an empowered birth?

Sources of empowerment for women seem to be everywhere these days, not least when it comes to birthing babies. I think I heard the word ‘empowerment’ more often while pregnant than at any other time in my life.

You’d think that would be a good thing, right? More empowered women should mean more women in charge of their lives, taking it to the man, building a feminist utopia of equality at home and work.  Only, wait ... that doesn’t seem to be at all what’s happening.

So is the constant goal of empowerment actually empowering?  

A few years ago the satirical newspaper the Onion published an article entitled ‘Women Now Empowered by Everything a Woman Does’. Here’s a sample:

“From midnight cheesecake noshers to moms who don't fool around with pain, feminist achievement covers a broad spectrum," said Bradley in her acceptance speech. "It is great to be a female athlete, senator, or physician. But we must not overlook the homemaker who uses a mop equipped with convenient, throwaway towelettes, the college co-ed who chooses to abstain from sex, and the college co-ed who chooses to have a lot of sex. Only by lauding every single thing a woman does, no matter how ordinary, can you truly go, girls."

At times, the article treads a pretty fine line between satire and (ironic) sexism, but it also has a point. These days ‘empowerment’ for women seems to be a confused and ambiguous term, used from everything from a conventional political understanding of ‘empowerment’ - meaning to challenge the norms and values of patriarchal culture (as, say the ‘female athlete, senator or physician’) - to what I would say is a capitalist deployment of the language of revolution to sell shampoo and stuff - think Pantene’s new Shine Strong campaign which draws attention to women’s over-apologising, Dove’s ‘campaign for real beauty’  or the perennial L’Oreal ‘because I’m / you’re /we’re worth it’ strategy. 

The language of ‘empowerment’ seems to particularly saturate everything when you get pregnant. It sounds great: taking control of your own birth experience, banishing the drugs as unnatural and - if you don’t choose to stay at home - going home from the hospital within hours of giving birth. For an empowered mother, having a baby need not even interrupt your week.

Only that’s not always what happens. And not everyone feels empowered by their birth experience.

Nurse-academic Ruth deSouza, for example, has critiqued the monocultural understanding of empowerment through birthing that dominates New Zealand’s midwife-led maternity services. In her 2014 analysis of the experience of new Korean mothers in New Zealand, she illustrates how the Korean mothers she interviewed felt profoundly dis-empowered by the care that they received. Where they wanted more tests and ultrasounds to ease their concerns about their babies’ development - what they would’ve expected as routine in Korea - they were told ‘not to worry’ and ‘everything was fine’, increasing rather than lessening their anxiety. Where they wanted hands-on assistance and more nurturing in their early days as mothers, they were instead expected to become independent immediately post-partum.  De Souza concluded that both their medical and cultural requirements were not met. This, in turn, left the women feeling incredibly anxious and vulnerable.

I found de Souza’s study interesting for a number of reasons. First of all, because I think it strongly highlights that a uniform and universal maternity philosophy practice does not suit everyone. Second, that, while maternity services may be empowering for the maternity providers and for mothers who thrive under it, it is not empowering for all women. Finally, I think de Souza’s work gestures towards the question of whether ‘empowerment’ is really the best or most helpful way to conceptualise birth. If we mean by ‘empowered’ feeling supported and cared for, and having your body and decisions respected, then it is helpful. But so-called ‘empowerment’ often means leaving women to fend for themselves, with minimal intervention or guidance, when they don’t really know what they’re letting themselves in for. I think this says more about over-stretched maternity services with fewer and fewer resources than it does about appropriate maternity care.

And, while I agree that pregnancy and birth are natural processes, I don’t think that means we must be expected to act as if everything will return to ‘normal’ straightaway. I think this expectation is unrealistic and profoundly disempowering for many women, not least the Korean migrant women in de Souza’s study. I have heard many women express shock and surprise at just how physically weak and vulnerable that pregnancy and birth made them, about how long it took them to recover, about the agonies of establishing breastfeeding and so on. Pregnancy and birth may be natural processes, but they are also profound physiological, psychological and emotional experiences. For much of human history, my guess is the concept that would’ve best described birth and early motherhood is ‘survival’ not ‘empowerment’.

The law changes in New Zealand - driven by both midwives and what the health system describes as ‘consumers’ (hmm, spider senses tingling there - what about ‘patients’ or, dare I say it, ‘prospective mothers’?) - were a legacy of second-wave feminism. Women wanted to wrest back control of their bodies from predominantly male physicians  who routinely cut and drugged healthy women who may not have needed such interventions. That history is certainly empowering. I am in no way arguing for a return to women having zero say in birth and being treated as little more than objects.

