THE NATURAL CHILDBIRTH MYTH THE
Today’s mums-to-be are given endless lectures on how giving birth without drugs or medical intervention is best. Grazia magazine editor NATASHA PEARLMAN was convinced — until the nightmare that was her own experience
ON MARCh 28, 2014, just under three-and-a-half years ago, I gave birth to my daughter, Rose. And March 25 — the day before my labour started — was the very last time that I felt properly myself. I don’t mean that in a casual, ‘Oh, life changes so much after having children’ way. I mean it in a profound, heartbreaking, so-hard-towrite-down-it-brings-me-to-tears way.
My very hazy 33 hours of labour passed in what I can only describe as ‘a darkness’. It started the moment my waters broke at home at 10pm and continued for the 18-plus hours in hospital where I was refused a bed, even though contractions came every two minutes.
It carried on through the two morphine injections I was given after getting down on both knees in a corridor and begging a doctor for help. Nor did it lift when I was finally allowed onto a labour ward, given two epidurals (there was a complication with the first) and then pushed unsuccessfully for an hour.
Two whole nights and a day. And yet I could not tell you anything about them. There must have been light. I just can’t remember it.
Everything went white in those final five minutes. The white operating theatre. Bright lights. Doctors in white gowns.
The C-section I was prepped for never happened. But what happen changed me — psychologically and physically — completely.
Rose was stuck. Too big to come out; me too small.
This is pretty normal in the scheme of birthing hitches, but it’s not one that you’re talked through in detail beforehand.
The doctors, as they must do in thousands of births every week, went for the forceps. My husband, whom I insisted stayed right up by my head the entire time, told me that it was the only time he had the urge to intervene.
A doctor was sitting on a chair, pulling with all her weight, yanking Rose out of me with a giant pair of metal tongs. One go wasn’t enough: it took three. Just imagine what that does physically to someone.
I tore. I was cut. I was stitched up. I couldn’t sit down without a rubber ring to support me (so humiliating) for four weeks. I had haemorrhoids. I bled.
I hurt for months — physically and emotionally. I wasn’ t depressed. I was in shock.
I had to go out and live a ‘normal life’ because I had another life to care for. And I had a baby who had allergies and needed help. Which seemed to take up so much of my time and brain space, I stopped really thinking about myself.
TO
BE honest, I didn’t know how to speak about it. And no one asked me. No doctor. Nor midwife. And, for a long time, I shared only sparing details with my husband (I felt too ashamed).
I felt, I suppose, like a failure. I also felt that I had been failed.
It’s these feelings of failure that the Royal College of Midwives (RCM) wants to end, with the announcement last month that it is going to suspend its 12-year campaign for ‘ normal births’ (ie, births with no drugs, no epidurals, no inductions, no C-sections).
The RCM’s chief executive, Professor Cathy Warwick, said: ‘There is a danger that if you just talk about “normal births” — and particularly if you call it a campaign — it kind of sounds as if you’re only interested in women who have a vaginal birth without intervention. What we don’t want to do is in any way contribute to any sense that a woman has failed because she hasn’t had a normal birth. Unfortunately, that seems to be how some women feel.’
It is. And yes, the ending of this campaign will hopefully help to remove the stigma now attached to not ‘doing it naturally’. (What is so wrong with wanting pain relief? We take paracetamol for headaches, for goodness’ sake.)
But what it won’t end, for me, is the overwhelming sense that women today are being failed, not just by a choice of words, but by the system, too.
Why
was I so obsessed with having a natural birth? I have asked myself this a million times in the years that have passed since Rose was born.
Childbirth is presented to women in a number of ways.
As a challenge: Are you tough enough to do it the ‘proper’ way?
As a holistic wonder: ‘The joy of passing through the pain.’
As a terror: But not, ironically, of what could happen during natural labour, but the terror of epidurals and C-sections. And the way most women encounter this information is via their midwives and NCT (National Childbirth Trust) classes.
Standing back from it all now, I feel such immense heartbreak at the way birth was presented to me, but also my complicity in it.
From my first appointment with a midwife on the NhS, there was a blank assumption that I wanted to do it naturally. I saw a different midwife every appointment, but no conversations were initiated about birthing options.
When I asked to whom I should give my birthing plan (a written plan of how I envisaged the birth, including who I wanted in the room with me, my preferences for pain relief and how I felt about interventions), I was told dismissively that births vary anyway and whatever was best for the baby would be done regardless.
(I still find this so difficult because it effectively dismisses the human who then has to piece together their body to take care of the child, although of course I understand that preserving life is of the utmost importance.)
At twenty- something weeks, I made, as many pregnant women do, the transition to NCT classes — six weeks of ‘lessons’ at a cost of £300, thank you very much.
The teachers, trained by the organisation, are passionate advocates of natural birthing. I’d actually gone into my NCT classes believing I wanted an epidural. I left fearing all intervention.
The once-a-week sessions taught me how to breathe to cope with contractions. We were told that epidurals carried risks, potentially delayed labour, made it hard to know when to push.
One of the dads in my group was an obstetric anaesthetist at the local hospital. he stopped the NCT teacher to angrily remonstrate with her — but the seeds of doubt had been planted in our minds.
