Ask any midwife, doctor or birth worker what three things they wish they could tell all women, and you’ll probably get three statements that tell you as much about the writer’s passion and beliefs as about birth. My list is no exception. I could tell you I wished every woman knew that they didn’t need to buy every baby product in sight, and I do wish that, but not nearly as much as I wish these three things, which reflect my passion for understanding different kinds of birthing knowledge and the ways in which they relate to each other.
The undermining of birthing knowledge
1. During the last century or so, a number of developments in society and technology have undermined women’s birthing knowledge. I’m not suggesting that this is a long-term intentional plot whose intricate details are hidden in some secret code on banknotes and in the relative location of maternity hospitals to ley lines, but even a couple of examples will illustrate the kind of thing I’m talking about.
- The invention of forceps, for instance, was a very helpful thing for the few women who truly needed (and still need) help during birth. But their entrepreneurial inventors had quite an influence on birth history. When they saw the potential to make profit, they kept their design very secret. This meant that midwives / families had to go to them directly for help. As sociologists and cultural anthropologists can tell you, social status can be gained by holding of a certain kind of knowledge, skill or technology that others do not hold. They could also tell you about how, if you want to be even more successful, you need to go on to persuade more and more people that they need your knowledge, skill and/or technology. But the bottom line in relation to birth is that, if we respect nature, most women don’t need technological help. (If we intervene or scare them, they may end up needing help. That might be because we have disrupted the flow of their hormones, so let’s not do that either).
- Ultrasound is another good example of how technology has undermined women’s knowledge. This can be an incredibly useful tool. I also absolutely uphold every woman’s right to use the technologies that are right for her. But it’s also important to consider that, as researchers like Sheila Kitzinger and Jo Murphy-Lawless have pointed out, before we had ultrasound, women were the main source of midwives’ and doctors’ knowledge of the pregnant baby. If midwives wanted to know how a baby was doing, they had to ask the woman about the baby’s movements or other aspects of its wellbeing. Nowadays, the use of ultrasound (and other related technologies that let us ‘look inside’ the body) circumvents the need to ask women such things. This can undermine a woman’s sense that she holds useful knowledge about her baby. Which is a terrible shame, because there are things that women can know about their pregnancies and babies that no amount of any kind of technology can tell us. Technology is amazingly clever and useful. And it is also fallible and only as good as the person using it and the framework within which is it used. This doesn’t mean we shouldn’t use it, but I wish I could tell all women that their knowledge is just as valid as machines, and sometimes more so.
The problem of risk
2. Certain groups also profit from the idea that birth is risky, and that their knowledge / technology / institution / protocol has the ability to reduce that risk. Again, I’m not going to get all conspiracy theorist about it. And I don’t want you to take my word for it because I think it is vital that we all think carefully about everything we hear and decide what resonates for us. But I think this one thing is worth bearing in mind when you encounter any ideas about birth. There is, sadly, profit to be made from scaring women into thinking they are at risk and therefore have to do certain things. Or to see certain people, or to pay for certain services or products in order to keep themselves and their babies safe. This approach isn’t just found in relation to birth; it’s used almost everywhere. It’s used to sell insurance and financial products. It’s used to persuade us to get our cars, boilers and bodies regularly checked and to get us to buy all sorts of things that we don’t really need. The really interesting thing is that many of those who are on the ‘selling’ end of this idea truly also believe it themselves and genuinely think that what they are offering is the best and safest thing. I don’t like the way in which fear is used to sell, whether it’s done with intention or otherwise, and if you don’t like it either, then you can decide – right now if you like – to refuse to be made to feel scared into making a particular decision, no matter how good the intentions of the ‘seller’.
You’re really rather amazing…
3. You already know WAY more than you think you do. Enough of the negative, because what I really, really want you to know is how amazing you are, and how amazing your body is, and how much you already know (even if you don’t know it). And that you can trust yourself, your body and your baby. I have seen women crave weird foods that turned out to be exactly what their body and their baby needed for nourishment. I have seen women and babies work together to get the babies born in a way that best suited the situation. I have seen things that appear to be mysterious and/or miraculous, and each of them serves to build the awe in which I hold women’s bodies and our ability to grow, birth and feed babies.
As a culture, we can sometimes be so arrogant about what we think we know through scientific and other modern ways of knowing. And these ways of knowing ARE amazing, and yet there are so many other amazing ways of knowing and kinds of knowledge – some ancient, some personal, some unique – that we will never learn by the means that are valued the most at this point in history.
Wildness, trust and leaving well alone…
Yes, there are always situations where modern technology, knowledge and skills will be needed if everything is to turn out well. We also do need to respect nature and be aware of her wildness! But most of the time, things will go well, women’s bodies know what to do, babies know when and how to be born, and trust is a better guide than fear. The National Institute for Clinical Excellence begin their their intrapartum (labour and birth) guidance with the statement: Explain to both multiparous and nulliparous women who are at low risk of complications that giving birth is generally very safe for both the woman and her baby. (NICE 2014).
In birth, as in life, there are no guarantees. It doesn’t matter how many pinging machines we bring into the room, how many research studies we do or how many specially-trained people are standing around. They will never be able to prevent every problem. What they will do, however, is to continue to undermine women’s knowledge, prevent the flow of the hormones that make birth happen (and generally happen pretty well) and perhaps cause problems that wouldn’t have happened if we had left well alone. I wish we midwives were able to spend less time applying monitors and risk assessment and put more of our time and energy into helping women understand, explore and honour their personal ways of knowing.
This is a version of an appendix in my book, ‘What’s Right For Me? Making decisions in pregnancy and childbirth‘. You can find out more about the book here. And if you’re a midwife or birth worker who would like to know more about my work, you can sign up for my free monthly newsletter and updates here.