'it was your choice to have a child'

“You'd think there was no right more sacred than to be financially underwritten by the community when you choose to have children too young, alone, and without the means to support them” (Columnist Rosemary McLeod writing in The Press)

Choose to? Leaving aside the mean-spirited politics, what kind of ‘choice’ is that?

Choice is a central obsession of late capitalist culture. As long as individuals have plenty of choice then everything is supposed to be all right: we can choose what job to work at, and choose when we have children, how many we might have, and how we might have them.

And, if we make the right choices, our kids will turn out all right ... right?  After all, we can choose to breastfeed them ... if we have the support and the ability to do so; we can choose to stay at home with them ... if we have enough money and the inclination; we can choose to feed them organic hand-reared meat or home-grown vegetables lovingly braised in a slow-cooker ... if we have enough money, our own homes, the time, and the desire to spend all day preparing food; and, eventually, we can choose to send them to private school ... if we have enough money and the right connections.  

The language of choice is ideological. It assumes an individual who has plenty of resources - financial, cultural and institutional - who can make the most of the choices on offer. If someone can’t - or won’t - make the correct socially-approved ‘choices’, they’re bound to be on the receiving end of, at least, disapproval (‘why is your son wearing pink?’) or, at worst, punishment (benefit cuts, children removed). The language of individual choice, then, absolves the community and the state from any stake in those choices: the individual makes the choice, and the individual takes the consequences. It’s a bare step up from ‘you’ve made your bed, you can lie in it.’ There’s precious little soul-searching about how we might have chosen to ignore families in our midst who really struggle with apparent choices that are not much of a choice at all. It’s like we made the bed, but refuse to recognise it as a device for sleeping, much less lying in.

There is a historical dimension to the ascendancy of ‘choice’ in childrearing. Journalist Sue Kedgley found there was a deliberate move away from State support of families to individual choice as part of the general policy shift in the 1980s and 1990s towards free market capitalism. She comments that the New Zealand Treasury no longer saw childbearing and childrearing as ‘critically important activities for the future of the state ... Instead Treasury ... redefined them as activities that are motivated by ‘personal choice’ or ‘irrational desire’ (Mum’s the Word, p 335) This re-definition meant that laws, policies and practices were similarly re-defined: the responsibilities of the State and community to parents and families shifted from collective investment in society’s future to enabling individual choice. Among other things, this has meant the removal of the family benefit, the glacial roll-out of paid parental leave, and, more recently, cuts to early childhood education.

Perhaps one of the most loaded ‘choices’ a mother can make is whether or not to stay at home to look after her children or go out to work to support her children.  But this ‘choice’ is not simply about the best way to mother. In her analysis of US working mothers who quit their jobs to return to the home, Pamela Stone found that the women she interviewed quit as a last resort, and for reasons of work, not family. She calls their decision "a kind of silent strike" and describes their failed efforts to re-invent the workplace in their image: "These women had alternative visions of how to work and be a mother, yet their attempts to maintain their careers on terms other than full-time plus were penalized, not applauded; it was quitting that earned them kudos." Their use of the language of choice "often had the effect of obscuring or rendering invisible to them the constraints they faced”. In “The Opposite of Choice”, Judith Stadtman Tucker agrees, observing that “the discourse of choice masks the persistence and variables of women's inequality, and the scarcity of adequate options”. 

In the absence of real choices, an increasing percentage of well-educated middle-class women - the group with most apparent choice - are choosing what Elisabeth Badinter has described as a ‘nuclear option’. They are not having children at all. For those that do have children, the language of choice has a policing function. As Aminatta Forna observes, “voices of dissent and dissatisfaction are increasingly met with dismissal and a response which has a peculiarly modern twist: that it was their own choice to have a child” (The Mother of All Myths, p 260). So what if you’re finding it hard to make ends meet, you’re about to go postal from isolation, and you’re sick of people telling you that you have to breastfeed: it was your choice to have a child. Or in other words, ‘you’ve made your bed, you can lie in it.’

In order to have real, meaningful choices an individual or couple can’t parent in a vacuum. Community and State support in the form of, among other things, high-quality affordable childcare, paid parental leave (ideally able to be shared), adequate living benefits for solo parents with young children, and commitment to flexible working both in the public and private sectors would be a good start.

Along with a little less sermonising and a little more understanding about the ‘choices’ people have to make.

That would be pretty choice, eh?

