Читать книгу Give Birth Like a Feminist - Милли Хилл - Страница 18

Freebirth, the choice to labour and give birth without a midwife or any other health professional present, may seem as far away from elective caesarean as it’s possible to get, but, in fact, as is so often the case with opposite ends of the spectrum, they have much in common. Blogger and doula Jenny Wren has described freebirth as a ‘feminist statement … because it is the radical notion that the woman takes priority over the baby’.[45] Several studies have been carried out into women’s motivation to freebirth,[46] finding that negative experiences of maternity care are a driving factor in many cases, with one study published in the journal BMC Pregnancy and Childbirth concluding:

The UK based midwifery philosophy of woman-centred care that tailors care to individual needs is not always carried out, leaving women to feel disillusioned, unsafe and opting out of any form of professionalised care for their births. Maternity services need to provide support for women who have experienced a previous traumatic birth. Midwives also need to help restore relationships with women, and co-create birth plans that enable women to be active agents in their birthing decisions even if they challenge normative practices. The fact that women choose to freebirth in order to create a calm, quiet birthing space that is free from clinical interruptions and that enhances the physiology of labour, should be a key consideration.[47]

Women’s actual stories of freebirth support these findings. I share two here in their entirety because I think they speak volumes not just about the choice to freebirth – which only a tiny minority of women make – but about the imbalance of power and overall lack of true listening that this chapter is essentially about, and that a much wider group of women are coming across in their maternity experience.

The first is from Megan, who gave birth in the south of England. Both her births took place between 2009 and 2019.

I have had two lovely home births. During my first birth I got the impression the NHS midwives that attended didn’t want to be there. It was a busy night on the ward, I was asked to come into the hospital for a VE (vaginal exam), but I declined, I didn’t want any VEs due to testing positive for Group B strep, and knowing they would increase the risk of infection and possibly rupture my waters prematurely which is another risk factor. I also have a fear of hospitals ever since witnessing the substandard care my sister experienced during her first birth. My informed choice was not respected and when the midwives did arrive at my home I was coerced into having an unwanted VE because they threatened that they couldn’t stay unless they knew I was in established labour. My contractions were 3 minutes apart lasting 2 minutes by this point. It was quite clear to anyone watching that I was in established labour. I was 7 cm upon checking.

I was later told, during pushing, I had to get out of the pool for an episiotomy because baby was in distress and not moving down (he was having heart rate decelerations). They had me semi-reclined in the pool and were coaching me to do horrible chin-on-chest pushing. I asked to try one more thing first, I listened to my body, got myself into an upright squat and pushed my baby’s head out on the next contraction with ease and no tearing. The next contraction brought the rest of his body out and he was perfect, alert, and peacefully looking up at us both.

I was then pestered for the next 30 minutes to keep checking his cord to see if they could cut it yet (I wanted to ‘wait for white’), and then once it was cut, it was more pestering about having the injection to bring the placenta out. Again I declined 2–3 times. I ended up having it tugged out of me by the cord. I had no idea how dangerous that was! There were great parts of my birth too, I wouldn’t call the birth traumatic. But I didn’t feel cared for by the midwives. I felt rushed and coerced into completing their tick list so that they could move on and get back to the hospital.

So during pregnancy two, as I reflected back on this birth I realised that the midwives being there didn’t make me feel safe at all. And safety is important in birth. I wanted an independent midwife who I trusted and had got to know as I did my doula, but I couldn’t afford one. So I wrote a detailed birth plan for the NHS midwives; no VEs, no temps, no BP, no questions, no talking, intermittent monitoring of baby’s heart rate only. Basically I wanted the midwife to sit back and watch me birth my baby, as a safety net in case anything did go wrong.

However, I got a phone call from the supervisor of midwives, who was gravely concerned at my request for a hands-off birth. She actually asked me if I would ‘allow’ the midwives to use oxygen on my baby if they were born not breathing! I could not believe this! How did a request for a hands-off birth get put into the same category as a mother who doesn’t want any medical assistance to her baby should there be complications? After that phone call I was so angry. I lost all trust in the NHS midwives. I decided that I wouldn’t be inviting anyone into my birth space until I knew the birth was imminent. As it turned out I had a virtually pain-free birth and no transition signs, I went from mild regular contractions to pushing contractions and my baby being born within 15 minutes with just me, my boyfriend, our three-year-old son and my doula present. She was perfect and healthy thankfully but I am still angry that I was put in that position because of such a rigid checklist system that we call midwifery care.

The second birth story is from Kay Parsons, in Massachusetts, USA, whose babies were born between 2004 and 2014.

I was 19 the first time I gave birth and felt like being young and unmarried really affected how I was treated. From the moment I arrived at the hospital I felt like my autonomy was stripped from me.

