The Business of Being Born

On Saturday, I attended the annual conference of the Irish Home Birth Association. I have been going to HBA conferences since I moved back to Ireland from the UK with my then four-month-old first baby, who will be six years old in May. I also attended some conferences as a child, when my mother was having her home births. Many of my friends have been or are still on the HBA committee, or have written their birth stories for the HBA newsletter. Home birth has always seemed as natural to me as breathing. I feel lucky to have been brought up with this attitude. I also feel lucky that home births were a legal, viable choice for me when I had both my children, that I had access to home birth services, and that the experiences themselves were absolutely amazing. Access to choices in childbirth and unbiased information should be a basic right for women. In many cases, the full spectrum of choices is simply not available for a woman to give birth as she wishes, or even to inform herself fully about the experience. I am aware of the prevailing attitudes in this culture-that birth is painful and dangerous, and that you must be “selfish” (compromising your child’s safety or life), peculiar (for wanting to remain fully awake and aware through such an excruciating event) or “brave” (read a bit naive, foolishly lucky or simply ill-informed) to actually want to have a home birth “in this day and age”. I have encountered all these attitudes and more. Of course not everyone “should” have a home birth if they do not want one, and of course not all births are suited to a home setting, some carrying higher risk factors than others for the participants involved. In a culture where the right to all the facts before making a decision is viewed as so important, however, there seems to me to be some imbalance with regard to how two different sets of “risks” are represented in the field of birth.

The risks involved to a mother and baby as a direct result of certain birth interventions are glossed over in damning popular media articles like this one. They are vaguely, fleetingly referred to here, as opposed to the fully researched account of the early “development of the mother and baby bond” explored in this article by French obstetrician Michel Odent. The targets of the first author’s negativity and rage – female advocates of natural childbirth – are described as “smug, sanctimonious harpies”. Attitudes like this are so culturally sanctioned that the facts are in danger of being totally lost in irrationality. Homebirth, on the other hand, widely regarded as being unsafe and irresponsible, associated here with angels, crystals and bongos, has been proven to be at least as safe for most women as hospital birth – and for the women cited in the next paragraph, a hell of a lot more enjoyable than hospital birth and the episiotomies and abdominal surgeries which often go hand in hand with it. As for the risk factors, almost all high-risk women who would not be suited to home birth can be identified during pregnancy by the skilled midwives who provide them with personalised care. Oh, and good healthcare and nutrition can prevent many of these factors from arising in the first place – but let’s not get into that. Why bother analysing the fact that companies make money out of all medical interventions and drugs, as well as vitamins, iron tablets and other “necessary” pregnancy paraphenalia. Who cares that vested interests may have some part to play in the fact that our healthcare services, in the main, necessitate the use of such products, since they concentrate on what so do when something goes wrong, rather than how to prevent it from going wrong in the first place. I suppose I’m a killjoy harpy for mentioning the fact that we are at least partly responsible for our own health and wellbeing, and can empower and inform ourselves by taking control of these things. Whew, now I’m getting angry too.

Ina May Gaskin, a highly experienced, pioneering and skilled midwife in the US has statistically and practically proven the effect of the mother’s emotional state and the attitude of any birth attendants toward the mother on the experience of birth. She has proven beyond doubt that a healthy lifestyle, good relationship with a knowledgeable, respectful midwife and continuity of pre- and post-natal and labour care all add up to a safe and – shock, horror, here it comes – often an ENJOYABLE, birth. Her reasearch and wisdom are available in the “Guide to Childbirth” and “Spiritual Midwifery”, as well as in medical journals and elsewhere. These evidence-based facts have obviously not gotten through to mainstream cultural understanding or to the popular press. Sadly, the common assumption is that natural birth is awful and you’d hate it, trust us, and that medically managed birth is “progress” and the best way for everyone. Such attitudes prevent real education on how positive birth can be, as well as propagating the devastating trauma which can result from unnecessary intervention and disrespectful attitudes of some medical professionals toward labouring women. Once again, vested interests and who profits from birth medication should be considered before any attempt at an objective conclusion can be reached. While we’re on the subject of who profits, I’d like to respond to the statement in the first article linked to above that breast feeding is “not a make or break issue for the planet either way”. Hmm. Do you really think so? We’re struggling for resources on the aforementioned planet. Of course it may not be any big deal to us here in the cushy, cosy developed world, but some people are already short of water and food. They have been for years, in case you’re interested. It might really open your eyes to investigate a bit of world history, and how nations which are now powerful and rich achieved their power and riches. And where does formula milk come from? How are the animals which produce the milk fed and managed? How is the formula processed, contained and transported, and what are the pollution rates, and energy and resource requirements of these activities? Do you know what the developing-world marketing strategies of the same companies who produce baby formula for the developed world might be? I challenge anyone to read Gabrielle Palmer’s Politics of Breastfeeding or facts provided by Baby Milk Action and ever look at these issues in the same way again.

I was also excited to hear that Ricki Lake would be speaking at the conference, the fact of which means that the HBA conference got its first ever (very brief) mention on the Late Late Show where Ricki was a guest last Friday. I enjoyed hearing Ricki speak, and I’d love to think that her high profile as a talk show host and film star might raise the profile of home birth. The fact that a high profile showbiz woman can have the same powerful, positive experience of birth as me, some of my friends or the women in Ina May’s book might actually make people sit up and take note that this is possible, rather than dismissing home birthers as hippies, earth mothers etc. Ina May is, unbelievably, still not exactly a household name – maybe because of her quiet, low-key working life in an intentional community in Tennessee. Since she is a more “mainstream” celebrity, I admire Ricki very much for her wonderful film, the Business of Being Born, and having the courage to speak up for natural childbirth in this hostile culture. I know the puzzling, hurtful accusations and the dumping of issues which this can leave one open to. I am saddened every time I read another ill-informed, stereotyping, negative article about birth. I look forward to when the facts about birth and all the different ways of doing it will be freely available, without (will this ever happen?) the distortion of facts by company interests. Hopefully one day, birth as a normal, natural event will become just as much a part of the public consciousness as the current assumption that it is an occasion of pain, danger and fear.

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