Another brilliant piece from a GUNNAS WRITING MASTERCLASS writer
We are having the wrong conversations about birth!
In the last ten years, I’ve given birth to three babies, so the debate around what makes a good birth has been very personal to me. What does make a good birth? The birthing method, our birth experience or both? Is “healthy baby, healthy mother” the measure of success? Or should we be expecting more?
Birth has been part of my world for many years now and I’ve thought about it a lot. I read stuff about birth. I have conversations about birth with pregnant women, other mothers, fathers, health professionals and randoms. What I’ve discovered is that my experience isn’t the norm; unlike many other people I’ve spoken to, I love birth. Not in a hippy chanting, candle burning kind of way, but in a “bloody hell, this is hard work but oh my goodness I got to feel a baby come out of my body and how amazing is that” kind of way. Birth has been the most extraordinary experience of my life.
Here is my problem. In all my discussions and reading and listening to people talking (and arguing) about birth I’ve come to the conclusion that we are having the wrong conversations about birth, personally, and culturally. Discussions around birth are all framed in opposition. We talk about natural versus medically assisted, vaginal versus caesarian. We talk about judgment of people’s choices and how we shouldn’t do it, all the while talking about home versus hospital. We talk about those people who have birth plans versus those who are leaving it up to the experts as “they know best”. We talk and we argue and we definitely disagree. And more than that we judge, even while saying we are not. Even articles that profess to be non judgemental tend to be full of generalisations, extreme examples, and even more judgement.
The conversation around birth has been reduced to having the argument, laying the blame and rolling around in the judgement.
What gets lost in this dialogue? We lose sight of the underlying reason for why we are having the conversation. Why are we talking about birth? Why does it matter? If “healthy mother, healthy baby” is the only outcome that is important then why oh why can we not let the discussion go? I would contend that it is because we are human, and so experiences matter to all of us. And because birth is one of the most extraordinary experiences we get to have as humans, then it matters more than most.
Birth can be an extraordinarily tricky thing to navigate. The stakes are high and often it is an extremely emotional situation. For the parents of course, but also for the health professionals, who are acting as professionally as human nature allows. For example, if as a medical professional you had a baby die because of XYZ yesterday then today your feelings of risk would be raised when faced with those same symptoms. Everyone’s experiences affect their judgement. That’s human. Throw into the mix that everyone involved (parents and medical staff) have different life experiences, cultures, philosophies, education, and often don’t know one another well, things get even more complicated. In some cases you get magic, and in others the situation can be fraught. Often times rhetoric and policy and practice differ, leaving all involved confused at best and feeling incredibly let down at worst. Nearly everyone involved, nearly every time will be doing their absolute best.
Here is my contention. I contend that your parenting experience – which lasts for about 20 years per child – really begins with the birth. A good birth experience (no matter what the birthing method was) where you felt heard, understood, acknowledged and supported, can equal a good jumping off point for the overwhelm that is early parenting. A not-so-good experience, where you feel incapable, scared, fearful, alone, confused, …..well I’m sure you get my gist. Early parenting is full-on enough without starting out feeling crappy.
I’m going to give you a simple and short example from one of my children’s births to illustrate my point.
My first baby was ten days post dates and so we went to the hospital to have the standard checks done. Cord flow looked good, baby’s heart rate was terrific, baby’s size looked great, but the amniotic fluid was low. We were sent to see the registrar. And here is where things got tricky. She said “So we are going to take you upstairs now to induce you”. I asked “Why?” and she answered “Because if we don’t your baby might die.”
I’ll let you sit with that for a moment.
I felt like I’d been punched in the chest and lost my ability to speak coherently. Lucky for me, my partner is not easily spooked and so he said “Well, we’re not going to do that right now. Instead we will go and talk to our midwife about the results, and if we need the induction we will come back”. The two of them talked for a minute about why we would do that, and while they were having this discussion the registrar was on the phone waiting for a response. She hung up before stating, “Well it doesn’t matter anyway as they don’t have a bed for you upstairs, so you would have to come back tomorrow.”
And again, I’ll let you sit with that.
This was nine years ago and I still feel frustrated. Frustrated that I then birthed my first baby in total fear that there was something wrong (there wasn’t!). Frustrated as I’m sure she has spoken to others in that coercive emotive way since, to speed things up, to follow hospital policy? Frustrated that I wasn’t treated as an intelligent, sentient being capable of being given information about the real health of my baby, the risks and the options. In that moment the registrar broke my trust in her ability to care for me in a respectful and evidence-based way. My experience of that first birth was totally altered because of this interaction
Before you think this incident is unfortunate and anecdotal I urge you to think back to the conversations you have had around birth with others, think about your own births, and think about whether the women in those conversations were coming out of their birthing feeling good about their experiences. Feeling heard, feeling supported, feeling capable, because to me that is the key to this whole debate. That feeling is where you start your early parenting from. It is the one you take with you into the first few weeks of your babies life. And from my personal experience, with three very different births – feeling supported can be the difference between enjoying early parenting with all its overwhelm, or sinking beneath the waves. Your post-natal emotional health and well-being begins with the birth of your baby.
I’m sure you know of some good experiences. There are many. But there are also too many negative birth stories floating around for it not to be clear that we have a systemic problem around how we birth our babies as a culture. A culture where if we ask for more than a live, healthy baby then we are being greedy, or privileged, or selfish.
If you travel this birthing journey with people who you can feel are on your side you come out the other side feeling like a champion. If you feel you are supported, heard and cared for, regardless of the type of birth, the place of birth and whether you followed your birth plan or not, you take this feeling into the emotional exhilarating scary time of new babyhood.
We need to have a different conversation about birth. One that isn’t full of judgement and isn’t using the discussion of birth choices as a distraction from the issue. One that acknowledges that everyone doing their best isn’t enough for the birthing women of the future. That women deserve more than the lottery that is possible with birth in Australia today. That we need to come to some kind of consensus on what a good birth is.
I think we all agree that “healthy mother, healthy baby” is the key outcome of birth but I want to pose a strong second outcome that I believe is critical to a woman’s journey into motherhood. That the experience of birth is respectful, inclusive, non-coercive and kind. That we are included in decision-making without being faced with scornfulness about our belief that our experience is important.
The conversation we should be having about birth is “How do we best support women through the birth of their babies in order to ensure they transition into early parenthood feeling capable, connected to their baby and supported?” Please let’s have that conversation!