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By Beth Whitehead
Birth is one of the most universal human experiences. Each birth is significant to the birthing mother and family. Yet in the Western world, modern maternity services appear to have managed to turn most births into crises where women and sometimes babies come out with some form of injury, physical, psychological or both. I remember when I had my first baby, I was seen by different midwives and obstetricians throughout my pregnancy. Each time, I had to explain my personal history and birthing preferences. Not all of them listened or respected that the decision belonged to the birthing woman - me. I felt that the service was inconsistent and inefficient.
At the birth at the hospital, I was handled by midwives that I had never met and they had no interest in my birthing decisions. The environment was hostile with harsh lighting. The midwives were stern and refused to listen. They were exercising protocols and treated me like a piece of meat going along a conveyor belt on an assembly line, being timed and squeezed into their processes. It was not surprising that in an environment where my birthing physiology and my humanity were not supported, I ended up having a long labour resulting in perineal injuries. It was like being kicked in the ankle when I tried to run. What stood out was not just the lack of kindness, care and compassion, but how the practices undermined my intellect and my body. I never thought healthcare workers could behave in the way they did. It was a cultural shock.
I grew up in Asia where the arrival of a baby was always a cause for celebration. We had family members and helpers around, usually older women, to assist with looking after the baby so the new mother could rest and recover. It is true that it takes a village to raise a child. However, in the UK, women are often left on the side like some discarded wounded animals with little or no support.
I wanted to breastfeed my baby as it felt intuitive to me, but the staff at the hospital kept pushing me to give formula. The Trust advertised they had UNICEF Baby Friendly accreditation1 but the reality of my experience was that there was no-one on site willing to offer breastfeeding support in those crucial early days. Sticking a bottle in the baby was pushed to me as the solution to everything, never mind what the individual mother or family wanted or the baby needed. I eventually gave in to the bullying and gave my baby some formula, but he just spat it out and cried. We later found out he was actually intolerant to dairy, so the cow’s milk could have made him very sick. That is why an authoritarian approach without considering the individual’s needs is harmful.
Going home was good as I was not being harassed by the staff to keep giving formula anymore, but the lack of support for breastfeeding persisted. I tried the National Breastfeeding Helpline.2 While it was comforting to talk to someone, what I really needed was in-person support as it would have been much more effective to be shown how to do something. Every mum and baby are different and now I know it is a partnership, how some adjustments in feeding positions, reading cues from the baby and encouragement can make significant differences to the nursing experience and length of feeding.
The knowledge of breastfeeding is usually passed on from older mothers to the younger ones in a communal environment but in the absence of such in the Western society, the help from breastfeeding counsellors is crucial. The low rate of breastfeeding in the UK is often cited as an issue when compared to the WHO recommendation,3 but we only need to look at the environment women are in to understand how little support there is for their birth and postnatal journey.
The breastfeeding clinic at my local children’s centre was open one morning a week for two hours. This support was the turning point for me and my baby to make nursing work for both of us. It was not just sad, but also infuriating when, over the years, the Conservative government cut the funding, the clinic was cancelled and, soon after, the children’s centre was closed down too. The village vanished. Nurturing the next generation is one of the most valuable contributions that mothers make for their country. Yet it is undervalued, unappreciated and unsupported by the ones who reap the rewards of mothers’ labour.
When I was pregnant, my husband and I attended antenatal classes. We were told that co-sleeping with our baby would be dangerous and that we should put the baby to sleep in a cot. Being first-time parents, we tried to take on board all the advice, so we had a crib set up nicely for when our baby came home.
The first night after we brought our baby home, following hours of trying to put him to sleep in the crib and him crying inconsolably, it became clear that he did not want to sleep there. As soon as I laid him next to me on my bed with my arm stretched out away from the top of his head, he stopped crying and started rooting for my breasts to feed to sleep. It felt natural and soothing for both of us. We fell asleep together shortly after that. Somehow, my body always knew where he was and curved around him. I tried to see things from his perspective. After being inside me for months at a constant temperature, listening to my heartbeat, being outside, breathing, feeling different temperatures and textures must have been a strange, perhaps even shocking experience. Being close to me, feeling my warmth, my smell, and listening to my heartbeat again must have felt incredibly familiar, comforting and safe for him.
Bedsharing felt right for us. It brought back memories of me co-sleeping with my parents until I was about 4 years old. Waking up and knowing my parents were nearby made me feel safe. The game-changer was once my baby and I worked out how to breastfeed lying down. It made me feel less achy. No-one told me how physically demanding looking after a newborn would be. In paintings and films, they almost always show how babies are fed using cradle hold with all the weight on the mother’s arms. The reality for me was that it never felt natural nor comfortable. In fact, it gave me terrible back pain. Feeding lying down or with the baby from the side (‘rugby hold’) or with him straddling on my leg (‘tiger in the tree’) were the most comfortable positions for both of us. I guess aesthetically, they do not look as tidy, but nature is not meant to be neat. We all come in different shapes and sizes, hence no one size fits all, but we experiment and find ways that work for us. That is why flexible and kind attitudes and environments are important in supporting mothers in nurturing their babies.
In an emergency on a flight, you must put the oxygen mask on yourself before you assist others. It is the same with postnatal recovery for mothers, except we live in a society where it is expected that the needs of others (e.g. the wider family or older children) are above a woman’s own. It is completely cultural and irrational. There really is no need to sacrifice a new mother’s well-being when it is a time for her to rest and recover. Looking at other cultural practices will shed some light on different ways to support mothers at this delicate time.
In South Asian culture, older female relatives usually give the new mother massages to help her relax. They make her nutritious food and herbal drinks that are believed to encourage breast milk production. I find that in the Western world, people are incredibly critical, arguing that herbal drinks do not contribute to milk production, due to the lack of scientific evidence. However, I think it is the kindness, care and thoughtfulness that make new mothers feel supported and relaxed, so that the hormones in their bodies can respond more favourably in nurturing their babies. Looking at the chemical composition of the herbs is really missing the point of how humanity, care and healing work.
In Southeast Asia, new mothers usually spend the first month after giving birth in confinement, resting at home with their baby. This is seen as a critical time for the mother’s long-term health. Family members or hired help take over the housework and bring her special postnatal food, often rich in collagen for repairing her body, containing nutrients believed to encourage breast milk production. These cultural practices acknowledge the fact that new mothers need rest and support for their postnatal recovery.
It is disturbing that practices that are natural, intuitive and helpful for mothering, such as physiological birth, postnatal recuperation and co-sleeping, are often shunned or discouraged in the UK. The time has come to reflect on how new mothers are supported or not supported in this country. What can the government and everyone else do to nurture these important life givers and carers? We need to bring back the village.
Author Bio: Beth is a writer on maternity and women’s rights matters. She lives in Southeast England with her husband and children.
AIMS supports all maternity service users to navigate the system as it exists, and campaigns for a system which truly meets the needs of all.
The AIMS Journal spearheads discussions about change and development in the maternity services. From the beginning of 2018, the journal has been published online and is freely available to anyone with an interest in pregnancy and birth issues. Membership of AIMS continues to support and fund our ability to create the online journal, as well as supporting our other work, including campaigning and our Helpline. To contact the editors, please email: firstname.lastname@example.org
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