Judging Birth

By Rachel Reed

Birthing Behaviour

Women’s behaviour has been judged and controlled throughout history. We are supposed to be ‘good girls’ – do as we are told and not create any problems for others. However, the act of giving birth is primal and ‘wild’. Our birthing behaviour originates in the limbic system, the area of the brain shared by all mammals. To labour well we need to shut down our neo-cortex – the thinking human part of the brain. The result is instinctive ‘animalistic’ birthing behaviour. Because we are individuals, our birthing behaviour is also individual. Some women become quiet, withdrawn and ‘in control’. Others become loud, wild and ‘out of control’. For many it is somewhere in-between, or both, at different times during labour. Just like behaviour during sex (also controlled by the limbic system) there are similarities between humans, but we all behave slightly differently.

The idea that there is a ‘right’ way to behave or worse, a ‘wrong’ way to behave is unhelpful and judgemental. It seems that being quiet and ‘controlled’ is considered to be the best way to birth. How many times have you heard a woman’s labour described in a positive way because she was ‘so in control and quietly breathed her baby out’? In contrast, the loud woman is encouraged to breath (ie. stop screaming/shouting) and focus. This happens often in the hospital setting where midwives attempt to keep a woman quiet so as not to ‘frighten the other women’. These women are often described as ‘not coping’ – when in fact they are coping just fine… but loudly. It is those around them who are not coping. Michel Odent suggests that the intense fear and sense of ‘losing it’ often experienced near the end of labour facilitates the fetal ejection reflex. Not many women experience this because midwives (or others) intervene to calm the woman and help her gain control of herself.

It’s not just midwives, but also mothers who judge themselves for ‘losing control’ and making noise. I find it sad to hear a birthing woman apologise for her instinctive behaviour – but they do. Indeed there are childbirth preparation programs aimed at learning how to be quiet and in control during birth. Unfortunately, some women who have undergone this training feel like failures when their instincts take over and they become vocal. Perhaps we (society/culture) are afraid of the primal power expressed during birth – here is a woman connected to, and expressing the immense power and strength of woman. The response is to shut her up and encourage her to act like a ‘good girl’ so as not to upset anyone (including herself).

Here is a beautiful example of a mother birthing instinctively and loudly:

So, lets honour our birthing behaviour whatever it may be. Whether you are a quiet, breathing birther, or a loud and wild birther – you are equally, but differently amazing. Midwives need to learn to distinguish between a woman who is expressing her wild birthing instincts, from a woman who genuinely needs reassurance and calming. Talking with her before birth about what she will say if she really does need ‘help’ can be useful. In addition make sure she knows that you will not judge anything she says or does during labour. It is also important that women hear and see birth stories that show a range of birthing behaviours – not just the quiet and in control types.

Birthing Choices and Experiences

Women are also judged (and judge themselves) on their birth choices. Here, you really can’t win. If you choose an elective c-section for no medical reason – you will be judged. If you choose to freebirth your baby – you will be judged. And for every birth choice in-between others will have an opinion and judgement about what you do, or don’t do. There is no right way to birth. For healthy women and babies a physiological, undisturbed birth is probably the safest option in terms of outcomes. However, some women don’t want this – or are unable to have this. Any birth choice a woman makes based on an assessment of the benefits/risks and her own situation/needs should be respected. The focus should be on ensuring women have access to adequate information on which to base their choice – not on the choice itself.

How the birth looks on paper may be very different to how it was perceived by the mother. I learned quickly as a community midwife doing postnatal visits that the ‘birth report’ had no connection to the woman’s perceptions of her birth. Women who had experiences such as ‘failed forceps’ and then a c-section could emerge feeling empowered and more than happy with their experience. On the other hand, women who had experienced ‘normal’ vaginal births without intervention could be traumatised. I find it is best to ask a woman how she feels about her birth rather than making assumptions based on the events. Often feelings centre around the care and respect, or lack of that was given during the birth journey rather than what happened.

Every birth experience is valuable – even those that don’t go as expected or planned. Hindsight is a wonderful thing, and we often look back and wish we’d known X because we wouldn’t have made the choice Y and ended up with Z. Many women choose homebirth based on a previous birth experience that with hindsight could have been very different. It is only because of that previous experience that they have explored and learned about birth and themselves. That previously disappointing (and in some cases traumatic) experience has provided the foundation for self-growth.

Sometimes birth does not go as planned because if left to unfold as nature intended the result would be a poor outcome. Appropriate intervention can, and does save women and babies. However, women are often left doubting their body and can then judge themselves and their birth experience as a ‘failure’. I have recently been discussing this issue lots with my lovely Doula friend Pernille. Her insights into this matter are interesting and I would like to share them (please let me know P if I’ve mis-interpreted you). For these women, the choice of intervention can represent the ultimate expression of motherhood. For example, allowing your own body to be cut open to save your baby is surely the epitome of mothering.

Summary

There is no correct way to birth, or to behave during birth. As women and mothers we are subjected to more than enough judgement from others and ourselves. Perhaps it is time to start nurturing and supporting ourselves and others instead.

This post is also available in Spanish at Placentera.

Rachel Reedmidwifethinking.com

Rachel Reed is a Lecturer in Midwifery at the University of the Sunshine Coast and a homebirth midwife. She has practiced midwifery in a range of models and settings in the United Kingdom and Australia. Rachel is committed to the promotion of physiological birth, and of women’s innate ability to birth and mother. Her PhD thesis is Midwifery Practice During Birth: Rites of Passage and Rites of Protection. Rachel has written articles for journals, magazines and websites and presented at many conferences and study days. She is also the author of the MidwifeThinking blog site.