With breathing, we learned, you could be in control. A water birth? The dream.
And C-sections? I can’t recall it being on the syllabus, other than yet more fear-inducing over a sixweek recovery, not being able to walk and not being able to hold your baby.
At one point, our teacher passed around a faded 20-year-old picture of a woman ‘birthing’ her placenta. I turned it over and refused to look. Who needed to see that?
I wanted to know what could happen: real scenarios, real options. Over and again I was reassured that I could do it naturally. I was made to feel that if it didn’t work out like that, then somehow it would be my fault. I just needed to go with it.
I’m an educated woman. I should have been more inquiring. I wasn’t. I made my decision to go ‘natural’ in part because of fear. Also because my sister had had a successful water birth (although accidental, due to the speed of her labour). And, at the fittest I’ve ever been, I believed my body was up to the challenge.
But mainly I trusted that my ‘educators’ had my best interests at heart.
Today, as shown by the Royal College of Midwives
climbdown, I don’t think they did. And the NCT? While I’m aware many people have a positive experience with these groups — and some do have wonderful teachers — for me, for the reasons above, I believe they are fundamentally no longer fit for purpose.
For a long time after, I played back the birth in my head to try to process it. At other times, it came to me in distressing flashbacks.
I was well aware that what happened to me wasn’t unique — but that was almost more upsetting. I felt like my wellbeing and my body had been totally disregarded. Surely I wasn’t alone in feeling like that? There were moments, too, when I blamed myself.
When my waters broke at home on the Wednesday night and the contractions started coming every one to two minutes (the time at which I was told by my NCT teacher to come in), we drove to hospital.
When I’d asked my teacher what to do if your waters broke before full labour had started, she replied, ‘That only happens in the movies’, and moved on.
So right from the start I felt unprepared.
The midwife who examined me in the admissions ward told me to go home. I wasn’t dilated enough (only 2cm, not the required 4cm) to be deemed admissible.
But I was scared. I also had no idea how I was supposed to know when to come back, when I was already experiencing nonstop contractions. I did not want to have my baby at home.
Did everything else bad that followed stem from what I did next?
I refused to leave. They refused to give me a bed. If I was insisting on staying, then my ‘ punishment’ was a windowless side room, with only a chair. To add insult to injury, not a single delivery room was occupied.
At first I remember feeling OK OK. It was my decision to stay stay. I was mentally coping.
Bu But when, after about eigh eight hours, they discovered tha that Rose had turned back to back (which, I learned onl only after I’d given birth, hal halts the progression of lab labour), I still wasn’t assG assessed properly.
Given that there is a lim limited time to deliver a ba baby after your waters br break (within 24 hours, to lim limit the risk of infection), lo looking back I would have ex expected to have been ta talked through some op options: to be given a ro room, offered an induction, ti or even just some si simple advice on how to tu turn the baby.
The midwives did n nothing. It seemed as if th they had made the decision decision, without consulting me, to push me to the absolute limit to deliver the baby naturally.
I was in a system out of my control. I also didn’t know how to ask for anything else. I didn’t even really know what to ask for.
Even when I was finally dilated enough to be admitted, I wasn’t. Why not? I have no idea. The windowless room remained my home. My spirit was broken.
I hadn’t eaten for I couldn’t remember how long. I didn’t know what day it was. I was high as a kite after the morphine I’d had to beg for.
And then, at some point late on Thursday, 19 hours after I’d first arrived, when the doctors were insisting that I needed antibiotics to prevent Rose being at risk of infection, I was allowed onto the medical labour ward to be induced.
Being under the care of doctors rather than nurses changed everything. I literally wept with happiness when the epidural and its huge needle threaded up my back.
It would have been about 5.15am on the Friday when I was asked to find the energy to push a child out of me. I tried so hard, I could feel my body breaking things I just knew could never heal. And when Rose didn’t come, I was sent to the operating theatre. I was so relieved I was going to have my baby that I no longer cared what was happening.
BuT
I should have. Because if I had not been so ill-informed, I might have been able to protect myself better. To prevent the long-term damage I still suffer from today. I paid good money to learn about birth. I came out so uninformed that I wasn’t able to insist on what was right for me. No forceps. Quick, fast pain relief. And a C-section.
The biggest shock of my difficult birth was the aftermath. It seems stupid to say but by the end of my labour I was so numbed with shock and pain relief that I hadn’t really expected what would happen to my body in those first hours, days and weeks after.
I cannot begin to describe the horror of realising that I could barely walk because every centimetre of my pelvis was swollen, bleeding or stitched up. The pain of going to the toilet for the first time. The complete fear of what my body was going to do next, coupled with a tiredness that was unlike anything else.
I had to wear incontinence pads just to walk about because maternity ones didn’t cut it. I shook constantly.
The first time I got on the Tube, when Rose was six weeks, I had a panic attack. It sounds bonkers, but it was like climbing Everest. I couldn’t believe I used to do it every day without thinking.
I also hated my body. How can you find the confidence to love your body again, and to even imagine feeling sexy, when it doesn’t work as it used to? I remember my husband trying to initiate sex for the first time after about six weeks. I literally recoiled in fear.
