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The E word

The word “Empowerment” is such an overused word these days. As the Onion notes sardonically, women now feel empowered by just about everything they do. Yeah, I know the Onion is satire. But it really does seem that anything that makes a woman feel better about herself or boosts her confidence is now “empowering”. Even more often, at least in the context of parenting – making a specific, fashionable choice (like “natural” birth, crafting a special vaccine schedule for your special snowflake child, etc.) is considered the empowering one, whereas those who make another choice are sheeple who mindlessly follow whatever those ‘in charge’ tell them to do.

It seems to me that this is very far from the original definition of the term:

1. To invest with power, especially legal power or official authority. See synonyms at authorize.

2. To equip or supply with an ability; enable: “Computers … empower students to become intellectual explorers” (Edward B. Fiske).

Assuming one doesn’t live in a dictatorship or is a member of the armed forces, the truth is that parents have a huge range of choice when it comes to raising their children. True, some of those choices may limit choices further down the line – e.g., refusing to vaccinate your child may limit his choice of preschool. Yes, there are stories of CPS abuse. Yes again, women were a disempowered group until a few decades ago. But generally speaking, you don’t need anything or anybody to empower you as a parent – you already possess that power by virtue of being one. The real dilemma is whether you use this power wisely or not.

Some women feel the need to demonstrate how ‘empowered’ they are by being rude to others, especially those whom they perceive as being in authority. Such women confuse an assertive manner with an aggressive one. A prime example would be the woman described in this post. However, true empowerment means you don’t have to put other people down in order to feel good about yourself. It means you can appreciate others’ experience and knowledge, and even acknowledge that they may possess greater knowledge and experience than your own, worth listening to and learning from. Remember, every king and prime minister has a bevy of advisors.

Knowledge – genuine knowledge born of long study and hands-on experience, as opposed to fly-by-night and Google degrees – really is the ultimate source of empowerment. But so is knowing how to seek out good sources of information, be they people or Internet resources.

Some women, however, do legitimately feel disempowered in other spheres of their life. Perhaps they didn’t have the opportunity to attain the academic degree they wanted; maybe their husbands refuse to participate in caring for the house and children, seeing these as “women’s work”. But if you’re ‘empowering’ youself vis-a-vis the medical profession or other perceived authorities in order to make up for other areas of your life in which you are disempowered, your feelings of satisfaction will probably be fleeting. After all, you haven’t actually dealt with the true source of your feelings, which would entail all sorts of inconvenient things like going back to school or confronting your husband about his behavior. “Speaking truth to power”, if that’s really what you believe you’re doing, is taking the easy way out. It certainly does nothing to increase the respect, or your power, in the eyes of the other party.

These are my (admittedly disjointed) thoughts about a word I really don’t like very much. Maybe it’s because I don’t see my main source of personal power in parenting, but in my chosen profession. And I think constantly about the power I hold over other people in that context, and how not to abuse it.

What’s your take on this buzzword?

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26 Responses

  1. Yes, yes, yes! We’re in Vulcan Mind-Meld-Mode, because I was mulling over this very subject last night, and considering blogging on it myself–now I don’t have to!

    A lot of people seem to think that empowerment is only inherent in the specifics of a particular choice, often a negative choice, e.g.: to refuse interventions in childbirth, to refuse vaccination. In truth, the empowerment is in simply having a choice. It is the fact that we have reliable birth-control, epidurals, c/s, vaccinations, etc, as well as reliable scientific information on their risks and benefits, hat empowers us. Whether or not you choose to use them does not impact one’s “empowerment.”

  2. I’ve been thinking about this lately, particularly in the context of pain relief during labour and the unquestioning way in which the “natural” labour movement links empowerment and suffering. By definition, empowerment is not dependent upon overcoming some great challenge or testing one’s limits of endurance. I like this post and the idea that we are already empowered. Any movement which suggests that women need to undergo suffering to achieve empowerment is inherently anti-women.

    • Ellen, I’ve always said that NCB ideology was about machisma, not empowement. Mind you, it didn’t even make me feel that “I am woman, hear me roar” powerful, either, but that’s beside the point.

