The Perfect Birth

Before I write about birth itself, and the rather amazing way your body works to help your baby out into the world, I wanted to say a few things about the pressure that now exists around birth.

It can be hard to remember that birth is just an act, nothing more. Like the act that got you pregnant in the first place, birth is a primitive, physical experience.  But with all the choices out there birth can become just another marker of achievement and success – or as birth guru Sheila Kitzinger has said, a ‘performance’. Do you go for a home, birth centre or hospital birth? Are you aiming for drug free, an epidural at the earliest opportunity or an elective C section? Sometimes the decision seems taken out of your hands –  the further past your due date you become, or depending on your baby’s position, or if you are carrying more than one baby…

Like so much in pregnancy and motherhood, birth very quickly becomes competitive. As you get closer to your due date, you begin to hear a maelstrom of birth stories – mostly negative, about 86 hour labours with 3rd degree tears or last minute C sections. Nowadays, as the natural birth movement is finding a louder voice, you also hear about pain free water births where babies are breathed out to the soothing sounds of ‘It’s a Wonderful World’.

Of course, both these scenarios are possible, but it can feel like you need to quickly form an allegiance to your Birth Ethos. But, as soon as you begin to think that birth is going to be a particular way, you enter into the possibility of failure when it doesn’t turn out that way. Having some gas and air to help you through your contractions becomes a source of disappointment instead of a well earned reprieve. Pushing out a squawling babe two weeks early on your kitchen floor becomes a messy nightmare when you’d planned a sterile setting with his birth date firmly fixed in the obstetrician’s diary. When antenatal classes and books are all geared to helping you achieve your perfect birth, you can easily lose sight of the end point – meeting your baby at last.

This is complicated by the increasing medicalization of birth. There is a general view – which we can call the ‘One Born Every Minute’ syndrome – that birth is always going to be an arduous ordeal. Recent changes to the NICE guidelines allowing every woman to choose a C-section birth, even with no medical need, accentuate this. While of course this may be necessary for some women, this change also gives the impression that major surgery is a preferable option to a normal vaginal delivery, and introduces a choice which is not necessary or desirable for most mums-to-be.

As pressure mounts on health services to deliver babies as quickly and low-risk as possible, protocol can unfortunately sometimes get in the way of maternal care. For example, the active management of labour in hospital settings can result in increased interventions when your labour does not progress according to a rather arbitrary rate of 1 cm cervical dilation per hour. Then, as anxiety increases that labour is not going according to plan, leading to ‘failure to progress’ (or perhaps, failure to wait), it is more likely that labour will slow even further (more on this next time), increasing the likelihood of further intervention.

You can read a lot about how the context of birth has changed – Sheila Kitzinger’s ‘The Politics of Birth’ and Naomi Wolf’s ‘Misconceptions’ are two examples. There are also a lot of great blogs and groups out there – including Birth Without Fear, Invisible Midwives and One World Birth which give a great education in a less ‘mainstream’ view of birth. (Please feel free to add any birth resources you like to the comments!)

There is a now a growing awareness that birth needn’t be complicated. In fact, there is now evidence that, for low risk women, birth in a home or midwife led setting is not only safe but offers benefits to the mother, including fewer interventions. On the flip side, alongside this has been an increased level of evangelizing about natural childbirth, which can be unhelpful for those who feel the reassurance of being in a medical setting will help them in their labour, or who require medical intervention but then feel a sense of disappointment or failure.

The thing that is often forgotten amidst all of these choices is that the choice is YOURS and yours alone. Where you birth your baby, and how you birth your baby are (up to a point) entirely up to you. All of those people with their scary stories and helpful advice can tell you those things because it’s not their body, and it’s not their baby. Many women don’t realise they even have a choice about their birth, and often entering into a medical environment can bring out the 5 year old in us, leaving us nodding meekly even as we’re hooked up to monitors and strangers come in to explore our nether regions…. But you CAN ask questions and you DO have choices.

And, once you’ve made those choices, the one thing you can absolutely guarantee is that birth will surprise you. It won’t go to plan. But feeling in charge of our bodies and empowered to ask questions means that, even when your birth plan goes out the window, you will still feel that you achieved something. Because, one way or another, your baby is going to come into the world.

And there’s nothing more perfect than that.