Trusting myself in birth

AIMS Journal, 2024, Vol 36, No 3

Salli and her mum on a bench commemorating the midwife who attended when she was born.

By Salli Ward

I was born at home in 1962 in rural Cheshire. My mum recalls watching from her bedroom window as the midwife arrived on her bike across the field. The midwife/district nurse who delivered me into the world was well known and highly respected. My mum recalls the doctors (there were only two) saying, ‘yes Maud’ when she instructed them. She was the expert.

When I was first pregnant in 1986, I assumed I would also have my baby at home. In my innocence, I didn’t think this was so controversial - though obviously I was aware it was slightly unusual - because I didn’t associate giving birth with anything medical – certainly not with illness. I didn’t entirely mistrust the medical profession; I wouldn’t hesitate to involve them if I was poorly, and they have saved much loved lives and limbs over the period of my life.

In birth, however, I believed in my body, in the bodies of women, and in nature. This isn’t to say I don’t think we should interfere with nature – surgery, antibiotics, defibrillators – they all interfere with nature that would have us die – but what has this to do with birth? Yes, people can have problems giving birth (I now believe, the more interventions, the more problems) but we can have problems climbing mountains, crossing the road, slicing bread, yet we don’t have doctors on stand-by when we do those things.

Back then I didn’t think all this through until my GP refused to – well, what do you call it? - be my GP! I found another GP, read a book called Birth Matters, and found out about my rights and about research into homebirth. All long before the recent very worrying signs of impending doom in maternity services.^[1]

Back then I somehow knew my body would be able to give birth. I wasn’t super-assertive, so I found it hard to insist, but I trusted myself. I didn’t even ask my then husband; to me, it was no-one’s business but my own. I expected (and got) his full support.

I now have two grown up daughters; one has experienced giving birth and it was awful. She did plan to have her baby in an excellent birthing centre but it was closed on the day. My second daughter is pregnant now and planning something similar, but in a different area. My step daughter-in-law is also pregnant but I can’t claim to have the right or the reality of much influence over grown people.

I cannot understand why women, particularly feminist women like my own stroppy, strong and mighty daughters, put so much trust in medics, in hospitals, in intervention, when they are planning delivery of their babies. I don’t understand why they fight misogyny, stand up for equality, dismiss damaging stereotypes and push themselves forward – yet willingly hand their beautiful, powerful pregnant bodies over to male dominated services (I know there are plenty of women in medicine now, but I believe it is forged in the fires of masculine domination). Furthermore, why do they fall for the notion that their bodies aren’t good enough, that they can’t stand the pain of childbirth, that they need interference to do what their bodies are built to do?

I am aware this sounds critical of other people’s choices. I want to stress that I believe in choice and if women want to choose hospital birth or caesarean or pain relief or whatever, that’s fine by me. What I question is how much it is a free choice. What puzzles me is why people make that choice when they are otherwise quick to stand up for women’s rights.

When I announced I was having my baby at home, the most common response was ‘how brave’. I took this to mean they thought I was doing something dangerous – this is worse than criticism to me. It means they thought I was deliberately putting myself and my baby in danger. For years I wanted to say, ‘how brave’ when friends announced their impending hospital birth, but I’m older now and have two birthing daughters – what can I say?

I did have my baby at home – and two others. My pregnancies were marred by concerns that I would be two weeks overdue and feel forced into being induced (my daughter was automatically booked for a cervical sweep when she was only a week ‘overdue’). With each of my births, I had to find my own doctor – all three were good – and work with the community midwives, who were amazing. I trusted them. I trusted myself and I trusted the power of nature. In labour with my first baby, I paced the floor until ready to push. I know that natural birth^[2] can happen in a hospital but I would be scared (‘how brave!’) of interventions and attitudes getting in my way (possibly literally).

I am aware that these days some conditions of birth – such as breech – can be dangerous because there are so few midwives left with the skills to assist a natural birth under those circumstances. Women’s bodies are essentially the same (actually better and stronger) and birth is unchanged, but so few people really know how to assist. My dad, born in 1927, famously (in the confines of our village!) came out feet first and had to be ‘pushed back in’ (full disclosure – he was a twin). My daughter’s baby is breech now – 5 weeks before she is due – I can’t advise her to resist intervention if the baby doesn’t move because I don’t know if we can trust anyone to deliver that baby safely. The skills may not be there.

This is a tragedy. As we move towards more caesareans and other interventions, will the human race eventually lose complete trust in women’s bodies? If my granddaughter is pregnant in 30 years’ time, will there be no-one who knows how to attend a natural birth?

This isn’t progress for women. I learnt recently that in America natural birthing (and breast-feeding) women are considered anti-feminist. It seems to be connected to the idea that women should be able to do exactly what men do – go back to work ten minutes after birth? What women do – especially if men can’t do it – has become so devalued that even ardent feminists are convinced it has little worth.

Why aren’t we demanding respect for what we do – what only we can do?

I try to trust the next generation will see sense. My three-year-old granddaughter knows that boys can wear dresses, that some children have two mummies (or daddies), that no-one can touch her without her consent, that bodies vary – and that’s all so very good. I hope that one day she trusts herself, her body and nature enough – I hope we can still leave her that legacy.

Bench in the village where I was born, remembering Nurse Hatton who delivered me.

Author Bio: Salli is mother/stepmother to 8 grown-up children with 2 – almost 3 – grandchildren. Born and bred in the north west of England, she now lives with her husband on a narrowboat around London – to where most of the children have moved – but she dreams of the countryside and looks forward to inter-generational communal living planned by two of the kids. Salli has been a dramatherapist, a charity CEO, a celebrant, and a fundraiser but is now a writer of policies, funding applications, articles, letters to the Guardian and unpublished (but extraordinarily good) books.

[1] Editor’s note: The author may be referring to the increasing reports from parents of poor support and of traumatic experiences, alongside documented concerns about staffing numbers, increased rates of induction and caesarean, and lack of support for women’s choices about where they have their baby.

[2] Editor’s note: Please refer to the AIMS position paper on Physiology-Informed Maternity Services: www.aims.org.uk/assets/media/730/aims-position-paper-physiology-informed-maternity-care.pdf