  3. I like your post. Up there on words I don’t like would be passion. When ever someone says, “It is my passion.” I think zealot. I like making stained glass but I would not call it “my passion” and no it does not empower me either. It is just a fun hobby.

  4. Pinky:

    Making stained glass IS empowering if you use a blow-torch. :-)

  5. What’s interesting to me is how words like “empowering” get hijacked and reused and made fashionable, until they do (and as you pointed out) become completely divorced from their original meaning. It no longer becomes a specific word, but a placeholder for emotion. You hear it, and it is meant merely to conjure up a feeling. Something strong that makes you want to … “join.” Join what? Whatever it is the person using the term is “selling.”

  6. Blow torch? Yes, I guess that is empowering. LOL. Squilo how do you come up with these things?

  7. I come across it all the time – midwives and others who want to “empower women” as part of their role. It’s all a load of crap. You cannot (by definition) empower someone else.

    “Empowerment” as it relates to maternity care is a stupid euphamism for “avoiding disempowerment”. And that IS a worthy goal. Women are not in control of nature, but they should be able to control of what is done to their bodies by healthcare professionals. pinky talks (in comments on another blog) of having at times performed vaginal examinations on women without asking their permission. That speaks volumes about the systematic disempowerment of women in maternity care. – because pinky is a conscientious, compassionate L&D nurse – and yet even she has done VEs without asking. What that says to women is that they have no rights over what is done to their bodies.

    So, empowerment – a load of crap. Not systematically disempowering women, and ensuring that they have choices and control in the maternity system – very admirable.

  8. Yehudit: I’m puzzled by your claim that you can’t empower someone else. I would have thought that the definition meant it *had* to be a transitive verb.

    I do, however, loathe talk about ‘empowering’ another group of people, because it’s so patronising. After all, the implication is that you not only don’t believe that group is powerful in the first place, you believe that they can only obtain power via your wonderful self being good enough to provide them with it.

  9. I think you can empower someone else, but usually this has to be done one a group/national level, e.g., emancipation via legal rights and duties. It’s usually done by the state towards a group of people. Or you can save an individual person from outright oppression – e.g., liberating a captive person from their captors.

    I’m pretty sure that doing VEs on women without asking them first, is not disempowerment, though. Rude, possibly humiliating and thoughtless, sure (well, depending on context). But it’s very hard to do a VE on a woman who’s actively resisting one – something all women have a choice to do. If the L&D nurses/midwives/OB’s were routinely calling security to forcibly pry women’s legs open so they could do the VE, you might have a case, but that’s not generally what’s going on when women cry “BIRTHRAPE!!” . They do have the right to say no, explicitly and implicitly (by making a VE impossible).

    The woman already possesses the power – whether she perceives herself ‘allowed’ to use it is her issue.

  10. The empowerment folks sound like a bunch of toddlers whose only perceived means of control is to say, “NO” to everything.

  11. I’m puzzled by your claim that you can’t empower someone else. I would have thought that the definition meant it *had* to be a transitive verb.
    I do, however, loathe talk about ‘empowering’ another group of people, because it’s so patronising. After all, the implication is that you not only don’t believe that group is powerful in the first place, you believe that they can only obtain power via your wonderful self being good enough to provide them with it.

    ++++++++++

    Well, grammar regardless, your second para explains very well why you cannot ‘bestow’ empowerment on someone. If person A is dependent upon person B to ‘give’ them power – then how ‘empowered’ are they really? The whole concept is paradoxical.

    Doing VEs without asking is not disempowering?? Are you sure?? And if she doesn’t want it, well she only has to close her legs! (With an epidural? In the middle of giving birth?). Wonderful. It is precisely this attitude that we have to change.

