Masters of birth… and swimming

It’s very hard to describe why physical experiences have such a lasting emotional impact. Possibly the most physical experience of all for many women is giving birth. So why is it important that a woman has control over how she gives birth? And how can mastering your body again help heal a bad experience?

Before I had babies, I believed the medical mantra that a healthy outcome for mother and child was paramount. By hook or by crook (often literally), both shall survive. But through experience and anecdotes of friends and family, I realised that a healthy outcome is much more than mother and child surviving birth; it’s a knife-edge, raw, critical mind-game that can break even the strongest woman.

It was April 2006, and Ellen was recounting to me her birth. We both had 6 week old babies. I was shell-shocked and dazed, but steady and happy; much how I thought we all must be feeling. But she was a mess. On the corner of a street, she crumbled, shaking, crying. A strong, positive, open woman, traumatised by her birth experience.

I looked down at her beautiful, healthy daughter asleep in her pram, and wondered how the manner of her arrival had such a profound effect? Yes, Ellen’d been critically ill, but she hadn’t died; they’d both survived; here she was 6 weeks later, outwardly showing no more scars than me. And yet she was destroyed.

It wasn’t until I started swimming that I began to realise how accomplishing something intensely physical is mentally empowering, because it helped chase away my demons. By that rationale, I understood how it is disempowering to lose mastery of your own physicality. I’ve blogged before about how replacing having babies with endurance exercise has been good for my mental health, and I’m still drawing parallels between giving birth and swimming.

It’s all about control. Not control in the control-freak sense of the word, and perhaps this is where there’s confusion in the maternal-control debate; but control in the sense that you have command of your body, rather than having things done to you.

Giving birth is such a base physical experience. It’s almost animal, in the way that reason can leave you as you tune in to and use the intense pain and energy of your body. That sounds a bit out there, but I can’t think of a better way to put it. When it goes right, it’s all about you and your body, and you finish holding your newborn in a state of euphoria that really has no comparison.

When it goes wrong, though, the medical team takes the reins, the pain becomes unbearable, even dangerous, and the woman is left at best with bonding difficulties, and at worst with post-traumatic stress, which was Ellen’s eventual diagnosis.

Making choices is key, even when things are going wrong. I could write pages on the many antenatal choices women can and can’t make, depending on who they are, where they live, who they talk to, but I won’t because there are many studies and campaigns out there already, not least by the NCT (National Childbirth Trust).

And there are choices during the birth itself. For example, during my medically-induced birth, I chose to have a portable heart-rate monitor so that I could choose my position rather than being stuck on my back. I knew to ask; it wasn’t offered, and I had to be a bit pushy. But my midwife assented, and it was a game-changing choice that affected my experience and perhaps the outcome of the birth, subsequent bonding with my baby and my mental health.

But words like choice and control are flimsy and ubiquitous. Women who use them as part of their maternity care dialogue are often dismissed as demanding or unrealistic. It’s also assumed that you’d choose to have the coveted natural birth experience, when of course drugs and c-sections can be equally valid choices.

An insanely stupid and irresponsible bit of journalism claimed that middle-class mothers were behind a rise in c-sections: “Some women do opt for a caesarean section because they can’t cope with the uncertainty,” said Louise Silverton, director for midwifery at the Royal College of Midwives. “They control the rest of their lives, but they can’t control labour.”

Quite apart from the fact that neonates are bigger than ever, mothers older, and many are, like, emergencies, some women choose to have a c-section for damn good reasons like they were traumatised and nearly died by attempting a ‘natural’ birth, and ended up having a c-section anyway.

For Ellen, it was the planned c-section birth of her second baby, the one she thought she’d never be able to face having, that helped undo the trauma of the first. Granted by a sympathetic consultant, it was, in her words, calm, peaceful and beautiful.

Anecdotally, it seems that one of the best therapies for women who’ve undergone traumatic physical experiences is to have a positive one. To use your body for good, to see how strong it can be, and prove that you can be the master of your own physicality. Others, like me, throw themselves into a sport or activity that demands a lot of our bodies.

I was interested to hear that one of Jimmy Saville’s victims has taken up open water swimming because she feels it has allowed her to take back mastery of her own body. I think that too has helped me understand how it takes a positive physical experience to help get over a negative one

All is not lost. Organisations like the Birth Trauma Association and Birth Crisis Network who seek to help women traumatised by their experiences, raise awareness and work to prevent it. Some NHS trusts also offer debriefs, though I’ve read the this vital service might be under threat by the Tory axe.

Nobody wants mothers and babies to die during childbirth. But it’s fast becoming clear that a positive experience of birth is just as important as a healthy outcome.