A different kind of Labor Day

ON LABOR Day, mothers, birth workers, and supporters gathered in Seattle to call attention to the conditions under which women labor and birth in the U.S. as part of the third annual "Rally to Improve Birth" national day of action, organized by the group Improving Birth.

The rallies aimed to bring greater attention to the alarming rates of Cesarean section and what Amnesty International has called a maternal health care "crisis" in the U.S. The U.S. spends the most money in the world on maternity care, and yet has one of the worst maternal mortality rates of all the developed countries: It's more dangerous to give birth in the United States than in 49 other countries. African American women are at almost four times greater risk than white women. These disparities have not improved in more than 20 years.

A safe pregnancy and childbirth is a human right for every woman regardless of race or income. Yet our for-profit health care system is shaped more by convenience, liability and profit than what science has proven best for moms.

The rally focused on the themes of evidence-based birth, and informed consent and refusal by mothers. Consumer advocates and national health organizations like the American College of Obstetrics and Gynecologists and the Joint Commission continue to point to physician practices--not medical need--as the driver in the overuse of Cesarean deliveries.

Meanwhile, women who have already had Cesareans report major access problems to vaginal birth after Cesarean (VBAC), including large numbers of hospitals are care providers with mandatory surgery policies that do not "allow" vaginal birth. After the first Cesarean, nine out of 10 American women give birth only by repeat C-section, despite national health policy calling VBAC safer for women in most cases.

Many women do not understand that they have the right to make decisions about their care, including the right to say "no." "Is there any other field of medicine where a person is told that they will only receive care if they 'consent' to surgery even if there is no medical reason, despite the increased risks, and against their expressed wishes? That isn't consent, it's coercion," said local rally coordinator, Amy Stenson.

Ralliers held signs for traffic and passed out information to passersby to inform women about their rights and options during birth, and point them toward more information on evidence-based care. Further, Improving Birth representatives are asking local hospitals to examine their own rates of procedures, labor ward protocols and physician practices to identify how they match up to national guidelines for safely preventing Cesareans.