Margot Edwards and Mary Waldorf described it this way: ‘Sheila acted a scene from a Caribbean revivalist church where women worshipped through song and dance. She rocked and gyrated in rhythm, stunning her audience with a dance that put the West Indian women in touch with the mysteries of their common past and opened them to a shared future.’16
I didn’t just talk about but demonstrated how medicalised birth trapped the mother by immobilising her and forcing her to lie on her back, often destroyed her capacity to give birth spontaneously by eliminating oxytocin liberated in the blood stream, and turned birth into an ordeal, so that the whole process was reduced to one of pain.
Margot Edwards and Mary Waldorf went on: ‘With equal drama, she described a different sort of ceremony, the rites of high-tech birth. The patient, dressed in hospital-issue gown, lies in bed with catheter in one arm and others inserted through her vagina into her uterus and infant so the contractions and fetal heart rate can be recorded on a machine. Communication between women and man is limited since she is immobilised and he is intrigued by blips on the monitor. Already the woman has undergone initiation into the patient role by ritual shaving and cleansing. She undergoes further humiliation in a delivery room filled with surgical equipment and peopled by masked figures.’
I showed how when an obstetrician isolates with drapes the lower half of a woman’s body, it becomes his sterile field. But it is clearly neither his nor, because of the juxtaposition of vagina and anus, sterile. It is a convenient fiction, however, by which he asserts his rights and insists that the woman keeps hands off her own body, which becomes out of bounds.
Niles Newton
It was at one of the American conferences that I first met Niles Newton, an amazing woman who did research with her husband Michael, an obstetrician and professor at Chicago University, on the impact of ‘happiness’ hormones on feelings, mothering behaviour, lactation and birth. She did a lot of work with mice, demonstrating the effects of disturbance on labour, and discovering, by introducing swabs soaked in cat’s pee into the cages of mice when they were having their pups, that they had longer and more difficult labours and were more likely to give birth to dead pups. Environmental disturbance can be dangerous.
She researched the environment for breastfeeding. Studying the effects of distraction and stress, she revealed that it affected the release of milk and the ability to breastfeed. Michael plunged her feet in icy water or asked her complicated maths questions while she was breastfeeding and compared the milk flow then with other days in which she could concentrate. There were two kinds of distraction days: in one Niles had a placebo injection of salt water or artificial oxytocin – she didn’t know which. When she had oxytocin and was distracted the quantity of milk she produced was almost equal to days on which she was not disturbed.
In her book Maternal Emotions17 she showed how lactation rites common in hospitals, including washing or wiping the nipples with an alcohol swab, damaged women’s chances of breastfeeding. She had deep insight into birth and breastfeeding as part of a woman’s sexuality in which, when she was undisturbed, there were oxytocin surges in her bloodstream. There was tremendous resistance to this from many people, as I found, too, whenever I wrote about the sensuality of birth. Niles had studied with the anthropologist Margaret Mead in the 60s and, like me, developed a cross-cultural view of birth and breastfeeding.
One outcome of Niles’ research on oxytocin, however, was that keen breastfeeders who were determined to do everything right added an oxytocin nasal spray to their breastfeeding kit, along with a curvy banana-shaped feeding cushion, a pump to extract milk and store supplies in the freezer, bottles and teats, and nipple creams and sprays, even though her research specifically showed that these were counter productive.
South Africa
In the early 70s I was invited to lecture in South Africa and had the opportunity to visit hospitals and indigenous birth practitioners in Johannesburg and Cape Town to learn about birth there. As a midwife bustled me through the labour wards of Cape Town hospital, the largest in the southern hemisphere (the register in the maternity department said ‘Admissions 1973: 20,601’) she remarked ‘The Bantu aren’t noisy in labour. It’s the staff who make the noise.’ It sounded as if life was very stressful for them. I glanced down the list and saw categories for ‘ruptured uterus’, rare in the West, for ‘symphysiotomy’ (slicing open the front of the pelvic cage), though this drastic operation had gone down from 87 in 1963 to only four in 1973. Groans were coming from the 25 cubicles in the delivery room, women writhing, mostly alone, with great puddles of blood on the floor. ‘For God’s sake turn off that drip! The fetal heart is down to 80.’ The patient, sweat pouring off her, was lying flat, her head pushing against the bars at the top of the delivery table as she struggled not to bear down yet. ‘Forceps – quickly!’
