Childbirth is one of the natural wonders of the human body that fill many of us with fear. As with death, we approach the beginning of life with uncertainty, apprehension and a need for control. Even though Western medical advances mean we now have choices in the way we bring our babies into this world, these choices seem to have stripped away our belief in the power of the human body.
Childbirth has become more feared than ever before, which in turn has seen many mothers-to-be question their ability to give birth without medical intervention. Too many women are missing out on this opportunity for transformation because of fear and misinformation.
Medical advances or medical intervention?
Australia has one of the highest caesarean rates in the world. According to the Australian government’s Institute of Health and Welfare’s most recent Mother’s and Babies Survey, 30.3 per cent of women gave birth via caesarean in 2005. This is not only a significant increase from the 1996 figure of 19.5 per cent, but far exceeds the World Health Organization’s recommendation of 10–15 per cent of all births.
While intervention is sometimes inevitable and indeed life-saving, the increase in non-life-threatening caesareans indicates that far too many women are being stripped of the empowerment of childbirth. The same survey also showed that 17.9 per cent of women who had a caesarean section did so without labour, indicating it was a planned procedure.
Although some sceptics would argue this is a sign of the times and the need for convenience and planning in a busy modern world, others would say it shows just how much we are now fearing natural birth and are being encouraged to opt for a caesarean section. Why is it so?
Statistics also show that a mother in a private hospital under the care of an obstetrician is more likely to give birth via caesarean than if admitted to a public hospital. The Mothers and Babies Survey 2005 found the caesarean section rate in private hospitals was 40.3 per cent compared with 27.1 per cent in the public sector. It also found that private hospital patients were more likely to have a birth requiring forceps (5.1 per cent compared with 3.0 per cent) or vacuum extraction or ventouse (9.7 per cent compared with 6.4 per cent). Why are we seeing such an increase in the need for medical intervention?
The fear factor
Caroline Murphy, a community child and maternal health nurse, yoga teacher and birthing class instructor, says there is more fear surrounding childbirth now than ever before. She thinks part of it is fear of the unknown, which comes from a lack of contact with other women and family members.
“We don’t live in communities any more. We move away from our parents and extended families. There isn’t much sharing of life experiences, so we have forgotten that giving birth is one of the most natural and awe-inspiring acts of a woman’s body.”
Without the sharing of knowledge around the kitchen table and among family members, we have turned to books, classes and DVDs for our understanding of how to give birth. While the information age has meant there is now a book or instruction manual on every style of parenting and birthing technique, it also means women are basing their approach to this unpredictable and organic process with a step-by-step guide. Many of these books do little to reduce fear, but instead often relate horror stories, list potential complications and prescribe the “correct” or “normal” way a birth should progress. This simply sets up expectations too high for overwhelmed mums-to-be and their partners, only adding to their fear.
Finally, fear also comes from giving our power to others. When we doubt our body’s ability to bring a child into the world, we hand over the experience and the decisions to medical professionals. By believing medical intervention is needed, we simply give fuel to our fears and focus on what could go wrong.
Caroline says she sees this all the time: “The worrying part of so many obstetric births is it’s the obstetrician who has the power in the room. The women see them as the ones in control, and not themselves. And in that process, they lose touch with the power of childbirth and the power of their own bodies.”
By returning to a belief in the body’s ability to overcome immense pain and trauma, and moving away from a reliance on medical intervention, women can begin to overcome their fears.
Taking back the power
For those who have been through it, an empowering childbirth can be life-changing. It can be the catalyst for growth, awareness and self-empowerment. By returning to a place of power and choice, as opposed to fear, women can discover their own strength and potential not only in parenthood but in life in general. However, whether a woman gives birth with pain relief or not, or requires a caesarean or not, is not what it should be about. It is about taking back the power.
Part of this also includes what we choose to focus on around the birth. The tendency to dwell on the nitty-gritty details of the labour is partly to blame for the shift away from the empowerment of childbirth. Instead of asking whether a woman had an epidural, we should be asking what she felt when she first looked into her baby’s eyes.
There are also situations in which a natural birth is planned but a caesarean is required for medical reasons. This was the heartbreaking reality for Anna Lee, 34. Anna had to learn very early on how to let go of her expectations around welcoming her son Lucas into the world. She had been so committed to having a natural birth with minimal intervention that at 12 weeks pregnant she had withdrawn from her private hospital care and booked herself into the public hospital’s midwifery program. She was determined not to have a caesarean.
However, we can plan all we want, but sometimes the body and the universe have other plans. So at 36 weeks, Anna and her husband discovered their son was transverse. This meant Lucas was not only positioned across Anna’s stomach but the umbilical cord was hanging below him into her cervix.
In an attempt to keep her dreams of a natural birth alive, Anna tried yoga, played music to Lucas to get him to move, and shone a torchlight in the direction in which they wanted him to move. The doctors even tried an ETC, a drug given to relax the uterus so they can physically try to move the baby into the right position. But nothing worked and at 38 weeks Anna had a caesarean.
