The mother of all battlefields

Women are claiming more and more rights over fertility and childbirth. But what of their responsibilities? By Rosalind Miles

The control of women over their own fertility and reproduction may be the last battle on the road to women's freedom, but like the case of Miss S and her Caesarian delivery, it has by no means been won yet. Last April a pregnant 29-year-old woman known only as Miss S was compulsorily detained in hospital and forced to have her baby by Caesarean section after doctors won a court order in effect giving them control over her body against her will. This week Miss S went to court to prove that the doctors had acted unlawfully in denying her right to refuse medical advice and decide on her own course of action.

The order was granted on the grounds that Miss S's behaviour had led doctors to fear for her mental state. When she was told that her physical condition meant that she and the baby would probably die, she replied "So be it." The forcible committal she then suffered under the Mental Health Act branded her as mad, and so unable to be responsible for her own health and that of the child. While the case of Miss S stands adjourned for another hearing, the questions it raises are of interest for us all.

Whatever mental state Miss S was in, 10 years ago the right of women to control their own bodies in a brave new world of increasing medical and technological advance barely existed. This right unpacks to reveal a whole new set of other bright and shiny "rights" - the right to have a child even when you are infertile; the right to terminate a child by an abortion; to control or end fertility by hi-tech contraception or sterilisation, or to choose how many children of a pregnancy may survive by selective abortion of twins, triplets or more.

Those who fought alongside Mrs Pankhurst could not have dreamed that such rights would take their place alongside the simple right to vote. But now the biological enfranchisement of women has reached such a pace that the cases are coming out of the clinics and law courts every week.

Mandy Allwood, the Birmingham woman who found herself carrying octuplets last year, anticipated Miss S in her refusal to agree to medical treatment which would undoubtedly have cost their brothers' and sisters' lives. No one thought her mad. Or perhaps with a lucrative pounds 1m newspaper contract in the offing, the world agreed that though this was madness, there was method in it.

An even starker example of "a woman's right" is to be found in the case of Diane Blood. While protesting the undying love for her husband which has made her want his child, Blood had his doctors subject the dying man to electric shocks to his genitals to force an ejaculation to collect his sperm. Whatever happened to a man's right to die in peace?

Of course it is right that women should have more empowerment and control. Despite a century of strenuous effort beginning with Mrs Pankhurst and her shock-troop suffragettes, women's rights in Britain are still grossly defective in some important respects. Of the four key demands articulated in the Sixties (equal opportunity, equal access to power, abortion and contraception on demand and equal pay) not one has yet been achieved.

In their place women have gained certain freedoms which may look like rights but which fail to advance us. At worst they take women into activities we should be stopping for men - women's boxing is a painful example here. When we add up all the new "rights" being claimed for women through the new technologies of biology, fertility, child birth and reproduction, a cautious questioning seems more appropriate than the triumphalism evident almost everywhere.

The aim of every act of intercourse may not and should not be the conception of a child. But the aim of every pregnancy by a mother who wants a child must be the production of a live healthy baby with the minimum pain and suffering to both. Even after four, six or eight children a mother does not have the experience of a junior houseman in his first week on an "Obs and Gynae" ward. In our efforts to reclaim motherhood for mothers we should be careful not to rubbish the knowledge bank of those who deliver babies all day every day to the height of their professional skill.

What drives women like Diane Blood and Miss S to feel that they know better than all those entrusted with such issues? According to a social worker, Miss S said she wanted to punish her ex-partner and hoped he would feel guilty if she died. In Blood's case, was the grief of bereavement channelled into displacement activity to distract the griever from her loss? Add the fact that Blood had been childless by choice for years and that she had wrung her husband's sperm from him in a procedure so unpleasant that its only justification could be the production of a child, we are bound to suspect some powerful guilt at work there as well.

And we live in an era where the gratification of emotional impulses is all. In a narcissistic culture, women are applauded for wanting to "fulfil themselves" through giving birth to a child. This is the wrong way round. The child's interests should always come first. For Blood deliberately to bring into the world a child who would never know its father, when we know that boys in particular suffer without a male parent, is narcissism at its height. For Miss S to refuse to be treated for pre-eclampsia, which could make her baby blind, deaf, brain-damaged or dumb, is even worse.

But while our world makes a virtue of "push-button control", it is not surprising that women reaching for the rights they have always been denied may err in the direction of claiming too much or the wrong thing. Let us return to first principles. Women should reclaim the management of their own bodies, and of their reproduction and labour above all. But it should be with the collaboration of doctors, in the interests of the child, and not as an expression of their own emotional urges.

Of course we cannot turn the clock back to the happy-clappy days of the first childbirth training, when smiling tutors wrapped mothers in incense and TLC, and assured them that there were no pains, "only contractions", as one earnest, apple-cheeked lady told me. There can be no glorifying Nature when she is such a rotten Mother herself. "Nature doesn't care about women," the eminent late gynaecologist Professor Hugh McLaren was fond of saying. "She tears great holes in them."

But none of this adds up to a set of new-minted "rights" for women against doctors or against their own child. This whole issue is in danger of becoming far more about mothers than about children, even when the wannabe mothers bleat most loudly about loving and wanting a child. The demand for rights also overlooks the whole question of responsibility, as if every woman wanting a child is behaving in a right and responsible way. And it leaves no room in the debate for the right of children at all.

Women pressing for rights like these are in danger of setting us all back by a century at least. Women's biological enfranchisement all too easily becomes biological determinism writ anew, the conviction that women are born to have babies, and that it's the best and most important thing they can do.

The behaviour of Miss S, Diane Blood, Mandy Allwood and countless other women gripped by the fertility frenzy feed another ancient and damaging stereotype. This is the notion that all women are governed by their wombs and liable to hysteria, if not downright mad. This still lingers on, not least in GPs' beliefs that their female patients are more prone to depression than their male counterparts, and that their symptoms and fears for their children's health are likely to be hysterical and not to be taken seriously.

Perhaps we should remember that in a finger-tip-control, touch-tone age, motherhood is a powerful force of nature that will not readily give us the total mastery of our environment we have come to expect. This is an offshoot of another all-too seductive "right" that has winged its way over the Atlantic, the pursuit of happiness as enshrined in American life. This one translates to mean "the right to do what I like when I like and how I like, for as long as I like." Well, a whole "me-generation" is currently raising its elbow to that. I would defend any woman's right to join in the fun, but can we leave the kids out of it?