Before I write the rest of this piece I feel the need to lay out my mothering and birth ‘credentials’. I am a mother to two daughters; I’ve given birth twice, both times vaginally, neither time without intervention. I found one birth traumatic and one deeply and intensely healing. One pregnancy was life-threatening and high risk, the other was not. (The traumatic birth was not the one which resulted from the life-threatening pregnancy.) I’ve breastfed both daughters, both exclusively for 6 months, and for an extended period beyond that. 5 years in total with some crossover in babas being fed at the same time (only once literally at the same time thankfully, I HATED that). I’ve spent the entirety of my life as a mother in the struggle for bodily autonomy in pregnancy (whether ended or continued) and birth. Here in Ireland, with the 8th amendment limiting our rights in both, it was always clear to me that pregnancy and birth are a continuum and the restriction of our rights in one aspect of it will be used to restrict our rights in others. The fundamental right to ownership of one’s own body has always been to me one issue.
I do not care how anyone births as long as it’s the way that’s right for them; one they have chosen as freely as possible, one they feel safe and supported in, and in a pregnancy they’ve chosen to continue. Likewise I do not care how anyone feeds their baby as long as it’s the way that’s right for them; one they have chosen as freely as possible and one they have, if problems have been encountered, received appropriate, accurately informed, and timely support for. Unfortunately when women run into problems with breastfeeding this is all too often not the case. I don’t just mean the kind of ‘support’ that involves telling brand new mothers with bleeding nipples to ‘just’ pump instead (the casual disregard for the work and time of women inherent in this is enraging), though. I also mean the kind of support which ignores the realities of that woman’s life, particularly when she already has other very small children around to care for, on top of feeding herself, and no other adult in the home for most or all of the day. The kind of support which pretends the problems of capitalism and patriarchy, where women’s work of feeding and raising babies, doesn’t exist, being instead part of a magical and wonderful nurturing process that is bestowed on us by some earth mother fairy godmother type at birth, and that all will magically come right if you just ‘feed feed feed’. Peer support and advice can only compensate for so much; without an additional set of hands there in the home, many mothers will simply be unable to complete all the separate tasks they must do in a day to ensure each of their children, as well as themselves, are safe, clean and fed. For this to happen, that set of hands would need to be a paid worker, provided by the state, because the state recognises that mothering work, and the work of bringing babies into the world and feeding those babies once they’re there is work of value. I do not believe that we will see this happen while we continue to individualise the ‘problems’ and place the ‘responsibility’ for breastfeeding or not on each mother. As I once said to a friend in the aftermath of her own journey to breastfeed ending earlier than she wanted, with a baby who just wouldn’t latch, I am an advocate for women, not for breastfeeding. I want to support people, not a process.
This piece has been brewing in my mind for some time now, with much of it brought to the fore by some of the response to a US study that found in a cohort of 6,000+ women, induction did not raise the risk of c-section, and that a woman who chose not to have an induction at 39 weeks was more likely to have a c-section. I certainly think there are questions to be asked around this study – I would love to know the outcomes of the 16,000 women who declined to participate. The interrogation of the concept that there may be an element of self-selection in the participants is a welcome one too, and I would like to know to what degree that matters. I also think societies which consider free maternal healthcare to be a basic right for all may not be directly comparable to a society in which those who cannot afford maternal healthcare must go without it. I would question too if it is reasonable to compare c section rates in a country in which some hospitals and indeed states will compel women to have c sections against their will to those which do not. I would also find far more interesting a trial which, for once, took into consideration the feelings of a large cohort of women about their births. There is a strong distinction to be drawn between the sometimes unavoidable damage to our health and bodies that pregnancy and birth can inflict and the always avoidable suffering and trauma that the denial of our autonomy wreaks upon us. As someone who has experienced both in different pregnancies, I found the former far easier to recover from.
In much the same way as I view breastfeeding, I do not believe in nor agree with the privileging of ‘natural’ pregnancy and birth above all else in the birth advocacy world. Not least because the insistence on ‘natural’ pregnancy as a process seems to me to be at odds with the struggle for our rights to choose to end or continue our pregnancies as we see fit. Please do not misunderstand me here; the fight for ownership of our own bodies in continued pregnancy and birth is frequently one that takes the path of having to defend our rights to say no to external intervention in pregnancy and in birth, rights which are all too often trampled on. But I simply do not agree that the one overarching goal of the entirety of the maternity and birth rights movement should be the prioritisation of ‘natural’ birth. I worry that the focus of this movement has shifted from our right to have the time and space and care to have the best birth for us, to the idea that there is only one best type of birth. It would be easy to understand how this might have happened, in societies in which all too often a medicalised pregnancy and birth is presented as the only option and in which it can frequently seem as though the intervention-free birth is only possible in one’s own home. But I am concerned that this focus on ‘natural’ birth, as distinct from the right birth for each birthing person simply creates a parallel between natural birth advocates and the paternalised medical system which so many of us have negative experiences of. Again, I want to be an advocate for women and each individual woman or person’s right to own their own unique experience, not an advocate for a certain kind of pregnancy and birth. I don’t always believe that what’s ‘natural’ is best for each and every woman, but I do believe in every pregnant and birthing person’s right to fully informed choice. And I believe with that right, and with supportive, informed, qualified, involved carers, from whom the person giving birth has had continuity of care throughout pregnancy, everyone giving birth would have the perfect (though perhaps not natural) birth for them.
As a final note, I haven’t mentioned anything about babies, their rights, and their best outcomes in this piece. This is a deliberate choice on my part, in part because I believe that information (as pertaining to breastfeeding in particular) is pointless without the resources to implement it, and in part because I don’t believe that the outcomes for babies should weigh on anyone who is not their mother making decisions about their mother’s body. Nor do I believe it is my role as a mother who breastfed to advertise breastfeeding to other women. Each individual woman is the only person who is or ever will be in her shoes and is the only one possibly qualified to make the right call for her and her baby in their best interests.