.. Not how I planned this.

In this issues articles on : Breech births, The trap of the normal birth, Healing after Caesarian, current birth support info, playgroup dates plus some moving personal stories surrounding the topic not how I planned this.

Words are powerful tools. They evoke and convey meaning. Words need to be chosen with care to ensure they are accurate, useful, and that they are not used in way that can damage.

I believe AIMS should promote the use the alternative term "quote "natural" birth, rather than the term "normal" birth.

After all, it is AIMS philosophy that birth is a natural part of life, and that in most cases the human body's intuitive wisdom will deliver a woman and her baby safely to the other side of the experience, without intervention being necessary. In all our literature, and our speech we should be aware of the powerful impact our language is having, and use our words carefully. We should use words which most accurately depict the ideals we aim to promote, and that are not damaging.

My case against the use of the term "normal birth" is on three grounds. The first two reasons relate to the meaning of "normal", from a population perspective and from a medical/obstetric perspective. The third reason relates to the psychological impact of the term on women.

So what exactly is the definition of "normal"? When I think of normal I think of the mathematical concept of the normal distribution.

The normal distribution comprises the range of values possible for a given characteristic in a particular population. We have the majority of values around the mid-point (or average), and then a huge range of possible values on either side of the average.

Values which differ hugely from the average are still normal, possible values: they are just less likely to occur.

I will now apply this concept of the normal distribution to the area of the human birth experience. The time it takes for a woman to labour with a first baby could range from 30 minutes to 48 hours: these are all possible values. The most common (average) time is around say 15 hours.

All these times are "normal", not necessarily ideal, or common, but NORMAL.
Likewise for the pattern of contraction times, or cervical dilation patterns and times: there is lots of variation on the one theme which is all accounted for, and considered normal in nature,

What happens in our culture and medical establishment is the adoption of the definition of normal being the usual, average, or typical state; conforming to the conventions of ones group. This is the commonly accepted definition of "normal", particularly as practised by the medical establishment.

What is average now becomes normal.

All those other possible, normal values of birth times, patterns, and experience now become "abnormal". These "conditions" then become such that interventions are deemed necessary.

This type of thinking is what sets up the patterns of obstetric management, for better and (often!) for worse in our hospitals and birth centres.

If the pattern, style, and beauty of a woman's own, unique labour does not conform to what is considered "normal", she is likely to be drugged and/or cut. Often times women are not educated about the range of possible normal birth patterns, but are instead told only about the usual or average pattern.

For instance in many ante-natal classes, and in most literature, women are not told about the patterns of contractions that can accompany posterior birth: contractions for primiparous women do not always start off slow and fuzzy: they can start close and intense: there is not always a pre-labour; if there is it can last weeks, days, or hours etc.

By perpetuating the use of the term "normal birth" we are further potentiating the ignorance of the many ways in which anyone birth may manifest itself and progress.

The other difficulty is that by definition, what is "normal" becomes dictated by what is the convention in that society or group, at that time.

For instance, with a caesarean section rate in some private hospitals running at 30-50%, abdominal delivery is certainly common and "normal". Likewise for episiotomy, rupture of membranes or any other intervention you care to mention.

If something is done often, whether needed or not, it becomes NORMAL!!!

We must stop using the term "normal" because it does not enhance our case for a more woman focussed birth culture: all it does is give legitimacy to the medical establishment to continue to intervene in the name of "good practice" because everyone else is doing it and expects it to be done!

The third reason 'Why I believe we should not use the term "normal birth" is because it is a term that can be psychologically devastating to women.

Imagine a woman longing for a natural, drug free birth who has had a long labour, a cascade of intervention and then a caesarean section. According to the medical establishment jargon, this woman has not had a "normal birth": so by definition her experience was abnormal.

Imagine how she feels: before her birth experience she was beautiful, strong, confident, and full of hope and expectation: afterwards she is told what she went through was not "normal".

What was it then?? Was she on Mars all those hours?? Why can't she be a normal woman again, and give birth like her "normal' sisters?? She has been cut open: physically, emotionally and psychologically.

Imagine how much kinder the term "natural birth" would be to use in this case. She will be the first to nod and acknowledge she did not have the natural birth she hoped for!!! This term may upset some women, but far fewer than those who currently have to suffer the pain, shame, and indignity of an "abnormal birth".

The other aspect to this third argument addresses women who may not want a natural birth. Some women want technology and intervention to be present and used. This should be respected, and appropriate language used so each woman can find a carer that fits in with her own philosophy. We need to start using the correct jargon to clarify this for them.

Natural birth is birth in it's pure state: no drugs, cutting or intervention.

Any other type of birth involving technology, drugs, or surgical procedures is a technology birth.

It is not necessarily normal, perhaps just fashionable.

I urge AIMS and it's individual members to lead the way in developing a more appropriate, accurate, helpful and humane birthing language.

Kathy Cornack

(This article first appeared in AIMS Australia issue no. 1039-593x, May 2001, Vol 7, no.5)

Birthrites: Healing After Caesarean Inc.

Below is an excert taken from the W.A. website http://birthrites.edsite.com.au/

Birthrites: Healing After Caesarean Inc. may be able to help you if...You have any questions about your caesarean section.

If you are worried about what your next birth experience will be like.

You would like to see sacredness, respect and honour returned to birth, to make it the beautiful empowering experience we know it can be.

Birthrites: Healing After Caesarean aims to provide a support network for women who've had a previous c/section, and to increase the awareness of these women's needs to their health carers within the medical profession. We aim to do this by:

1) Providing telephone contacts - someone to talk to who knows what you've experienced, as they've had a c/section themselves.

2) Weekly "Get-Togethers". Women can be around other like-minded women, given a chance to talk about their experience and hear other women's stories. Give and receive support from each other, over coffee. Often a midwife attends the meeting. Dates are on our calendar.

3) To increase women's awareness of birth choices via a suggested reading list, the Internet and by talking to health carers.

4) To increase public, and medical, awareness of the increasing c/section rate and inform them of the safety of VBAC, in most cases.

5) To inform women of Birthrite's philosophy so they, in turn, can support and encourage other women in their search for a beautiful birth experience.

6) To return some women's rituals to birth, whether that birth is a VBAC or a caesarean section.

In Dec'1997/Jan' 1998 Birthrites: Healing After Caesarean was set up. We are a group of dedicated women committed to supporting women who've had a previous caesarean section, whether planned or unplanned, and informing them of their future birth choices/rights.

It started with 7 committed core group members, and over 30 members in total. The core group meets six-weekly to discuss our goals and get things "happening"; in a positive direction, for specific women's rights, within our local community.

We provide an emotional and physical support network for all women who've had a previous c/section, and we lobby to reduce the c/section rate and increase public awareness of the safety of VBAC, by promoting ourselves within the health community.

Everyone is welcome to join Birthrites: Healing After Caesarean, and if anyone has an urge to help with our core group they are encouraged to become involved.

Women should become informed enough to be able to make their own birth choices. The decision of whether to have a VBAC or a repeat c/section should not be made by their doctor or midwife.

Women should be supported in their decision, and nurtured throughout their pregnancy towards a positive outcome for both mother and baby.

Birth needs to be honoured as a sacred event, involving rituals and respect for the mother's birth choices, allowing it to become a healing experience.

If you do not have access to the internet, but you are interested in the above site please contact Jane on Ph: 5447 2799 and I will send you out a contacts list.