But with the decentralisation of healthcare, the continuing cuts to maternity services - as well as increased workloads - what may once have been empowering is now dressed up in the language of ‘choice’: choose your midwife or other Lead Maternity Carer, choose how and where you want to give birth, choose to have an epidural or not. Such choice, without the support and care to make informed decisions, is not empowering for everyone - for many, it is overwhelming and alienating.

Speaking personally, I did not feel empowered by my first birth experience. I felt shocked, violated and incredibly weak. I also felt like I never wanted to go through that experience again. And even before that, I felt a lot of uncertainty about the process, and was dismayed at how difficult the system was to navigate. 

For most of my second pregnancy, it’s fair to say I was in almost total denial about the forthcoming birth. It wasn’t until the last few weeks, and a conversation with one of the consultants at the hospital, that I actually started facing what I was about to go through. 

During that conversation, the doctor said:

‘A positive birth experience this time round could be incredibly empowering’. 

That word again. 

‘But,’ he added, ‘Another difficult one won’t be.’ 

I was then asked what I wanted from the birth. Um, I guess that meant apart from a healthy baby? 

Without thinking, I blurted out, what I thought was half seriously, to the other four people in the room, ‘I want to survive it.’ 

Nobody laughed.

I guess not everyone prepares to give birth by mentally composing their wills. But my thoughts about the birth had nothing to do with empowerment, or challenging the system, or making a political statement of any kind.

After a bit more discussion, we agreed that it was up to me to make a choice and they would support me in whatever I wanted.  As I have blogged about previously, I decided to do what was - for me - the least worst option. Ironically, this time, as well as feeling physically weak and groggy and all the lovely things that new mothers experience in the first few days after birth, I did feel somewhat empowered: by the  fact that I had faced my fears and made some practical decisions that enabled me to take some control back.

Genuine maternal empowerment is not about conforming to someone else’s notion of what your birth should be like, no matter how well-intentioned they may be. It is about being supported to make the best decisions that you are able to in the particular circumstances in which you find yourself in order to receive the care you feel is necessary. For the Korean women in de Souza’s study, that meant more tests and ultrasounds and more nurturing in the postpartum period. For me, my ‘empowerment’ was incidental to, not the goal, of my second birth experience; it was a by-product of first feeling profound dis-empowerment and a subsequent quest for survival. 

Maybe we’d be better off trying not to find empowerment in everything from birth to beauty bars and feeling like failures when it doesn’t materialise. Perhaps a better concept to guide maternity care is neither ‘empowerment’ nor ‘survival’ - both of which focus almost exclusively on the individual - but on ‘support’. Different women will need different kinds and levels of support both before, during and after birth. Focussing on providing ‘support’ rather than ‘empowerment’ also ensures mothers remain at the centre of birthing experiences, but not in isolation.  

For my birth experiences, I would much rather have been able to say ‘I was supported’ than ‘I was empowered’. Though being able to say ‘I survived’ is pretty good too.

by george, she's done it!

I hadn’t planned for my first post in a wee while to be about the royal birth, not least because I’m not a monarchist, and have not been following The Pregnancy with avid interest. Two things, however, made me change my mind. The first is that my last few posts have been on reasonably ‘heavy’ subjects and I thought it was probably time for a change of pace. The second is that The Happy Event occurred about 24 hours after the earthquake I last posted about: news about something as everyday and positive as a new baby suddenly seemed way more appealing than it had previously. It also provided a bit of light relief from constantly refreshing GeoNet or the Wellington Regional Emergency Management Office Facebook page for news.

The coverage of said Happy Event left me pondering a few things about the narratives constructed around pregnancy and birth, both this particular royal birth and births in general:

1) Back in March this year, author Hilary Mantel, who has written bestselling novels involving historical royals, made some fairly conventional remarks to the effect that Kate Middleton’s job was basically to look pretty and breed (although she may have worded it a little more strongly than that). Her point - a minor one in her talk - was about the perception of the Royal Person generated by the tabloid media, but this didn’t prevent her being pilloried by media (both tabloid and some broadsheets) and politicians alike (I mean, really, didn’t Ed Milliband or David Cameron have anything else to do that day? Surely the latter, at least, had benefits to cut, programmes to slash and jobs for the boys to distribute?) 

But, not surprisingly at all, the coverage of Middleton’s middle as it expanded and then of the subsequent birth pretty much conformed exactly to what Mantel said it would: a focus on her looks and body and on all the minutiae of the pregnancy and birth. So, basically, whatever else she may have to offer, Middleton, like other women in the public eye, was reduced to the corporeal, specifically to her reproductive capabilities. Attention was also drawn to the fact that she listed ‘Princess’ as her job on the birth registration form. Nothing like peddling some conservative constructions of womanhood to sell a few papers is there?