All the maternity patients in this hospital were likely to be high risk cases. For most women had to be delivered at home, whether they wished it or not, in the African township outside Johannesberg where the Bantu were herded in row upon row of small concrete and tin-roofed shacks, up to four families living in each.
We went into a dark, unfurnished room where the women were kneeling on the pitted concrete floor. Elisabeth, an impressive matron with a number of small foster-children clustered round her, indicated that I should kneel in front of her. She was in training as a witch doctor, was a trained nurse for seven years before, but now felt it was her vocation to do Zulu tribal healing. Her mentor, Dorcas, an established witchdoctor, knelt shyly in the corner, hiding behind the child on her lap. They told me about herbs which, taken in pregnancy ‘make the baby play free inside’, how to deliver a baby when labour is prolonged by smearing the hands with bone marrow and helping it ‘get through the road which is closed’. ‘She must follow the pain, keep quiet and listen.’ The mother holds the baby and kisses it immediately, for ‘the child must know who is the mother’. She confirmed that grandmothers breastfeed when the mother must be absent at work, but said that there was more and more bottle feeding. I had noticed the hoardings for artificial baby milk as we drove through Soweto ‘Mom fed me on KLM’ and for SMA, the most expensive milk on the market.
We talked about sex too. When the baby is three months old, the husband says he is going to ‘grow up the child with intercourse’. I asked how the woman felt about it. Elisabeth rolled her eyes and exclaimed, ‘The wife feel sweet – oh! Oh! Oh! – Then!’ ‘When he feels the wife has felt it he discharges outside until the child is one year.’ Then she went into a trance and started to prophesy.
I also interviewed Vusamazulu Credo Mutwa who knew ancient Zulu practices and lore which were no longer understood by most of the Zulus in Soweto. Although he had written a book, an epic of tribal myth, Indaba My Children,18 and I expected to meet an author living in fairly comfortable surroundings, his home was the same kind of dwelling as those of Elisabeth and Dorcas. Europeans keep their pigs or chickens in similar huts. We squatted on mats. A storm was building up and the sky was black with clouds, I could no longer see the carvings, drums and sacred objects crowding his dwelling. The air was electric and the heavy rumble of thunder came nearer and nearer.
I asked him if male witch doctors had anything to do with childbirth. He told me that in the past a witchdoctor should be present to bless the ground on which the first-born was to be delivered, and to help in cases of need. Maidens smeared cow dung on the floor of the grandmother’s dwelling where a woman usually gave birth. ‘When the child is born it must look on something beautiful, for this will affect its life.’ So coloured beads and special childbirth carvings decorate the room. ‘The first minute of life is the most important.’ If the woman bleeds too much, the witch doctor orders a red calf to be sacrificed and she drinks some of its blood. After delivery she is always given a special dish of spinach to make her blood strong. A retained placenta is delivered by getting the mother to blow into a bottle. This is an almost worldwide practice for dealing
with a delayed third stage.
It was the custom for a male witch doctor to deliver his own child so that it might inherit his spirit. He said hospitals make this impossible – doctors and nurses ‘do not realise that the forces that activate the birth are much older than humanity itself. They turn birth into a spiritual nightmare’. He told me Zulu children are taken to see a birth ‘to instil in them respect for human life’ and ‘to regard birth and death as part of life’. Not all women were allowed to bear children, and girls of 16 who have irregular periods use a pessary made of gum, hair and Kaffir beer water. Swazi women considered unfit for childbearing have a tiny stone inserted in the uterus.
