The fight for control SCIENCE

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women • IYInAInem DIITE by the -11251 THE recent court case in which Brian Radley was fined for attending the birth of a child in the absence of qualified medical supervision (at the request of the mother, Michelle Williams) raises several interesting points - not least that in law a mother-to-be figures as an object with neither rights or responsibilities.

The whole situation arose because of Michelle Williams' experience of ante-natal care (unpleasant) and of giving birth to her first child in hospital (being treated as an object and in particular being given drugs against her wishes).

During the trial, it was implied that Michelle Williams had been irresponsible in not seeking ante-natal care, and indeed it is true that there is a lower incidence of complieatinno amnno thnae who attend MART-PIE astanatal shine regularly. Hówever,, the treatment of women in such clinics is "undignified, depersonalised and 'tedious" , according to Nicky Hart in the Guardian. Even Patrick Jenkin has referred to their 'cattletruck" atmosphere.

Do they have a beneficial effect despite their shortcomings, or is it that regular attenders tend to be healthier, better off, and living in better conditions? A survey published in the Lancet in 1980 suggest the latter. Looking at the three most common complications in pregnancy, it found that malpresentation (baby wrong way round) was detected most afficiently - 88% of cases being identified, but only by about week 36 (i.e. about three weeks before birth - about the time Michelle Williams contacted the midwifery Less than half the cases of poor foetal growth were detected and for every correct diagnosis, there were 2.5 wrong ones, resulting no doubt in unnecessary worry for those women. With high blood pressure, there were 1.3 wrong diagnoses for every correct one. The conclusion of the study was that the productivity of antenatal care was extremely low.

So what did Michelle Williams want? She wanted a "natural" or 'active" childbirth with the baby being born from the squatting, "natal crouch" position, instead of a high technology hospital birth with little control over what was being done to her -which could include unnecessary inducement of birth followed with doping up with pain-killers; foetal monitoring (which some the perineum (the skin between the legs) to enlarge the opening of the vagina - often made without anaesthetics (these are the source of extreme pain after birth, though it is downplayed by the medical profession).

Natural

The "natural crouch" position usually does away with the need for such technological or medical intervention, since the birth process is quicker, the woman being able to push more effectively since she has gravity on her side.

The "natural" method has been used throughout human history and by the majority of women in the world today. However, in Britain and other "advanced" countries, the natal crouch was replaced poly of the midwives was broken by the male-dominated medical profession" • (See 'Of Woman Born" by Adrienne Rich).

This undoubtedly accounts for the observation in a standard textbook of human biology that women in the West seem to suffer more complicated births.

So is "natural' childbirth just a trendy, middie class idea? Not according to Professor Roberto Caldeyro-Barcia, past president of the International Federation of Gynaecologists and Obstetricians.

Easier Formerly a leading supporter of full medical/ technological intervention in childbirth, he made a comparison both anproaches and concluded move around freely in the first stage of labour, has an upright position in a birthing chair during the second stage, has no drugs or oxytocin la hormone used to induce birth) and has a supportive partner present, then births are quicker and easier, babies are healthier, and there is less need for medical intervention.

There is a further disadvantage to conveyor belt maternity wards, according to Diane Walters in Spare Rib (May 1982).

Many women suffer depression after giving birth. This post-natal depression may have several causes, but according to a survey carried out factor seems to be the experience in maternity wards, particularly the amount of control they felt they had over what was While in hospital, of those allowed no contro., 74% were depressed; some control, 64%; as much control as they wanted, 53%. More alarming still, a month later, back at home, the figures were 79%, 53% Control Looking at the effect. of technological intervention during birth, for 10 out of 11 possible procedures, more women who had had them had post-natal depression.

All in all, the actions of Michelle Williams were quite justifiable and the sooner the socialist movement iukes up the right of women to control of their bodies during childbirth, the better.

by Les Hearn

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Socialist Organiser no.95 August 12 1982. Page 13