Sex. That is the one thing no one ever prepared me for postbirth. The pain. Thankfully it got easier after a few months and pretty much back to normal after six. But for a while, I just had to grit my teeth and get through it.
You can see why so many marriages come under strain after a baby. It takes an enormous understanding on both sides that the thing you have loved, and made your child, can feel so violating for a woman after.
When I went back to work after six months, it was a relief. I wasn’t cut out for maternity leave, but then I suppose my maternity leave was also a reminder of the bad times. My blind focus was on trying to restore as much of my old life as possible.
And in many ways that has saved me. I filled hours with work and Rose. There was no time to think about it any more.
For a long time, I was aware that other friends had been through traumatic births, too. But apart from comparing a few surface horror stories, we never spoke about the longterm damage.
How many, sitting there over lunch, felt like I did inside? Did any of them also weep silently alone at night? How many of them still find what happened difficult to talk about?
Three-and-a-half years have passed, and in many ways, my life is more than I could ever want it to be. I’m the editor of Grazia magazine. I have Rose. And a marriage I’m incredibly proud of.
Yet underneath it all is a trauma that defines me. I still can’t run, walk at a fast pace, get on a trampoline or even sneeze without suffering incontinence. ( How’s that for front- row fashion-week chat?)
And I am utterly terrified of getting pregnant again, while knowing that my husband would really love another child. I carry my shameful little secret around with me constantly. One that isn’t actually my fault.
This is no pity party. My experience is by no means the worst. It’s also by no means the most traumatic ( I am incredibly lucky never to have experienced loss).
But it is the truth — about what can happen to a female body during birth, and the psychological and physical consequences of the obsession with natural birth at any cost.
AND
the reason I feel so passionate about talking about it is that it is a truth that has been hidden for far too long.
There is growing evidence that I am not alone in feeling this way. The Birth Trauma Association, a peer- to- peer support group, estimates that as many as 200,000 women may feel traumatised by childbirth and develop untreated symptoms of post-traumatic stress disorder. Another 10,000 seek treatment every year.
More than 90 per cent of women who have vaginal births tear or need an episiotomy (a cut). up to half of all women who have children suffer some form of prolapse. And according to a 2015 study in the British Journal of Obstetrics and Gynaecology, 24 per cent of women suffered pain during sex for 18 months after giving birth.
How is it that childbirth — the one thing our bodies do that male bodies can’t — can feel so anti-feminist?
How is it that while feminism has advanced our careers, it
hasn’t advanced the one thing that can cause us the most trauma and most lifelong physical changes?
And why has it taken so long for us to speak openly about it?
For many years, I think that giving birth was a badge we were meant to earn. When you have the entire RCM set fundamentally against the feminist founders of Spare Rib magazine, who were lambasted for their belief that every woman deserved a pain-free birth, how were we meant to move forward?
Similarly, women who opted for C- sections were labelled ‘too posh to push’.
Then, more recently, the trend for natural birthing ramped up — with the explosion of hypnobirthing, ‘orgasmic birthing’ and the RCM’s ‘normal’ campaign.
Yet all this is set against a 20 per cent rise over the past 30 years in women having ‘assisted’ births. (They now account for 60 per cent of all babies delivered in the UK, which is attributed to the rising average age of mothers and the increase in baby birth weights — although figures in a 2016 RCM study suggest it’s even higher — nearing 80 per cent.)
But now we are on the cusp of another huge generational shift. Women of my generation have become mothers in the age of social media. We share our lives on it. We are empowered in so many respects by it.
And we are tentatively beginning to share the real birthing stories that have, in many cases, irrevocably changed us.
We have grown up expecting careers. And we take care of ourselves. We want to return to work after having a baby, and we don’t want to do that physically altered. We want to exercise, to run — and not to have to wear sanitary towels just in case we sneeze. We want to have the information beforehand so we can make the choices that are right for us. We want, as much as possible, to be in control.
We are aware that no man would ever accept this level of injury or lasting damage if they gave birth. I’m certainly not advocating a switch to C- sections. Why shouldn’t women want, and have, a natural birth?
But if we were armed with knowledge, wouldn’t we know far better what to ask for when things stop going to plan? How differently would we feel about birth if it were placed more in our control?
In the three and a half years since I gave birth, I’ve often wondered what has stopped us telling women in advance what childbirth is really like, and I can’t help but think it’s a form of control. Do we fear somehow that if we tell a woman what it’s really like, she might not want a baby?
Would I have wanted a baby despite knowing everything that could happen? Of course. Would I still have tried to have a natural birth? Probably.
I just would have gone into it with eyes wide open. And I truly believe that, at the very point I realised it was going to go horribly wrong for my body, I would have insisted on medical intervention.
If I were ever to do it again, though, I would never go natural. Just last week, at a doctor’s appointment, I joked to my amazing GP: ‘If I ever have another child, I’ll tell you right now it’s not coming out of my vagina.’
She laughed and replied: ‘Why do you think I had a Caesarean for all three?’ She knew. She chose. Now it’s time the rest of us got told.