Someone gave my youngest son one of those individual banana cases, in bright yellow plastic. My immediate thought was “it sure is going to be hard to find bananas that will fit perfectly inside this thing”. The banana in question would have to be the exact length, width, have the exact curvature as the little yellow plastic box. And sure enough, in spite of my little one´s excitement at trying out the case as soon as he got home, none of our bananas fit inside. Because the plastic box was built based on what we associate with a banana, how the perfect banana should look like if you will. Almost like a cartoon banana. Like the “ideal” banana.
That got me thinking about birth. Don´t ask me how bananas got me thinking about birth, but I think about birth pretty much all day every day, so in my head it makes perfect sense that bananas got me thinking about birth. It reminded me of all the situations women are put into boxes, categorized, and forced to fit someone else´s idea, ideal of how they should be looked after during their pregnancy, how they should birth.
Maternity systems all over the world are designed as big factories, where on one end the pregnant woman goes in, and on the other end, she comes out with a (hopefully) live baby. What that mother and baby have gone through while inside is anyone´s guess, and frankly, in my opinion it is built that way. Maybe that is why when women tell the tale of what happened to them, to their babies nobody really believes them.
The bananas did not fit the box, some were too big, others too straight, others too fat. Others fit because they were small, but wobbled inside and I was sure, would get pretty bruised if moved about long enough inside it. I was persistent, so I made them fit. I forced them to. Some were bruised at the base, as I forced their end into the curved shape. Another one I had to cut into pieces so I could place it inside. She would never be the same. And because she was so big, part of her was left out. Another one was so big and fat I had to mash her to fit it all inside.
It was sad to destroy such perfectly fine bananas just because of the box, they were beautiful before, so diverse, ripe and full of promise.
What are maternity systems doing to women and babies on a daily basis?
Care in pregnancy and birth are not doing a good job of covering women´s needs and wants. It seems now that all that matters is assessing risk, following an institution’s protocol. It´s become a system of ticking the box, going through the motions, where professionals are taught to look at the tests, the screen, the forms, but not at the woman standing right in front of them. They are not really seeing her. They are trying to get her to fit into a mould.
It´s understandable that we have a big system, and of course there have to be measures in place that ensure women are offered tests and screenings that are appropriate to their needs. But only some of these needs are based on her medical conditions. Some of it will be feeling heard, understood, getting to know their health professionals. Having a choice whether or not they want to invite them into their pregnancy and childbirth journey. And those needs are not being met.
Can we have a system that is inclusive, caring, and diverse? Centred on the needs of that particular family? Is that so utopic? Is that hard to achieve in a modern medical system, in a modern obstetric unit? I don´t have a definite answer to that. But my guess is, the answer may lie in making that box bigger. If there is more space, more options, maybe, just maybe, all women can fit very nicely inside.
Women, babies, families come in all shapes and sizes. Our world is wide and diverse and our societies are as well. Our maternity system should reflect that. And in my belief this is everybody´s business. It´s not enough to just listen and agree. We must take action. And although change is often difficult, it is necessary.
I will forever be an optimist. So I believe that all of us together, could make that happen.