Birth Pains

“For the first time in my life, I understand the concept of home: it is not a refuge, not necessarily a snuggly place of warmth and cheery domesticity, not some essential rightness like the satisfying click that releases a lock, but rather a sense of peace with contradiction. It is a giving in, an acceptance, the place where I finally strip life of all its decor of aspiration and regret and let it be what it is, where it is, and nothing more.”

Sarah Menkedick, A Wilderness of Waiting

 

The Business of Being Born was produced in 2008. At the time, it was a small indie production, released only in the US. 7 years later, it has become a launch pad for many pregnant women, one we are told we must experience, before we set off on the path of birth plans, feeding options, OBGYNs, midwives, birth centres and doulas. The movie is a rallying cry for a return to the basics of birth, before pregnancy and birth were medicalised and women found themselves navigating inductions and epidurals and the seemingly inevitable emergency Caesars.

 

The movie forms part of a broader movement that is in revolt against many of the changes that came after the second wave of feminism sought to liberate women from the constraints pregnancy and motherhood put on their bodies and on their ability to work outside of the home. In the post-Friedan world, women grabbed hold of the innovations medicine offered – twilight sleep, epidurals, C-sections, formula, breast pumps – so that pregnancy and birth did not mean inevitable pain and/or injury, and motherhood did not mean one would be chained to their infant twenty-four hours a day, seven days a week. However, this opened the door to the extreme medicalization of all these processes.   As The Business of Being Born points out, women found themselves being excluded from important decisions about their bodies and their babies. Medicine often needlessly rendered them patients and not participants.

And so the movement against the medicalization of birth began, and with it came the voices of the ‘natural moms’, who advocate home births and midwives, and who caution against the overly liberal application of medical interventions.

My husband and I unwittingly waltzed into this maelstrom some months ago. Entranced, I watched The Business of Being Born, read ‘natural’ birth story after ‘natural’ birth story, devouring the details and slowly starting imagine my own birth experience.   It was a heady time. I can’t tell you the exact moment when the whole movement lost me but I remember watching the documentary again (with my husband this time) when I was about 20 or so weeks pregnant, and hearing the judgment inherent in every interview, every birth story showcased, every doctor portrayed as selfish and disinterested. I don’t know when I started seeing it, but I can tell you why. At 20 or so weeks pregnant, I was exhausted (and now, at almost 40, I am none the fresher, let me tell you), and carrying what seemed to be a large boy. I was actually starting to really picture what it would mean to push this child out of my body into the world. I started tentatively asking my doctor about epidurals. Then I started sending my husband links on C-sections. I know what you’re thinking (especially you, natural moms), but it wasn’t that I was scared. Yes, at that time, our baby was measuring well above the average for his gestational age, but as my doctor keeps telling us, that doesn’t mean much until the baby actually gets here. Big babies sometimes measure small; small babies, big. Ultrasounds, it turns out, are less of an exact science than we think.   What I was starting to worry about were all the things that could go wrong. Even the best-laid birth plans cannot account for nature and the surprises it holds. I am a relatively small woman, and I’d read that babies could sometimes get stuck. I had heard stories of labour experiences that went on for days, leaving both the mother and the baby exhausted. How would I summon the energy to learn how to feed after a marathon birth? Basically, what worried me was this: my pregnancy journey, which avid readers will remember, began when we started trying to conceive, has been all kinds of surprising. It has taught me that nothing is guaranteed, and that plans can be kind of pointless. So, how could I continue to visualize and become seriously attached to a single birth narrative when I knew all the messiness and unpredictability of bringing life into the world? I’d read stories of moms who went in, armed to the ovaries with doulas and midwives and birthing tubs and breathing exercises, only to find that the universe had other plans. These women profess to having their earliest experiences of motherhood coloured by what they experienced as a ‘failure’, a capitulation to everything the ‘natural’ movement taught them was disempowering and wrong.   Could I really afford to spend my son’s first few weeks of life feeling like that? With all this swirling in my head, I slowly started opening the door to medicine. Besides, I thought, I trust my OBGYN, and I am aware that she is not the kind of doctor who would ditch me for dinner.   So, slowly, I have started to picture other births, medicated births, major surgeries, and anything we could do now to ease our transition from pregnant life to life with baby. My husband and I started considering support options should I need time to recover from a C-section. I haven’t given up the idea of going the ‘natural’ route (we’ve kept the doula, we’ll be practicing the exercises, we may even draw up the birth plan, eventually), but I’ve forced myself to look at it as just that – one route. And so we’ve set off on a different journey, a more cautious one. We are determined not to pick a side and to (rightly!) see our baby’s birth as the most natural, joyous experience, no matter what chemicals or scalpels may or may not be involved.

