Monday, October 02, 2006

IF ONLY

I should have been having regular pedicures. I should have been having regular manicures. I should have had a monthly – or even better weekly – facial. And full body pregnancy massage. I should have cooked exquisite organic low fat meals every day. I should have eaten more of this, and less of that. I should have had my eyebrows tinted. Except that dying hair is out of bounds. I should have worked for an employer who allowed time off – with pay – for things such as prenatal yoga, facials, massage, pregnancy aqua aerobics. I should have had a job which allowed me to pay for the facials, massages, and pedicures. I should have napped when I needed rest. I should have spent more time lounging on my bed, with dappled sunlight falling through the window, staring lovingly at my unborn child, reading it stories and playing gentle soothing music while stroking the belly. I should have written a birth plan.

And then after the baby was born, I should have used this sterilizer. I should have used this sterilizer as well. And I should have breastfed exclusively for 6 months. And I should have worn a silk negligee in hospital to help me feel sexy again (hello????????) And I should have eaten this, and that, and a little more of this, and a little less of that. I should have played this music. And I should buy these videos. But I shouldn’t let my child watch videos. I should have used this toy in the cot. And this one in the stroller. And this one in the living room. I should have used this spoon and plate set. I should have used this dummy. I should have used these nappies. And these wipes. I should have used cloth nappies. I should have made my own wipes. Except dummy’s are out of bounds, so I should have used this as a soother. But then again this dummy should have been used as well. I should co sleep. I should get the baby into a good routine. I should feed on demand. I should feed at strict times of the day. I should have photographed my baby every day and kept every memento of their life in a nice neat album instead of an old box under the bed. I should have read to them every single opportunity I had. I should use cue cards. I should let them learn of their own accord. I should have enrolled the baby in gym classes. And swim classes. And music classes. And language classes. And drama classes. Aunty Cookie has some great views on all of this.

Because if I don’t do any of this, my child will be so far behind developmentally, physically and emotionally, that I will be forever held to believe that it was all my fault if they do not turn out to be happy bright sparks who make friends with ease and never throw a tantrum.

Bollocks. Oh. I wasn’t supposed to say that was I. Yet, if you pick up any general pregnancy/parenting magazine on the newsagent stands, the entire magazine will sprout this philosophy to you. Read carefully, and every single item is phrased in such a way that to not do what they’re asking is tantamount to endangering your child and stifling their development. And the contradictions from page to page are no-ones business. Not only are you led to believe certain products are better than others – and yes I do acknowledge some products for some things are better – but to suggest that some products will make your child happier, healthier and brighter is really misleading.

But none of this comes even close to the anger and disappointment I have with many of these magazines in the way birth, and to a lesser extent, pregnancy, is portrayed. There is one popular pregnancy magazine commonly available in Australia and the UK (and possibly the states) which follows a soon to be mother - not necessarily a first time mother either – through her pregnancy and her birth. It’s a diary format. The idea is great – to show different birth and pregnancy outcomes. But it fails miserably. The pieces are so edited, that the reality of the birth experience becomes so sanitised, and eventually so glorified, that to go through the same birth for yourself, you could be forgiven for thinking you were going mad if you came out thinking it was anything other than glorious. There is no follow up report at 6 months, and a year, as the mother’s perspective on her birth alters over time.

For many women these magazines are a life line through their pregnancy, a wealth of information about what to expect, what choices they have, and the medicalisation of birth demystified. And there is a lot of great information in there, if you sift through and back up anything you read with further research and information. But turn the corner and look at some of the discussion boards on popular sites like Babycentre, and you’ll realise that dissatisfaction with birth outcomes due to lack of preparation and information prior to, and during, birth play a huge part in birth outcomes. Despite the wealth of information out there, women are still giving birth disillusioned and unsure of what happened and why.