So how can you still be empowered and grow through childbirth if the opportunity to have the birth you wanted is taken away from you? You learn acceptance. Anna realised in the two weeks between discovering Lucas was transverse and having a caesarean that she could either keep spending all her energy on trying to fight reality or start using her energy to make sure she had the best possible experience.
“I realised the birth is only one day in the whole motherhood experience and I was not going to start my journey as a mum feeling let-down and disappointed. If I approached it negatively, it could affect the bond with my baby and that was much more important than whether it was a natural birth or not.”
Letting go
Bringing your child into this world is not all about natural birth and it’s certainly not about bragging rights at the end. Whether a woman needed every drug available to survive the labour or a caesarean was needed to prevent injury to mother or child should not matter. We must not make women feel guilty about their choices. As mentioned above, it is about taking back the power of your own body and mind and making conscious decisions about how you welcome your child into the world.
Part of this empowerment is letting go of all expectations. Birth plans are helpful in the preparation for birth but shouldn’t be set in concrete or considered the only “successful” way of birthing. So often, women feel like they failed or let themselves and their partners down if they did not follow their birth plans to the letter. There is nothing wrong with being overwhelmed and actively choosing pain relief, but the key word is actively.
It took me a number of days after the birth of my daughter to let go of my preconceived ideas of labour and begin to feel empowered. My labour stopped and started for five days before my waters broke and full labour began. For five days I questioned why my body was not allowing labour to progress. My midwife couldn’t tell me why it kept stopping each evening, except to say that my body was working to its own timetable.
Instead of booking me in for a caesarean, my midwife allowed me time to let go of my plan for the perfect birth. I had to begin to trust my body’s wisdom. However, five days later, exhausted, frazzled and still only 4cm dilated, my midwife, husband and I decided to have my waters broken. Ten hours of full labour later, I brought my daughter into this world.
Unfortunately, my first thought was that I had not done it like I had planned. I had let myself, my baby and my husband down by needing pain relief during her birth. But as I began to come out of the exhaustion and look back at it in wonder, I started to realise just what an amazing thing I had achieved. Nothing had gone to plan, but I had done it. It wasn’t about drugs or no drugs; it was the fact that I stayed true to myself and my baby throughout. I had learnt that life was unpredictable, but I could survive anything.
The power of breath
Yoga can be an important tool during pregnancy to help women understand their bodies and particularly their strengths. It increases the awareness of the connection between breath and body, and helps women learn how their bodies move and how to let go of the outside world and listen internally. As Caroline Murphy points out, “It’s about reclaiming your inner strength and inner knowing of what your body can do.”
For many women, pregnancy doesn’t mean a slowing-down in their lives or their careers, so yoga provides a time to pause and be aware of the changes in their bodies. Often, the one-hour class each week is the only time busy women stop and acknowledge the changes in their bodies. These classes force women to slow down and learn a little about their breath. Kate points out, “The more you are engaged with your body and your baby throughout your pregnancy, the more the birth is just the really exciting conclusion.”
However, Caroline is quick to say that yoga is not about achieving a natural birth. It is about getting in touch with your body during this amazing time of transition. “Even though yoga prepares your body and mind for childbirth, women still need to acknowledge the fear is something they want to do something about.”
During both her ante-natal yoga classes and the birthing courses she runs, Caroline says her main objective is “how do I reduce the fear, and increase the excitement?” She adds that yoga can also help with letting go. This is something Anna found really helpful in the lead-up to her caesarean birth. “If you worry about being in control, yoga helps you learn how to surrender and accept whatever comes.”
Empowerment through birth
In the end, childbirth is not about how the baby is delivered but is about becoming a parent. We need to return to a place of excitement, awe and wonder at the ability of the human body to overcome all obstacles and not be overpowered by the medical system. Of course, there are times when intervention is necessary, but decisions about that must be informed and not made out of fear. By making decisions based on facts and an awareness of the body’s ability, women have the chance to get in touch with their inner strengths.
Kate Bailey, 33, says that by giving birth to her son Liam she has a newfound confidence in her own strengths as a woman and a mother. “It has improved my sense of self physically and mentally. I don’t worry about self-image any more. So I have a stretched tummy — who cares? I carried my child in this tummy.” She says, looking back, it’s not about how you got through it; the point is you got through it. “I feel privileged to have gone through childbirth. It was the most beautiful experience and, even now, I use it as a reminder of what I can do.”
Childbirth is exciting. Becoming a parent is truly thrilling. We need to bring back the joy of childbirth and look forward to it again, not dread it. We need to remind women this is a chance to uncover parts of themselves they never knew existed, an inner strength that will see them through the rest of their lives.
Childbirth is a right of passage and we cannot allow fear to rob women of this right. Through giving birth, we learn so much about the preciousness and excitement of life. In the end, childbirth needs to be about the journey towards becoming a parent and what you uncover about yourself in the process.
Amy Taylor-Kabbaz is a broadcaster and freelance writer with a passion for social issues. She currently writes a weekly blog on the trials and triumphs of being a first-time mum, called the Mummy Monologues, for the ABC website in Adelaide (www.abc.net.au/adelaide).