It should be so simple, right? What we’ve found – what I have found, as a woman navigating this middle ground – is that neither side is truly happy to cede ground to the other. The medical side has a history of treating women like we are idiots, especially when it comes to our own bodies and experiences. I am lucky in that the worst I experienced was our fertility specialist telling me that all my worries about symptoms or the lack thereof during fragile early pregnancy was “silly”. But the recent controversy that’s flared up once again in the US over whether or not to vaccinate children as shown up just how disrespectful and arrogant medicine can be. Yes, the anti-vaccination movement’s distrust of medicine may not be founded on sound evidence, but these are real, thinking people who are trying to make the best choices for their children in a world that offers parents a lot of conflicting ideas and conditional support. As Jessica Valenti points out in her (highly recommended) book Why Have Kids?, most of these parents are mothers, women whose very particular fears and anxieties about parenting in this age have long been disrespected and ignored by medicine. So, when someone comes along to validate these fears and anxieties, whom do you think mothers will believe? A particularly arrogant viral Facebook post by a doctor illustrates how the medical profession has contributed to the great vaccination hole they are now in: in it he admonishes patients who refuse to vaccinate, telling them of all the other serious health concerns he sees in other patients. In this practice, he tells them, we vaccinate. If you don’t, he will call Child Protective Services.   My husband and I believe in vaccination, but the venom and naked contempt expressed in this post and in others like it for parents who are skeptical and maybe a little bit afraid took us by surprise. I can see why the anti-vaccination movement remains distrustful of the medical establishment. I’m not saying the natural birth and motherhood is the same as the anti-vaccination movement. In fact a great deal of what the natural movement says is based on the science of childbirth. But the vicious resistance of the medical and/or non-natural options available to moms seems to come from the same place.  Who wouldn’t mistrust a suite of such openly hostile and condescending professions?

Then again, the reaction to medicine’s condescension can be taken to the extreme by the natural movement. These extremes often harm the parent and the child, rather than offer the easy, uncomplicated liberties promised. When we first met with our doula, she asked about our plans. I launched into an incoherent ramble about how I had been considering a C-section, but now wanted to try, as long as the pain relief was available to me (i.e., let’s write it down somewhere that I may request an epidural so that no one can tell me that the lesser-spotted anesthetist isn’t there when I need it, damn it). Her lukewarm response? “Interesting”. She’s a nice lady, though, and she later talked me off my ‘no-pethidine-so-help-me-goddess’ ledge, and showed signs of warming to our not-totally-drug-free tentative birth plan. A few weeks ago, we completed a series of (otherwise) edifying and extremely helpful antenatal classes. One of the last classes was on breastfeeding. This is important, we thought, we want to get this part totally right (and not chicken out like we did with the birth plan business – kidding). Turns out, getting it right includes but is not limited to: cue feeding (where you feed whenever your baby signals their hunger or need for attachment, even if you’re in the middle of say, a work day); avoiding bottle feeding (even if the milk in the bottle is your own); avoiding supplementing with formula (don’t you know, formula is the devils, folks? Besides, think of all those antibodies you’re cheating your baby out of. Why would you diss your baby?). The kicker was a pamphlet handed out during class on ‘Breastfeeding and the Working Mother’. Ah, I thought, here finally, is something to assuage one of my greatest anxieties about motherhood. The pamphlet advises us working moms that leaving our child in the care of nannies and daycare workers is “less than ideal”. What you should really do, Mom, is negotiate serious flexi-time (a couple of mornings a week is one option offered), and try to be near your baby as much as you possibly can. Breast is best, and your baby knows that, we were told. In fact, some babies may refuse to feed all day from bottles you loving pumped into, knowing that the real thing, you, will be home and can feed them all night. And if you don’t or won’t do this?   Well, your baby won’t get those antibodies they so need. You also miss out on key bonding experiences, which is a cause of postnatal depression. Afterwards, when I had emerged from the dumb silence into which I was struck, I said to my husband, “You know what would depress me? Being told that there’s only this one way to do it and if my life or finances or identity cannot bend to it, I am basically endangering my child and the bond between us!”

