Come on Mr NICE guy, be nice!
It was going to take a handsome prince to wake me from my blogging slumber. Alas though there’s no such thing in cyber land. Instead, though, Mr NICE guy has thrown a bucket of cold water over me while I blissfully ignored all the controversy that’s been swilling around birth for the last couple of months.
What are we to make, then, of this guideline, that anyone who would like one, should be allowed to have a caesarean. Is this a shot in the arm for feminism, or a blow to it? And similarly, to the NHS?
I saw the headline yesterday and avoided the article in order to protect my blood pressure. I have continued to avoid much of the media debate today because I fear it will be misinformed and simplistic.
I suspect that the back story for guideline is avoidance of birth trauma, and facilitating birthing women to give birth in a way that is as meaningful and unstressful as possible for them. But if my suspicion is correct, I feel very deeply that NICE has missed the point rather spectacularly. Because actually the evidence tells us pretty clearly that what makes people feel good about their experience of birth is being listened to, nurtured, loved, even. Of exploring their fears and perhaps facing them, and coming out of that experience feeling strong and powerful.
Now, for some women that is a very low-tech homebirth, for others that is an elective caesarean – and for many it is somewhere in between the two. Naysayers on both sides of the caesarean versus homebirth debate will state that the other is fraught with danger and an inefficient use of resources (quoting my friend Charlotte Morbey). But where one is to be offered without prejudice or judgement, surely the other should, too? Each with their own open, kind and loving conversation to accompany it, so that a woman and her family can truly understand the implications of whichever way she choses to give birth.
As an antenatal educator, if someone comes to me (as they do reasonably often), saying they want a caesarean, it opens up a conversation, and an opportunity to explore a host of feelings and options. If this guideline provides that opportunity to more women, who then genuinely feel that they have made the right decision for them and their family, then it is a good thing. But if the associated conversation – the TLC – doesn’t happen – if it’s just ‘hello doctor, I’d like a section please.’ ‘Fine, I’ll put you in for the 21st at 9am. Next!’ then it could well be there is a growing population of women who are feeling at the very least emotionally and physically unsatisfied with their experience of birth, and possibly even traumatised by the passive, non-participatory way in which their child was brought into the world.
We know what makes women feel good about their birth experience. It’s TLC and love. And if NICE could rustle up a guideline which gave birthing women continuity of carer, and empathy – however the birth unfolds on the night – then quite honestly a whole lot less women would opt for major abdominal surgery in order to become mothers. And those for whom it became the only option would feel far more accepting of it. I promise.