And then we wonder why the statistics for PND are so high or greatly underestimated, and why women struggle to accept birth outcomes, and why women feel like they “failed”. This is a really personal thing for me. I have long held that antenatal classes teach the wrong things, and that there is a general fear of letting women know the reality of some births because we as a society have placed so much emphasis on natural birth. In addition, we as women have come to expect that because we choose natural birth, it will automatically happen, and we often turn a blind eye to potential problems. No longer is natural birth a natural occurrence – it is a thing which is planned and controlled: You did the yoga, you did the massage, you bought everything the magazines told you to buy, you bought the birthing ball and you have the essential oils all packed. Hell, you even got the cot ready at 34 weeks – look how prepared you are!! I know one woman who said to me that she had good thigh muscles because she’s been doing yoga, therefore she will, of course, have a natural birth. Good thigh muscles have little to do with a baby and body clock divorced from the preparations you have made.

When I did my first lot of antenatal classes with the hospital in London when I was pregnant with Max, I asked in the first class whether we would cover the potential problems of various forms of intervention and pain relief – it’s all very good telling us what options are available, but what of the consequences of those actions. The teacher looked at me aghast. Why No! We would not be doing that because you will all have natural births. Okaaaaaaay. Yes – we all were planning natural births, but the likelihood of us all actually having natural births was different. To suggest we needn’t cover other birth forms and their impact on us because we chose otherwise is really debased. Her version of what constituted important information for birth was spending two hours teaching our partners how to massage out leg cramps (true!), that was one class out of 4 gone, and another class spent going over and over how to ring the hospital to tell them you were in labour. After the entire class insisted on having some information about basic baby care post baby (apparently post baby stuff is irrelevant. Never mind none of us had held a baby before and had no idea), that left one 2 hour class to discuss birth. I don’t need to say it was fairly pitiful. Luckily I had booked in for NCT classes at my own expense, and they covered so much more, in so much detail, that I don’t think anyone there would have felt unprepared for various outcomes. NCT is very pro natural and that’s why you choose their classes – but they also know things go wrong, and that to be prepared for that is a part of their role as educators. Natural does not necessarily mean without drugs, without intervention - it can also incorporate understanding, and knowledge of cause and effect and being empowered to deal with whatever situation is presented at the time - planned or unplanned. We covered emergency c-sections in one class. While every one of us probably put a lot of that information away in a file in our head labeled ‘Not Needed”, I can tell you that when I did have to have an emergency c-section, knowing how many people were in the room and why, and what they did, and how long it would take and what generally was going on was a huge relief. I could focus on other things rather than why 11 people (yes 11) were introducing themselves to me. And I understood how I ended up there too.

I know I come at this from a slightly more technical background, and therefore my perspective is slightly different to other people, but because of that I also feel for the lack of real information which is given to women, irrespective of how they plan to birth. I did my Architectural design thesis on a birthing centre attached to a large teaching hospital in Melbourne. I looked at many spatial relationships of the pregnant women in society, and the labouring women through birth within an institutional environment, and how we could change those spatial relationships to gain a better birth outcome – ie a natural birth – for the mother, partner and baby. Part of my research led me to many medical books about intervention, and the prevention of intervention in birth. I have a much stronger appreciation of the cyclic cascade of intervention than most – I have read the pros and cons of basic care procedures, pain relief, induction techniques and management systems through labour. And because of that, I see how unprepared we, as intelligent women, really are when we go into the labour ward.

I don’t intend this post to be a negative slur on being prepared and making whatever preparations you feel necessary. I personally had a monthly facial from 5 months during my first pregnancy because I had such a horrid time that I needed something nice for myself. I don’t intend this to be anti natural birth or to take away from those who have had a great birth experience natural or otherwise – on the contrary my views are very pro natural and they continue to be despite the traumatic birth I had with my first child. I would just like to see a little more realism and understanding, and for women to acknowledge realism in birth outcomes and expectations of them as mothers. And to allow women more trust in themselves as good parents without magazines telling them what is best for their child, or pushing certain parenting ideals. It’s about taking pressure off ourselves.

15 Comments:

Anonymous Jessica said...

What an awesome post. I'm due in December with my first baby and I've been astonished at the lack of real info in pregnancy books and magazines. I know some fo the birth process is gross/gorey/technical but I still need the facts about it! I also love that most of the resources give you the impression that you can't trust your instincts or common sense during pregnancy or while your child is an infant, but when the child is older that approach is recommended. Aaagh. I hope this wasn't too ranty. Thanks so much for writing about this topic.

