I am not a mother and will probably never be a mother. However, yesterday, while hanging out on my favorite ExMormon site, I started a discussion about a woman who was depressed about being pregnant and had no health insurance. Because she was depressed, broke, and not wanting to be pregnant, she was planning to have an unassisted birth at home. Indeed, she was even considering foregoing a midwife's services. This mom already has two kids, but both were born in a hospital and mom had the benefit of an epidural. Mom was apparently going to "trust God" to make sure the baby was born okay. At five months pregnant, she has yet to seek prenatal care.
I was interested in what others would think of this situation. I have advanced degrees in public health and social work and have worked in maternal and child health, as well as with teen moms. Teen moms, being young, poor, and clueless, would be more likely to be in the situation I described. It was my job to help them get hooked up with services to help ensure that their baby was born healthy.
Anyway, the response to my query was interesting. A lot of people seem to think that babies should be born in a hospital. Like I said, I don't have any babies myself, but I have some expertise in public health. Frankly, I think the last place a healthy person should be is in a hospital. There are many exotic germs there and hospitals are typically very busy, noisy, regimented places. Come in to a hospital and say good-bye to your autonomy because there are many rules. Chances are, you'll be hooked up to an IV, cut off from food and drink, and encouraged to take a hit of Pitocin. That's not appealing to me. I would rather give birth in a place where I have more choices.
On the other hand, I totally understand that sometimes a medical environment is best. Mothers who have high risk pregnancies or are carrying multiples... or even just first time moms who don't know what to expect might prefer a hospital birth. My feeling, though, is that women should have a choice.
Of course, the mom I described in my initial post is depressed and, from what I gathered, is a bit reckless. So what should be done about her? Several people insinuated that the mom better get the right care, since she could be held liable if her baby suffered harm due to her choices. At that point, I had to speak up. One poster even said that pre-natal care isn't just for the mom, it's for the baby, too. Duh.
My response was that to my knowledge, no mother is legally required to get pre-natal care or even show up at a medical facility. Giving birth at home with no one around is legal. And while I agree that pre-natal care is desirable, I would hate to see it become a legal requirement because that would come too close to treating pregnant women like incubators who have no rights until they give birth. While I do understand that pregnant women are responsible for another life, the fact is that until the baby is born, it's part of the mom. And the baby's rights cannot supersede the mother's. Unless we start locking up pregnant women and forcing them to take care of themselves-- hell, unless we start locking up fertile women and forcing them to take care of themselves-- there's no way we can ensure that every unborn baby will get optimal care. As it is now, many people feel perfectly okay about telling pregnant women what they should or shouldn't do. Once the baby is born, some people still think it's okay to opine about a mother's choices.
I was so interested in this poster's assertion that the mother could be held responsible for a bad birthing outcome that I started searching the Internet for information. Most of what I found indicated that while there have been cases of physicians getting court orders to force pregnant women to get medical treatment, the trend seems to lean more toward respecting the mother's choices. While I'm sure it's frustrating for a medical professional to see a mother make choices that seem unwise, I think it's better to let competent adults choose for themselves.
Most moms will cooperate because they would rather do what's best for their kids. I don't think we should make new laws dictating what pregnant women can or cannot do, just because a few of them don't want to get with the program. Besides, sometimes doctors are wrong and push interventions that ultimately are not necessary or even dangerous. I would be very upset if I went to a hospital for help and was treated like an incompetent or a criminal and was forced to take treatment I didn't want... it wouldn't make me want to seek help the next time I needed it. So I think it makes sense to respect the mom's choices... and let them in on choosing their own medical care and that of their unborn child's.
Women have been having babies for thousands of years and even today, plenty of women give birth unassisted. In fact, in many other western countries, having a baby in a hospital is not the norm, unless the mother needs medical treatment. Giving birth is a very natural part of life and needn't be turned into a medical procedure. That being said, I personally would not be comfortable having a baby with no one around to help me. On the other hand, my choice may not be another woman's choice.
The bottom line is that we can't force protection on a pregnant woman. We have to let the woman make choices for herself, as hard as it is. As for the woman I wrote of, I hope she gets help for her depression. She has two kids who need her and a baby that is going to be born. Those kids deserve the best possible start in life. But even as I recognize that they deserve a good start, I don't think it's my place to force their mom to seek a doctor's care.