William Reville
Science of life
Motherhood should be a very special time filled with joy and love but many new mothers can labour under such a burden of expectations and pressure to perform to certain standards that they end up feeling bad about perceived underperformance or failure. This phenomenon is very marked in America and is well described by Claire Howorth in Time magazine, October 10, 2017. The phenomenon also exists in Ireland although to a markedly lesser degree than in America. However, such fashions have a habit of migrating eastwards across the Atlantic.
Howorth describes the aspirations that build up so strongly in the minds of American women who are expecting a baby. Basically these aspirations are to ideals of perfection. These include making ideal preparations for birth beforehand, eating all the right things and avoiding all the bad things, doing all the right exercises; having the perfect birth, ideally at home and medication-free, attended by your midwife, doula and your partner; breastfeeding your baby for at least six months and ideally for up to 2 years, and so on.
Delivery
A doula (a word of Greek origin) by the way is a non-medical assistant hired by the pregnant woman to help her to prepare for the labour, to be with her during the labour and delivery and to help her settle down with her new baby after the birth. Doula services are now available in Ireland.
Of course there is nothing at all wrong with a pregnant woman having these aspirations but the problem in America is that many women feel that they are failures if they cannot fulfil them. And of course, circumstances over which the woman has little or no control arise in many cases and dictate that one or more of these aspirations will not be fulfilled. This is nobody’s fault and no legitimate reason for feeling bad but nevertheless many women do feel bad.
Time magazine carried out a survey of over 900 mothers and found that half the women experienced regret, shame, guilt or anger, mostly because of unexpected complications and a lack of support. Over half said natural birth was very important but 43% ended up needing drugs or an epidural, and 22% had unplanned C-sections. Breast-feeding posed unexpected difficulties for many. Twenty percent planned to breast-feed for at least a year – fewer than 10% did so. The women surveyed felt under pressure with the majority identifying “society in general” as the source of pressure, followed by doctors and other mothers.
Many of the women spoke of their introduction to motherhood in terms of failure – the women who had unplanned C-sections were all disappointed, the women who couldn’t breastfeed for ‘selfish reasons’ such as returning to work or suffering from chronic lack of sleep all felt guilty, women who planned to have medication-free births but ‘gave in’ to an epidural felt they had failed, etc. Almost all these women had given birth to a healthy baby, the whole point of pregnancy, but their natural enjoyment of the beauty of motherhood was severely diminished by all this needless anxiety and guilt.
American society as a whole has conspired to establish a vision of motherhood that is away over-precious but women have bought into this vision on a widespread basis. This vision proclaims that pregnant women should strive hard to be completely compliant with nature throughout the entire process of pregnancy, labour, birth and subsequent nursing of the baby. They should strive to have intervention-free births and, of course, should breastfeed baby. There is nothing wrong with these aspirations of course but they should be tempered by the realisation that individual circumstances frequently intervene to prevent their attainment.
Circumstances
The desirability of breast-feeding is probably the single most canvassed practice advocated for the new mother. There undoubtedly are good reasons to favour breast-feeding – it offers some health advantages to the baby and helps mother to bond with her baby. All this is widely accepted by women and 80% of American mothers try breast-feeding.
However, complicating circumstances often arise. For example, some women can’t breastfeed because of blocked ducts or bleeding nipples or having to return to work a couple of weeks after giving birth – 87% of American workers don’t have paid maternity leave. Also some women cannot breastfeed because they do not produce enough milk to feed the baby. The pressure on women to exclusively breastfeed has inadvertently contributed to a number of cases where nursing mothers accidentally starved their babies to death.
A pushback against the relentless pressure to breast-feed is developing with many people feeling that breast-feeding is now being over-promoted just as bottle feeding with powder formula once was.
Organisation
Howarth points out that it is not so long ago when bottle feeding was hailed as one of the boons of feminism. A new organisation called Fed is Best advocates advising women on all the options for feeding baby and not neglecting to mention the under recognised risks of excusive breast-feeding ranging from jaundice to starvation.
Hobarth sensibly emphasises that there is no such thing as a single golden template for the perfect birth. Of course women should pay close attention to medical guidelines, should consider medication-light births and should plan to breastfeed baby if that is feasible. But there is nothing at all wrong with a woman availing of more pain relieving medication during labour or of opting to bottle feed the baby. Personally, I am so squeamish about pain that, if I were a woman, I think I would opt to sleep my way under heavy sedation through the entire labour!
William Reville is an Emeritus Professor of Biochemistry at UCC.