Oh God, I mean, I laugh about it now. Which is funny in itself really, the idea that 10 years later I’d be laughing about the day, the dawn, where, white-faced in a room with blood up the walls, I would hand our new raw blinking baby to my boyfriend in order to frantically find, in my Notes app, the document I had grandly named Birth Plan. What was I hoping to find there, I wonder now. It’s funny, it is funny, how I scoured it – “I want a mobile epidural”, “I want gentle guidance rather as opposed to being forced to push” – this plan, written as if ticking off boxes on a dim sum menu, written in the voice of the person I was before. It seemed crucial, in that moment, to see if perhaps I’d given them the wrong piece of paper. Had it been an admin error? The forceps, the lack of drugs, the breast milk not coming in, the blood, was it my fault? I remember reading it again and again, I hadn’t slept for some time, of course, and the baby was crying, but I felt, I think I felt, that even though I had tried to do everything right, something had gone terribly wrong.
It turned out, despite my shock, despite the horrors and their ripples that followed me for years, my experience of giving birth was almost comically pedestrian. It reminded me of the time I got my ears pierced, I must have been about 12, going home on the bus looking at other women’s earrings and thinking, “OK, you’ve felt that same agony” – now I traipsed around London with the baby strapped to me looking at other mothers, thinking, “and yet, you are walking, you are smiling, you are putting on red lipstick in the reflection of a phone?” As the years have passed I’ve talked to other people about their births with a kind of hunger – these are stories of babies almost dying and mothers almost dying, and worse, of course – so when last week’s report on birth trauma was published, no part of me was surprised at the findings. I can’t imagine many parents were.
It’s estimated that 30,000 women a year in the UK have suffered negative experiences during the delivery of their babies, with one in 20 developing PTSD, at least in part because of the government’s austerity measures. The report put forward 12 recommendations in total, including: recruit, train and retain more midwives, obstetricians and anaesthetists to ensure safe levels of staffing; respect mothers’ choices around giving birth and access to pain relief; commit to tackling inequalities in maternity care for ethnic minorities; and universal access to specialist maternal mental health services. It probably says something grim about me, or perhaps points to my own PTSD, that I read the recommendations with the memory of my well meaning yet worthless birth plan ringing in my gut.
I wondered often, in those hot white months following my daughter’s birth, whether alongside my birth plan, it would have helped me process the shock if we had also been encouraged to consider a plan B, and C, and maybe D. Instead, we compiled long lists of “essential” items to take to hospital – drinking straws, protein bars, aromatherapy. We heaved an Ikea bag of pillows and tiny T-shirts into a cab, then across the car park and up in the lift and it remained in the corner of the maternity ward for the next long week. The report calls for a system “where poor care is the exception rather than the rule”, which, honestly, threw me a bit, because surely eliminating poor care altogether should be the overriding theme, the very baseline from which we begin, but I’d add some softer, highly achievable additions to the recommendations. Starting with antenatal classes. As well as the lessons in breathing for pain relief and the introduction to other new parents, there is surely room for measured conversation about the possibility that your birth will not go to plan and how to deal with the trauma, if it comes. With this should come, too, the acknowledgment and support for people who want elective C-sections (a number of my friends chose, or fought for, caesareans after harrowing first births) and those who can’t or don’t want to breastfeed, especially following trauma.
There’s still, I think, a code of silence around difficult births, the sense that one might summon ghosts and bring bad luck into the room. I get it: pregnancy lends itself to a kind of magical thinking, this unseen creature growing inside you, that got there, you say, from sex? But often this obscures reality. The prospect of pain is discussed in mad new ways – one hypno-birthing session I did as my due date approached reassured me labour would not hurt if performed correctly. Now I understand that lesson maybe as a way of rethinking the language of pain, or of attempting to reduce our fear, but at the time it threw me into pits of confusion and guilt. It was a minor example, I think now, of the many linguistic muslins thrown over conversations with parents-to-be, to diffuse anxiety, or encourage the brisk getting-on-with-it. More clarity, more honesty (as well, of course, as properly funding the NHS and profoundly improving the quality of care to women) might help prevent so many negative experiences of birth, and help us walk confidently into parenthood, rather than crawling on our knees.
Email Eva at e.wiseman@observer.co.uk or follow her on X @EvaWiseman
