Birth: everyone’s got an opinion

It is the most private and intimate moment in every mother’s life, and yet birth is something that everyone is more than happy to jaw about judgementally. Should we have baby at home or at hospital? Pain relief? No pain relief? Years ago women gave birth happily in their living rooms set against the back drop of open coal fires, men twiddling their thumbs nervously in adjoining rooms, waiting for fresh towels and for the water to boil (presumably for a cuppa?). Then it was hospital all the way. We were told that this was safest for mother and baby. To make alternative arrangements was apparently irresponsible. But, change again. Now we’re told home-births are just as safe as hospital births. Some women chose to “free-style,” having babies alone, following little or no prenatal care during their pregnancies. Some like to give birth naturally in pools filled with water. Others opt for caesareans, or ingest enough pain relieving medication during labour to tranquillise a small herd of elephants. To each their own. There are now a myriad of options available to soon-to-be mothers, but unfortunately this has not been as liberating for women as it should be. The ease with which some individuals cast aspersions on the intentions of pregnant women, or are deliberately obstructive to the achievement of personalised birth plans, demonstrates the extent to which an expectant mum is still considered public property and unable to make personal choices free from prejudice.

The North Shore Birth Centre in Massachusetts presently provides women who are having low-risk pregnancies with an opportunity to give birth naturally, away from the clinical setting of a hospital. It is a midwifery led unit situated on the campus of Beverly Hospital, and since its establishment in 1980 has assisted the birth of more than 6,000 babies. However, the centre is under threat from closure following the submission of a report by hospital management. This report outlines a vision for a “unified model of healthcare,” which is apparently contradicted by existing birth centre procedures. On November 18 2008 the Board of Trustees of the Northeast Health Corporation will consider the proposal, and understandably a number of women are unhappy that this decision will effectively deny them a birth choice, forcing them to labour and deliver in hospital. There is currently a Facebook group and a campaign promoting the birth centre as an alternative to hospital births. But while these make reference to a very specific case of birth centre closure, what they represent in general is the extent to which women are essentially disempowered to make choices about how and where they give birth. We can make decisions, of course, but only within predetermined perimeters. Women should have the opportunity to happily develop a birth plan based on the number of options now available, and then have access to the services needed to facilitate their preferences. What’s so complicated about this? Why is it even an issue? Why is a birth centre providing women with the opportunity to labour and deliver naturally in a comforting and relaxed setting considered a negligible, nay inconvenient, provision?

I have never given birth, nor do I have any plans to one day become a mother. However, the experiences of a friend who has recently had a baby have made me reflect on the pressures placed on women during pregnancy and birth, and the extent to which they are disempowered to make their own choices. While breast-feeding, for example, is medically proven to have health benefits for new born infants, if a woman does not breast-feed it doesn’t mean that her baby is destined for a life marred by physical ailments. Nor is she a failure. Sometimes women just cannot breast-feed. They may not have milk. Their babies may not take to the breast easily. Maybe it just doesn’t feel comfortable? Whatever the reason, surely the health of mother and baby should be priority? But apparently not. Not in all cases. My friend, for example, found that, while pregnant, breast-feeding support groups and some midwives failed to provide impartial information, instead heralding breast-feeding as the only viable option, the bastion of motherhood, the implication being that if any woman is unable to do so she is a letdown. My friend found that breast-feeding wasn’t for her, not because she didn’t try, nor because she didn’t like it, but because her baby clearly wasn’t getting the nourishment that she needed. She contacted her midwife who told her to persist, even though her baby was crying with hunger. Eventually she used formula milk, and has a very happy, healthy baby. A friend of hers who found herself in a similar situation was so brow beaten by her midwife that she continued to breast feed, even though her baby has not gained weight as is expected, and while not starving is physically failing to get the nutrients needed to grow at a normal rate. But she’s breast-feeding, so the midwife is happy.

Is it fair that so-called healthcare professionals should make a woman feel inadequate, like a failed mother, because breast-feeding does not work for her? Surely this is likely to inhibit the development of a bond between mother and child by suggesting from the outset that the new mother cannot care for her baby, and is not just a failure as a parent, but by default as a woman. From what I understand even the most uncomplicated pregnancies can be hard work. Women have to relinquish control over their bodies for nine months, adapt to hormonal and physical changes, and ensure that they nourish their unborn babies. Add to this the high-probability that working mothers-to-be are in many cases likely to be discriminated against in the workplace, and it seems that pregnant women have a lot to contend with. It seems unfair then that, all things considered, should a women fail to comply with a template of what supposedly constitutes the “perfect mother” with the most perfect breast-feeding breasts to facilitate the most perfect breast feeding, then she is considered a maternal outcast, not qualified or equipped to look after her young. I was completely amazed that women could be undermined and berated by other women in this way, especially at a time when, having just given birth, many are probably feeling more vulnerable, especially as a first time mother when it is not known what to expect. But how typical is this of treatment of new mothers and mothers-to-be? What have your experiences been like? Have you felt disempowered to make choices regarding your unborn/newborn child, and judged for those you have made?

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