I so clearly remember the moment they told me that they thought he may be malpositioned or have his cord wrapped around his neck. I had taken some prenatal yoga classes and wanted to try different positions to give him space to turn or adjust but they ‘wouldn’t allow’ me to. They forced me onto my back so they could monitor his heart rate.

There were so many people rushing in and out of the room. Every time I’d have a contraction, 10 people would run into the room and stare at my belly or at the monitors as though doing so would somehow change the outcome of his heart rate deceleration. Of course it did nothing to help him and made me feel like an animal on display in the zoo!

At one point I had five different people all holding sharp objects wanting to poke or prod me in some way. I couldn’t catch my breath, started to cry, and asked for a moment to just centre myself and breathe and a nurse said to me, ‘Oh honey, you can’t cry now, you have so much more to come!’

In the end he was born by caesarean. The whole experience was so traumatic and brought to the surface past experiences of sexual trauma and the feeling of having no voice, no power, and no right to decide what is best for me or my baby.

When I got pregnant a couple of years later I knew that I would never feel safe having a baby in the hospital again. We hired midwives and had a lovely, but trying and long home birth. Five years later I had another midwife-assisted home birth.

I found that the midwives were all great. I really believe in midwife-assisted home births and have trained to become a midwife myself. But I’ve always struggled with feeling like even midwife-assisted births contain an element of fear and trying to control the outcome.

I’ve found that many home birth midwives are great at supporting women to labour autonomously, follow their intuition, and trust the birthing process. But even the best of midwives change when a woman starts pushing. They rush around and get a bit frantic and have their hands all up in her business. It’s like they are ingrained to need to ‘do something’ perhaps out of fear, perhaps out of excitement, perhaps out of liability. But the energy of the room changes. Things get busy, and rushed. There’s the clanking of instruments and busyness of preparing for the big moment. And I’ve found that their fear becomes palpable to me. Even in my trance of ‘labourland’ I feel pulled out into the mundane of their sense of responsibility for the outcome.

I read an article once about the holistic stages of childbirth that talks about the moment of pause before a baby fully arrives earthside. This quiet moment where the world stands still and they emerge into the world and I longed for that experience.

I didn’t want anyone to rush the moment of emergence. I wanted to birth without the fear that comes with the anticipation of baby’s final arrival. I wanted to savour that moment, in between the worlds, where my baby is not yet fully outside me and yet not completely within me either. So I planned a freebirth with my last baby. Just my husband, me, and two of my dearest friends.

And when she arrived, I had my moment. The whole world stood still. It was just me, her, my husband, and our hands as she made her way earthside. It was the most empowering moment of my life!

But perhaps I placed too many prayers on holding the slowness of that moment. She was a little slow to start breathing normally. It was like she sat in that pause with me for too long and when she started breathing, it was shallow and fast, like she couldn’t quite catch her breath and arrive. We were nervous so we called the paramedics ‘just in case’.

They arrived, and the two male paramedics were obnoxious and a bit freaked out, but this one woman paramedic was amazing. Before ever touching my baby, she knelt down beside me, looked me in the eye, and congratulated me before ever saying another word. She never judged me for birthing at home or birthing alone. She expressed nothing but support for my autonomy and my choices. She held the sacred with me, even if she didn’t know it.

She encouraged me to bring her in and have her evaluated but at that point she was already breathing normally. When she found out she was my fourth baby she laughed and said, ‘Never mind, mama. You got this!’

It was a moment of such deep healing. Of course all of the nightmare scenarios were running through my head, the fear of being judged, disempowered, having my magical moment taken from me again. And instead I was met with utter respect and trust in my knowing of my baby and my body. Somehow it healed, all the way back to that first experience of birth, and all the way forward to every moment of support I will offer another woman. Even in the midst of ‘complications’ this paramedic reminded me that we have the choice, to join mama in the sweetness and the stillness and treat her with respect, autonomy and trust.

Every generation likes to think that they are free, and often, only the clarity of hindsight can reveal just how restricted they actually were. My mother, for example, like many women in the seventies, thought that it was the pinnacle of freedom to have her labour induced, to know what day of the week on which I would be born and make practical arrangements, and to have a kindly midwife look after her newborn while she rested. Looking back on it now, over four decades later, she can more easily see the restrictions placed on her personal freedom that were epitomised when, lost and drug-hazy, she wandered the hospital corridors looking for the baby she knew she had just birthed, but could not find anywhere.

It would be foolish to assume that ‘that was then, this is now’ and that there is nothing happening to women in twenty-first-century maternity care that will not, when we look back on it in another forty years, seem laughable or even barbaric. In fact, you don’t necessarily need twenty–twenty hindsight – you only have to talk to women who are experiencing the current birth system to hear a myriad of restrictions, small and large, that are placed on their freedom, and a range of abuses, small and large, that are happening to them and hiding in plain sight in every maternity ward. When I listen to these stories, the same thought keeps coming back to me – birth needs a feminist revolution! But where is it? Where is feminism?