September 09, 2008

Helmets and Home Birth

Several nights ago, it occurred to me, in the middle of the night, when I couldn't sleep, that I am a mess of contradictions. I think we all are. But here's the contradiction that occurred to me at 4 am: Why do I support a law requiring folks to wear helmets when biking, but not a law requiring babies to be born in hospitals? The American College of Obstetrics and Gynecology says it is going to push legislation in Congress outlawing home births and any birth occurring outside a registered hospital, claiming that births at home and independent birth centers are not safe. Meanwhile, a state legislator in Oregon proposed a law recently to require bicyclists to wear helmets, claiming that riding a bicycle without a helmet is not safe. I oppose the former and support the latter (mostly I support the latter; I recognize that public education would probably be more effective in the case of helmets). But it felt like a contradiction.

So, Saturday morning, over granola, I asked Brady to help me reconcile this thing. He was immediately interested, because it had to do with politics and political philosophy. (I love talking to Brady about these things).

Brady holds the same opinions as me on both issues, and started by pointing out that when people enter a public street paid for by taxpayers, whether they are traveling via car, bicycle, skateboard, segway, or foot, they have certain responsibilities, and the state has a certain right at that point to regulate behavior. Helmets help prevent major head injuries in bicycle-car collisions, which keeps our citizenry from becoming vegetables and draining public resources. Incidentally, if we ever DO get socialized medicine, I think it might become more important to have helmet laws. I don't want to pay for someone's medical bills, via my taxes, who didn't wear a helmet while biking. I realize this gets us on to the slippery slope of socialism, but I don't mind it so much, and my libertarian brother will never read this or give me flack about it because he thinks the Internet is how the government tracks him, so he doesn't use it much anymore.

Conversely, in the privacy of one's own home, one has the right to birth how she chooses. She's not birthing on a public street. It's a matter of the level of control you have over your own activities, in your own house. It's also a matter of a woman's control over her body and her fetus/baby. And the government has no right mandating what I do with my body or my fetus or my baby (this is the libertarian streak in me).

Then there's the issue of public health. Biking without a helmet is, statistically, more risky than giving birth at home with a trained midwife. Unbiased studies show that in most cases (i.e., if the birth is not high risk due to health issues the mother already had before the birth), women and babies are safer giving birth with midwives outside of a hospital than with doctors inside a hospital. The American College of Obstetrics and Gynecology does not want to admit this or even see it because it treads on their turf. The safety of home birth over hospital birth has to do with the number of interventions most hospitals unnecessarily conduct on healthy birthing women. This does not mean that all hospital interventions are bad or dangerous, just that they’re overused.

So, okay, these arguments helped me meld the contradictions in my political philosophy. But then, an interesting thing happened. I was walking down the street the other day, noticing a woman with curly hair not wearing a helmet (I’m guessing because she didn’t want helmet hair, which really is annoying for curly girls), and I thought, I don’t want to tell her to wear a helmet just like I don’t want somebody else telling me I can’t give birth at home. The government has a long history of passing laws that do not have the public’s safety in mind – quite the opposite. I think sometimes certain bureaucrats and lawmakers try to really do things for the public good, but our system is corrupt and it gets warped by corporations and special interests. Our food pyramid and federal dietary guidelines are a perfect example. It’s crap, based not on science but on agribusiness and food industry interests. So, maybe I am a libertarian. This is when the conversation started to upset Brady quite a bit because he felt like the worse things get with our government etc, the more conservative I’m getting. And for a few things, that’s true. Although, arguing that government should stay out of the bedroom and my body – whether the issue be childbirth, gay marriage, or abortion – is not exactly a “conservative” stance. I think it falls to that place in the political wheel where liberals join with libertarians.

And that ends my rant today. Stepping off the soapbox now. Thanks for tuning in.


Kate C said...

Natalie, I tend to agree with you on both helmets and home birth. But when it comes to seat belts...for example...i'm less inclined toward a laissez faire government. Perhaps I have grown accustomed to seat belt laws. And there's obvious public health benefits to requiring them.

It's a difficult line to decide where the government should be able to intrude on private citizen behavior.

The most interesting argument I've heard about this (as it relates to women's bodies, privacy and pregnancy) is an open-letter to Sarah Palin regarding her choices about her own pregnancies and her positions on abortion. It was written by, Lynn Paltrow, the executive director of advocates for pregnant women.

Apparently S.P. did not go directly to the hospital with her most recent pregnancy; instead she waited several hours after her water broke and even gave a speech in the meantime. Paltrow connects S.P's personal decision to the legal cases against pregnant women who have made similar decisions. Some of these women have been forced to have c-sections or have been convicted of crimes when they experienced a pregnancy loss or stillbirth.

Anyway, I'm interested to hear your thoughts.

I believe that any infringement on personal rights must be balanced by a real improvement to the public good. I don't think that this is likely in the case of ACOG's position toward home birth. In fact, I think requiring hospital births actually increases the likelihood that women will experience morbidity during their birth process.

azgeochick said...

Very though provoking post, Natalie. I have to say I'm not sure I'd support the helmet law - I didn't realize I had a libertian streak;-) But that post on Palin and Pregnancy was a real eye-opener! I had no idea women's civil rights are being so abused by legislation.

On a more positive note - I know just what you mean about the way you feel when the baby moves. It's a wonderful secret, isn't it:-)

Love, Christie

Natalie Henry Bennon said...

It's true, state legislation, and federal administrative rules, are really affecting women's civil rights. Oregon had a proposed law -- via a ballot measure, like a proposition, for all voters to vote on -- for fetal rights a couple years ago that failed. Other states establish fetal rights in their laws. South Dakota almost passed a law last year prohibiting all abortion even in cases of rape and incest; it failed, but since the majority of opposition was about the rape/incest part, they're trying again this year with an exception for rape/incest. So, better, but still, abortion could essentially be outlawed. And the federal Health and Human Services Department right now is changing the federal definition of pregnancy to be beginning at the point of conception; it currently starts at the point of implantation, which is what most doctors say is when a pregnancy really starts. Starting it at conception would mean any hospital or clinic or doctor/nurse etc receiving federal funding would not be allowed to dispense the morning after pill. The way the draft rule is written, they wouldn't even be able to tell patients about the pill.

amy said...

natalie, i agree with your views. here in MD we are still fighting to keep the motorcycle helmet law.

The open letter to Palin is very good. It is disturbing that this VP candidate is so out of touch with her body. If she can not be present to herself and her trying to be born child, how could she possibly be present to govern! How will she guide her pregnant daughter?

I am always looking for the REAL perason in the candidate, I have little patience for stumping. Am looking forward to the debates

i realize that Im off topic now
Oh Well -Mamie