Yesterday The Telegraph published an article by Milli Hill headlined: “The myth of the painful birth – and why it’s not nearly so bad as women believe”.
Hill’s argument is that most pregnant women are scared of labour. “We just can’t talk about childbirth without stating how impossibly agonising it is in the same breath,” she says. When it comes to sport, she goes on, we all understand how important it is to have a positive mental attitude. What if, Hill asks, we applied the same principle to giving birth?
It’s not a new idea. Back in the 1930s, the obstetrician Grantly Dick-Read wrote a book called Childbirth Without Fear, in which he argued that much of the pain women experience in childbirth is the result of fear: if you feel frightened going into labour, then your muscles tense up, making it harder for your body to do the job it’s supposed to do. Dick-Read believed that the use of breathing and relaxation techniques could enable women to have a happier and even pain-free experience.
If Dick-Read isn’t completely wrong (feeling relaxed encourages the release of the hormone oxytocin, helping labour along), then he is also a long way from being completely right. The factors that influence whether you have a good birth are mostly physiological: the size of the baby, the position of the baby, the size of your pelvis, how efficiently your uterus contracts. If your baby is positioned awkwardly, no amount of positive thinking is going to stop it being painful.
I’ve heard dozens of birth stories, and while some women are pleasantly surprised to find labour easier than they expected, there are far more who approached it in a positive frame of mind only to be shocked by how excruciating the pain was – and how long it lasted.
On the Birth Trauma Association’s Facebook group, one woman, Morgan O’Neill, wrote of her “overwhelming” pain and exhaustion after spending 10 days in early labour, and another 28 hours in active labour. “That’s a looooooong time,” as she put it, with some understatement. Her 9lb baby was born with head and eye injuries, and O’Neill herself is to undergo reconstructive surgery to repair internal and perineal damage.
Nilufer Atik prepared for a natural delivery, only to go through a 53-hour labour characterised by intensely painful contractions from the start. Her labour barely progressed in that time, and her baby was born by emergency Caesarean section. The position her baby was in meant that she was never going to be able to give birth naturally.
It would be good to think such experiences are rare. But when I spoke recently to a group of health professionals about how women can be traumatised by a difficult birth, an obstetrician took me to task for using the phrase “when birth goes wrong”: emergencies in labour are common enough to be regarded as a routine part of the birthing experience, she said.
Her next sentence is still ringing in my ears: “Apart from the day she herself is born, the day a woman gives birth is the most dangerous day of her life.” Her view was the reverse of Hill’s: too many women, she argued, go into labour with unrealistic expectations, believing that a positive mental attitude would be enough to see them through.
Many women whose stories I hear feel angry that they weren’t warned about how painful labour could be, while others beat themselves up for not being positive enough or strong enough. But there should be no shame in not being able to bear the pain of childbirth: no-one tells a person suffering from the agony of gallstones that all will be well as long as they take a positive approach.
Hill is well-intentioned: she wants what we all want, which is for women to have good quality care in labour. But the danger is that by telling women their experience is within their control, you set them up to fail, with the result that they feel guilty as well as traumatised. Luckily, O’Neill recognises that there was nothing she could have done differently. “I was very prepared, strong, healthy, fit, positive,” she says. “It just went catastrophically badly.”