FamilyLifeWomen

Whose birth is it anyway?

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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 whenwas 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.”]

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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 

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9 Comments

  • Reply
    cara @ peonies and polaroids
    May 13, 2014 at 10:30 am

    Firstly, hi!

    Secondly, congratulations on your pregnancy!

    Thirdly, ‘don’t you want a birth story?’ is one of the stupidest questions I’ve ever heard. HOWEVER your child comes into the world is a story (I’m trying so hard not to swear on your lovely blog.)

    I’m deeply for midwife led units, less medicalisation and the promotion of home births, I do genuinely believe that they are just as safe as hospital births for many people/babies. However I don’t believe in pushing anything on anyone in this situation and I do believe in treating women like intelligent adults, capable of making their own informed decisions. Men would not be treated like children, were they the ones giving birth. I’m utterly sick of women being talked down to and belittled throughout pregnancy and childbirth when they should be being treated with the respect that CREATING LIFE deserves.

    End rant.

    • Reply
      Natasha
      May 13, 2014 at 10:51 am

      Cara, I am totally with you. I am absolutely not against natural/home/water/whatever birth is right for you – and I completely see that a straightforward birth without intervention is a wonderful thing. But most of all I agree with every woman’s right to make an informed, intelligent decision without being railroaded or belittled.
      Natasha x
      P.S. Thank you! Cannot wait to meet this one – however s/he makes a debut.

  • Reply
    Sheepskins Fairylights
    May 13, 2014 at 11:03 am

    What a shame you didn’t have a midwife who could discuss options, listen to you and ultimately arrange for you to discuss further with your consultant. It should be about informed choice……your choice…..your baby. Giving birth is a beautiful journey, however you get there, the most important thing is you are comfortable throughout. I hope you are given the opportunity to discuss your options, XX

  • Reply
    Claire
    May 14, 2014 at 8:23 am

    I’m the opposite to you – I have had 2 emergency c sections, and am expecting number 3. I would love to try for a vbac again but I have to accept that for various reasons I am probably going to go for the elective c this time. I feel like I have to ‘come to terms’ with the fact that I won’t experience a vaginal birth and there is a sadness there, even though I KNOW the way they come out isn’t important in the grand scheme of things.

    Incidentally I didn’t find that much support for my vbac in my 2nd pregnancy – there seemed to be an assumption (true in the end) I would end up having a caesarean.

    Good luck with the rest of your pregnancy

  • Reply
    Laura Wheat
    May 14, 2014 at 8:55 am

    How irritating that the midwife spoke to you like that. My boyfriend is a GP and he tells me that virtually all of the female obstetricians choose to have caesarians!

    Personally, I would want a full set of hospital staff at the ready to handle whatever birth situation might occur in order to maximise the baby’s chances and my own (women, after all, do still die in childbirth). I don’t really understand the benefit of home births – the idea of squeezing a small person from my vagina in a paddling pool in my dining room… If something goes wrong you have to wait for an ambulance and a hospital transfer. Just doesn’t seem sensible to me but I am a pragmatist.

    Also, two of my close friends both have horrific ‘birth stories’ from their first pregnancies where they would have been considered ‘low risk’. Luckily they were both in hospital but even so one experienced a fourth degree tear after induction with no epidural because the anaesthetists were all busy elsewhere.

    Women need to ensure they are as informed as possible about their options and the associated risks. I think you have exactly the right attitude. The new guidelines are definitely worrying because many women won’t think to question or doubt them.

  • Reply
    Sam
    May 14, 2014 at 12:16 pm

    I just wanted to say how much I agree with your approach and sentiments, here. I had two c-sections with both my girls (the first one due to the terrifying scenario you mention above – v. long, painful labour followed by harrowing last minute emergency section, the second by choice) and I prickle at the assumption that anyone could think I didn’t experience birth! I sure as hell did. I gave the world two little people. I looked at their little faces and felt the hugeness of it all. I held them and looked into their eyes. As Cara says above, we should respect the fact that however it happens, whatever the outcome or process, we are CREATING LIFE. It’s hard, it’s courageous, it’s intensely personal, and how it happens often depends on a whole lot of factors we cannot choose or influence. Very best of luck to you with your pregnancy and new baby to come – however he/she gets out into the world.

  • Reply
    Sonja
    May 14, 2014 at 10:52 pm

    I totally support every mother’s right to choose how they have their baby. I was very lucky that most people I came across (not least my husband) chose to support mine, and it’s terrible to hear that isn’t your experience.

    One thing that I don’t think you touch on in your piece is that there’s plenty of evidence that many complications in labour are CAUSED by women being in hospital and the medical intervention that goes along with that. They are put into unnatural situations (bright lights, constant interruption), unnatural positions (flat on their backs), and then told that their labours are not progressing quickly enough (not quickly enough for whom??). So they are given oxytocin, for example, which makes their contractions more painful, which makes them need pain medication, which stresses the unborn baby etc., etc. and so events can spiral.

    Most women in our culture go into labour already being frightened, because much of what we hear are stories of how painful, difficult, and potentially dangerous it is (even during pregnancy – I mean who does that? Cab drivers I found were the worst). I wish we could reverse that.

    You say that your ‘first priority will always be your baby’. Of course it will. As will it be for someone (like me) who chooses to have their baby at home. The suggestion that natural birth means putting the mother’s ‘wants’ ahead of the safety of her baby is frankly insulting.

    Sometimes things will go badly wrong. That will happen for women at home or in midwifery units, and it will happen for women in hospital (since modern medicine doesn’t always get it right either). All we can do is make the best choice we can and get on with it.

  • Reply
    Andrea
    May 15, 2014 at 12:36 am

    I completely agree with you! My son was born by emergency c section and have never felt cheated for not having a ‘natural’ birth. I wanted a healthy baby and have forever been grateful for the facilities that were available on the day that gave me exactly what I wanted!

  • Reply
    Lisa
    May 15, 2014 at 6:52 am

    Hi Natasha,

    I am in complete agreement with you. So refreshing to read this viewpoint.

    I had twins via planned C Section and don’t feel in the slightest that I don’t have a ‘birth story’. I also know a C section was the safest and most sensible route to take in our scenerio, and would repeat the choice every time.

    I get VERY annoyed by women who give me the sad face/head tilt/concerned eyes when they hear I delivered by C section. I honestly wouldn’t have wanted it any other way (including a ‘natural’ birth if I’m honest). When I told people I was going to have a C section so many told me I would be “out of action for weeks”, “unable to hold my babies”, left with “terrible scarring” (people don’t feel the need to hold back when discussing C sections – why is that?!) etc etc. in fact the reverse was true. I was up and about in days, felt brilliant and could do most things including being signed off to drive after 2 weeks (very handy with 2 bubs in tow!). Friends who have delivered ‘naturally’ have had some horrific after effects. My point being that c sections are so demonized and I really can’t understand why when you are more often than not left with a gorgeous healthy baby and a mum who feels fit and well.

    I think you hit the nail on the head when you talk about mums putting their needs/wants/birth story over and above the welfare of the unborn child. Less chat about candles, floating in water, background music and more talk about the best way for baby to arrive safe and sound, whatever your preferences may be.

    Wishing you all the best
    X

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