    We are at the service of the woman giving birth, not the other way round. And if it would help us be of service to her to do a vaginal examination, put up IV fluids, take her blood pressure, whatever….then we have the OBLIGATION to explain what we want to do and why, ensure she has consented and not do it if she does not consent. Now, that may sound laborious, but it really doesn’t have to be if you can just get your mindset around the fact that it is the mother’s body not yours and that under normal circumstances any observations, investigations or interventions are done with her say so. We should explain that we OFFER to do these because we believe they are for her benefit. Sadly, this is not the impression most women have when then come into contact with maternity services. They talk of what they “have to” have done, what they are “allowed” to do, what we will “let” them do. The structure of the maternity service disempowers them. It convinces them that it is merely ‘impolite’ for someone to do a medical examination without consent.

    Even in an emergency, it is important to explain “There are about to be a lot of people in the room, and a lot of things are going to happen at once.” And telegraphese of what you are doing and why. “I’m doing this [hand rubbing up contraction] to help stop your bleeding” even as you are pulling the emergency buzzer, rubbing up a contraction, etc… Not knowing what is going on, having people do a bunch of stuff to you as if you were not there, are all things that can add to the trauma of an already traumatic event. That’s the clear message we get from the “Birth Afterthoughts” service run in my hospital, where we go through the notes with women to help women after birth experiences that have left them unhappy, confused or frightened.

    • Yehudit, there’s no doubt that a woman has the legal power to refuse any and all interventions, including VEs. Whether or not she has an epidural, she can still use her hands and her voice to deny access to the examining nurse/midwife/OB. If a HCP continues despite her protests, the woman can sue them for assault.

      Should HCP’s ask for explicit consent before a VE? Absolutely. But that doesn’t mean that women have to lie there and take it if they don’t want to – and I think that most women know this (and if they don’t, then patients’ rights should be the #1 thing to teach in prenatal classes, even before the fancy-shmancy breathing techniques). It’s not a matter of others disempowering the woman, but of the woman choosing not to exert her own already-existant power. Nor is it empowerment to choose to use one’s freedom of choice in birth just to show the staff who’s boss and be a PITA (which is what kidzaplenty was doing).

  12. Well since I have no idea who kidzaplenty is, that doesn’t much matter too me. My view is informed by what I see on a daily basis – which does not include women using their freedom of choice to show the staff who’s boss.

    Patients’ rights are not really high on the agenda of NHS antenatal classes. I see a lot of women who feel they need ask permission for everything, ask what they are allowed to do, what they have to do, what we will let them do.

  13. Yehudit, there’s no doubt that a woman has the legal power to refuse any and all interventions, including VEs.

    +++++++++++

    A woman in labour is in a vulnerable position in relation to her caregivers, and could well be concerned that lack of compliance will effect the future care she recieves. Legal power is fine, but you have to be in a position to exercise it.

    • Kidzaplenty is the woman from the link in the OP (to remind you, we discussed her over at Dr. Amy’s – woman with HELLP who insisted upon nickle-and-diming her HCP’s at every step, to the point where she could have killed herself and/or her baby, and only be sheer luck she didn’t). A prime example of a woman who abused her empowerment.

      You could make the case that anyone is at a disadvantage WRT their attendants who have superior knowledge and experience. When I go into a bank and deposit my hard-earned money according to the investment clerk’s recommendation, if I go to a mechanic to have him tell me what the problem is with my car, when getting on a plane — in all these situations I am, to some extent, entrusting the care of myself or my possessions to an expert. That doesn’t mean I’m not empowered to make the choice, nor am I exempt from the consequences if I refuse a service offered for my benefit. And as I said, if some women don’t know that, it should be made #1 priority to teach them that and the logic behind the ‘requirements’ (though I suspect most people have heard of patients’ rights before they enter the L&D). But lack of knowledge doesn’t mean disempowerment – it means lack of awareness of empowerment.

  14. This conversation reminds me of my needle conversation I have with young mothers. They come in and say, “I don’t like needles.” I tell them, “well you can refuse anything you want to refuse. I am not going to draw blood or put an iv in without your permission. But if we cannot put an IV in, we cannot safely put in an epidural so you will be going the natural route if that is your preference.” Most women say, “hell no, hook me up with that iv pronto!” It turns the whole situation around and women should have a choice but they also should be accountable for the choices they make. Which is not the case in the United States. If anything goes wrong, even if nothing could have prevented it, we are still sitting ducks for a lawsuit. In the past women have refused treatment, had poor outcomes and the Doctors and staff have been sued.

