Why is it so hard to believe birth will be ok?
2020 is a shitstorm, so I’m going to offer you the chance to take a moment and rewind to 2010. It was a simpler time. Fewer pandemics, fewer demagogues, and here at Edun Towers I was pregnant for the first time and very, very scared.
In fact, to be honest, I was truly terrified at the prospect of getting this child from the inside out. I knew the narrative; birth is horrendous. For some people it’s good, but mainly it’s horrendous. I just couldn’t seem to get any clarity about how to guarantee a good experience. Whatever, it all seemed so deeply unpleasant I knew it couldn’t be left to chance. So I did the work, practising my breathing, listening to my hypnobirthing, watching the positive birth films, reading the positive birth stories. Despite all this positivity and aspiration, though, I just could not shift the deeply held sense that somehow it would all go wrong. All I could envisage was being another body on the conveyor belt of birth, at the mercy of other’s people’s judgement about what would be best for me. I was terrified of losing control, and simply disappearing in the inevitable horror of birth. I just could not get off the merry-go-round of anticipation, fear, opportunity, pragmatism.
What I felt in 2010, and what so many of the women I work with now feel, is a queasy dissonance. Like most doulas and antenatal teachers, I am very, very familiar with the anxiety and frustration my clients express. I know how it is to lie at night, hands on your growing belly, feeling the big, physical reality of what you’re about to do and worry that it will be an assault on your autonomy, your dignity and your privacy. It’s the tension between what birth can be like, and the prevailing depiction of it in our culture and language. It’s the anxiety feeling you get when you look at your carefully considered birth plan and remember what you’ve been told about it all going ‘out of the window’ as soon as the contractions kick in. Those feelings – anxiety, bewilderment, dissonance, frustration – are how the power of Hegemony feels.
Hegemony? I know, I know. I haven’t actually used that word since my first degree last century. Words like ‘consent’, ‘autonomy’, ‘empowerment’ are much more common currency for birth workers, and of course they are valid and important. It’s only fair, though, that we recognise these words are only necessary because we birth under the auspices of that hegemony.
Hegemony – as I was reminded last week by both Patricia Di Quinzio (in The Impossibility of Motherhood) and Ruth’s husband Ian – is the way in which some ideas gain such power, they become orthodox, and in their orthodoxy they prevent us from really being able to conceive of, let alone see, other options. It is easy to see how this manifests in birth. Think about how birth is overwhelmingly, presented to us in the context of risk and rescue. Seeing birth on TV? Odds are the mother is panicking and out of control. Birth in a movie? I’ll bet the partner is helpless and hopeless while medics sweep in and save the day. Magazines and the press? Yep, they do it too. Birth is always shown as an emergency, and often the mother is barely present, a bit part in the unfolding drama.
This narrative of birth as an inherently difficult, dangerous, crisis is absolutely pervasive, and we women are given are good long lead up to it. We learn early on that our reproductive bodies are dangerous, unruly and require management to make them acceptable. From learning how to hide tampons up sleeves to disguise our first periods, to scented panty liners reinforcing the lie that our vaginas and vulvas are smelly and unpleasant, to sex -ed where girls are passive and at risk whereas boys are driven and priapic, to birth control, pubic baldness, the diet industry…. I could go on. By design and implication, with subtlety and shocking directness, at every turn we are encouraged to doubt and mistrust our bodies. And then we get pregnant, and every doubt & discomfort we felt in our form is accelerated and intensified. Through pretty much every birth we see in art and culture, in almost every birth story we hear from our mothers, aunts, sisters, friends, our mistrust is reinforced and our expectation of bodily failure and betrayal reinforced. This, my friends, is hegemony.
‘Your body is not a lemon. You are not a machine. …Even if it has not been your habit throughout your life so far, I recommend that you learn to think positively about your body.”
Ina May Gaskin
My purpose here isn’t to get you to dismiss the possibility that birth can be shit. We all know it can be. But birth workers – whether midwives or doulas - will tell you it needn’t be. My purpose is to alert you, to bring your conscious attention to, the fact that the pervasiveness of the ‘birth is bad’ narrative prevents you from really being able to believe other options are available to you. This omnipresent depiction of birth as overwhelming the mother and her body, a crisis from which she needs rescuing, is repeated & reiterated, conformed & consented to over and over again, to such an extent it obscures and masks any other possibilities. The power of hegemonic narratives of birth is such that despite knowing full well that a positive birth experience is possible, you can’t trust that it’s realistic for you, because the belief that birth = powerlessness & panic is too deeply embedded in our collective and individual psyches. Examples include the prevailing belief that labour must be diagnosed by a midwife performing a cervical examination (when in truth, established labour is clear to see and also cervical examinations give midwives an indication of how labour is progressing and that your body and your baby are well positioned for a healthy labour), and that home birth is dangerous (when in truth, if you are having your second baby, your baby is as safe at home as in hospital, and there are further benefits for you.)
This is where that tension arises for lots of you who are making an active attempt to secure a better birth experience. A cursory scroll through the IG feed of the International Association of Birth Photographers (which I highly recommend) will show you that birth happens in multitudinous different ways to multitudinous different people. Anyone who has read Milli Hill’s Give Birth like a Feminist , or joined a Positive Birth Movement group, or is following a ‘good birth’ account on the socials will see how great birth can be. You’ll see how birth can be the source of your greatest power, how it can augment you rather than damage you. You’ll start to identify that power and intensity are not the same as suffering. How you can be completely centred and respected in your birth, however that baby comes out of your body. And yet, when you are full term and as full as an egg, it’s really hard to truly dismiss the feeling of doom and concern, because, well, Hegemony.
Pregnancy and birth is complicated. It’s not true that if you just surround yourself with positive images and believe in your evolutionary capacity it will all be fine. Birth is complex, multi-axial and can be unpredictable. However, it is also true that you are the pinnacle of evolution (until you give birth to the next generation). It’s true that your body is designed to gestate and birth a healthy baby. If there was a better way to do it, that’s what we’d have evolved to do. I’m not advocating you opt-out of good, qualified care. Midwifery care is there to keep you safe and also the majority of pregnancies and births in this country are safe (and perhaps might be more so, if we didn’t faff around with them quite so much). Do please remember, though, that predominant ideas serve to limit your access to other options. You know some women are having positive birth experiences, so please, trust that this is as accessible to you as it is to them. Do your research, create your birth support team, and maintain the balance!
The Birth Place Study, available at : https://www.npeu.ox.ac.uk/birthplace/results
Beard, M., (2017). Women and Power : A Manifesto. London : Profile Books
DiQuinzio, P., 1999. The impossibility of motherhood : feminism, individualism, and the problem of mothering, New York ; London: Routledge.
Hill, M. (2019). Give Birth Like a Feminist. London : Harper Collins
Ollerenshaw, V. (2016) Liberating Motherhood. London : Womancraft Publishing.