Tuesday, December 30, 2008

Old midwives' tales

I thought I had blogged my last entry for this year when I wrote yesterday about the 6-week postnatal consultation. However, an opinion piece in today's newspaper has, sadly, left me feeling that I need to defend my profession, yet again!

'Orgasmic birth and other old midwives' tales' has appeared in various Fairfax newspapers.

I have made a nice cup of tea, enjoyed a chocolate (there are too many sitting around after Christmas!), and am imagining how this article will impact on women who are considering the possibility of planning homebirth. As one of the 'old midwives' practising in and around Melbourne today, I need to reflect on the notion of orgasmic birth.

I don't have any comments on the film, Orgasmic birth - the best kept secret. I haven't seen it. I don't feel I need to defend Ina May Gaskin, the 'hippie guru'. I have met her once, and listened to her give an inspiring talk at a homebirth conference. But Ina May would agree with me, I am sure, that the work of a midwife is not about being a guru, or any other tag. It's all about a presence, being 'with woman'.

Natural, physiological birth does not belong to any cultural group, hippie or homeschooler, or even home birthing. Natural birth does not belong to any professional group; midwife, doctor or anyone else. The knowledge of natural birth is stored deep within each woman's intuitive mind, and this knowledge becomes available in the same way that other hormonally directed behaviours are awakened at certain times in our lives.

Midwives carry knowledge and skill that helps us to work in harmony with each woman's own natural processes in birthing and nurture of the newborn. We see some women giving birth quietly, with apparently minimal pain or distress, and we see other women struggling and roaring through the enormity of their labours. We watch the birthing of not just a child, but also of a mother, as she receives her child into her arms, and intuitively does what mothers do. We hear women from both ends of the experience spectrum, and from many points in between, tell of their satisfaction or their disappointment. Although the rates of normal birth are high for women whose primary carer is a midwife, we can not guarantee a particular outcome.

I don't know how many of the women I have attended for birth would jump on the 'orgasmic birth' bandwagon, and claim that they had 'it'. I don't care. My job in being 'with woman' includes being constantly mindful of the wellbeing of mother and baby. If they are both well, it doesn't matter if the mother smiles at her beloved, or moans or closes her eyes. It doesn't matter if she stands proudly to give birth, or curls up in a pool of water. The experience of birth is a deeply etched memory which the mother takes away from the birth, and she can interpret the experience as she pleases.

Childbearing women today are influenced by sales pitches and marketing of every aspect of the childbirth experience, including the experience itself. When 'good' is no longer good enough; when the length of labour, and the power of the contractions is just right, and the urge to push is as the person who gave the class said it would be, and the noise coming from deep in your throat is the most powerful birth song you have ever imagined, and whole experience of birth needs to be the most ecstatic ...

No! This is all wrong.

Let's not compete over birth, as if the bits that come together to make up the whole are items you can select from a supermarket shelf, or learn from watching a film. Birth is a new beginning, a new life, full of potential. Giving birth is one of the most complex and awesome acts that we will ever be privileged to participate in, either as the mother, or in a relationship with the birthing mother. Once we set out on the journey of birth we cannot know where we will end. But we do know that in birth journeys there is no safer path than the natural process, unless a decision point is reached in which a valid reason for interference is apparent.

Will it be agony or ecstasy? You can't know. But you will never know unless you choose to engage in one of life's most demanding and most rewarding journeys. Today you have a choice: either to seek to work in harmony with your body's natural ability, 'Plan A', or to ask a doctor to dull your senses and remove the baby from your body. A skilled midwife can be with you, but only you can achieve 'Plan A'.

May the year 2009 bring many women to a new knowledge of their amazing birthing ability, with happy and healthy birth days.


Sif said...

Ah, what a fantastic post, Joy!

As a woman who had an "orgasmic" birth (for my most intervened and least natural birth), and then some pretty low key, natural, but not particularly ecstatic (yhough all the same satisfying) births, I feel uneasy with the A + B = C theory of birthing.

How women must question themselves when they have the "perfect home water birth" with the "right" people there saying and doing all the "right" stuff, and they don't experience something akin to a painfree, fearfree, frustration free Nirvana... Is it fair to women to sell birth as a defined product that can be ordered, even if it does convince them to turn away from interventions as a matter of course?

Joy Johnston said...

It's a real worry if anyone out there really thinks birth can be packaged and sold as a product, Sif.
We have the 'baby accessory', with all the goods and chattels that go along with him or her. So is the marketing of birth - natural or 'sans naturel' as it may be, a linked phenomonen? "It's your choice, as long as you have the $."
You say "even if it does convince them to turn away from interventions". I wonder if there is any credible evidence that women who are 'educated' about natural birth do turn away from interventions, and prepare themselves to engage with natural (+or- pain or pleasure) birthing?