Rent-a-womb?

Interesting. In an Australian first, surrogate mothers in NSW will be paid $10,000 for carrying another woman's child in a proposed change to existing laws. Although it is argued the commercial surrogacy will still remain illegal in Australia, the money is supposed to help surrogates cover lost wages while they are pregnant as well as medical costs.

The Opposition's spokeswoman on women, Pru Goward, says the planned changes are a good idea.

"The Opposition supports compensating women for the medical costs in the last couple of months and also the loss of earnings in the last couple of months because most pregnant women don't work in the last couple of months," she said.

"What the Opposition would not encourage is the commercial surrogacy, the hiring out of a woman's uterus."

John Morrissey from the Australian Family Association says "Commercial surrogacy amounts to rent-a-womb, obviously. But our concerns are with surrogacy in itself, that it commodifies a child," he said.

I tend to disagree. I think that just because women are helping other women to become mothers does not mean that pregnancy cannot also be a business transaction. I hate that as a result of this long-standing perception of women's bodies as 'natural' and being closer to nature, therefore, anything related to motherhood is automatically pure and uncommodified. If you think about it, everything about pregnancy today is totally commodified. From designer prams, boutique maternity clothing and expensive prenatal care, affluent women spend an enormous amount of money on pregnancy and their bodies during this 9 month period. No one seems to have a problem with this. It seems ridiculous to worry about the commodification of a child through surrogacy when foetuses are commodified through entertainment ultrasounds and through the purchase of baby clothing well before the baby is born. Pregnancy is commodified through IVF when couples pay to have their eggs fertilised and no one seems to have a problem with that!

I think this is a dangerous argument because it is just like saying that women who stay at home to be mothers don't 'work' because they are not being paid to stay at home. The only reason that SAHM are not paid to be mothers and to do housework is because it is too often assumed that women should selflessly do caring work; to ask for or to be offered compensation for nurturing/domestic tasks is antithetical to everything our culture believes to be associated with motherhood. This is the same situation with surrogacy. If a surrogate is being paid, it leaves an icky taste in many a mouth because it suggests that women can sell their wombs, in effect, taking the romance out of pregnancy and motherhood.

Any thoughts?

Source: http://www.abc.net.au/news/stories/2009/01/18/2468523.htm

Choices in childbirth more complex in 2009

Welcome to 2009. What better way to celebrate the new year then to see new statistics from NSW that show a huge disparity between childbirth intervention rates in private and public hospitals. According to recent reports, here are some humbling statistics:

• the caesarean rate is hovering close to 40% in private NSW hospitals
• between 1/4 and 1/3 of women in private hospitals have an episiotomy compared to only 10 % in public hospitals
• forceps and vacuum deliveries comprise nearly 15% of all private hospital births
• in one NSW private hospital, only 4% of women go without any pain relief

Whereas American private hospitals have long been the 'bad guy' when it comes to intervention in childbirth (nearly 50% of women in some New York hospitals are induced), it looks like Australia's private health system is increasingly putting some women in danger of being subject to a similar cascade of intervention as the age of childbirth increases, more women are requesting elective caesareans and more middle-aged women have private health insurance and are increasingly concerned about any 'risk' to the health of their foetuses.

Although there are not any easy solutions to such a complex issue, particular when it comes to the role of choice and power in hospitals, it seems that some things can be addressed quite easily. For instance, midwives often encourage women to give birth standing up or in other positions that progress labour more quickly and effectively. When women have epidurals, standing is not possible.

Any Aussies out there who feel they were forced to 'choose' intervention during birth?

Source: http://www.smh.com.au/news/national/the-painful-truth-about-childbirth/2009/01/02/1230681748836.html

new elective caesar policy

This article is causing some profoundly mixed emotions for me. On one hand, it's truly fantastic that the NSW government (that's New South Wales, the most populous state of Australia for non-Australian readers) has acknowledged that not only is the rate of elective caesareans increasing but that it is also possibly endangering the lives of women who are uneducated about the procedure.

However, I have strong feelings about taking women's responsibility for their own bodies away from them and giving control over to the government to decide what is best for birth. Clearly, major abdominal surgery is a significant leap from vaginal delivery but is it really fair to insist that women must not have a technologised or interventionist birth if that is what they really want? Sure, some of you might say 'Well, how does she know what she wants if she doesn't know the risks?' That goes without saying but adult decision making is kind of like that. We make decisions about lots of things without knowing all of the associated risks. With birth, it seems like everyone seems to know what's best for pregnant women except women themselves.

We dont have to agree with the choices other women make but I think we need to respect them. I might not choose to have an elective caesar but I don't think my choice not to have one should prevent another woman from having one if that is what she feels comfortable doing. I think it would be a completely different story if for instance, the NSW government decided to ban women from having pain-reducing drugs during labour because pain relief is non-surgical. All of the most common pain killing drugs have side effects and there is plenty of research to support that. Hell, epidurals are injected into the spine. That's a major risk; but women who want to have less pain in labour should never be forced to 'suffer' needlessly and many women are willing to take a risk to be comfortable. I think this is the same issue. Maybe it seems a little strange to some of us that a woman would rather have surgery than give birth vaginally but in my own work, I have interviewed a number of women who have had elective caesars for various reasons. Fear of pain is a primary reason and who can really fault them for that? It's not my place to do so and it's not the government's place either. Women need to make up their own minds about how they have their babies. Caesareans should remain an 'option' because women should have every opportunity available to them to have a comfortable birth and if that means being cut open, who am I to judge?

Caesars can either serve or impair women's agency not so much by the inherent character of the procedure (in terms of obvious physical risks), but in how the politics surrounding elective caesareans coalesces with the needs of variously situated women (economically and politically and also varying by race, class, and sexuality). What is 'good' for some women is not necessarily appropriate for all women.

NSW hospitals move to block caesarean option
7 April 2007, The Age

WOMEN will not be allowed to insist on caesarean deliveries in NSW public hospitals without a medical reason, under a new health department policy. Under the new rules, women must be told in detail about "the benefits and risks of caesarean section compared with vaginal birth specific to the woman and her pregnancy". The policy cites a US study of more than 5 million births, which found that babies born by medically unnecessary caesarean were three times as likely to die in the newborn period as those born vaginally.The new policy also obliges health professionals to advise women about the implications for subsequent pregnancies. A 2005 study of 136,000 second pregnancies across NSW found those women who had had a caesarean first delivery were at much greater danger of a ruptured uterus, hysterectomy orinfection, while their babies were more likely to be premature, have serious breathing problems or need intensive care. Elective caesareans have increased by 25 per cent since 2001, and now account for one in six births. Many of these are for medical reasons, but doctors say more women are opting for caesareans from preference. Andrew Child, a member of the NSW Health Maternal and Perinatal Committee,which drafted the directive, said that while first caesareans were generally safe, dangers escalated steeply with subsequent births. Hannah Dahlen, secretary of the NSW Midwives Association, said: "People are... thinking of it as just another option for birth, rather than major abdominal surgery."JULIE ROBOTHAM