1:24 pm  
Anonymous shannon said...

With so much information at our fingertips its easy to just be a follower. Im the first to admit that everytime I faced (and still do) a parenting hiccup Id grab a book, read a magazine or look to the internet. Then think 'what would I have done I was a woman living 30 years ago?' Follow my instict.

During my pregancy I devoured mags only to forget everything when it came to the crunch and relying on who was around me. Realising this time around Ive got better things to do than read about whats cool about stokke cots, body after birth and what sex is really like. Who cares man. I just want a healthy baby, OK and one that sleeps...hang on better re-read that 'sleeping for dummies' soon....

1:45 pm  
Blogger Cari said...

Thanks for this post. You know how it hits home for me, of course.

Our childbirth class covered interventions and their impact, the whys and whens of them quite thoroughly. Even armed with that knowledge, when my birth plan gave way to the full catastrophe of interventions after four days of labor it was traumatic. Extremely traumatic. I understood what was happening, understood why the interventions and ultimately the c-section were necessary to save my and the baby's life, but that understanding didn't make it easier to accept.

Yes, I did feel like my body failed me. And that chances are I'm not built for childbirth. But more than that... When I had so had my heart set on that part of the birth plan that insisted the baby be placed on my chest immediately after delivery... Because of the realities of the c-section, I was the last person in a very crowded operating room to see my baby. That still hurts. I'm not sure any amount of prenatal education could have prepared me for that.

1:47 pm  
Blogger Kate_knits_a_bit said...

This was a really important thing for you to say - I hope that we can move away from a "shiny, happy" idealised notion of birth towards a more realistic set of expectations, that include appropriate antenatal care and education. Perhaps part of the problem is that society is organised differently now so that for many of us, having our own child is our first experience with children and first contact with birth, and so we have become extremely reliant upon books, media, and classes to tell us what is normal. Perhaps regular antenatal attendance at a nursing mother's or playgroup meeting would provide a more realistic picture of birth and parenthood.

4:48 pm  
Anonymous Anonymous said...

I think that women need to take a certain level of responsibility for informing themselves about the reality of labour and birth. I am always SO shocked when I come across first timers who haven't even bothered to take a hospital tour.
There are many avenues to explore (like NCT) if you are one of the people comforted by information. But the plethora of sugar coated mis-information about does make it hard to distinguish the truth from the fairy tale.
I think the biggest contribution we can make is by talking honestly about our own experiences. Birth was much less of a mystery when women going through it had seen sisters, mothers or cousins cope before them. I'm sure many of my difficulties after the birth of my first son would have been easier to deal with if I hadn't felt quite so alone in experiencing them.

11:28 pm  
Blogger rebecca said...

A wonderful post, thank you. I did NCT classes too and each week for 9 weeks we would rock and sway and breathe and push, all believing we were one step closer to that elusive 'natural birth'. Out of a group of eight, five end up with emergency c-sections, one episiotomy/forceps and one ventouse delivery. Luckily like you we had covered all these eventualities in our classes, (our teacher even had a lego operating theatre with which she had talked through the whole c-section procedure!) However it didnt stop many of my friends feeling that they had somehow failed in childbirth which is very sad. I always remember my NCT teacher saying that as a midwife she would far rather walk into a delivery room to find a teenage mum with no birthplan who would just scream, yell and swear her way through it whatever happened. Than to find a thirty something first time mum with a neatly typed birthplan and see the huge disappointment and post birth angst when things didnt work out as hoped.

6:53 am  
Anonymous Alison said...

I will happily admit here - and really there's a whole new post for me to write about this - that even though I was prepared, and I understood what went on and why, I still felt I had somehow 'failed' - if I'd only tried harder/gone for longer/stood my ground/had more energy.....There are things which still make me angry, and still hurt, and still upset me. Cari is also right: that no amount of preperation can really shield you from what can happen, and you just can't predict what will be the thing which really gets to you.

Ali has really hit it on the head - women need to talk about birth stories and what went on for them to other women and not create a fairytale: that's the only 'reality' and from that they gain valuable information and experience. I hope we're attempting to do that here.

