A PASSION FOR BIRTH

. . . and why their prejudice can harm mothers AND their babies, by the woman who taught a generation how to give birth

SHEILA KITZINGER was the natural childbirth activist who taught generations of British women how to give birth. Here, in the final extract from her memoirs — completed just before her death in April at the age of 86 — she shares some of the more startling conclusions from her lifetime’s work . ..

OVER the past few decades, thousands of pregnant women have been taught to breathe in a specific manner through their contractions. Breathing ‘correctly’ became a massive trend, which Americans particularly took to heart. At antenatal classes, the men actually had stop-watches so they could time contractions and regulate breathing with precision. In the first stage of labour, it had to be so many breaths at precise ‘levels’ (for example, deep slow breaths for a certain number of seconds); in the second stage, the woman would be ordered to hold her breath for at least 30 seconds at a time.

Women were also taught to contract their abdominal muscles while they pushed. Yet this made little sense to me.

A woman who pulls in her abdominal muscles usually simultaneously tightens her pelvic floor muscles, thus delaying the descent of the baby and causing herself unnecessary pain.

So women were being trained to do something which was quite unnatural.

It was when I walked through some fields in the Cotswolds one day, at the peak of the lambing season, that I realised why all the prescribed ‘huffing and puffing’ was also wrong.

As I watched ewes giving birth, I was fascinated to see that they produced short, rapid breaths through open mouths. Cats and dogs do the same. They don’t go in for all the huffing and puffing and breath- holding that women are taught to do.

Nor do they get into the extraordinary positions that are often required of women in labour, such as lying flat on their backs with their legs in t he ai r. I nstead, t hey’re in a semi-upright position during the final stage, and often move around and shift position.

The fact is, that when a woman does what comes naturally, she’s likely to breathe in the same way as other mammals.

Women have a similar breath pattern when they have orgasms.

At first, breathing is at least three times faster than usual, and then the woman involuntarily holds her breath. She may do this up to five times at the height of orgasm, then her breathing slows down as it passes.

Giving birth can be an intense and joyful psycho-sexual experience.

When women allow themselves to be swept up in the natural rhythm of labour, each contraction follows on from another like the waves of the sea. Meanwhile, the same hormones are pouring into their bloodstream as those activated during sexual arousal.

YOU CAN DANCE THROUGH A DELIVERY

A WOMAN who’s enjoying her labour will swing into the rhythm of contractions as if birth-giving were a powerful dance. As the mother of five children, I’ve not only experienced this myself but seen it happen time and time again.

In one hospital I visited, women were labouring in cell-like rooms, lying flat on hard, narrow beds. The staff talked to each other about each ‘patient’s’ progress as if the women themselves were deaf, dumb and blind. One woman was moaning and tossing in pain from side to side. ‘The cervix isn’t dilating — there’s no progress,’ I was told.

I asked if I could get her out of bed. The senior midwife looked surprised, but gave her consent.

Once we were alone, I lifted the woman off the bed. Holding her lightly, I started to rock and circle my pelvis. As each contraction ebbed away, I gave a long breath out and was still; when I sensed another was coming, I danced and breathed my way through it with her.

After about half an hour, a midwife came in to do a pelvic exam. The woman was fully dilated. We laughed and hugged each other.

Even now, some doctors and midwives take it for granted that a woman will be on her back during labour and delivery.

But this position can often cause acute pain. It means that many women never have a chance to experience the excitement of childbirth. Instead, it becomes a kind of contest, with cheer-leading teams urging a mother on to ever greater effort.

This makes her feel that she’s falling short of a standard that’s impossible to attain. And if she strains or holds her breath for too long, her blood pressure drops, reducing the amount of oxygen available to the baby.

If you really want to help a woman in labour, try not to manage, conduct or coach. What she needs far more is someone to help boost her strength and confidence.

LET OLDER CHILDREN WATCH THE BIRTH

AT THE age of five, my grandson Sam was invited to witness the birth of his sister.

Tess — the only one of my five daughters who’s had children — had decided on a home birth in a pool, and he’d made it clear that he wanted to be there.

Already, Sam knew more about birth than many pregnant women do.

He’d seen his own birth photographs, and all his questions had been answered candidly. He knew how the baby developed in the uterus and what it could do at each stage of pregnancy. He’d even heard the baby’s heartbeat and felt the baby’s movements when the midwife came to check up on Tess.

