This afternoon I saw this tweet, and, in replying, came here to find the piece I was sure I’d written on the subject in the past, only to find I never had- despite spending a huge amount of time talking and thinking about it all over the last few years.My first child was born by emergency caesarean. After a straightforward pregnancy, I went into labour spontaneously ten days after my due date and all went as planned till he was found to be presenting ear first. You don’t need to be an obstetrician to realise that that poses a problem, especially when the head to which that ear was attached turned out to be above the top percentile for size. We were lucky in that there was an operating theatre and staff on hand to allow him to exit via what the surgeon referred to as “the sunroof”.
Did I feel I had failed? Yes. Was that an entirely rational response? No, of course not.
Partly it was to do with the fact that I hadn’t altogether understood what was going on at the time. A debrief with the head of midwifery a few months later and a copy of my notes helped with that, and helped me rationalise that I hadn’t done anything “wrong”. I still was bothered enough about it, though, that I remember shaking uncontrollably when telling my birth story to an acquaintance almost 18 months later, shortly before my daughter was born. She was born by VBAC (vaginal birth after caesarean), as was No3, three years later (this time at home).
Why did I want to go for a VBAC in each case, rather than an elective section, which would certainly have been an option? Had I been somehow brainwashed by advocates of a particular form of childbirth? Did I still feel that I had somehow messed up the first time round and wanted to make good?
Quite possibly, yes, in part. The other way of looking at it, though, is that having read the evidence, vaginal birth (and ultimately home birth) in my circumstances seemed like a the best option. Not guaranteed safest. Not guaranteed risk free. But, on a balance of probabilities, likely to result in the optimum outcome for both my baby and myself. It wasn’t a blanket rejection of hospital or medicalised childbirth, or an attack on those who plumped for those options. It was, quite simply, nothing to do with any other birth than those two.
Perhaps, too, there was a grain of good sense behind my disappointment about the first time. It’s possible to be grateful for the availability of medical intervention while regretting that it was necessary; possible to recognise that sometimes things weren’t as perfect as we would have liked while appreciating that we were fortunate that they weren’t much worse. I don’t think we do women any favours by devaluing their feelings of disappointment or equating them to selfishness or a lack of gratitude. Would so many women feel that they have “failed” to experience a perfect birth if they felt free to express their honest emotions about what happened? Moreover, there are valid reasons for caring how a baby is born: women know that certain outcomes carry risk both for their baby and how they will go on to mother.
Having a baby, especially our first, is definitive in many ways: the end of one era of selfhood and the beginning of another, in which we are no longer responsible for ourselves alone. No wonder that we struggle and feel conflicted if our experience of birth is not what we had hoped or expected, when we are encouraged to prepare, participate and – yes, make choices - beforehand, but are rebuked verbally or otherwise afterwards for caring about anything other than a healthy baby.
There’s another aspect, too. Women now are older when they give birth and, in general, may well be used to a degree of autonomy in their work and home lives denied to previous generations. We choose, by and large, to have our babies. Many women will do antenatal preparation and approach labour not as a patient but, at the very least, as a partner in the process. Does our system of maternity care, under financial pressure and with an eye eternally on the implications of the worst-case scenario, allow for a genuine mother-led partnership? I am not an expert, and perhaps it does – but I would argue that many times women feel, for whatever reason, that events and decisions in labour slip out of their control and that the psychological and emotional aftermath reflects that.
Do women “choose” (or advocate) a particular form of childbirth as a statement or a status symbol? Here, I think it gets complicated. After my eldest was born, I found it very difficult to hear about “natural” birth. Preparing for a VBAC, reading some of the passionate views online, I did feel that there was a current of criticism of those who, like me, had birthed differently. It was a difficult choice to make, and, for a while, I too was passionate about the arguments. Rather facetiously, thinking about holidays this week, I noted that no-one would feel judged for their choice of a camping trip by someone who was jetting off to a catered villa in the south of France, or feel compelled to justify themselves for a week in Haven rather than a luxury skiing break. Envious, perhaps, but not judged. Of course, these are consumer choices, but they’re choices made by individuals with due regard to their own personal preferences and circumstances, not with a view to criticising those whose position is different. It is telling, I think, that we readily impute bad faith to a woman’s experience or opinion in this, when we would hesitate to do so in other circumstances.
Could it be that women are conditioned to feel guilty and inadequate in all aspects of our lives, long before we pee on a stick? Could it be that we are so accustomed to anticipate censure of our choices and our decisions that we pre-empt attack when none is intended? That we conflate objective observations with our own subjective narrative, and that we are used to a culture of unspoken competitiveness where we translate another’s “success” as necessarily requiring our own “failure”?
And then, at the same time, as real-life motherhood is devalued in many ways, there is increasing pressure on women to get this, as every other aspect of their lives, (impossibly) perfect. There is extensive coverage of celebrities having babies: their figures, their choice of names, their philosophy of parenting.There is a culture of blame, too, which tips into finger-pointing in the round (including at ourselves) where things happen or decisions are made which don’t deliver the desired outcome. It’s a fairly toxic brew. Added to this is an apparently deliberate approach by mainstream media to take advantage of all of the above, which affects so many women so closely, in order to generate audience attention and engagement by means of forcing allegiance, the taking of sides, where there would ordinarily be no such polarisation. And so, we settle into camps, raise our heckles and our unrealistic expectations, and so the cycle continues.
Why do some women feel that they have failed – in childbirth, when feeding their baby, at motherhood in general? To (horribly) misquote Jane Austen, I am not surprised that any woman feels that she has failed. I rather wonder that any thinks she has succeeded.