I’ve um-ed and ah-ed (mostly to long-suffering Alex) about writing this post. Probably because I know several people who willl heartily disagree with what I’m about to write – and my modus operandi tends to be pro-diplomacy and anti-boat-rocking.
But sometimes, I tell myself, it’s good to stick your head above the parapet; also, I’m fascinated to hear your views on the subject of birth; and then this morning I was listening to the Today programme (pretty much the only acceptable accompaniment to the morning), and heard about the revised NICE guidelines – which suggest that first-time mothers with low risk pregnancies have their babies in midwife-led units (rather than consultant-led obstetric units) and for second-time mothers with straightforward pregnancies, a home birth may be just as safe as a birth in the unit.
Interesting. And to my ears: slightly alarming (the word ‘may’ rings bells for starters).
At my last prenatal appointment, the midwife said that, “of course” I’d be trying for a VBAC. (A VBAC, for the child-free/fearing amongst us, is vaginal birth after caesarean. I know, you preferred the acronym, didn’t you?) She was rather startled when I was startled by her assumption – and said I’d like to chat it through with a consultant obstetrician.
But didn’t I want a natural birth? She asked, sounding astonished. Didn’t I want a birth story? To experience the journey? And then she wrote “Refusing VBAC” on my form in large (and, strictly speaking, inaccurate) red letters. Like I was a naughty student who had failed a spelling test.
The thing is: a “birth story” is not my agenda. Because as far as I’m concerned the birth isn’t about me and what I want; it’s about having the baby in the way which is best – for which read safest – for the baby. It isn’t “my” birth or “my journey”. It’s not about me. Yes, pregnancy and birth are a wonderful thing, but they are, to me, a means to an end: the end being a new addition to our little family; a sibling for my little girl; another beloved grandchild; a new little person who we can’t wait to meet. Also, I have a birth story, thank-you-very-much: she is three years old and entirely delicious. I hope very much, all being well, that soon I will have two tales to tell – however this one comes into the world.
[Also, I might add – in defence of women everywhere who didn’t come to motherhood by way of their vagina – that the implication that if you don’t – for whatever reason – have a baby naturally, that you’ve somehow not experienced “giving birth” is nonsense. You are no more or less of a woman or a mother however you have your child – ‘birth’ is subject to several interpretations. Did you see this weep-inducing feature in last weekend’s Stella magazine? The subject, Annabel Stockman, adopted two children from China: “There was no “settling in period”: the very first time Stockman met her daughter was the moment the child became hers.”]
Am I just bit odd for thinking like this? Maybe. Some people certainly seem to think so. My attitude is “so medicalised”; I’ll “regret it” and feel like I’ve “missed out”; don’t I want to do what’s “natural”? Certain elements of the press (you know the ones I mean….) laud celebrities/future queens for eschewing drugs and opting for a natural birth.
To this I would say: modern medicine which allows me to have my baby in the safest manner possible? What’s the problem with that? (I’ve noticed that people who have been lucky enough to have little need or no personal encounter with medicine are the ones who tend to be the most dismissive of it’s amazing benefits. Perhaps having been in serious need of modern medicine on more on the one occasion has coloured my attitude?) Towards the end of my first pregnancy, I was assured that my baby’s head was engaged (despite my wondering why I felt all the kicking at the base of my womb)– only to find quite by chance that she was breech and owing to several factors, a natural birth would not be possible. I sometimes think how different it could have been: how I would remember my daughter’s birth not as this calm, controlled time, which was all about her arrival into the world, but a possibly prolonged, painful, stressful time with an emergency c-section at its end.
Please don’t think I’m knocking natural birth – I am in all favour of every women’s right to choose the birth which is right for her and her baby. I wholeheartedly support other women and their choices (you know we do – your response to our breastfeeding post was heartwarmingly ‘you go girls, whatever you choose to do’). I’m just (tentatively) putting it out there that the lionisation of natural birth means there is a potential danger of putting what the mother wants ahead of the baby.
The issue I have with home or midwife-led units is that (as I understand it) there is no immediate access to pain relief (should you find you want it) and, more importantly, no immediate access to doctors or consultants. [Addendum, thanks to the fab Doctor and Daughter: many midwife-led units will be in hospitals so, yes, it will be possible to transfer to the labour ward. One of the concerns voiced is that the infrastructure should be in place for a speedy transfer to hospital in case of disaster, for all women who choose to labour at home or in one the units.] Midwives do an amazing job. But things can go wrong during birth. Things do go wrong. We all know women for whom they have. And if they do, I would want to be within immediate reach of medical help. My first priority will always be my baby. And I want to stack the odds in its favour.
It’s an extreme example, but did you read this article by Anna Wharton in The Times about what happens when natural (in this case, home) birth goes wrong? (Available in full here.) She writes that her birth plan came “ahead of the welfare of my baby” and makes the very good point that, in the end, “we all want a healthy baby, safely delivered”.
I’m with her. It’s all I want. It’s what we all want. However it comes about – a healthy baby, safely delivered, is the most important part of this equation.
As ever, we’d love to know your thoughts.
Photographs by Kelly Stuart from the beautiful The Glow