Wednesday, November 5, 2014

On Re-entry to the West, and Taking Risks...

Many people have asked me how I’ve found returning to Australia after living in Indonesia for four years.  It’s a good question... spending years trying to adapt to Asia does leave a person changed.  I’m still comfortable in Australia, but not quite as much an “insider” as I used to be.  The right cultural move doesn’t always slip out naturally anymore.  For example, I remember in our first week back having a discussion with Derek about the etiquette for leaving on the house’s porch-light overnight.  “You have to turn it off in Australia,” he says.  “No way!”  I protest.  “No, you really do!” he replies, “You remember, in Australia you leave it on when you are expecting a guest, then switch it off after they’ve left.”  Oh, then the memories return.  I agree, and switch it off; but it feels very, very, dark, and somehow quite wrong, and sad.  This is what re-entry is like.  I’ve forgotten the rules; and even when I remember them, I don’t quite believe in them anymore.

Apart from these sorts of fairly minor re-adjustments, though, I have to say the most frustrating and annoying part of Australian culture for me, as a returnee from Asia, is the high level of enforced risk-avoidance imposed from above.  In other words, I feel my freedom to choose how risky I want to be is limited in Australia.  What does that look like?  Well, before I went to Asia, I was a stickler for obeying traffic rules, slowing to 40 at every school zone, speeding to exactly the limit on every highway.  I just believed in the rules and obeyed them with my whole heart, and gently tut-tutted those drivers who disregarded them.  They deserved their speeding tickets, I thought.

But now, I feel differently.  I resent being told to slow to 40 when I can clearly see that there are absolutely no people about, and 50 is a perfectly safe speed to drive at.  I writhe in my seat while waiting at a red light in the middle of a totally deserted road at 10pm.  I once told Derek that I was conscientiously objecting to a certain speed limit, proud of my ethically-driven rebellion, but he (being a lawyer in a past life) advised me that such an objection wouldn’t stand because speed limits are not a moral issue.  I would debate that... but... sigh.  Road rules, apparently, cannot be escaped.  Yet, ultimately, I feel annoyed, not that I have to drive slowly, but that my ability to make a good decision is not respected.  I don’t want to run into someone on the road.  Of course I don’t!  And as a grown-up, I feel I have the ability to choose a safe course of action.  Someone - “the government” - telling me that my own common sense and desire to preserve my life (and the life of others) is not sensible and safe enough - that they need to step in and prescribe a safer speed for me - really grates.

A similar thing occurs with child restraints in cars.  I know that kids are safer in proper child restraints in the case of an accident.  And, we don’t want our children to die.  So we’ve borrowed the proper restraints and make sure they’re strapped in well every drive.  But I have also been driving for 15 years and never had an accident, even on some very hairy Asian roads; and once - just once - I might want to take my baby with me on my lap.  It’s not inconceivable, is it?  Or is it totally unreasonable?  Say, as a not-so-random example, I have just given birth to a baby, and I want to take her home from hospital.  Is it bad parenting to want to keep the hours-old baby with me in a sling for the 20-minute car ride home, rather than strapping it into the capsule in the back seat while I ride up front?  Is it right that my conscience is pricked, with premature guilt at being potentially responsible for a child’s death, or the fear of a monetary fine which labels me as an irresponsible parent?  Or is there something to be said for the beauty of snuggling with a newborn, and a mother’s fierce longing to be close to her child - even if it entails slightly increased risk?

Basically, what I’m getting at is this: I feel, deep in my bones, an unhealthy and inhibiting desire for safety in the Sterile West, which I was not bound by in the Wild East, and which can be seen to trump other important parts of being human.  Including that part of being human which is called informed risk-taking.

Allow me to expand on a timely personal example.  I am currently housing a baby who is in the breech position at full term.  Sound the alarm!  A risk factor is present!  See the medical staff begin to scurry around!  For those who aren’t in the scene, a breech baby has their bum down and head up.  This sounds like a sensible thing to we who are long-born, but only a small percentage of babies enter the world bum-first, and it’s a little more complicated than entering head-first.  Now, given the increased level of complexity in birthing a breech baby, and a certain study which showed that fewer breech babies died from being surgically extracted than from being born naturally, a decade or so ago, the Australian medical establishment therefore decreed that all breech babies should be cut out of their mamas instead of being given the chance to be born vaginally.  A classic reduce-the-risk policy.

14 years later, and everyone’s forgotten the tricks they once knew about delivering breech babies vaginally.  And lo and behold, the study they were relying on (in deciding to caesar all breechies) has been shown to have been flawed; in fact it is now thought that breech births in favourable circumstances can be just as safe as caesars, perhaps even as safe as normal head-down births - one one condition - that the doctors and midwives are experienced in delivering breech babies.  See the bind this has created?  A need for more experienced medical staff in delivering breech babies, but a 14-year time period where none were getting that experience.  Whoooooops...

