Giving birth is not a competition

International Women's Day has been a powerful reminder of how far we've come as a species.

IWD has also shown how far we still have to go to create a social world where the vast majority of women and many men enjoy the human rights of sovereignty and social safety to live as they desire and deserve.

From delusions of being able to create the master race to the idea that you can reduce or even eliminate risk in life, medicine and science have sought to control and dominate nature.

Nowhere is this more apparent than in the area of reproduction and in particular, for western women. Western women have come under increasing surveillance, control and criticism from medical 'experts' and the population at large during childbearing and parenting.  Conflicting advice abounds creating confusion and distress for women, all of whom want the best for their babies and want to do 'the right thing'. Women are told on the one hand that the rate of stillbirth doubles after age 40 and so induction around 37 weeks is recommended. On the other hand, other experts say that babies born early around 37 - 38 weeks with induction of labour are at risk of health problems.

What's hard to reconcile with the constant negativity with what is a very normal, human activity is that evidence shows that medical error causes more death and disability to people in hospital than motor vehicle accidents, breast cancer or AIDS. You may note that childbirth doesn't get it a look in with the comparison because the real problems with childbirth, even those caused by intervention, are so low in the western world. The other disturbing fact about hospital culture is that people are afraid to report errors because they fear recrimination. So really, we don't know what actually goes on in hospitals. Our only clue in NSW for example, is the Mothers and Babies report and that is a broad brush view.

We do not know exactly what the rate of intervention in the birthing process is doing to developing brains and human relations, but there are some signals that there are detriments.

Various individuals and groups challenge medical domination of birth and the medical profession's dismissiveness of the social aspects. There are thankfully, some enlightened doctors championing "patient" centred care and calling on clinicians to "relinquish the role as the single, paternalistic authority."

Films such as the Face of Birth, which aim to defuse the hysteria and show the social view of humanity's most primal act, have a tough gig. The media's delight in traumatic tales, coupled with 'reality TV's' depiction of birth all flavour enhanced by the medical profession's staunch opposition to birth at home and midwifery care, especially in Australia, has led to public opinion becoming increasingly hostile and disapproving of those who choose other than the 'doctor in charge' status quo. As a result, western women are becoming increasingly fearful of birth.  They are increasingly feeling under 'siege', a state of perpetual fearfulness. What is not so well known is how 'fear' affects a person's physiology.  The biochemical correlate of fear is cortisol. There is a lot of work being done on the effect of cortisol on physiological functioning and brain development for the fetus. Prenatal programming is a burgeoning field of inquiry investigating how a person's lifetime risk of disease or health is actually 'set' in the womb and dependant upon the mother's social world. We need to really wake up to what that means.

Western women are also becoming increasingly insecure about their parenting, which for heaven's sake is hard enough without the avalanche of 'advice' and disapproval from all and sundry.  I have been reading the comments under the mass media's articles on birth at home and the different perspectives are fascinating and show how we all see life through our own lenses of beliefs and experiences.  What, however is alarming, is the punitive and nasty way that some people respond to people's choices.

The scorn and criticism heaped on women who choose to do things differently, no matter what 'norm' is being touted by whichever interest group, is horrendous and needs to stop.

Where a woman gives birth and who she gives birth with is her business. For anyone to think they care more about a woman's life and baby than she does is the height of ignorance and arrogance. Our job as a society is to support women's choices because the evidence is clear that when a women feels supported and has choices her cortisol level is lower and her physiology and therefore her baby's physiology is more likely to be 'normal'.

Birth is NOT a competition.

It is about feeling safe, supported and respected.  Interestingly, the outcomes, including those of maternal satisfaction, are very very good when that is the situation. On another note, so many people downplay the need for the woman to feel good after birth - the health and wellbeing of the family are enhanced when a woman feels loved, respected and cared for, so that should be the focus of society.  We need to ask ourselves where does she feel safe and how can we, as a society support her in that?

Meanwhile, in too many countries, women are dying in childbirth.  The current estimate is that around 1000 women die every day giving birth.  That statistic is shocking and, with the right conditions, preventable.  These statistics illustrate clearly the social determinants of health and disease. Women are dying because in their cultures, they are "nothing" - they are worthless in the eyes of their culture  - they are the possessions of their partners or parents; they have no access to contraception and often have (too) many children, their nutrition is very poor, they are dreadfully anaemic, in some areas have malaria, HIV/AIDS and live with domestic violence and the threat of more of it hanging over their heads. Their living conditions are harsh. If we use Maslow's Hierarchy of Needs to think about the social determinants of health, you can readily see that these women exist without even their basic human needs being met. No wonder the challenges of reproduction are sometimes too great for them.  These women do not have the best conditions at home to give birth there - even the hospitals are poorly equipped and lacking in staff, but at least there may be someone there, with some education and training, who can support them and help them give birth safely. We know that when there is a strong and capable midwifery profession,  childbearing women and their babies do well.  Capacity building midwifery education is one of AusAid's projects to improve maternal and neonatal wellbeing and decrease mortality and morbidity rates in PNG.

People in the western world who are so concerned with what childbearing women do and where they give birth need to turn their attention to the developing world and work on making it safer for all women and their children.  We are, after all, living in a global village. What affects one, affects us all.

Instead of making birth a "who's right or wrong' competition, let's make it about cooperation, compassion and support.

If we want a peaceful society and happy mothers and babies, we would do well to ensure women felt loved and cared for, respected and nurtured, fed good food, rested, kept away from bad news and surrounded by loving family and friends and able to give birth the way they want to, with people they know and trust around them.

