By Rosalind Howell
In December the NICE guidelines were updated to reflect changing cultural attitudes to pregnancy and birth. They acknowledge that for women, birth is a ‘significant and emotionally intense life experience’ and also acknowledge the effects of birth are far reaching and so far little is known about this.
Having given birth three times in the last four and half years, I have felt caught between two modern paradigms, the medicalised, intervention-full hospital birth, and the gentle, pain free, (even orgasmic) homebirth. These extremes seem to reflect a cultural unwillingness to reconcile some of our most difficult and challenging feelings around birth and motherhood.
The popularity of hypnobirthing classes, as well as websites such as sacredbirthing.org and sarahbuckley.com, reflect the desire by many women who are pregnant or hoping to conceive to positively affect the experience of childbirth for them and their baby. Perhaps too, women are looking for a discourse that acknowledges that birth is significant for women as well as babies – that as women become mothers, transformations can take place. However, as we not only set ourselves up for feeling guilty, judged and not good enough, if we end up in hospital or receive some other kind of medical intervention during childbirth, we may also be avoiding thinking about an important component in the development of relationships.
We are told that pain during childbirth can be a ‘myth’ (Mongan), that birth can be sensual and pleasurable (orgasmicbirth.com). It should be ‘soft ‘and ‘conscious’ (sacredbirthing.org) in order not to traumatise our baby, and that in our birth and our mothering our watchword at all times should be ‘gentleness’ (sarahbuckley.com).
Naturally this puts women under tremendous pressure to birth in a certain way. They may feel guilt and anxiety before, during and after birth if their experience does not look and feel like these descriptions of an ‘ideal’ birth.
Psychoanalysis tells us that all relationships can be characterised by ambivalence. D.W Winnicott even went so far as to list 18 reasons why a mother hates her baby (“The baby is a danger to her body in pregnancy and at birth. He is ruthless, treats her as scum, an un-paid servant, a slave.”) He suggests that it is vital for a mother to acknowledge her most difficult feelings around her baby (without resorting to retaliation) in order to assist the child’s developmental journey from experiencing relationship with the (m)other as a fantasy, to one based on reality.
Discourse that idealises birth, that only allows the idea of a gentle birth to be ok, that ascribes only gentleness as the characteristic of a ‘good enough’ mother is doing a disservice to women and children. By disavowing violent, aggressive, even hateful experiences we miss the opportunity to describe fully the complex experience of birthing, being born and developing in all its pain and joy.
Fantasises of the symbiotic nature of the mother/baby relationship do women the double disservice of not allowing their more difficult feelings regarding becoming a mother and thereby missing its potentially transformative powers. It is the violent separation as the baby leaves the mothers body that haunts us for the rest of our lives, and fantasies of pain free, easy, birth deny not only the physical but also the emotional pain of that first separation (Kristeva).
Writing in 1977, Julia Kristeva claimed that we were in thrall to the traditional religious representations of motherhood – the cult of the Virgin Mary. As she noted, the 4th century orthodox church attempted to prove that Mary remained a virgin after childbirth, thereby not only denying mothers their sexuality, but also the violence of birth where their tissues are torn through birthing.
Writing again in 2005, Kristeva maintained that what remains of religious feeling in our culture still colours our thoughts and feelings about motherhood. When the author of sacredbirthing.org describes how she ‘received a message’ to create ‘a new kind of birth for the master race coming’ it is a rather crude example of the way, as Kristeva says, women collude with societies ‘overvaluing’ of pregnancy, the ‘sacred womb’ and the ‘marketing of the perfect child’. Yet as women we must cope with the imperfections of our children and our mothering and face the fact that our baby is not our own imaginative conception (Winnicott).
In her journal writing, written shortly after the birth of her son, Kristeva says: “… a mother doesn’t give birth in pain she gives birth to pain… it settles in… a mother is branded by pain” (my italics).
So what other pain characterises the mother’s relationship to her child? The pain of increasing separation as the child grows towards adulthood; of not being able to protect one’s child completely from suffering; of the loss of one’s pre-mother self… the list is long.
By wanting to take the violence and the pain out of the discourse around childbirth – and call it ‘sensation’ for example (hypnobirthing.co.uk) – might we be trying to deny the part of motherhood that is inherently painful and as a result actually make it harder for those feelings to be borne by us?
Winnicott says, “sentimentality in a mother is no good at all from a child’s point from view”. In other words, the child can only learn to acknowledge and tolerate her own complex mix of feelings regarding human relationships if the environment she is in doesn’t deny the ambivalence inherent in mothering. As relations between mothers and babies move out of fantasy and into reality, real exchange is possible (Phillips & Taylor).
As birthing women we don’t want to be overwhelmed by the fear of pain, violence, separation and loss but this is less likely to happen when all feelings, including difficult ones are allowed to enter the birthing arena, thought about and so more easily born.
Women need kindness and compassion from their caregivers and those seeking to give advice, not sentimentality. Perhaps as mothers to be we look to ‘birth experts’ such as sacred birthing.org for a type of support we are afraid we won’t get from our own mothers and our midwifes. Yet this type of discourse is offering something akin to ‘magical kindness’, a very primitive form of kindness that carries with it the belief that we can somehow be rescued from all our difficulties (Phillips & Taylor).
As the NICE guidelines recommend a ‘normalising birth’ route for women with low risk pregnancies, might a normal birth be one that allows all aspects of the experience into the birthing room: the love and the hate, the soft and the not so soft, the pain and the pleasure?
NICE guidelines also now state that information regarding ‘low risk’ births should be presented to women in a less risk based way. Perhaps too, we should also be re-thinking the idea of risk in pregnancy and childbirth. As Kristeva suggests, we are still failing to grapple with the real questions of having children. What are the risks and benefits for me as a woman to step onto the path of motherhood? What are the risks and benefits to the child, the father, and to society as a whole?
Kristeva, J. (1977) Sabat Mater. In : Moi, T. The Kristeva Reader. Blackwell, (1986).
Kristeva, J. (2005) Motherhood Today. www.kristeva.fr
Mongan. M (2008) Hypnobirthing: The Mongan Method: A Natural Approach to a Safe, Easier, More Comfortable Birthing. Health Communications
Phillips, A. Taylor, B. On Kindness. Penguin, (2009).
Winnicott, D.W. Hate In the Countertransference. In Collected Papers: Through Paediatrics to Psychoanalysis Karnac. 1958.
Rosalind Howell is a trained Movement Psychotherapist. She currently facilitates workshops for staff teams who wish to develop their reflective skills. She also holds quarterly women’s talking circles at her home. Since giving birth to her three children she has also given birth in herself a passionate desire to express her ideas in writing. Her articles have appeared in E-Motion journal and Juno magazine.