Nobody is more invested in a safe outcome for her baby, than the mother herself, even when this may not look to be the case...
To the home birth mother, another mother's decision to opt for an elective caesarean might seem callous and unsafe. Similarly, the caesarean mother may view the home birthing woman's birthplace choice as unnecessarily risky. One woman will choose to let her baby come when its ready, even if that's 3 weeks past the clinical 'due date', another will opt for a medical induction of labour at 41 weeks gestation. Both have their baby's best interests at heart, yet each may view the other's decision as dangerous to the baby's health. One mother will avoid all routine interventions and technological assessments offered to pregnant and birthing women, another will opt for every intervention and assessment that's on offer. Again, both are aiming for the safest outcome for their baby. One woman will leave all the key decision making up to the birth care professionals, another will insist on being given all the information she requires to make an informed choice about each aspect of her care. Neither has a greater investment in their child's health than the other, despite their very different approaches. The list here, of course, could go on and on, but the point is clear: despite the different birth choices women make, each woman is doing what she can to reach a healthy birth outcome for her and her baby. Fullstop.
We all have our own biases and, if not externally, at least internally, many of us find ourselves making judgement calls about others. But let's just take a moment to assess where our biases derive from and, more importantly, who seeks to benefit from the judgements we make, because let's face it, if our judgements are doing nothing more than fuelling the oppressive 'mummy wars', we might do well to keep them in check!
It is not our own narcissistic tendencies, our need to seek approval from others, nor our impassioned desire for an orgasmic birth that dictates how we choose to birth, rather, I would suggest, it is fear. This is not to say that fear is the be all and end all of a mother's birthing decisions, but I do believe that, overwhelmingly, it is fear that wields the most directive force. If I think about my own births, all of which took place at home with minimal interventions, my decision-making went something like this...
* As a student midwife and midwife I'd witnessed many home and hospital births. Almost invariably, the home births were more gentle, involving less trauma to the mother and baby.
* In my career I'd seen the differing practices of various maternity care professionals. The midwives who encouraged home births tended to be more committed to spending time developing a rapport with women antenatally, they were less inclined to perform unnecessary interventions during birth, and the women they cared for appeared to have great trust in and respect for their midwives.
* The common interventions that I witnessed taking place in the hospital rarely seemed to have a positive outcome for the mother and baby, yet many women were encouraged to undergo these procedures even when there was no justifiable indication for them.
When I became pregnant I had no doubt in my mind how I would choose to birth. It was a no-brainer. Yes, I wanted the loving, spiritual, gentle birth experience that I'd witnessed others having, but even more so, I wanted me and my baby to be safe. Hospital, to me, was a place that encouraged poor birth outcomes for perfectly healthy women. I knew that I would only give birth in hospital if I required secondary services for a safe outcome, and thankfully, this was never the case for me.
So, my midwifery experiences clearly influenced the choices I'd made. What if I had not chosen a career in midwifery, what would have influenced my birth decisions in that case? I think my own gentle birth story that my mother shared with me, the birth stories of my friends, the accounts of birth in the media, the experiences I'd had in relation to the hospital environment, the reading I'd done around birth, all these would have played a part. Even to a greater degree, though, would surely have been, a) who I'd chosen as a midwife (many first-time mums seem to be quite flippant about who they choose and simply go with the midwife who their friend had and liked), and b) how much trust I had in my self - in my ability to make good, informed decisions for me and my baby, and in my body's ability to give birth (I believe the midwife has a huge impact on a woman's self-belief, but also family, friends, partners, the media and so on). I'd like to think I'd have chosen to home birth, but I don't honestly know.
The point I am trying to make is that a number of personal, familial and societal influences guide a woman's decision-making around her birth, and having not walked in another's shoes, it may be hard to understand how they came to conclude that their birth choices would offer the best chances of a safe outcome. But we do need to trust that women are making the best decisions they can for themselves and their baby based on the information that they had at the time. It's essential that we trust in this belief, because you know what? Women are bad enough as it is at blaming themselves for poor birth outcomes without having their mothering community criticising them as well. I'm sick of women trampling all over women, especially at the vulnerable life-phase that new motherhood is. Women need to respect one another's choices. We need to demonstrate trust in our sisters who truly were only seeking the exact same thing you and I were when we planned our births... a healthy start to life for their precious baby.