After Max's birth the hospital were keen to organise something where I as a new mother did go to antenatal classes and speak to women, and make myself available to talk through what can happen, but I left the country. It's something I feel really strongly about and wish I had an opportunity to do.

7:37 am  
Anonymous dani (pyglet) said...

Thank you both for such wonderful thought-provoking posts.
I thought I would hesitantly jump in but find it quite difficult to be as eloquent and concise as those before me.

Collectively women do surround themselves with information and the like in 'preparation' for childbirth. I needed the same in my first pregnancy and did everything I could to be as prepared in every way that I felt I could. During this, my second pregnancy, I feel that I cannot really prepare myself for a process that could turn any number of directions. I just want to be able to stay present in the moments rather than the process running away from me, particularly emotionally.
My concern with this pregnancy is where I found the greatest problems in my first and that was the lack of ongoing support after the labour that left me feeling alone and abandoned. It is not that I didn't have a strong network of family and a helpful mother's group to talk to but coming from pre-birth of many appointments, classes, community comments and care about how my pregnancy was going to the relative attentive void of new motherhood was a shock.
I felt I had been though something significant. I had so many feelings. Grief, disappointment, worry, failure, triumph, and such extremes of emotion that I had never experienced before. Something had fundamentally changed within me. I definitely needed to debrief in some way. All the new mothers I was spending time with were the same, reliving their experiences and trying to come to terms with what had happened (good or bad).
As with Alison, I also understood what and why my pregnancy and labour had progressed in the way that it had but that did not make me feel OK about that. I was left relative to pre-labour, on my own to process the emotional upheaval of one of the most significant happenings of my life. I think mothers’ generally could use more post-birth support, not just for learning the process of caring for a new baby but specifically for navigating the dramatically changing and developing new emotional landscape that they find themselves experiencing.

11:54 am  
Anonymous alice said...

Yes, indeed. It seems like childbirth and -rearing is the only area of human endeavor that elicits the quantity of free (often unsolicited) up through expensive advice that's so full of misconceptions/perceptions and things that just don't work--or haven't for any of my friends or myself.
I had an unplanned c-section the first time, and a VBAC the second --after switching practices at 36 weeks to a hospital that was actually supportive of VBAC, rather than just giving lip-service to the idea.
The advice that helped me most was the mantra that a birth plan is just a plan--which may or may not work out the way you envisioned it--and I luckily got a healthy child out of each birth.

1:12 pm  
Blogger sooz said...

After my first birth - a text book disaster - I spent a lot of time thinking about why I had never expected it to happen to me. I knew the stats, I'd done the research, I'd read the books, the mags, spoken to friends, but I certainly put that C-section chapter in the mental trash can. Despite how much the whole thing shocked me I was not traumatised, didn't have a sense of failure, didn't feel let down. I don't know why I escaped that, why I was lucky enough to not feel the lingering effects. It still strikes me as odd. Especially given how traumatised I felt by the things that happened in the years that followed - but that's another post...

The best I can come to explaining it is to think it has to do with expectations. Perhaps because I have a lot of experience in things not going to plan, perhaps because I have more than your average exposure to the medical world. While I didn't expect it to happen to me I didn't feel it was mine or anyone else's fault when it did. If I drew a short straw, then it seemed like just that, the outcome of a lottery.

What concerns me in all this is the question of how (or even if) those of us that know can improve the situation for those that come after us. In my experience few expectant mothers want to hear the worst case scenarios, the scary bits, the likelihood that things won't come out the way they want. I remember feeling that wa. When in the week after my 13 week ultrasound no less than three people told me about friends who lost babies in the second and third trimester it did nothing but destroy the relief I'd felt about getting through the miscarriage zone.

How expectations are created, how they are inflated and how realities are concealed seems to be a really complex and enmeshed picture. In birthing as well as so many rights of passage my instinct to outrage over 'not being told' is gradually tempered by my wonderings over how I could have been told. How much anyone can have realsitic expectations over something so enormously individual and unknowable.

3:34 pm  
Anonymous aili said...

