A Scrambling Consideration of Biopolitics

“They” say that when you are pregnant it can feel like your body is no longer your own. Not only is there another life leeching your nutrients, kicking at inopportune times, and squishing your internal organs into such a puzzle that your bladder becomes magically nonexistent, but for some reason other people feel that they have the right to comment on how you look and your habits, and to touch your body without asking. It’s true. But more than MAKING my body not my own for the duration of pregnancy (and breastfeeding?) I believe the experience has brought into focus the fact that my body is already not my own. The medical gaze is intensified during pregnancy, but it does not begin then.

Did you watch Stargate SG-1? Being pregnant sometimes feels like the trial between Skaara and Klorel in season 3. I am not saying that I feel like a slave to a hostile, evil host, with no control over my body. The relationship I have with my little alien is a lot more like the positive symbiosis of the Tok’ra- I would do almost anything to make sure that the little one inside me is comfortable and growing healthy, and yet I feel like I am constantly on trial for my actions. Society views the pregnant condition as a shared condition, and as such a woman surrenders many of her personal rights. An external court decides what is right for the voiceless fetus, and since a baby is viewed as helpless, blameless, and the epitome of potential, the court almost always rules in favor of the fetus. Of course I am speaking of the social court, not the legal court, although the social court is trying to sway the laws. This is not a question of abortion. It is instead a question of how a woman chooses to direct her pregnancy. Society does not trust women to want the best for their growing babies, and to know what that might be.

In Bulgaria, where social healthcare is the norm, this is emphasized. A Bulgarian woman is expected to go to the doctor as soon as she finds out that she is pregnant. Immediately they draw blood, run tests, and insert the fetus into the modern medical system. From that moment until birth medical decisions fall into the realm of “expertise,” and out of the control of the woman. The fetus becomes the responsibility of the state and the mother is seen as a barrier, or an inconvenience, to that responsibility. Monthly checkups are standard- including sonograms, the drawing of blood, and other types of less-invasive monitoring. None of this has really bothered me because I enjoy the sonograms and I know that with a history of anemia I am at a slightly higher risk to become anemic during pregnancy. I suffer from severe depression connected to my anemia and it is nice to have that extra warning system in place for when my iron levels begin to dip. I realize that many women may not appreciate the monthly checkups at all, but they haven’t been too unsettling for me. What has me bothered, and is beginning to open my eyes, is the actual birth process.

Everyone I talk to seems to approach the topic of birth from a position of fear. They are quick to assure me that it is not so scary, I shouldn’t worry, and it will be okay. They assume that I am frightened of the pain associated with giving birth- with all of the things that could possibly go wrong. What they can’t seem to understand is that it is not the process of giving birth that scares me. I am EXCITED about birthing. I think it is going to be intense and overwhelming, but beautiful and unbelievably good. I also think that with my psychological preparation in the realm of BDSM, my personal beliefs and understandings towards pain and pleasure, and my relationship with my body, I stand a good chance of having an orgasmic birthing journey. I realize it will be difficult, but I believe that women are built with the capability to give birth, naturally. However, I must admit that these people are right to assume that I am afraid. What I am afraid of is not the birth. It is the very thing that is supposed to make me feel secure and protected: the hospital experience surrounding the birth.

If I lived in the US I might elect to go with a home-birth, but probably not. I am on the same page as my yoga instructor, who said last week, “It’s not that I don’t believe a doctor should be there. I just think he should be in another room, drinking a coffee unless there is an emergency.” Ideally, I would probably choose to find some sort of birth center that doesn’t have the appearance or immediate medical interventions that hospitals seem so eager to give. But I don’t live in the US. I live in Bulgaria, where mid-wives do not have the legal right to practice without a licensed doctor, and home births are rarely heard of, unless they go badly. The other day I read an article about a woman who chose a home birth in Sofia. The article was about a single baby that died during a home birth. Of course, home birth was painted very negatively and the woman as irresponsible. Ultimately the article ends with a comment on the high rate of mortality during home births compared to hospital births, which is probably true in Bulgaria. I wonder how much of that has to do with being at home, and how much has to do with the fact that stigma and laws against home birthing CREATES an unsafe environment by taking away any at-home options for medical assistance. Here I feel the need to point out that babies also die at hospitals, sometimes due to negligence on the doctor’s part and sometimes just because they do. However, it is much more difficult to find an article blaming a mother or doctor for a specific death that took place in a hospital. That would be considered poor taste against a grieving mother or professional slander. But society has no problem demonizing a mother who went outside of the system to do what she though best for her baby. Society seems ready and eager to blame women who refuse to surrender to the medical gaze.

And just what is the medical gaze they are refusing to surrender to? It involves a dehumanizing hospital experience where the patient is separated as a body, on which actions are performed, from the patient as a human with rights and desires. My only experience being admitted to a hospital was a gruesome experience. It was in the United States and it involved a suicide attempt when I was twenty. The first night was terrifying as I was connected to IVs and pumped full of drugs to clear my system. No one was gentle with me. At one point I shied away from a particularly large needle, and a nurse roughly informed me that I had no right to complain or resist. I had surrendered my rights to refuse any treatment when I had chosen to try to commit suicide. I understand the anger she felt. It makes sense for medical professionals to feel a bit of frustration and disgust for suicide patients when they are trying so hard to prevent death on a daily basis. What doesn’t make sense is for doctors to feel the same impatience and disdain for pregnant women, but from what I have been reading, pregnant women in Bulgaria are not given any more rights or respect than I was given in the hospital ten years ago.

