With the natural birth movement challenging the more medicalised model of birth, new mothers are feeling as if they’ve failed if they have an epidural, or need medical intervention during childbirth. Emma Svanberg explains why this is a feminist issue…
Dr Emma Svanberg is a clinical psychologist working in the perinatal period. She supports women and their families during pregnancy, birth and the early years of parenthood.
Have you noticed that when we talk about women, and all things womanly, how black and white we become? The Mummy Wars – depicting women as split over invisible dividing lines of work or stay at home, attachment or Gina, breast or bottle – is a perfect example. For most women, those battles exist only in the media. In contrast, mothers usually find other mothers supportive and compassionate.
So why is there a need to pit women against each other? Well, one reason would be that as long as we are arguing amongst ourselves, we might ignore the greater injustices we still face. There’s less capacity to question unequal pay, sexual harassment and our overwhelming mental load if we’re obsessing over whether we’re getting our mothering right, isn’t there?
A new battleground has been emerging over these past few months in the birth world. Over the past forty or so years, the natural birth movement has been working quietly away challenging the more medicalised model of birth that had been prevalent until then.
Somehow, while the original intention was that women should be empowered to take control of their bodies and their births, women ended up feeling pressured to ‘do birth’ vaginally and with no pain relief. For many women, this results in feelings of failure when the natural birth they had so hoped for does not transpire. And worse, results in traumatic symptoms when birth is derailed.
Over the summer, we saw a huge backlash against the natural birth movement, with the publicity surrounding the Royal College of Midwives’ decision to change the terminology they use from ‘normal’ birth to ‘physiological’ birth (a decision actually made three years ago).
The press picked up on these changes, with a flurry of articles about how the pressure to have a natural birth meant that renegade midwives with their hidden agendas were letting women down. Jeremy Hunt even got in on the act, conflating natural birth with increased neonatal death (based on the specific findings of the Kirkup report into one particular NHS trust which had ‘series of failures at almost every level’ not just on the wards).
What this means is that women, regardless of their birth experience or choices, become defensive. When the language becomes so emotive, automatically we feel under attack. If we had a positive experience, we may wish to minimise it because we don’t want to trigger difficult feelings in those who had a negative or even traumatic experience. If we had a negative experience, we don’t want to scare others. If we had a natural birth, we’re worried we’ll appear smug. If we had a medicalised birth, we’re worried we’ve failed to meet a ‘gold standard’.
Often we then either keep quiet, or we become passionate about our own experience and they become part of our values. The more pressure there is about birth, the stronger our views will become in response. So if we’ve had a bad experience with a forceps delivery, we’re vocal about how forceps should be banned. If we’ve had a positive home birth, we rave about how every woman should have a home birth. Essentially, if we’ve had a positive experience we think everyone should have it. If we’ve had a negative experience, we think everyone should avoid it.
Why do we do this? It’s simple cognitive dissonance. When we have a belief, we don’t like that belief to be challenged. It creates internal discomfort for us. So when we get evidence that our belief might not be as certain as we would like, we have two choices. We can either change our belief, or we can adapt the evidence to support our existing belief.
So, if we’ve had a difficult hospital birth, and we come to the conclusion that hospitals are not good places to give birth, when we hear a positive hospital birth story we could change our belief (‘oh, maybe hospitals aren’t so bad after all’), but often we don’t want to. Changing our belief gives us the added information that maybe we could have had a different experience. Understandably, this is upsetting, so we’d rather find a way to hold on to our belief.
So, we ignore the new evidence (‘who cares about birth anyway’) or we alter their story to suit our belief by minimising it (‘they’re just kidding themselves’) or adding information to it (‘well, that hospital has a good record, but the others are still no good’). Everyone argues from the point of view of their own limited experience. And the more this goes on, the more polarised we get.
What about the shades of grey that get missed when we’re distracted by these opposing positions? Often what gets lost is the importance of individual choice.
When we take a particular stance, because of our own experience, we overlook the millions of factors that make our experience unique. So many factors affect birth – our bodies, our local services, the individuals tasked to our care, the support we have from those around us, our own values and beliefs – that it is almost absurd to think that anyone will have the same experience at all.
Essentially this means that a positive birth is an individualised one. This is written into maternity policy – every woman is now entitled to personalisation and continuity of care in their maternity care as part of the Better Births recommendations and continuity of care has been part of Department of Health policy since 2007. However, it is clear that, in a struggling NHS, this is not always being implemented.
If we see birth as a personal journey, it stops us from seeing it as a potential battleground. And enabling respectful, personal choice in birth brings us into the arena of women’s rights. Let’s not let the storms in the media distract us from asking for these essential rights to be heard.
As part of the Better Births initiative, maternity services are currently undergoing major changes; the Maternity Transformation Programme. You can influence these changes by getting involved with your local Maternity Voices Partnership. There are also very active groups on social media where you can make your views heard, such as MatExp and the Royal College of Obstetricians and Gynaecologists Women’s Voices Involvement Panel. If you would like to find out more about women’s rights in birth then take a look at the Birthrights website, too.