    For an example, Jeff Phalen MD JD had brought this storey to my attention.
    Pt comes into hospital in labor. Doctor at some point sees the fhr is ominuse. Patient refuses c-section. Nurse is on her knees begging this woman. Please let us do the C-section, your child might die. She continue to refuse. BAby is delivered vaginal with horrible HIE. Totally disabled. Patient brings Doctor and nurse to court for liability. Patient says, “Yes you told me my baby might die but you never told me my baby may be brain damaged!” Damages were awarded to this mother by the Insurance company. WTF???? Is all I have to say. It is not a normal situation maternity care in the United States has become a 3 ring circus.

  15. I’m in two minds about this. Yehudit sounds like a very sensitive, respectful midwife and I think we could do with more of those. I would like to be attended in labour by someone like Yehudit. On the other, I frequent a VBAC forum where the regulars jump all over anyone who dares to say “I’m not allowed to do this” or “they won’t let me do that”. Now, I think this is to some extent a figure of speech. I, like Esther, suspect that most people do realise that they are entitled to refuse treatment – it’s just that they don’t want to! They recognise that going into hospital usually involves undergoing things that one would rather avoid, but that one “has” to undergo them. That is not disempowerment. And refusing treatment when you don’t understand the rationale for the treatment is definitely not empowerment or a meaningful decision.

    • I am all for respectful and sensitive HCPs, and I usually explain things to my patients up the wazoo (to the point where patients often come to me after they’ve been to the specialist so I can explain what the specialist said in plain Hebrew). I can even tell them what I might do (or have done) in their situation – but only they are empowered to make a decision for themselves/their child.

      And I agree that a lot of the use of the “not allowed” and “not let” term is like how a diabetic will say “my doctor doesn’t let me have sweets”. It’s not like doctor is going to ransack their patients’ kitchens and throw out the sweet stuff. It’s an expression representing a very strong recommendation from an authority figure.

      I suspect the people who feel disempowered by HCP’s also have issues with authority figures in general…

  16. If knowledge is the ultimate source of empowerment, and you can’t empower anyone else, we’ve got a problem. :-) Because what is education for, then?

    Granted that you can’t just pour it into their heads, but surely there’s a fine line to walk here.

    And yes, I try to avoid the word “empower”.

    • You make a very good point (what else would one expect from an epistemologist?). But education is a two-sided thing – it has not only to be imparted, but also to be received, and perhaps, acted upon. The second part is out of the educator’s hands.

      • Sure, and that’s what I said, isn’t it? (“Granted that you can’t just pour it into their heads…”)

        Insofar as the stuff labeled “empowerment” is actually stuff that might more accurately be labeled “education”, I have no problems with it.

        We *are* dependent, all of us, on other people with the power of knowledge and the willingness to share it. That’s simply because there’s no way we could derive all the specialist knowledge we need to live. (Left to my own devices over the course of my entire life, I might, if terribly lucky, get so far as to invent the zero, but the odds are pretty bad. And then there’s the rest of mathematics.)

        And that’s where the whole idea of empowerment goes sideways, at least in NBA, from the use of the term that I understand you to be objecting to. Expert recommendations and advice give me the power to make a rational decision in support of my own interests and values.

        • The thing about education being entirely synonymous with empowerment – inasmuch as just about anything can be a teaching moment…an unpleasant birth experience can be every bit as “empowering” as a pleasant one. Which is why that definition falls a little flat to me in the way used by NBA’s.

          I’ve actually been wanting to write about this for a while, but it’s such a slippery topic, KWIM?

          • My experience, where everything went completely pear-shaped, was quite educational.

