Since the Duchess of Sussex announced that she was planning a home birth, we’ve seen endless criticism of her choices, and now it seems many are delighting in the rumours that her hopes were scuppered and she ended up having to be whisked to hospital.
Personally, I hope we never find out where Harry and Meghan had their baby. Women’s decisions in childbirth should be made in private with personalised, evidence-based information and compassionate support.
But I also hope that we can get beyond the flawed idea that a change of plan means the plan wasn’t worth doing in the first place. Birth planning is about listening to women. It reminds those around us that we matter, that we are autonomous individuals and that we must be afforded dignity, respect and kindness.
On paper I had the births I wanted: two planned home births that ended with a baby born safely in my home. Nevertheless each birth brought unexpected challenges, like when my second baby’s birth unfolded in a painful, 40-minute blur. My son was born so shockingly quickly that my midwife and doula were still racing towards me as he emerged on my bedroom floor.
I was lucky. I had good support before and afterwards: people who actually listened to me, and realistic childbirth education and midwives and doctors who (for the most part) treated me with respect. My babies’ births strengthened me.
Sadly my positive experience is not universal: 25 to 35 per cent of women describe childbirth as traumatic. This is worrying when we consider that women remember their childbirth experiences vividly for years, that this is the time in a woman’s life when she’s most vulnerable to mental illness and that suicide remains the leading indirect cause of maternal death.
Of first-time mothers planning a home birth, 45 per cent transfer to hospital. Though birth planning is officially encouraged, perhaps part of the reasons it’s often not respected is because we just can’t control some aspects of childbirth. A detailed birth plan can can lead to sneers from some doctors and, at the births I’ve attended, eye-roles and negative comments from midwives.
We shouldn’t promise women the perfect birth because it doesn’t exist. If we put the responsibility for having a good birth on individual women entering an enormous system that she can’t control, then we risk making her feel like a failure especially when the stakes feel so high. Women receive a drip feed of information from the media, public health messaging and healthcare professionals that what they eat, drink, how much exercise they do, the way they give birth or feed their babies might have an impact on their child’s future.
Focusing on promoting one kind of birth as the “best” or “safest” pits women against each other and fails to account for bumps in the road and our individual needs. It’s easy for those of us who want to help mothers thrive to fall into the trap of telling women that it’s up to them to get birth right.
Courses, classes and products sometimes sell the perfect birth for the right price, to the woman who is most dedicated.
This is perhaps why people seem so exhilarated by the schadenfreude of rumours that Meghan’s birth didn’t go to plan. We attach a sense of failure to a birth that doesn’t go to plan, and there’s a sense of vindication in seeing someone like the Duchess of Sussex succumb to the same humanity as the rest of us. We forget that a good birth isn’t about sticking to an ideology but navigating an ever-changing event surrounded by people who listen to and care for us.
But the reality is that however well prepared women are for childbirth, however many hours of hypnobirthing they have done, the system is still unfriendly to women much of the time. NHS leaflets, websites, national maternity policy and best practice all promise choice of where to give birth, respect for women’s decisions and are often quick to explain the benefits of “natural” birth. Yet many women find little support for their choices, an overstretched system that favours intervention and a culture that infantilises or ignores them. We need to prepare them for this, mitigate it as much as possible and change the system at the same time.
Emergencies and changes of plan will happen. Women who plan home births may still give birth in hospital and those who plan elective caesareans may end up push their babies out in the taxi on the way to hospital. Instead of using this as a reason to reject the idea of women daring to have an opinion about this most personal of events, we should remember that they are less traumatised by events in childbirth if they respect if they feel in control and treated kindly.
We should stop picking over the details of Meghan’s birth and accept that in this most private of moments there is no right or wrong way to do things. A change of plan is not a failure just as making a plan is not naive. A woman who dares to do things her own way should receive only our quiet gratitude and support.
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