So, the ‘natural movement’ for all of its emphasis on the empowering reclamation of women’s bodies from the evils of medicine basically does the same thing medicine stands accused of. It tells women there is one right way, and anything else, any slight misstep and there are consequences to your child’s well being. Had an epidural or pethidine? Your baby will be born drugged out – congrats, Mom! Unlucky enough to have had a C-section and had your doctor deliver your baby (I have seriously heard C-sections described in this way)? You’re missing out on one of the all-time greatest experiences of being a woman and becoming a mom, and also bonding – good luck with that, Mom! Need to go back to work after baby? Well, you may compromise your baby’s internal feeding schedule, and also, you are making a tiny baby follow your selfish schedule? Really, Mom? Not to mention that moment when your baby calls the nanny ‘Mama’. But go on, you hardened careerist, you! As I said to my husband, once the shock of the breastfeeding class had worn off, “Seriously?” These can’t be women’s only narrative options. You’re either a perfect mom who went ‘natural’ or an uncaring, selfish bitch who chose comfort and career over your child?

I write this very much aware of all I am still to learn about babies and how they get here (still). I write from a completely rudderless middle ground, where the instructions are many and are polarizing. And the thing is, we need those instructions. Pregnancy and the preparation to become a parent are the most soul-destabilising processes I have ever experienced. They wrench you, quickly and brutally from all your easy answers, your coping mechanisms and you are disabused of everything you ever thought you knew about yourself and the world. And, of course, this is all before the baby is even here. What I really needed – what I think most women going through these experiences really need – are stories from those who have been through it and have lived to tell the tales, as they are, unvarnished and real and raw, minus the ideological stands. What I have found more helpful than any of the classes and the movies and the books are the stories told to me by the women in my life who’ve given birth: my mother’s stories that reveal how different it was giving birth to my baby sister in a country that is not her own, far away from her own mother and her first long and difficult labour and birth; my mother-in-law’s stories about her two very different births and the very different children and mothering experiences the births brought her; my friend who had her twin boys at 28 weeks and the difficult, life-changing months that followed; the friend-of-a-friend who heard a short while ago that a years-long adoption process is now final and her daughter is legally her daughter. These stories, told by women of great strength, still standing long after birth and well into motherhood, are what we need more of. The essence of these stories doesn’t lie in the kinds of births they had, or not they were medicated. Those are not the indicators of a woman’s ownership or presence in the story of how she began to become a mother. They are only the beginnings of a series complex relationships and long stories, developing and unfolding still, rich, vibrant tapestry over the neat black and white lines of limiting ideology.

Pema Chödrön writes that

 “As human beings, not only do we seek resolution, but we also feel that we deserve resolution. However, not only do we not deserve resolution, we suffer from resolution. We don’t deserve resolution; we deserve something better than that. We deserve our birthright, which is the middle way, an open state of mind that can relax with paradox and ambiguity.”

As my husband and I approach the next beginning in a series of beginnings, this is what we hope to hold on to: a middle way, and a comfort with ambiguity, far away from the brutal certainties that threaten to rob us of lived experience.