Hey - thanks for writing Pushed. Your main idea about how women are pressured into unnatural procedures during the natural process of birth really made me rethink pregnancy and birth, something that I saw no problems in before.
"Really, which parts were most effective or important for you?"
Well, in the last third of the book you focused on midwives and society’s battle against their practice, tying it in with the rights of women in the birth process, which added another angle to the first 2/3rds of the book. But let me be more specific:
You shared with us the hopes of a midwife, who wishes that the structure around birth will evolve again, closer to its natural state: “’I think there will come a time when we will remember or will rediscover -perhaps it will be so distant that we’ll feel we have discovered – the intrinsic value of birth under one’s own steam. Maybe we have to evolve back to a place where we realize all of this is folly. That we can’t control health in the ways we think we can. And that in fact the most important and valuable thing we can give ourselves is a woman under her own steam, bringing her babies forth,’” (p. 248). I believe this was definitely one of the main points of the second half of the book. There will come a time when we realize that birth is not something to be controlled, but instead a natural process that we must leave to its own devices. This reflected well off of the previously discussed cesarean sections and induced labors in the first two thirds of the book.
Then you continue with how the rights of the women and the rights of the child compare, something that has definitely developed over time along with the intervention of hospitals: “’These issues are not just problems of fetal rights, they’re not just problems relating to pregnancy. They’re also profoundly about race and class and our legal system’...And they are profoundly about how we treat women. Paltrow reframes the debate: ‘The question is not when do fetuses have rights, but at what point in pregnancy do women’s civil rights end?’” (p. 257). This ties in well with the abuse of mothers we see in the first two thirds of the book. Whom are we really protecting? It seems that everything is done in the interest of the baby, but when has the mother become worthless? As a conscious being, it seems only fair that the mother have rights at all times, as the child can not yet make decisions for itself.
Lastly, I found that your definition of vaginal birth to be quite mind altering, as we see that it is not a procedure, but nature: “I asked Paltrow whether vaginal birth is a procedure that can be denied. ‘I would argue it’s not. It’s not a procedure,’ she said. ‘And as is often the case with claims of fears of liability and institutional protection, those fears have very little foundation in reality,’” (p. 261). All of the roles that the hospital plays in pregnancy tend to be those of interference because something is going wrong. Natural childbirth however does not need this intervention; it can thrive on its own. Doctors can clearly not refuse to support the natural process of childbirth, while the mother is not allowed to refuse their intervention. It is the mother’s body and should therefore be up to her how she is treated, especially considering the consequences highlighted in the first two thirds of the book.
"But what could I have done to make this a better book - that would more effectively fulfill its mission?"
Well, let's be clear - your text sought to provide journalistic analysis and policy analysis with a few narratives, from the perspective of a well-educated researcher for the book-reading-public to better understand pregnancy & birth in our culture. Given that aim, and your book, the best advice I would give for a 2nd edition of the text would be to add a little more narrative and perhaps your own personal ideas, rather than letting the facts speak for themselves. While facts are hard data, they become much more interesting to read when tied in with deeper analysis and narrative. But I don't want you to feel like I'm criticizing. I appreciate the immense amount of labor you dedicated to this important issue and particularly for making me think about the risks of hospital intervention, such as cesarean and induction, and the harsh ruling against midwifery and natural birth in our society. In fact, I'm likely to have birth differently as a result of your book. I had always imagined going to the hospital as a child, deeming midwives “old-fashioned”, however now I feel that I could not see myself going to a hospital unless it is absolutely necessary.
"Thanks! Talking to you gives me hope about our future as a society!"
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