            There’s a calculus quote I’m very fond of:

            “…at about the age of sixteen, I was offered a choice, which, in retrospect, I can see that I was not mature enough, at the time, to make wisely. The choice was between starting on the calculus and, alternatively, giving up mathematics altogether and spending the time saved from it on reading Greek and Latin literature more widely. I chose to give up mathematics, and I have lived to regret this keenly after it has become too late to repair my mistake. The calculus, even a taste of it, would have given me an important and illuminating additional outlook on the Universe, whereas, by the time at which the choice was presented to me, I had already gone far enough in Latin and Greek to have been able to go farther with them unaided. So the choice I made was the wrong one, yet it was natural that I should choose as I did. I was not good at mathematics; I did not like the stuff….Looking back, I feel sure that I ought not to have been offered the choice; the rudiments, at least, of the calculus ought to have been compulsory for me. One ought, after all, to be initiated into the life of the world in which one is going to have to live. I was going to have to live in the Western World…and the calculus, like the full-rigged sailing ship, is one of the characteristic expressions of the modern Western genius.”
            –Arnold Toynbee, _Experiences_

            The heart of the problem seems, to me, to lie somewhere on the gradient between autonomy and beneficence. In order to gain the sort of autonomy that’s worth having, in a formal education setting or anywhere else where you’re not an independent expert, generally someone has to decide for you what you need to know, and then you get to make a decision based on your own values. The people who decide for us — the teachers who determine curriculum, the MFMs who sum up the choices, etc. — are generally beneficient authorities on our side, trying to maximize our autonomy.

            In a situation like Oscar’s birth, it’s not the fault of the person providing the information that the choices available to you are all lousy. Nor is it a loss of autonomy to not get to pick what you’d prefer to have be true instead of what *is* true. It’s just yet another encounter with reality. But sometimes that can feel like a loss of autonomy or like maleficence.

            I suspect the concern with parenting “empowerment” reduces to awareness that we don’t know how to do this perfectly, and sometimes experts disagree, and sometimes we are the experts. A reliable authority is hard to come by, and no one’s being terribly beneficient any more, either. There’s not a lot of scaffolding in place for new parents. People used to learn this sort of thing from immersion as children — I certainly did — but when you’re not around children until you have some of your own…

  17. An interesting and thoughtful perspective,Caryn.As a teacher,I am certainly open to the idea that true “empowerment” is a consequence of education, and the choices that can be opened up. Certainly maximising autonomy ought to be the end of real education – though I am not sure how often that is the aim or the result. I am also not sure how this fits in to childbirth or parenting choices, which seem too often these days to be bound up with ideologies or even passing fads as much as a true seeking of autonomy.
    Like you, I found that when things went pear shaped, I certainly learned a lot. Not through being empowered to make “choices” which no longer existed but through that very contact with a reality a long way from the ideal. What was empowering to me, if I were to put it that way, was to find to my surprise that I could deal with that loss of the hopeful dream of a straightforward, un problematic birth without feeling that it diminished me.. I DID feel pissed off! I did feel that my body, which had caused me no problems previously, had failed me in this very simple task of growing a healthy child. In some ways, the very complexity of the feelings was an education, not to mention the exploding of the illusion of choice. In hindsight, there were some decisions I wish I had questioned. I do think women should be informed, and question, and if necessary fight, but it is not that helpful when the one piece of information – will my child survive – is not available to you or the doctors.

    As for “parenting”, well, I think I have always been aware that as parents we do have real power, for good or harm, for another person’s entire lifetime, and it has little to do with whether you decide to use cloth diapers. And the flip side of that power is responsibility. Personally, the only time I felt disempowered was the NICU stage.

  18. Liz, I think there’s a pretty big problem with the ability to recognize actual authorities, and that’s where the whole thing explodes. You’ll hear things very similar to the things I just said coming from people who are listening to authorities — or perhaps “prosyletizers” is a better word — who haven’t actually done the work of checking the things they are claiming of reality against, you know, actual reality.

    So we have CPMs, who are arguing for education and autonomy and empowerment, and who are asserting all sorts of stuff and teaching it to their students, and who are building an accreditation structure, and schools — and who don’t, when push comes to shove, have any data.

    Reality has special ruling authority. :-)

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