Do as I say


Poor Oakley. Not because she’s 18 and she’s having a baby with a 33 year old methadone user (I thought he was rather lovely, actually). Not because her midwifery care is lacking – she is super lucky to be one of the very few women in the country who benefits from continuity of carer in the NHS. Not even because the two who provide continuity of care are horrible – they’re not. They’re lovely and bubbly and fun and I would be delighted to spend a night out with them.

But poor Oakley because none of the carers around her have any faith in her ability to give birth normally, which she clearly wants.

We see Oakley’s midwife reminding her that she’s going to have a big baby. Then we hear her saying, ‘if you’re going to have the faintest chance of pushing your baby out yourself, you’re going to have to use all those upright positions we’ve been talking about. Because let’s not kid ourselves: this is one big baby.’

We cut to the staff room, where the other midwife is rolling her eyes, laughing, and saying she’s not looking forward to it – it’s all going to go wrong. We see another midwife saying, ‘she’s going to have a caesarean.’

And then in they go to Poor Oakley again, all smiles.

I wonder how Oakley feels today, seeing all those midwives expressing their lack of faith in her behind her back. I wonder whether she has put two and two together?

Language is a very powerful thing. This is the premise on which antenatal education like Hypnobirthing, and some elements of antenatal yoga, are based. You tell someone it’s going to hurt and guess what – it’ll hurt. You tell someone it’s going to be fine, and chances are, it will be.

If you don’t believe me, think about a time when you felt something sticky on your hand. You looked down, and saw that it was blood. And it was the action of seeing the blood that began the pain. Your brain was told – ‘I’m bleeding. Bleeding hurts.’ So your brain made it hurt. Or, if you have kids, try this unethical experiment next time you’re in the playground. Shout out ‘don’t fall’ when they’re precarious – and watch them land on the ground. They have heard ‘fall’. You have put in their head the idea that falling is possible. So they do it. Compare and contrast with your next playground trip, when you say ‘hold on tight,’ or ‘take care’.

Oakley had absolute faith in her carers – their relationship was touching. I have no doubt that the midwives felt that they were doing the right thing by her, laying it on the line, trying to set her up for a normal birth. But if they genuinely felt that, it must be because they hadn’t considered the power of their language. Because you don’t have to read between the lines very far to hear, ‘this midwife doesn’t think it’s going to happen,’ ‘big babies are hard to birth,’ and the rest of it. And in fact perhaps even the wonderful continuity of carer then worked against Oakley: she trusted her midwives totally, and of course if her midwives are saying, ‘you can’t push out this baby, it’s too big,’ she is going to do as she is told.

'I can't do this' is not an option

This use of language is well meaning, I’m sure. Perhaps it’s seen as preparation, or as telling it like it is. I’ve been with a woman as a doula when one of the first things the midwife said to her (when she had got to 5cm dilated without even really noticing it), ‘I’m not going to pretend this isn’t going to be the worst pain you’ve ever experienced in your life,’ I’ve had another doula client, planning a homebirth, be told ‘three of you are booked around the same time, but chances are none of you will manage to have a homebirth,’ and then told her of the ‘hours and hours of continuous pain’ of labour.

But I think that actually, it’s setting people up for failure. There are endless debates about this with the antenatal world, and that’s time for another blog, but let’s just consider an analogy. You’re going out for a run. Does your partner say to you, ‘have a good run, see you later.’ Or do they say, ‘you’re not going to manage this, you know. I know someone who fell down a rabbit hole and broke their ankle. And what if you get a stitch? You need a map, you’ll get lost otherwise.’ Finally, to appease your well-meaning but nervous partner, you agree that he’ll take the car and drive alongside you, to make sure you’re OK. Every minute he stops and asks if you’re OK, and suggests that you get in and he drives you the rest of the way.

Birth is a normal physiological process, just as running is. Granted, it doesn’t happen as frequently as running, but we’re designed to do it, and here’s the amazing bit, folks: it’s designed to work. Problem is, it’s not designed to be interfered with, any more than running is, and when people, or cultures, or societies (be that an entire nation, or a relationship, or a family history) decides to spin it a certain way, we, valuing our relationships or cultures or societies, do as we’re told.

Oakley was being told over and over again, ‘you’re not going to be able to do this, you know.’ And guess what? She couldn’t do it. Because she was being a good girl, and doing what she was told.

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~ by Kedi Simpson on March 15, 2011.

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