When the great day dawned, Sam and his father Jon settled in the kitchen with felt-tips and paper, while Tess floated in a pool set up in the sitting-room.

Sam wandered in and out, obviously aware that something momentous was happening but not anxious about it.

He was in the room as the baby was born, sharing his mother’s excitement and anticipation as she pushed.

Afterwards, he sat on the rug by the log fire, cradling his baby sister tenderly in his arms. She looked up into his eyes and he spoke softly to her. They were already friends.

Until World War II, children were often around when a baby was born. They were always involved with the preparations and often had a cuddle from Mummy during labour.

They weren’t given much idea of what to expect, but birth was a normal part of life.

Sometimes children just happened to be present at the birth, and they climbed on to the bed to hold the new baby when i t was only a f ew minutes old.

In my research in Britain, Australia and the United States, I’ve found that

children who were present at a birth often communicated a sense of awe and wonder.

The pictures they drew afterwards usually showed Mummy smiling; sometimes they gave her a crown, drew in a cake and made it look like a big birthday party.

Today, however, we tend to shield our offspring from the realities of childbirth.

This is partly a legacy of Victorian times, when middle-class children were told that the doctor had brought the baby in his little black bag, or that it had been picked from under a gooseberry bush.

But the main reason is that most babies in Britain are now born in hospital — where the woman becomes a patient and birth is r arely an experience f or t he whole family.

This means that children learn about birth from TV: they see a woman suddenly doubling over in pain, and then there’s a mad dash to hospital.

Often, this takes place in a drama in which the baby’s life is at risk, and sometimes the mother’s, too. Then they’re both saved by a highpowered medical team performing an emergency Caesarean in the nick of time. In other words, we’re conditioning our children to think of birth as a medical emergency, like a road accident or a heart attack. Scary!

SPITE OF THE SISTERHOOD

In The Seventies, I was viewed as a radical for saying that birth was being depersonalised and treated as if it were a pathological event, rather than a normal life process.

To my surprise, it wasn’t just obstetricians who dismissed what I had to say. I also found myself in conflict with feminists, who saw birth in very simplistic terms.

Why? Because they claimed it was every woman’s right to give birth painlessly.

An article in Spare Rib, the radical campaigning feminist magazine, went further.

Without any evidence, the authors asserted: ‘Undoubtedly, hospitals, with all their faults, are the safest places in which to give birth. For this reason, we think we should press for improvements in hospitals rather than support a move to more home confinements.’

I was appalled at how my sister-feminists could fail to support woman-centred birth. Polly Toynbee, writing in The Guardian, was particularly virulent, dismissing me as a lentil-eating earth goddess.

‘how extraordinary,’ she said, ‘that those who call themselves feminists fight for women’s right to suffer and, in the process, inflict so much unnecessary suffering on women. The right to safe local anaesthetics, properly administered by experienced obstetric anaesthetists, should come first.’

Of course, it’s up to the individual if she chooses to have drugs during labour. What concerns me is that freedom of choice comes only with knowledge of the alternatives.

In some hospitals, I discovered, women were being persuaded to have pethidine or an epidural without knowing what that entailed. nurses would simply ask at the height of each contraction, ‘Don’t you want something to take away the pain?’

In some cases, women were given 150mg of pethidine — enough to cause extreme drowsiness, nausea and vomiting, confusion, amnesia, visual disturbances and hallucinations. It also makes the baby less likely to breathe spontaneously at birth, especially if the drug is given close to delivery. The baby may also be sleepy in the days following birth and slow at sucking.

epidurals were being routinely ‘pushed’. Typically, even if a woman didn’t need pain relief, she’d be told that she was bound to need it later, so she might as well have an epidural now while the anaesthetist was around.

Many women were not told about possible side-effects. So they were surprised when their blood pressure suddenly plummeted, they felt weak and faint and their bladders had to be emptied with a catheter.

They didn’t even realise that having an epidural increased the risk of a forceps delivery.

A lot of this still happens. Yet studies have shown that when staff give warm approval to a woman’s determination to cope without drugs, this boosts her morale. And that, in turn, makes it much more likely that she won’t need them.

ADAPTED from A Passion For Birth by Sheila Kitzinger, which is published by Pinter & Martin on Thursday at £20. © 2015 Sheila Kitzinger. To pre-order a copy for £16, visit mailbookshop.co.uk or call 0808 272 0808. Offer until this Saturday; p&p is free for a limited time only.