First, thank you for starting this blog. I’m very happy to have found it just now, 31 weeks into my first (and unplanned) pregnancy. Lately I’ve been feeling very vulnerable and frightened. My mother and I don’t communicate all that well, and none of my close friends have had babies. The acquaintances who have are happy to talk about how much weight they gained, or which books they liked, but are not eager to delve into details of labor or the rest of it. I’ve just read through all the entries, and most of the other comments and I feel like I should start another blog just to say everything I want to say. Instead I will limit this post to a few responses.
1. The pressure-from books, from magazines, from family members (especially from family members). From the cousin who thinks that we are too young and haven’t known each other long enough (we’re not married yet, we don’t own a home, etc) to the aunts and mil who think we shouldn’t even consider daycare-they never did (they also never had to as there were 6 sisters living within ½ mile of each other, all with babies), to my mother who thinks I should give up on things that are important to me as I become a mother, but might be too hard, before I even try (or give birth).
2. The choice of whether or not to come back to work. Can we afford for me not to? Can we afford for me to come back and pay for daycare? Can I work out some sort of part time schedule? Will I go crazy if I stay home all day and never see anyone? (this is all aside from the family pressure and the personally inflicted guilt either way). I also know all too well about unemployment as Mr. Dad lost his job a month after we found out I was pregnant and it took 3 months plus to find a new one, what if that happed again?
3. I have never been around a newborn, let alone changed one’s diapers or even clothes. I’ve been around older babies, and done those things, but it’s not really covered in the prenatal classes (4 sessions-including the optional one on breast feeding). And I’m terrified.
Anyway, thank you. Most of my support system is long distance, and it’s nice to know there’s someplace to be heard and to hear other struggles that is only a click away.

5:53 am  
Anonymous Janet said...

The day after giving birth to my daughter, I asked my mother why she didn't tell me what it would be like. She said that she tried but that although I heard, I didn't seem to understand.

Mostly I was pretty happy with how the birth went. My birth plan was to have my mother and partner there and to do what was necessary to have a healthy baby. As it happened, I had a natural labour with some midwife interventions, some gas and pethodine. But I was really unprepared for the pain, the intensity, the relentlessness and the elemental nature of the experience. I was also really unprepared for the moments of ecstasy when the pain stopped and I held my daughter on the outside of my body for the first time.

I remember having conversations with other mothers (in the poky little feeding room which was the only place with decent chairs in which to breastfeed at the public hospital that I was at) that antenatal classes taught all the wrong things. I felt that what we needed was some sort of "warrior" (sorry I can't think of a better word, I'm thinking more mental yoga than fighting) training to prepare us for what was ahead.

I had noticed before I had a child, that women I knew seemed to be transformed by childbirth, in a way that seemed inexplicable to me pre-child. I don't know how we should prepare women for birth and beyond, but definitely resisting sugar coated stories and being honest is a good start.

5:34 pm  
Blogger Kate said...

Such a great post! I have heard so many stories at playgroup since I had my girls that I wish I had of heard before I had them.
I guess I was lucky in a way knowing that for twins I probably would need a c-section and I never had guilt over this, but I had no idea what that would be like to have them in a room packed with people and to have the girls whisked away without even seeing one was pretty traumatic and then for my milk to not really ever come in (a whole different traumatic story).
I'm an avid reader - but I haven't read one of those magazines since I had them - I just couldn't relate, instead I have tried to seek out real info from other twin mothers or twin books and realistic information is hard to find.
Thanks for this blog, it is good to read such honest thoughtful writing.

9:27 pm  
Blogger filambulle said...

Well said my dear!
I wish that your second birthgiving will help you to sooth and soften the anger and dispointment of the first one. This has been the case for me (and the fight for a natural birth after two c-sections, and the third birth a little bit better, even if "failed" too...)
I can thank Benoît for being able to think of Plume's birth without tears.

3:01 am  
Blogger mamaloo said...

It may seem self-serving, since I am a doula, but I would add to the "arming yourself with information and realistic expectations" getting yourself a doula.

A doula is there before the birth, during and after to give you the informational, physical and emotional support that you need. Just having one with you can give you a fantastic amount of confidence at a time when women are at their most vulnerable.

Great post!

1:35 am  

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