Give Birth Like a Feminist. Milli Hill

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СКАЧАТЬ returned to her. Odent has an interesting theory about why, with our early clamping, washing, wiping, weighing, and bewitched colostrum, nobody can seem to leave mothers and babies in peace. The disruption of bonding has an evolutionary advantage, he argues, creating tougher humans and better warriors: ‘The greater the social need for aggression and an ability to destroy life, the more intrusive the rituals and beliefs are in the period surrounding birth.’[38] Whether or not Odent is right, it’s certainly true that Westerners value ‘independence’ in their children, and that the link between parenting and personality is well established. In disrupting the Hour of Power, our cultural values – that efficiency and tick boxes matter more than relationships and connection – are certainly being upheld. Furthermore, if Odent is right, we’re upholding the patriarchy, too, laying the foundations for a new generation of aggressors and destroyers, who will in their turn cut, clamp, separate and generally disrupt the oxytocic peace. Whichever way you look at it, Odent sums it up well when he says, ‘reconsidering our attitudes during this short period of time shakes the very foundations of our cultures’.

      Love from a distance: life in the NICU

      The early attachment of woman and baby is also low on the list of priorities when a baby is born prematurely. Common practice is for the baby to be taken to a special unit and placed in an incubator, with only a few pioneering neonatal units in the world doing things differently. In Uppsala, Sweden, Dr Uwe Ewald and colleagues encourage ‘kangaroo care’,[39] whereby the separation of the baby from their parent is kept to a minimum. His state-of-the-art unit places babies in skin-to-skin contact on the chests of their carers, out of the incubator and in bed or often in slings, with mobile monitors in the parent’s pocket. However, in Dr Ewald’s experience, parents will often detect issues several seconds ahead of the monitor. Ewald’s work is inspired by a focus on the rights of the child not to be separated from their parents, an understanding of early infant attachment – ‘Bonding is a bit more than just holding a finger,’ he points out – and an empathy for the experience of both the baby and the parents and the anguish of separation they may be feeling.

      Dr Ewald’s way of thinking is highly unusual, however, and the majority of parents whose babies are in the NICU will be apart from them and will often feel the need to ask, ‘Am I allowed?’ ‘At the start we didn’t realise that we were actually able to touch her,’ said one mother. ‘Nobody told us we were allowed and we thought it was just the nurses who could. We didn’t hold her either because we didn’t realise we could.’ ‘I did not feel like she belonged to me,’ said another NICU mother, while another commented, ‘I felt like I was cluttering the place up because I hung out there so much.’[40]

      Donna Booth, who founded the New Zealand organisation NUMB (Neonatal Unity for Mothers and Babies) after her own experience, told me of how the imbalanced power dynamic of the NICU made her feel assaulted. ‘My baby was born by caesarean and I had a general anaesthetic that I did not want. This was the first assault. The second assault happened when I was in recovery and NICU staff kept sending messages insisting on having my child’s name given to them to write in the notes and on the incubator – but I wanted to be the one to name this child when I recovered. The third assault was when I finally got to the NICU in a wheelchair and the nurse (probably thinking she was being welcoming and helpful) introduced me to my baby, taking the hat off the baby and telling me the hair colour and remarking on the fingers and toes. I wanted with all of my heart and soul to be the one to discover these things myself, to reclaim this time, to marvel in the gorgeousness of my perfect child; but she stole that from me. There were further assaults. Mothers like me who want to be with their babies are a challenge for the NICU. “Parents can visit any time” does not mean you can stay for twenty-four hours a day without some sort of resistance, punishment or even being positioned as somehow not right in the head.’

      ‘Re-centering me as the decision maker’: love and loss

      Attitudes and practices like these of Donna’s NICU staff are usually well meant, but often so deeply ingrained that they are beyond everyday awareness and rarely analysed or reconsidered. They are another part of our ‘allowed/not allowed’ birth culture. We know that, most often, health professionals have their patient’s best interests, and in particular safety, uppermost in their minds. To a clinician, everybody getting out of birth alive is the greatest priority. They have been trained to view every aspect of the experience through the framework of safety and risk, and this can sometimes be the justification for the over-medicalisation of birth or even for treatment lacking in empathy or compassion: ‘There simply wasn’t time.’ It’s interesting, therefore, to look at what happens to women when these safety concerns are completely removed, in that terrible scenario of baby loss.

      ‘Attitudes to stillbirth have improved a lot in recent times,’ Mel Scott, from the charity Finley’s Footprints, tells me. ‘Up until the past decade or so, babies who had died tended to be whisked off immediately or after just a few minutes. I still get messages from mums who lost their baby twenty years ago, who didn’t see them, hold them, name them, and don’t know where they are buried. And they have never forgotten, never got over it, and always regret not having that time. Although there have been some great improvements, it’s still the case that most parents don’t realise they have choices they can make about how they welcome their baby, or how they spend their time together, or where their baby goes.’

      Natalie Lennard, whose son Evan was stillborn in 2013, had to fight for permission to give birth to him at home, even though he had a condition – Potter’s Syndrome – that meant there was absolutely nothing a hospital could have done to save him.[41] Hospital protocol was to end the pregnancy via an in-utero injection and induce the birth under epidural – choosing not to do this was a highly unusual and counter-cultural choice. With the support of Virginia Howes, an independent midwife, Natalie finally got permission to birth at home, at term, a triumphant and positive experience for her in spite of her loss: ‘His nose, ankles and wrists were squashed from having no fluid around him in the womb but otherwise he was my simply perfect baby. How could I have ever wanted him whisked away, cleaned and wrapped? No way, holding his bloody birthy beautiful body in my arms was the best part of all!’ Natalie is passionate that it was the support she received from her midwife that made truly informed choice possible; she was ‘the only character who stood alone from any party, and kept re-centring me as the decision-maker’.

      Natalie goes on to say, ‘I joined a group on Facebook for Potter’s Syndrome and every few months a new woman joins from somewhere in the world, whose baby will have been diagnosed with exactly what Evan had, and sometimes she terminates within a couple of days because in their words, the “doctor thought it best”. Those women were never even given a choice, they probably didn’t think they had one. It would have been hard enough for me even with my own determination, but these women have no one to play the role of angelic devil’s advocate … Virginia’s attitude is nothing short of revolutionary, the future of all health care.’

      Currently, a revolutionary attitude, and, if possible, a ‘Virginia’ for back-up, is required all round if you want to birth your baby, from your body, where you want, and how you want. Elective caesarean? This might require persistence: a report from the charity Birthrights in August 2018[42] highlighted that, in spite of UK NICE guidelines supporting a woman’s right to choose and be supported in this option, 15 per cent of trusts have an explicitly stated policy not to offer it, while a further 47 per cent were unclear as to whether a woman requesting a surgical birth would actually get one. The reasons for elective or maternal request caesarean are complex,[43] but in many cases requesting surgery is an attempt to take control over bodily autonomy, often after a previous birth experience where this was felt to be completely lost: ‘I chose an elective for both physical and psychological reasons,’ the journalist Natasha Pearlman writes. ‘The thought of surgery terrified me, to be honest, but not as much as giving birth naturally again.’[44] Autonomy is also a factor for women who have a history of sexual abuse: ‘I chose caesarean because СКАЧАТЬ