Stand and Deliver!: And other Brilliant Ways to Give Birth. Emma Mahony

to have a good birth should be every woman’s right.

       FIRST STAGE LET’S START AT THE VERY BEGINNING …

       CHAPTER 1 … A Very Good Place to Start

      From the moment I realized as a little girl that my biological destiny was to have a baby, childbirth hung over my head like the sword of Damocles. Unless you are a child of a flower-power mother, and strew daisies on the floor while Mummy laboured in a yurt, birth seems a frightening and mysterious act. You know it’s going to be awful because you have watched ER on TV, and seen the actresses pinned to beds by machinery, flailing around like salmon on the end of a line. You believe it is just as likely to happen in the back of your car, because these are the horror stories that you read about in the papers. And, most of all, you are convinced that it will hurt more than having all your teeth removed with string and a doorknob, because every stand-up comedian has cracked that joke (and no one ever heckles). Our cultural conditioning around birth is so firmly implanted on our mind map that it is amazing women fall pregnant in the first place (well, perhaps not, post-Sex and the City). We all live under the illusion that a ‘cure’ will be found during those nine months of gestation.

      Well, I’m here to convince you today that birth can be fun. Say it extremely quietly, but there are plenty of women who have actually enjoyed giving birth. So much so, that they want to go and do it all over again AS SOON AS IT IS OVER (now you understand the hushed whispers). Don’t believe all the doomsayers. Birth does not have to be like sitting O levels unprepared. If it goes right, it can be a wonderful, transforming, empowering experience that can change your image of yourself and your life for the better. I’m not saying it won’t hurt. The ‘ring of fire’ has never been more aptly named. I’m just saying that pain and pleasure go hand in hand, especially if you add to the cocktail some powerful hormones to help it all along.

      The birth of a baby is a defining moment in every woman’s life, and the better it goes, the easier her transition into motherhood. So, how do we rid ourselves of all the cultural conditioning that makes us think that birth is a bad thing, a terrifying and horrible experience to be endured rather than enjoyed? Through cultural unconditioning.

      Cultural Unconditioning

      This is going to be very hard. You need to think about all those frightening little snapshots of birth that you have picked up over your non-childbearing years, write them down, screw up the paper and throw them in the bin. How you think and feel about birth is going to have a bigger effect on your eventual labour than that epidural that you have already booked. If you can look forward to it, have confidence in yourself and trust in the physiological process, then you’re already halfway there.

      Getting to this point is not always an easy ride. Somewhere in your psyche there is the shock of your first impression of birth. For me it was a video shown at primary school, of two legs and a human baby coming out between them. It was probably a biology class, but all I remember is looking away, shocked by the bloody violence of it all. Distanced in a clinical way by the medium of video, it became a scene from Alien rather than a sacred moment. Even then I could see that birth should be an intimate and private event, not open to voyeurs.

      But if that image shocked me at a tender age, it did at least clear up how babies get out. Before that I believed they came out of my tummy button, an otherwise seemingly pointless part of the body.

      Assumptions and ignorance about our bodies is rife among even the most educated women, and pregnancy is a good time to reacquaint yourself with your body. One 70-year-old midwife from southern Arkansas described how, when she was in labour with her first baby, she, too, didn’t know where the baby was going to come out. At a conference in the 1980s she related: ‘When I was alone in labour, I looked all over myself. I had a mirror and was looking all over my body. When I opened my mouth, I thought “That must be it!” When I saw that little thing in the back [her uvula], I thought that was the baby’s big toe. I thought I was going to have to throw up the baby. It wasn’t till the midwife came and washed between my legs that I suddenly realized where the baby was going to come out!’¹ Most of you will be further along on these issues than the midwife and my younger self, and some of you may even have studied the birth pictures in Dr Miriam Stoppard’s and Sheila Kitzinger’s pregnancy books. Once again, you are wiser (and braver) than I am. I still have to peep at shots of other people’s births through my fingers – three babies later – and not because I get distracted by the beards and long hair in the photos (for some strange reason, all birth books only feature Seventies’ casualties). If you, too, cannot stomach these images, don’t worry. It won’t affect your labour. When it comes to your birth, you will be heading up the important part, up top. You can leave the messy stuff to the professionals.

      Doctors and the Medics

      When you go into hospital – a place that will always bring up some anxiety of being ill or visiting sick relatives – you do so as an intruder. As a woman you are not ill, just pregnant, but as you sit in the waiting room as one of many, you may begin to experience new pinpricks of fear that weren’t there before. In the ultrasound department, this fear may be coaxed out by giant posters on the wall showing photographs of your baby in utero looking like a visitor from outer space. Other posters will carry information about how you could already be harming your baby by smoking or drinking. In the waiting room there will be more posters of mothers cradling a newborn with a headline telling you Why Breast Is Best or another showing a baby sucking on a bottle of sugar, warning of the perils of giving juice in a bottle. The hospital atmosphere itself might make you start thinking new thoughts: ‘Will this baby be all right?’ or ‘Why do they want me to take a blood and urine test? Does everyone have these, or can they see that I am a bit thinner/fatter/taller/smaller than the woman next to me?’

      Sometimes, talking to a doctor can be more confusing than enlightening, as strange words are used, as if you were already in the know: ‘We are measuring the nuchal fold,’ says the radiographer. ‘We are looking for protein in the urine,’ says the midwife, as if you had some understanding of its significance. The use of language like this builds a barrier between you and the people with the stethoscopes round their necks, and often you feel a little more helpless and a little more ignorant than before you went in.

      Of course the picture I am painting may be far worse than in your corner of the country. Here in London every hospital antenatal appointment is double-booked, so you can wait over two hours for your precious five minutes with the consultant. Even in those five minutes, if you have a medical student present the doctor may not be addressing you but teaching while talking.

      Testing, Testing, One, Two, Three

      As well as the brief chats with the doctor, there are also all sorts of tests that you may have in your pregnancy. The main thing you need to know about all these tests is that of all the 760,000 women who fall pregnant in the UK every year, only a tiny, tiny percentage will have to alter the course of their pregnancy after being screened. Some of the tests, such as routine screening for gestational diabetes (where you are given a glucose drink to take beforehand and, unsurprisingly, your blood sugar levels go wild) are being abandoned now anyway. Peter Brocklehurst, Director of the National Perinatal Epidemiology Unit, has this to say about the GTT (Glucose Tolerance Test): ‘The test is unreliable, doctors do not know how to treat it, and anxiety in the minds of the woman and her carers could be raised, increasing the risk of the pregnancy ending in a Caesarean.’²

      I’m not suggesting that some of these tests don’t have a place. The urine test to find out whether there is a certain protein in the pee to indicate pre-eclampsia (a pregnancy-induced condition