So now, enter me and my situation.  Here’s my fiesty little girl, refusing to be a risk-avoider, and refusing all my tricks to get her to turn.  I’ve tried the Western way - three ECVs (manual attempts to push the baby into a head-down position in hospital) - usually one try is enough, so I’ve gone above and beyond!  I’ve tried the Eastern way - smoking my little toes with mugwort sticks.  I’ve tried the hippy way - hanging upside down off a couch, trying desperately not to puke up my lunch.  And I’ve tried the alternative therapy way - chiropractic joint-cracking fun.  Now, finally, I’ve decided to stop torturing myself and just enjoy the last weeks of pregnancy with a beautiful breech baby.  

Having now stopped trying to turn her, I realise the strength of the pressure I felt to “turn the baby” at any cost - ie, “eliminate the risk factor” at any cost.  Am I a bad mother if I fail to do everything in my power to get her to turn?  Will I be partly responsible if something goes wrong in her (breech) birth, because I gave up too soon on all these possible methods?  Or is it OK to just chill out, sing a lullaby, stroke her sweet head at the top of my round tummy, and let her be born in a higher-risk way if she so chooses?  What a relief to finally embrace it instead of fighting it!  (Incidentally, I only tried all these things so that I could potentially have a homebirth - which is a whole ‘nother story...) 

But now I face yet another dilemma:  If I go overdue (as I have with my other 2 bubs), or in fact, even if I don’t, there are many who would pressure me to go for an elective caesarean.  Because, you see, there are increased risks with overdue babies, increased risks for induced babies, and increased risks for breech babies... put all this together and you get a whole heap of risk factors which send people running in a frenzy for the nearest scalpel.  It does make sense, doesn’t it?

But wait!  At risk of putting “that song” into all your heads - what about me?  What about the fact that I will probably have only three chances in my entire life to birth a baby?  What about that my two previous birthings have been the most spectacular and defining moments in my 33 years of life, and I wouldn’t trade them for anything in the entire world?  What about that birthing is an extremely fierce, intimate, human, relational, hormonal, primal, female, intense, spiritual, wonderful urge, unlike any other known to (hu)man?  What about the fact that I am a woman with a psyche as well as a body, and I want to be given the freedom to try to birth my very own baby if I choose?  What about that I care about my baby’s wellbeing waaaay more than you do?  Does that change things?  Do any of those factors count?  Or is it still considered that evading this slightly increased risk of death is worth it?  Worth slicing me open for, and surgically removing my baby, while also removing this rare and precious opportunity for me and my baby, and my husband, to walk through such a profound experience together?  

To be perfectly honest, I do fear death, and I do fear my baby’s death.  But more than fearing death, I fear not living.  To me, choosing the knife to protect myself from a slightly increased risk - “just in case” - is a terrible, frightening thought.  I appreciate that not all women would feel this way.  But that is how I feel.  I want to live, and for me, I have never felt more alive than when birthing a baby.  I don’t want to die, but for me, the loss of freedom to live life to the full is more painful than the grief of loss and death.  So, for me, I have a choice - risk death, or a part of me dies.  

But to the casual observer (ie, doctor), focussing on the physical, it looks more like - risk death, or not.  They don’t see what’s happening inside when they suggest an elective caesar.  So of course, the obvious choice is to not risk, and they pressure me to make that choice.  To them, it’s caesar, or foolish.  To me, it’s not that simple.

I read in this article about Dr Andrew Bisits, who, at a recent breech birth conference in the UK, stressed “how important the experience of attempting a vaginal breech birth is to some women”, and, “that moderate risk-taking confers psychological benefits.”  When I read these words, I fell in love with Dr Andrew Bisits.  He is first on my list of people to marry next.  Someone has realised that there is more to a person than a body, and more to birthing (and life) than risk-avoidance.  (He’s Australian, too, by the way!)

Anyway.  Enough said.  My main point is that in Australia I’m struggling with the intensity of having risk-management promoted, suggested, urged, even enforced, from the powers that be.  Yes, it’s not all bad - I want to get good risk-management advice.  I want scientific and expert help to make good decisions to promote the health and wellbeing of my family and me.  But in the end, to be able to take an informed risk is part of what it is to be an adult, and it is part of what it is to be free.  Informed risk-taking is a way each of us can express our deep and personal values.  We take that freedom away at our own risk.

1 comment:

  1. Finally I have read this!! Yippee. I enjoyed the way you described the pure joy it is to give birth naturally(can't quite write the v word comfortably;) You really captured how exciting and how totally thrilling it is to embrace the 'task' ahead as a beautiful, maternal, intense opportunity to let our bodies do what they were made for....give birth to tiny little humans. I remember embracing the fear and taking the challenge as a blessing and a gift....I feel that urge of gratefulness come flooding back after reading your blog. It was, and if Jase changes his mind, will be, the most amazing experience ever. Lotsa Love Anna. Missing you.