I would like to thank Lynn Morrison for her invitation to co-author this article.
We are two expat women living in the Netherlands. We each have two daughters, gave birth around the same time, and had our first child outside of the Netherlands and our second one here. We have both met women who told us stories how their wishes and needs were ignored because the midwives expected them to have a more natural birth experience. This inspired us to co-write this article to present a slightly different perspective on the human rights in childbirth debate.
This past summer the Netherlands hosted the Human Rights in Childbirth Annual Congress. Thought leaders, researchers and political figures from around the world gathered in The Hague to discuss the rights of women to determine when, how and where their childbirth will take place.
We were only somewhat surprised to see that most of the presentations that got wide coverage were about women who wanted to give birth at home at all costs. We started asking ourselves these questions: what about those of us who want to give birth in the hospital with every pain relief option? Are our own rights to the birth of our choice worth less than the rights of women who want to give birth at home?
LYNN’S POINT OF VIEW
I gave birth to my first child in the United States. I attended childbirth classes well in advance and was educated on all of the different types of pain relief available and the risks and side effects (both for myself and my child) for each one. I approached the birth with an open attitude – I would listen to my body and use exactly what I needed to get through the birth. However, after 8 hours of laboring at home, I arrived at the hospital and asked for mild pain relief. I was provided with an IV-drip that helped to take the edge off of the contractions but still allowed me the freedom to move. After two hours later I realized that my early plans to walk through the labor pains were not realistic. If I wanted to get through the next hours (I was only at 5cm at this point), I needed stronger pain relief. I was then given an epidural, and this full-strength relief took away all labor pains but still let me feel enough to push out my child with no problems. I left the delivery room feeling pleased with my whole experience. My pregnancy in the Netherlands was a complete contrast. Knowing the national opinion on epidurals (“bad and unnecessary”), I vocalized my desire for one at every single appointment during my pregnancy. Every time I was told that it was noted but they could not guarantee that such relief would be available. In the end, I was able to get one for my delivery, but I felt rushed into the decision due to the imminent departure of the staff anesthesiologist.
I am confident that had I not been both resolute in my desire for pain relief for my second pregnancy I would not have received the care and treatment I wanted. I don’t think a woman should be vilified because she doesn’t want to feel every single pain associated with labor and delivery. If anything, the relief that the epidural gave me allowed me to be more relaxed and focused on the arrival of my child and not on the side effects. I would like to see more doctors in the Netherlands support a woman’s right to choose pain relief during delivery, instead of vilifying the epidural.
OLGA’S POINT OF VIEW
My experiences are very different from Lynn’s. The first time, I gave birth in Germany, had a very hard, long, exhausting labor (38 hours and almost 3 hours of pushing), and took ages to recover. Obviously, I wasn’t very thrilled with how the birth went, but I had a healthy, beautiful baby girl. I didn’t have pain relief, since the pain was manageable, but the exhaustion wasn’t and I can’t help but think that maybe an epidural would allow me to sleep a while during labor, and maybe I would feel better after the birth.
I became pregnant very fast after that, and looked into other opportunities for having a better birth experience. I decided that I would have a homebirth, and felt that this choice was respected in the Netherlands. I liked the idea of having my own midwife. The second time, my labor was 6 hours. I was transferred to the hospital for a minor complication, and a midwife I didn’t know took over. In the end, it didn’t bother me. I was monitored in labor, but could move around. I didn’t have pain relief, but I didn’t feel it was necessary. We went back home the next day. Even though I didn’t have the homebirth I wanted, I was very happy with the midwifery model of care.
I believe in respect in childbirth, and that women should have the right to choose. But just as in many countries women feel that they can only go the medicalized route, and possibly end up with a C-section they don’t want, in the Netherlands many women (especially expat women) feel that they are denied their right for pain relief. Just like the doctors in other countries, in the Netherlands it’s the midwives who are in a position of power: often, they try to push their opinion on women because they can’t provide certain services, such as pain relief. There is no shame in needing help in labor-whether it is pain relief, a C-section, or a doula and natural remedies.
I think that “human rights” and “dignity” should have to do with respecting all kinds of choices without compromising safety. It should have to do with giving and receiving the help that is needed. And even though I support homebirths and midwives, I would argue for more choices in the Dutch healthcare system- and I don’t mean more midwives, I mean more doctors, and an easier access to them.
What are your thoughts on this subject?