CHILDREN / Delivering the goods at birth: Dina Rabinovitch recalls the births of her three daughters and finds that a gifted midwife and a bath are best for mother and baby

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The Independent Culture
IT WAS the wellington boots I really minded. Like one of those early morning nightmares full of grotesques, and situations you can't struggle out of, I was lying on a bed wearing nothing but a white T-shirt, my legs up in stirrups. Doctors like stirrups, it gives them a clear view, but as a woman, you'd have more dignity stapled across the centre of Playboy.

The obstetrician walked in, draped herself in a pea-green cloak and called for wellington boots to protect herself from the mess of baby about to emerge. She loomed over me, brandishing forceps. 'They're just like sugar tongs,' she leered.

This, the delivery of my first daughter, was painless. I had an epidural early on, and I can still remember the relief it brought. An injection in my spine, being on a drip, all things which had seemed unbearable before labour set in, were - once contractions started - mere quibbles standing between me and anaesthesia. From being a panicked, writhing wreck I was suddenly lying in state watching Wimbledon on TV.

But I felt not just physically numb afterwards, but also mentally shocked. There had been no process of having a baby, just some pain, followed by a blotting out of pain (which believe me, I'm not knocking), some socialising with midwives and anaesthetists, and then, out of numbness, a baby.

The latest charter spawned by the Major government is Baroness Cumberlege's birth charter, designed to give women more choice as to how they will give birth. Where I live - a corner of London purloined by the perambulating classes - choice ways of reproducing abound. Set loose and pregnant into this fertile region, and armed with foreign insurance which covers birth, I have over the past six years given birth to three children in three quite different ways: in a private hospital, with an epidural; breathing in gas and air in an NHS ward; and, three months ago, under water.

Despite the wellington boots and the forceps, daughter number one emerged blissfully sublime. My resentment about the birth didn't affect my feelings towards her, but it made me wary of obstetricians. So next time round I told my GP: absolutely no doctors. The world's most understanding GP said what you want is a domino delivery.

This is not, despite the name, a method of giving birth by numbers, but a scheme under which you are assigned to one midwife for all your antenatal care, and for delivery of the baby. For women it means you get to know the person who will deliver your baby, and for midwives it gives them autonomy and involvement in the birth.

However, the night I went into labour, the midwife who'd done all my antenatal appointments was away on holiday, and another of the domino midwives stepped in.

Maisie was a huge, rollicking Caribbean woman with a very down-to-earth approach to babies and their delivery. She was warm, earthy and reassuring but also completely to the point. She broke my waters early on in the labour without mentioning it - no messing about with Sheila Kitzinger-style discussions about the whys and wherefores - and when the pain was too much she whacked the gas and air contraption over my face.

Apart from making you feel sick, gas and air just distance you from the pain somehow, without actually taking it away. You feel as though it's all happening to another person. I remember hearing myself yell with pain, and thinking: 'Oh, that's you, you are screeching.' Very odd. Daughter number two came out screaming blue murder.

By the time I was pregnant with number three I felt a sort of resigned despair about giving birth. Naturally, older and wiser now, I knew the process of giving birth was just a distraction compared with the real hard stuff of looking after the live, kicking beings, but I vaguely thought it would be nice - albeit unimportant - if giving birth could somehow be a positive experience.

Time to try a water birth. In fact it was odd it had taken me so long. Down our way yuu can barely conceive without stumbling over birth gurus. Michel Odent up the road, Yehudi Gordon round the corner. But - and I wish I could help it, but I can't - my skin breaks out in a rash every time I meet another man masquerading as God's gift to women in labour.

Then the world's most understanding GP told me that a group of midwives had set up the equivalent of a domino scheme in Yehudi Gordon's clinic. For a lot less than it costs to use a private consultant - and by this stage I'd pay the pounds 5,000 cost of a consultant just to keep one away from me - four of the midwives at the St John and Elizabeth hospital do antenatal care and deliver babies, and provide aromatherapy massage for mother and baby into the bargain.

Long ago, before I had my first baby, a far more senior journalist had turned round to me one day in the women's lavatories and said: 'Natural childbirth is going to turn out to be the biggest con ever perpetrated on middle-class women of the late- 20th century.'

This was in 1987, and it was the way women were feeling then, reeling from the shock of taking the 'natural' approach on NHS wards staffed by tired, stressed-out midwives and quite often in dirty and unpleasant conditions.

The phrase rang in my head as the contractions of my third labour grew serious and the midwife, Maureen, ran a huge bath of warm water. 'Remember, Maureen,' were my last words before I slipped into the pool, 'I reserve my right to have an epidural.'

'That's OK,' she said. 'We're here to give you the kind of birth you want.'

And the kind of care I experienced was quite different from any previous experience: here was a midwife with the patience to aid properly in the labour, with faith in her capacity to ease the pain.

First of all, the water helps. As each wave of pain hits, you can sort of float your body through the warmth and somehow the water carries the peak of the contraction. Then the darkened room is soothing. On top of that Maureen would rub my back with lavender oil and, immensely skilful, her hands could touch the worst places with just the right kind of pressure. Every so often, a good witch, she would pop some sweet homeopathic powder under my tongue. 'This will help,' she said. Well, one is immensely suggestible in labour.

Which is not to say I wasn't yelling and ungrateful towards the end. By ten to five I was quite sure it was unbearable and calling for an epidural, for forceps, for anything to get that baby out. She was born minutes later, her head delivered into my husband's hands. It was the most clear-sighted, the most emotional of births. Daughter number three came out - according to her sisters who walked in soon after - 'very dusty, Mum'.

So does it matter, after all, how the baby is born? I think the method probably does not. But a feeling of having control over events, of having supportive, involved women around helping - yes, I think that matters a lot. Unfortunately a choice charter doesn't deliver that - though better pay for midwives might.-

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