'an obstetrician is like a car mechanic'

Continuing my non-linear approach to blogging, I want to look back at when I first entered the health system after finding out I was pregnant. I had already taken an over-the-counter pregnancy test, which came back positive. Not really knowing what to do next, but feeling that health professionals should be involved, I made an appointment with my GP. When I say ‘my’ GP, he wasn’t really, just one of the doctors at the local practice, who I hadn’t actually seen before. My husband and I both went along for the appointment, feeling both nervous and excited. That didn’t last long.

My first clue should have been that he was a sports doctor. His wall was papered in images of him attending prone rugby players in a natty shell suit, which dwarfed his practicing certificates. I’m guessing too that his clients didn’t include netball players or other female athletes, as, when I mentioned that I thought I was pregnant, he looked like he didn’t know the meaning of the word. Instead of offering congratulations, he asked what we’d like to do about it. Feeling my good mood start to evaporate somewhat, I said, ‘um, that’s what we’ve come to you to find out about.’ He looked startled, as if he would much rather have had to deal with an injured hamstring or a misplaced metatarsal.

As we looked at him expectantly, he started mumbling about obstetricians, and trying to think of names of golfing buddies who weren’t holidaying in the Caribbean, I presume, that we could see. Feeling confused, we asked whether we had to see an obstetrician or whether we could go with a midwife. Being asked a direct question seemed to at last provoke a semi-coherent response.

‘Oh no,’ he said. ‘Seeing as this is your first pregnancy, and I’m not sure how it’s going to go, you’re really much better off being seen by an obstetrician.‘ Well, seeing as it was my first pregnancy, and I wasn’t really sure how it was going to go either, I wanted to know why he was so dismissive of midwives. Having done a short research project on midwives about fifteen years earlier, I suspected gross institutional sexism and a reversion to the Dickensian Sairey Gamp stereotype. I wasn’t too far off, as he then proceeded to tell me that there had been a few cases in the Wellington region where babies had died under a midwife’s care. He also noted that midwives didn’t even have to be nurses these days, and some had only trained for six months.

I wasn’t exactly sure what the situation was, but felt pretty strongly that this was a load of crap (side-note: it was, as we later found out). At this point, I should also add that maternity care for women in the New Zealand public health system is free. The primary care-givers, known as Lead Maternity Carers (LMCs) are either midwives or GPs who also deliver babies. If we had elected to go with an obstetrician, we would have to pay private fees, running to thousands of dollars.

I could tell my husband was not impressed by the doctor’s answers so far either. Rather than feeling stonewalled like I was, he attempted to get some more information. ‘So what exactly is the difference between an obstetrician and a midwife?’ he asked.

‘Well,’ replied the doctor, speaking slowly as if he were addressing someone who was a bit thick. ‘One is a doctor, who has trained for several years, the other one isn’t.’

Suppressing the urge to say, ‘no shit Sherlock,’ my husband persevered. ‘The course you’re recommending could cost us a lot of money. What’s the benefit of going with an obstetrician as opposed to a midwife?’

The doctor searched around for something to convey the difference. ‘Well, an obstetrician is like a car mechanic ...’ he began.

At this point, I can’t even remember what he said next, as I reeled from the shock of being compared to a car. That’s right, a car. An inanimate piece of machinery. That doesn’t give birth to little cars. To my face. I think we both decided then and there that we were 1) not going to take any advice from him and 2) going to change doctors asap.

Unfortunately, this visit left us floundering somewhat as to what to do next. We didn’t even have a list of midwives in the area that we could ring, much less any idea of whether they were any good or not. This then led to a merry dance over several weeks where we actually tried to get some information to help make this decision. I contacted the Ministry of Health and they supplied their list, which didn’t list every midwife in the area. The Midwifery Council’s list was voluntary and didn’t contain contact details, although it did list qualifications, where they had been provided. In the end, we asked around friends and colleagues who had given birth in the last couple of years, to see if they could recommend someone. In the end, we took a colleague’s recommendation and were cared for by an excellent midwife. While we had a good outcome in the end, it was an unnecessarily protracted and stressful process.

This incoherent state of affairs is dressed up in the language of choice. Women can choose what kind of care they want, where they want to give birth, and which midwife to use as their LMC. It sounds good, doesn’t it? As a middle-class, well-educated professional, however, I found all this choice overwhelming, confusing and scary as the weeks ticked by and I didn’t have a midwife. I wondered how people who didn’t have my advantages managed. I support some choice, especially concerning where and how to give birth, which I do believe should - as far as is possible with such an unpredictable event - be driven by women. But I question the value of such a piecemeal system, where no one place even has the full information about services available in the region. Is using the language of the free market really empowering, or is it, rather, importing its stratification and actually limiting choices for some? I guess it works for those whose GPs aren’t certified idiots, and can point them in the right direction in the first place.