Today marks the 124th anniversary of Women’s Suffrage, it is also 27 years since the Nurses Amendment Act was passed (28 August 1990) These two things may not seem related, but they are very much a part of the same picture, a picture where we fight for women to have agency in their lives, where our goal is that they have choice and the rights to exercise that choice. Yet whenever we celebrate milestones of emancipation, I feel conflicted. Yes we have come so far, yes we have so far yet to go. Women may have the vote, but we still have less representation at a political level, our tangata whenua even less so. We still have to fight for our birth rights. We may not be fighting laws, but we do fight budget cuts, institutionalised medicalisation of birth, midwife attrition through inadequate working conditions, and an ongoing public message that frames birth as mother vs baby, midwife vs obstetrician, safety vs satisfaction. These false dichotomies are misdirection, they take us away from the bigger picture. Human rights in birth matter, women matter.
The message I want us all to hold at the front of our thoughts this Suffrage day, is that rights are not gifted, they are fought for and won. The sacrifices of women before us have led to the rights we have today. We should not let the work of our foremothers go unacknowledged or worse, undone.
Through complacency or through inaction, our rights can still be transgressed. Small changes in law and legislation, for seemingly good reasons can lead to the fundamental loss of our rights, whether intended or not. The onus is on us, as a community who value our rights to choose, to hold fast to the values we cherish and not give ground. Even if we sit by and watch as others rights are eroded and we do nothing, thinking “this is not my battle”, we are paving a way for this to happen to us. The Health and Disability Code of Rights is the cornerstone our maternity care. Yet it is not invulnerable nor is it always honoured, there are areas in practice where the edges blur, even in current maternity care settings women are not always afforded their rights in any meaningful way. You can often identify these moments, they come with their own set of markers. When a woman says “I wasn’t allowed” or “I had no choice” she wasn’t given agency. When she is told a birth plan is not important, or that her trauma is not relevant, that she should expect to lose all dignity, that as long as her baby is healthy that nothing else matters, she is not being centred in her own birth. When her maternity provider withdraws care, or she can’t access the care she needs, or she is forced into choices through coercion or ignorance, these are the moments to watch out for. These are the markers that signpost a path taking us backwards. Yes these every day trespasses are not always acts of intention, or some Machiavellian evil, but in this, intent becomes less relevant than the outcome, which is ultimately a loss of agency in birth.
As seen in other countries, the rights to birth on our terms can die the death of a thousand cuts. The stories of Agnes Gereb, Caroline Malatesta, Brenda Atlookan and the other countless women who are denied their basic right to autonomy in birth are warnings that should not be overlooked.
When viewed in an historical context, the bodies of women, in particular the bodies of women in pregnancy and birth have been a battleground of legislation. We have moved through an evolution of birth that included ‘Labour pains as Eve’s sins’, purpureal fever epidemic through poor sanitisation, forced sterilisation, twilight birth, the birth of gynaecology though oppression, and many other trespasses that when taken as a whole, illustrate that birth as it sits in our current milieu is still at an intersection of oppression and control, and for our tangata whenua, colonisation.
It would be easy to count our blessings and reflect on how lucky we are to have a continuity of care system. Be grateful for what we have. But we need to take time to acknowledge the hard work done by Joan Donley and her contemporaries to bring in the Nursing Amendment Act, acknowledge that our midwife lead system is inherently vulnerable to the vagaries of political whim and funding cuts, acknowledge that we as birthing wahine, hold the future of Home Birth in Aotearoa.
There are voices in our community who want to see birth removed from the vocation of midwifery, there are voices who don’t value the work of mothers, who don’t trust birth, and through lack of trust or through lack of knowledge wish to remove the agency we fought so hard for. They don’t want the rights removed wholesale, they just want some rights waived, for some people, sometimes. And that is the beginning of the end.
Home Birth Matters
Volume 4 Issue 4
Published continuously since 2013
Editor: Sian Hannagan
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