At the time of birth women are separated from their bodies. They are almost treated as an inconvenience of birth instead of an active participant. I am sure that doctors would appreciate not having to deal with a screaming woman who has fears, desires, and urges. It is no wonder that 40 percent of births are c-sections here, scheduled months in advance. I am afraid that signing the admission forms here will be similar to giving away my rights to refuse treatments. I do not want an IV. I have an intense disgust towards needles and I do not think it will be emotionally or physically helpful to have a needle in me for such an intense process, but IVs are standard practice. I do not want an epidural for the same reasons, but epidurals are pushed like candy here. They want everyone on an epidural because it is, ‘more comfortable for the mother.’ I am wondering if it is the comfort of the mother they have a concern for, or the comfort of the doctors, nurses, and other patients who do not want to be around the messiness of pain and intensity of an undiluted birth experience. I am very concerned with time limits. If a labor is not progressing, then drugs can be given to help it along. It seems like 12 hours is the standard before doctors loose their patience, and I am not sure that I am legally able to refuse those drugs here. I would prefer to give my baby 2 full days, if it is needed (But I really hope it wont). Perhaps most unsettling is that in Bulgaria it is the general practice for a woman to go into labor alone. They have to pay extra for the husband to be there, emotionally supporting the woman. It terrifies me that the system WANTS the woman separated, on her own, with no one to advocate for her desires at a time when she might be at her weakest. It all adds up to a system where the doctors supposedly know best, and the patient being a sentient being is a mere inconvenience. Additionally, the woman is required to stay in the hospital for at least three days after birth. During that time she has very little control over her baby and again there are severe limits on visitors, including the father. I find the three day stay kind of nice, because you get basically free, trained nurses to care for your baby while you are recovering, but I wish that it existed as an option instead of a law, as I  would much rather be together with my family as a whole during that critical bonding time.

Of course much of this is here-say and fear. I have not had a full discussion with my doctor about all of it, as I was told to wait until my 8th month so we would see how my pregnancy was progressing before we started to discuss options for birth. I realize now that I need to be much more demanding about that conversation taking place now, because I have a lot of mental preparation to do if I want to take as much control as possible and not have this be a traumatic experience for me, including possibly changing my birth center and finding a place that will accommodate me to the fullest extent that they can within the laws. I have also read stories of women who were pleasantly surprised by their birth experience in Bulgaria, who did not feel dehumanized and punished by their doctors. So there is hope. But I wish I had more control and did not have to rely so much on luck. This really does bring into focus the extent of the medical system and the power that others try to exert on the body of the individual.

In Bulgaria enrollment in the national healthcare system is mandatory for all citizens and permanent residents who have jobs. When I first moved here I thought that socialized health care was a great thing. For a very small fee I have access to doctors, nurses, and dentists. The quality of care might not be the best in the world, but it is far from the worst either. However, with that option for care comes a certain expectation for people to utilize that care. Vaccinations are free, but they are mandatory. Prenatal care is nearly free (not for me, as I am not yet in the system), but expected. So is dental care and regular checkups for children. This has me thinking about the Affordable Care Act, and moving (however slowly) towards a single payer healthcare system. Single payer healthcare is great, in that it drives the prices down into a range that is affordable for everyone. But people are pissed off that they are being told they HAVE to purchase insurance. Yes, it is great to be insured in case something goes wrong, but to what extent does that insurance force an individual into the modern medical gaze? I realize more and more these days that I would much rather work with nutritionists, herbalists, and other “alternative” forms of preventive medicine than pay to be able to go to a doctor when things get bad.

I was checking out an herbalist website that happened to create a comparison between herbalism and modern medicine. Modern medicine is great at dealing with emergencies. If you cut yourself deeply, or get into an accident, or are in the middle of a severe allergic reaction a doctor is probably going to help you much more than an herbalist. However, as far as preventive medicine goes, an herbalist can be much better at educating an individual about understanding their bodies and creating a healthy, strong baseline.

Apparently, if you go back far enough, the word ‘doctor,’ did not mean healer, but teacher. It was the role of the doctor to teach the village about the spiritual realm and their bodies. Allow time to progress and the focus shifted from a doctor being someone who teaches to someone who has been taught- or an expert in an area. That is where we are today- doctors do not spend time teaching patients. They do not spend time investing in preventative care. They are experts, who know what is best, and spend most of their time putting out fires rather than empowering their patients to maintain themselves. Because a patient is not a doctor, they are not, “taught,” and since a doctor is no longer a teacher there is a gap in the education of the common man regarding his own health.

So yeah, paying for insurance for emergency care is okay, but what if I would rather invest that money in preventive education for myself? Ideally I would like a single payer system that is affordable, optional, and focuses heavily on education instead of the sterility of modern medicine.

I feel like this has been a ramble, but I think that there are some important ideas in here. Perhaps some day I can thread them out. Maybe others feel the same way as me- tired of our bodies being pawns in the areas of power and politics. Maybe some day things will change. 

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