2) Having said that, I’m not going to deny that the birth of any baby is special. But, as nurse-academic Ruth de Souza, eloquently writes, I wish ‘we’ treated every baby as if he or she were as special as this baby. De Souza, who formerly worked in a post-natal ward, points out that not all mothers and their children are sentimentalised in the same way and provides some excellent background as to why. I particularly liked her wishes for all new mothers and babies:

• I wish the arrival of every infant in the world was greeted with the same sense of anticipation and enthusiasm as the Royal arrival.
• I wish every mother, infant and family could receive the same “care” as the Royals will.
• I wish “we” cared as much about maternal and infant mortality around the world.
• I wish “we” cared as much about “other” mothers who aren’t supported in their mothering and against whom active measures are taken to regulate and surveil their bodies merely because of the accident of their own circumstances.

I would also be much happier about The Happy Event if it helped trigger greater awareness or debate about these issues. 

3) While the ante-natal vigil on the streets of London by journalists eager to scoop the opposition and press photographers poised to capture the first glimpse of the baby was kind of amusing - ‘our latest report is that there is nothing new to report’ - the post-partum parade of new mother and baby was a little disturbing. I know that a straightforward birth can mean a new mother can go home or be up and about within a short while of delivering a baby, but most get to slope incognito out the hospital door wearing trackpants and a loose t-shirt. 

Not so Princess Kate. 

Instead, she was paraded before the waiting media, hair done, full make-up on, tasteful dress echoing that worn by her deceased mother-in-law in her own post-partum parade. While this was no doubt expected and planned for - that dress was surely no coincidence - one can only hope she was doped up to the eyeballs so as not to feel any of the swelling and pain that even in the best circumstances doesn’t subside until weeks after the birth. I can’t help but feel that this kind of tableau perpetuates the idea that birth is a walk in the park, particularly in countries where both infant and maternal mortality is low, and creates false and unreasonable expectations for new mothers. 

What’s more, some media hacks and twitter trolls, who seem to have little understanding of basic biology, were already scrutinising her post-partum body and finding it wanting: look at that bump she still has! How’s she going to get rid of that?  Kate’s post- pregnancy weight-loss plan! Good lord. While trade in celebrity post-natal weight-loss stories has been going strong for a while now, other celebrity mothers at least seem to get some choice about when and how they participate in this narrative (and get paid for it!) The rest of us just get to feel bad about how we can’t live up to these impossible ideals. Following hard on the heels of this damaging nonsense, however, was a wave of commentary supporting Kate and her bump display, saying that she, at least, was sending a positive message to women and girls that this is what a post-partum body looks like and it’s perfectly OK.

4) Around the world, The Happy Event was celebrated in a range of ways: buildings lit up in blue and read, word spelled out by anonymous bodies on naval ships, commemorative newspaper and magazine covers. In Wellington, the plan was to conduct a 21-gun salute. Yep, that’s right: letting off 21 loud noises from phallic-shaped machines designed to kill people to celebrate something that is virtually the complete opposite. That’s not at all weird. 

What was weird, however, was the decision to go ahead with this ridiculous ceremony a mere day after the city had experienced a pretty strong earthquake, which may not have been deadly but certainly frayed nerves (mine included). Apparently celebrating the birth of a baby 12,000 miles away with a militaristic display was deemed more important than the mental wellbeing of some rattled residents. It’s great to know out city cares. 

Now, I’m not saying that they need even have done something as sensible as not marking The Happy Event at all, but perhaps a more suitable alternative could’ve been found in the circumstances. Releasing 21 balloons, perhaps? (Or even 99?)

5) I have to confess that it would’ve been quite nice if the baby had been a girl (and I'm not alone in this one either). Not, I hasten to add, because I have anything at all against boy babies. I’m aware that the laws governing the royal succession were changed to specify that either a boy or girl would inherit the throne before the gender of the baby was known. While this may have positively impacted other members of the aristocracy, a number of Commonwealth states, of which the British monarch is still the titular head, decided to opt for a wait-and-see approach. This means that their succession laws still specify that a male heir needs to inherit the throne, and this in turn impacts on the coming into force of the British law i.e. despite the law change, until all 15 Commonwealth countries who have the monarch as their head of state change their laws it's in no way a done deal. The arrival of a boy ensures that primogeniture - one of the ribs making up the skeleton of patriarchy - survives for another generation, at least. 

Kind of like the new Dr Who, in a way.

But in spite of all that, I wish you good luck new royal parents and baby: a newborn baby is  precious, but also hard work. I’m sure the privileges you enjoy will ease some of that, but then I expect the downside is that, as your baby grows up, you will continue to be publicly scrutinised, idealised and perhaps even condemned for your parenting in a way that most of us are not.