Compassion hurts

The massacre of young people in Norway has shocked and distressed me. I know I am not alone in feeling these emotions. My heart goes out to all those youngsters who survived as they now process the loss of their friends and the feelings of guilt that comes with surviving such unfathomable horror when others didn't. I have been reading all the reports and stories, quite compulsively I realised. I was surprised by my compulsion and became aware that I'm trying to get some sense of where that cold, calculating killer was coming from; what enabled him to mercilessly and methodically shoot scores of young people. 

I read that this killer lived with his mother. As a midwife, my life has been dedicated to helping women, their partners and babies connect, knowing that our primary relationship(s) set the stage for our future health and well-being in every aspect of life.  I wondered how his mother was feeling. There was no mention of his father or any other family member in the news items. 

My information about the horrible events in Norway have come from individuals and links posted on Twitter. I have read the various newspaper reports that were linked on twitter. As the information trickled through the net, painting the picture of the events unfolding in Norway, I couldn't get my head around the way that the killer set off the bomb in Oslo, then travelled to a small island where teenagers were on a summer camp and slaughtered so many of them.  Why????

A link on twitter provided a clue "Who kills 80 Teenagers, one by one?" .

We now know there have been at least 94 teenagers murdered, but there are still some young people unaccounted for and still to find. I can only hope they are alive, but the prospects are grim. 

The car bomb was placed near the offices of the socialist government and the teenagers were worker's party members. Rick Falkvinge, the blogger, suggested that the bomb in Oslo itself was a diversionary tactic to keep the police busy while the killer "executed (the teenage party members) in cold blood, as a political strategy to cripple a political party decades in the future." 

The killer's murderous rampage drew the following comment on Falkvinge's blogpost. 

Let Norway show him mercy, not because he deserves it, but because their vision of civilization is more complete than his.

A steady stream of information was tweeted by Ketil B Stensrud, who described  himself as a 'football-fantatic journalist, who worked for The Independent, Daily Mirror, AP, TV2 and VG, turned general manager at Radio NRJ Kristiansand.  One of his tweets contained the following:

BREAKING: Here you can download the Oslo/Utøya gunman's manifesto, in which he gives detailed account of planned attack. 

The manifesto is enlightening, if depressing. 


There are pages and pages of anti-Muslim, anti-multiculturalism rhetoric. There is anti feminist rhetoric. The manifesto is worth looking at as it shows how a mind seeks the evidence it needs to support its biases and bigotry. We are all capable of that self affirming and self referencing behaviour. As you read it, you can see how delusions can become very powerful and how the brain can become closed to any other way of thinking. 

In the document, the killer's reasoning is carefully laid out. His plan to decimate the pro-multicultural element in his country has been brewing for 9 years according to the information in this document. The level of lies and deceit he employed are breathtaking. 


The New York Times article this morning "Scouring the Web for Clues to a Suspected Attacker's Motives" contains sources and links to information about the murderer and his motives by both the journalist and the readers.  A psychologist has, in response to the massacre, written that mass murderers see themselves as victims. That somewhat fits this killer's positioning, however, he seems himself more like an avenging angel or knight. 


He saw himself as a Justiciar Knight fighting multiculturalism. You can read in his manifesto what that means. He surrendered easily to the police when they arrived on the island and under interrogation, confessed to the crimes. This newspaper heading indicates what is to come.    Norway massacre suspect calls his deeds atrocious, but necessary

There have been examples of extraordinary heroism throughout this horrific event by individuals and immense courage and resiliency of the young people.  The leader of the party Jens Stoltenberg has been an inspirational and compassionate leader, saying: 

Today,we have been hit by two savage and cowardly attacks. Tonight, we all stand together, taking care of each other"affirming that "The answer to violence, is even more democracy. Even more humanity"

The massacre in Norway illustrates the profound problems inherent in fundamentalism of all stripes. The killer espouses a vile fundamentalism that strips away people's dignity and worth. His fundamentalism seeks to validate violence for the 'right' reasons of his own making. Norway and her people and their response to this ghastly event remind us that respect for different viewpoints and valuing diversity is the only way humanity can evolve and even survive.  

I feel sad. I feel a bit despairing that a native of a country with such great values and social justice practices as Norway could commit such a crime, but people are people. 


I take comfort in the knowledge that for every person like this dangerously misguided and deluded individual there are thousands who are trying to live life in the best, most socially responsible, inclusive, generous hearted way.  


Elizabeth of @mymilkspilt fame posted this earlier today. The comment summed it all up for me:

 "Compassion hurts. When you feel connected to everything, you also feel responsible for everything. And you cannot turn away. Your destiny is bound with the destinies of others. You must either learn to carry the Universe or be crushed by it. You must grow strong enough to love the world, yet empty enough to sit down at the same table with its worst horrors."

Andrew Boy (Source: myspiltmilk via changingmyperspective, via guerrillamamamedicine)

I don't know who Andrew Boy is, but I sure admire his sentiment.


The following are the last two tweets from the man who provided much of the information I've shared in this blog post. 

ketilbstensrud Ketil B. Stensrud

The brutal, calculated home-grown terrorist has confessed. Rest is now left to our judicial system. I'm exhausted. Time for bed.

ketilbstensrud Ketil B. Stensrud 

One last thought: It's a beautiful world we live in, with warm, inspiring, loving, courageous people all over. Let's keep it that way. Out.

I love his parting comment. It truly exemplifies the spirit of the Norwegian people. I hope he managed to get some sleep.  Thinking of all the people in Norway as they recover and heal from this terrible ordeal and come to terms with the loss of so many beautiful young people. I know that Norway will continue to provide the inspiration, ideals and values that we all love and admire so much; the leadership and people have demonstrated that commitment in the worst of times.