When the great migrations took place tribal elders sought forgiveness of the ancestors, animals were killed and their livers used for divining, and the ceremony of ‘closing of the gate of the mothers’ was performed, using stones from a sacred river.
It became increasingly difficult to hear Credo’s soft words as torrents of rain beat on the tin roof, and lightening ripped across the sky, followed by an enveloping roll of thunder.
In the third month of pregnancy the Zulu woman was taught by a folk midwife how to breathe ‘to give life and strength to the child’. Each morning she went outside the hut and facing the East, took three deep breaths, followed by a long breath out, to cast out all evil. In labour she focused all her energy on breathing alternately through her mouth and her nose ‘to lessen her consciousness of pain’.
In the second stage, Zulu Shangaans and the Bechuanas kneel in labour, whereas the Bushman woman make a space in the bush, like a nest of grass, and tying a rope to the branch of a tree, bears down while holding the rope. Traditionally there was an opening to the sky in the centre of the roof of a Zulu dwelling. ‘She must kneel, concentrating all her attention on this space, through the hole where she can see the stars. We say of a woman who is in labour: she is counting the stars with pain.’ I later included what he told me in my book, Rediscovering Birth.19
The next day I was invited to visit the most luxurious private maternity home in Johannesburg. It was like moving between two different worlds. ‘There’s the woman, varnishing her nails, a box of chocolates at her side, the radio blaring and the baby hanging at one breast, and she is supposed to be trying to feed it … They’re spoiled little rich girls in here!’ said the obstetrician, (who made his living out of them). This clinic was designed to provide rooming-in for mother and baby, but now according to doctors, was losing money because the patients could not tolerate having their babies with them, and preferred nursing homes where newborns were lined up in central nurseries to be looked after by the staff.
Sister told me: ‘Lots of mummies are silly. They handle their babies as if they were little china dolls. They go home with a Sister, and often two Sisters, one for the day and one for the night, and when they leave an African nanny takes over.’ I asked what education was provided for women in caring for and relating to their own babies, and she said, ‘Mummies like to cuddle too much. They spoil the babas.’ And indicating the glass doors leading from each mother’s bed through to the nursery, ‘Of course, we lock the hatches when the daddies come. They are not allowed to touch the babies.’ At night, according to the paediatrician, the mothers were fed several Mogadons, and the babies removed and sent to the central nursery. The women wake up ‘with breasts like footballs’. I said that it was not surprising that parents who were not encouraged to explore and handle their babies failed to develop confidence. ‘But,’ protested the obstetrician, ‘we can’t have women mollycoddling their babies!’ This, I was told by the Association for Childbirth Education, was the most progressive maternity home I would see. I went away shuddering.
In the private maternity home where Grantly Dick-Read introduced what were then his revolutionary ideas of birth without fear, the nuns sat in a circle of beaming faces and fresh white habits, offering tea and cakes. But here babies were not with their mothers at all, but in solid masses of plastic cribs in rows like cemeteries for the war dead. ‘Oh, it’s rarely that a mother asks for her baby’, Matron said. ‘We believe mothers need a rest.’ The nuns glowed as they tended ‘their’ babies. Fathers were taboo, and although some were present to watch the delivery, most were sent to the fathers’ waiting room downstairs where they smoked and worried together, and – latest development of modern technology – viewed the births on a TV screen. Mothers and mothers-in-law turned up too, and sat with vicarious pleasure or suffering watching their daughters deliver. All the mothers were white. Apartheid might have been beginning to crumble – but only just. ‘We have to get permission from Community Development when perhaps an Indian doctor’s wife wants to have her baby here, and she has to be kept separate. We have a room downstairs where we can keep her.’
The Politics Of Birth In South Africa
At the end of the 70s I did a lecture tour and spoke at the PACE conference and visited both private and public hospitals in the Transvaal. The public hospitals were like cattle markets.
