Amity Reed // 20 May 2011
Childbirth. Most people consider it solely the domain of mothers, the secrets and intricacies of which are only shared when one becomes pregnant and chooses to carry a foetus to term. A large percentage of women, even the most well-informed and body-aware, can get through a third or more of their lives without knowing much at all about the physiology of birth. So when we are about to embark on it ourselves, it is mostly still a mysterious process. And with mystery comes a certain amount of curiosity and fear.
Being fearful of birth is not a surprising reaction to pregnancy, really. Over the years, we have become conditioned to believe that giving birth is both the most wonderful and horrendous thing we could ever experience, the first ‘test’ of motherhood wherein we sacrifice ourselves (our bodies, our wishes, possibly our lives) for the good of our children. We’re told that the love we will feel when we hold our babies will be like nothing else we have ever known, the fierceness and infinity of it a biological inevitability of unequaled bliss. This is not always true, of course, but it is ingrained in our culture nonetheless.
Concurrently, pregnant women are frequently regaled with negative, dismissive, even horrific anecdotes as their bellies grow, told they will need considerable amounts of drugs, instruments, machines and medical experts to help their woefully inadequate pelvises allow safe passage of their oversized-of-head offspring. One in four women in the UK will end up undergoing major abdominal surgery (caesarean section) at birth, more than double the optimal level for safe outcomes recommended by the World Health Organisation. Take these facts and messages and add to them the wholly unrealistic portrayals of birth in television and film, and it’s not difficult to see how we got to the place where childbirth is both revered and feared in equal doses.
We’re not the only ones who are scared, either. As maternity wards become busier and more understaffed than ever, at the same time that pressure for perfect outcomes grows, birth becomes more and more medicalised and the rate of caesarean section steadily rises. Midwives, obstetric consultants and hospital administrators are increasingly risk-averse, wary of being sued, fined or reprimanded if a woman’s labour falls outside of strict protocols or if the baby requires any special care at birth. With no continuity of care and little time or resources to allow for a woman’s individual choices and unique labour patterns to be respected, the push to make mothers-to-be conform to the law of averages becomes stronger and more acceptable, leaving traumatised, even assaulted women in its wake.
How did we get to this place, where giving birth is something to be survived and suffered instead of something in which many women can find a sense of empowerment, accomplishment and joy?
Some of the terminology surrounding birth demonstrates the level of disassociation and disempowerment that we have come to expect: going ‘overdue’, ‘failing to progress’ or having an ‘incompetent cervix’ can elicit feelings of guilt and failure, stripping women of confidence in their bodies; someone else ‘delivers’ the baby, making the mother a passive player; mothers-to-be are unsure what they will be ‘allowed’ to do in labour, completely unaware that they have any choice in the matter. The good patient phenomenon means some women are willingly handing over their rights, or are bullied out of asserting them. Fear of making the wrong decision or fear of being perceived as selfish in any way, when mothering is sold to us as a selfless act, can be surprisingly powerful.
So where does modern feminism fit into all of this? The first and second-wavers fought for greater access to pain-relieving drugs for those who wanted them and medical interventions for those who needed them. And thank goodness they did because many women at that time were being left to suffer, bleed or die unnecessarily in childbirth. Obstetric care, as it evolved throughout the 19th and 20th centuries, was in many ways a godsend. But now, many feel the maternity care pendulum has swung widely and dangerously the other way, with drugs and interventions forming the status quo, even for healthy women experiencing uncomplicated pregnancies. Midwifery for normal birth is under greater strain than ever, with midwives unable to provide the service they trained to do and promised to uphold. The feeling of being on a conveyor belt of care that is focused on the baby and not the living, breathing person carrying hir is a sentiment that many new mothers express. I often wonder if the writers who came up with the hospital sketch for Monty Python’s ‘The Meaning of Life’ knew how eerily accurate it would become.
Amongst the birth community — which includes antenatal educators, midwives, parents, feminists, doulas, maternity care activists (and a fair few doctors too!) — there is a very strong sense of revolution, that we are on the cusp of reclaiming birth as an awesomely powerful and completely normal event in a childbearing woman’s life, on that does not have to be anticipated or remembered with fear, sadness or guilt. It does not mean only advocating for natural birth either, but informed choices, real choices and the autonomy that birthing women and their partners deserve, regardless of what kind of birth they choose or end up having.
It means care providers who elicit and accept informed consent and informed refusal, one as equally important as the other. It means women are not fobbed off when they request a home birth or an elective caesarean, or told they are too old/fat/young/small/’overdue’ to do x, y or z. It means we hold women in such high esteem and reverence that we trust them to make sound decisions for themselves, their babies and their families. What could be more feminist that that?
If you are interested in learning more about protecting birthing women’s rights and supporting families in the life-changing time surrounding birth, the following organisations’ websites may be of use:
I also urge you to watch the trailer for an upcoming documentary from filmmaker Toni Harman. It is part of an inspiring new advocacy community called One World Birth in what appears to be an exciting and refreshing catalyst towards a major shift in maternity care and mothers’ rights.