Discussion about the ‘best’ place for women to give birth is ongoing today, with new guidance from the National Institute of Clinical Excellence (NICE) that state “45% of women are at extremely low risk of complications and may be better off giving birth elsewhere” (not in hospital). However, we need to remember there is no ‘right’ way or place to give birth, and to not forget about the needs of women who have suffered a traumatic birth.
The argument is that giving birth at home, or in a midwife-led unit is safer for mums assessed as being ‘low risk’ because they are more likely to be relaxed in familiar surroundings and are less likely to have unnecessary interventions. That makes sense to me, and sounds very positive.
Empowering women to choose where they have their baby is a wonderful thing, provided they are given all the information they need to ensure that choice is informed, and best for them and their baby.
Ultimately, every woman is individual with individual needs.
My pregnancy was going completely to plan until 24 weeks, when I was diagnosed with severe preeclampsia and severe HELLP syndrome. I was transferred from my local hospital to a specialist hospital two hours away by blue light ambulance.
Being so ill, and at genuine risk of death if left untreated, I was effectively relieved of any choice over what happened to my body. I felt like a human pin cushion; I had wires going in to and out of my body, and so many medical professionals from different specialties coming to see me I lost count.
My son Hugo was born by emergency Caesarean section while I was under general anaesthetic. I woke up in intensive care, and first met my son 30 hours later.
Yes, my situation was rare and extraordinary, but it is why I get so cross and frustrated when I read comments that say words to the effect of “All women should have a choice about where they give birth.” In an ideal world, yes, they should. But we need to reflect that there are many situations where women do not have a choice, situations where interventions are necessary for the sake of mum and baby.
That statement should read “All women should have a choice about where they give birth wherever possible, and according to the woman’s needs.”
Those who promote the positive birth movement do a fantastic job promoting the message that for the majority of women, giving birth will be a beautiful, natural event, and women should be encouraged to see it that way.
However, it can be difficult to get people to understand how frustrating it feels that Hugo’s birth was anything but natural – and it compounds my distress that my birth experience was anything but ‘normal’.
Even though I know rationally that my illness and the premature birth of my son were the result of circumstances beyond my control, there is a large part of me that feels like I failed as a woman and as a mother because my son’s birth was so medicalised.
I was heartened to read in the Birth Trauma Association’s statement about the new guidelines that “there is no right way to give birth” – for women who, like me, had a traumatic birth this is invaluable validation that I am not ‘abnormal’.
What is more important than validation, however, is appropriate support after a traumatic birth for women who need it. Individual mothers will need support suited to their individual needs. They need to be signposted to relevant services.
It is unacceptable for women who have experienced a traumatic birth to leave hospital without knowing what support is available, and have to proactively seek it out themselves, as I did.
My needs are complex, because my birth trauma issues are intertwined with grief over the death of my son, Hugo, who died aged 35 days. I have finally got the support I need, which I am so grateful for – but I had to fight for it.
Some women may feel so helpless and disempowered as a result of their experience that they may never get the help they need.
Pregnancy and birth is a beautiful, natural experience. But we should also take time to acknowledge that birth will not always go to plan, and there will be times where women will not have a choice because of circumstances beyond anyone’s control. We also need to ensure mothers get the support they desperately need to overcome their ordeal.