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There is an unspoken reality lurking in the undertones of maternity care.
It is sinister and unconscious, a toxic unawareness that seeps into all communications and puts the weight of responsibility and expectation onto The Woman.
I will call this The Game of Birth.
It is a game about power, about control. A game of Dark and Light. The aim of the game is to keep it light. The rules are simple, but never implicit. You sense the rules. And if you do not play by the rules the game gets dark. Very dark. The stakes are high.
In reading through the literature on birth plans, I discovered this undertone. The language women are expected to use, to signify their place beneath the authority, includes 'being polite' and using 'preferences'. Women must be 'flexible', which is code for obedient.
We often hear that a 'birth plan' should use polite language, not be 'adversarial', and be concise. All of this ignores the intent and purpose of a birth plan: to communicate a woman's informed decisions.
The woman is expected to consider the emotional needs of her care provider, her partner and any other staff she may (or may not) encounter. She carries this unspoken burden, or mental load.
Why is a woman simply stating her informed decisions considered impolite, or adversarial, or defensive? Why must women continually step aside, and make room for the feelings of others, whilst her own are utterly disregarded?
All that matters is a healthy (alive) baby
THE GAME STATES: A woman who attempts to experience birth is selfish, or irrational. She is not thinking of the baby's safety. She can not be trusted, and is not worthy of respect.
This illogical statement is human rights violation.
Women are expected to carry this burden of everyone's needs, and yet not trust with it.
This catch 22, is wrapped up in the concept of informed consent.
At no point in the game is a woman issued with instructions or guidance. At no point are any clues given.
This is called woman-centred care.