“Do you think I’ve failed?”
So asked my close friend, her voice wobbly with emotion. She was 38 weeks’ pregnant, her baby was breech, and she had been booked in for a c-section later that week. She had conducted herself throughout her pregnancy like a diligent A grade student preparing for her school exams, with weekly antenatal yoga and one-to-one hypnobirthing classes. She had attempted a range of interventions (paid for privately, of course) to try to turn her baby. Sadly, the natural birth of her dreams was not to be. And with that epiphany came a crushing sense of failure.
The feelings she expressed were not unfamiliar to me. When I gave birth to my daughter in 2013 I had such good intentions for a natural birth with no interventions. Like my friend, I had diligently attended my prenatal Pilates classes. I had practised my optimal positions for labour. My husband had perfected his back-rubs through my imaginary contractions. I knew just how to breathe to cope with the pain. When it came to it, though, exhausted from a fairly short and intense labour, with little break between contractions, I demanded an epidural as I reached full dilation. Yes, ultimately, I was delighted to have safely delivered my beautiful baby daughter. Yes, a part of me felt like I had failed.
Where did this sense of failure come from? Was it due to pressure we had piled on ourselves, or was there more to it? Perhaps it was because neither my friend nor I had experienced a “normal birth”. This is the terminology used by the Royal College of Midwives (RCM), the midwives’ trade union, in a campaign it launched back in 2005. Its purpose? To encourage expectant mothers to have “normal births”, that is to give birth without medical interventions including epidurals, inductions, caesareans and use of instruments. I applaud the RCM’s decision, as reported extensively in the weekend’s newspapers, to abandon this value-laden language and to refer instead to births without intervention as “physiological births”. Better late than never, as they say. Professor Cathy Warwick, the chief executive of the RCM, conceded that the terminology used was potentially contentious. “There was a danger that if you just talk about normal births – and particularly if you call it a campaign – it kind of sounds as if you’re only interested in women who have a vaginal birth without intervention,” she told the Times. “What we don’t want to do is in any way contribute to any sense that a woman has failed because she hasn’t had a normal birth. Unfortunately that seems to be how some women feel.”
The purpose of this short blog is not to seek to undermine the value of a “physiological birth”. I was delighted, in 2014, to deliver my son at home in a birthing pool, and I would gladly attempt to recreate the experience were I to have another baby. Was it right, though, that the delivery of my friend’s first baby by c-section or mine with an epidural should be regarded as not normal? Of course it wasn’t. Ultimately, any initiative which makes expectant mothers feel they have failed is failing mothers, and there is no room for that.