There is, necessarily, more than one being involved in this mess that is pregnancy. In our case, there’s Bugbear, whom I very much love and want to be healthy. There’s Michael, whom I very much love and want to be healthy. And there’s me, whom I need to love and whose health is a constant project. To claim that all that matters is a healthy baby is to kick out of the equation those who are capable of making any choices, who already exist as human subjects, and whose bodies are subjected to medical attention and intervention. In the face of that pressure, I find myself ignoring, dismissing, and not loving myself as much as I should, all in the name of maintaining a sort of tenuous compliance with American notions of health.

Responsibility

 

Compliance is a huge part of what we consider health. We have all sorts of problems with defining health, but we somehow know what a good patient who wants to be healthy looks like.  Good patients often hand over responsibility for their choices in exchange for being considered responsible in their actions. I will wholeheartedly agree that medical professionals often know more than I about health and illness. But I’m not going to ask a cardiologist for breastfeeding advice, and I’m not going to ask a family practitioner to read neurological scans with the same expertise as someone who spends her working hours examining brain pictures. I am, at the very least, responsible for choosing what I ask of whom.

By no stretch of the imagination am I am neo-con. Talking about personal responsibility often gives me hives because of the political connotations. But responsibility in a medical situation needs to be addressed, and to be handled differently if pregnancy has any hope of moving beyond being all about “the baby.” If I am seen as incapable, irresponsible, or not needing to be burdened by pesky facts and choices, then I cannot be responsible, because I am not even treated as human.

So what does that have to do with pregnancy?

Everything.

Pregnancy is not only about “the baby.” There are other things, like how I am treated, by whom, and to what end, that do matter. Do these matter more than “a healthy baby,” whatever that means? I don’t know. But I shouldn’t have to choose.

Change

Women are only going to be respected and treated as equals when we not only request it, but demand it and expect it. We must stop being so concerned with being good patients that we willingly write ourselves out of our pregnancies, in the name of "good" doctor-patient relationships, in the name of “they know more and therefore they know best,” and in the name of having healthy babies at the expense of all else.

If I want a broken system of relationships to change, I need to become a vital part of my own care. So long as there is a risk that blanket admissions consent forms mean that things can show up in my vagina when I don’t want them there, that I can be restrained without consent, and that I can be harassed, coerced, or made to feel less than others because my beliefs and desires do not coincide with norms, I am not a vital part of my own care. When those things happen, and are considered perfectly acceptable because I come out of an ordeal with a healthy baby, I am an incubator, a dehumanized cog, a woman whose use value is higher than her actual worth. And those things must change. Like so much other social change, this isn’t exactly convenient. Fortunately for the change I want to be in the world, though, I’m not about convenience.

I’m in good company, though. Babies aren’t so much about convenience either. There is nothing stopping Bugbear stopping from turning breech at 42 weeks, or deciding that s/he’s done cooking and wants to come out NOW in the middle of my taking an exam. And nobody is telling my fetus that so long as mom is healthy and happy, what s/he wants doesn’t matter and should be dismissed out of hand. Mutual respect is probably a bit much to expect of a fetus, but respect for both those being born and those giving birth should be a minimum in this world, not a goal we have to fight for.