Change started to come in Cape Town, which was ahead of the rest of South Africa. Home birth was becoming popular, for example. One childbirth activist wrote, ‘Traditionally coloured midwives have always practiced among their own people – they are trained nursing sisters. However, no more training for them has been provided for some time, so their ideas are often archaic. The idea was to phase them out and move the women to hospital. But now there is a group of young white midwives becoming active. It’s sad to say, but because they are white they have more clout. I have a large number of American and German couples, with other European countries well represented. I am also seeing a small number of coloured (not black) Indian and Malay couples. It is especially hard for Malay (muslim) fathers to attend, because they are considered “perverted” by their families. I have one such couple at the moment, and while the parents’ families are trying to make plans for ceremonial treatment of the baby and the placenta, all the young people are interested in is getting the full Leboyer birth right (complete with sitar music!) This is a real clash of generations.’
In 1983 I received an invitation from the National Childbirth Association and the University of the Witwaterstrand in Johannesburg. The Experience of Sex had just been published there and my publishers were keen for me to appear because it was selling very well. The book was banned at first by the Censorship Board, which allowed publication only after seven photographs had been removed. I declined the invitation telling them ‘It would be wrong to condone a society which is based on apartheid’.
CHAPTER SEVEN
EMOTIONS IN CHILDBIRTH
I have always been passionate about what I believe. Not for me cool, unengaged opinions. Body, mind and spirit, I get involved. How we give birth is an important element in feminism.
In Sylvia Pankhurst’s book The Suffragette20 I couldn’t find one single reference to babies, pregnancy or childbirth. Yet for the majority of suffragettes babies were as much a part of daily existence as the wind and weather. Most struggled, as they themselves proclaimed, with ‘one hand tied behind their backs’ trying to pack in a revolutionary cause between feeding a family their dinner, the cries of a baby for the breast, and cleaning up and running a house. Unpaid domestic labour, the bearing and nurturing of children, runs as a common thread between the lives of the suffragettes and those of us who are mothers today.
Until recently those common patterns have been considered by feminists less central to the struggle than rights to abortion and free child care.
When the childbirth movement started after the Second World War it was anti-feminist, part of a wave of idealisation of motherhood, social pressure for women to return to the home, and psychoanalytic teaching about motherhood as emotional fulfilment. The ideal woman seemed to be the breast-feeding mother-at-home clustered around by cherubs. (You could almost see her halo and the enfolding wings.)
In Giving Birth: Emotions in Childbirth, published in 1971, I wrote from a radical perspective: ‘Birth i
s treated as if it were a pathological event rather than a normal life process and this has an effect on all those working professionally with childbearing women as well as on the women themselves. By concentrating almost exclusively on the training of obstetricians and midwives on the diagnosis and treatment of disease and malfunction and on intervention, our society has succeeded in producing professionals many of whom have never seen a natural birth and who know nothing of the skills of supporting the normal physiological process. It is important for those working in maternity care to understand labour also as women experience it and this is much more subtle than just saying “It’s painful” or “It’s painless”.21
‘The woman who attends the antenatal clinic or who is in labour is supposed to be a ‘good patient’; that is, she is meant to be quiet, placid, polite, appreciative of what is being done to her, quick to respond to instructions, able to comprehend and remember what she is told without requiring the information a second time, clean, neat and self-contained and should not disturb other patients, or the staff, by emotional instability of any kind. The word “patient” itself derives from “passivity”; the patient is someone to whom something is done…
‘In achieving the depersonalisation of childbirth and at the same time solving the problem of pain, our society may have lost more than it has gained. We are left with the physical husk; the transcending significance has been drained away. In doing so, we have reached the goal which perhaps is implicit in all highly developed technological cultures, mechanised control of the human body and the complete obliteration of all disturbing sensation.’22
A Passion for Birth Page 18