Active birth was the doorway to more than a positive birth experience: it changed my understanding of womanhood and my family’s birth story, writes Caroline Brewser
It’s the birth experiences of our mothers that are most likely to shape our image of what birth will be like. And for those of us born from the 1960s onwards, the story tends to involve a woman in a hospital, subject to control by those around her, undergoing a ‘procedure’ to extract a baby as a means to an end. And the pain is recounted as the badge of honour. My mother’s story does at least have a hint of ‘feminist backlash’. One wintry Sunday night in the late 1960s, my father having been sent home an hour before with the assurance “Nothing is going to happen tonight”, she was told that if I didn’t emerge in the next minute they would cut her nether regions with a knife. As she puts it, “I wasn’t having that!” and so, presumably laid flat on her back, she gave an almighty heave and I entered the world in a moment of glory.
This was the only birth story I knew in any detail when I became pregnant for the first time. Like most newly pregnant women, my focus was on my baby, and definitely not on the means to her arrival. After all, nine months was a long way away, and it occurred to me that every mother must have managed to endure this ‘process’ to reach a happy life of love and gurgles.
According to the midwife’s literature, pregnant women were supposed to ‘do yoga’, and so after about five months I tried two pregnancy yoga classes. One turned out to be worse than useless, reigniting an old back injury. The other was the doorway to something that completely transformed my life.
But it wasn’t actually yoga per se. The classes were led by Vivien Tallis-Evans, who had been a fitness trainer and yoga teacher for many years before she studied active birth with Janet Balaskas at the Active Birth Centre in London (none of which I knew when I met her). By selling her services as ‘yoga’, Vivien attracted women who wanted an active role in their pregnancies. If she’d promoted her classes as ‘active birth’, I wouldn’t have known what she meant and I probably wouldn’t have thought they were for me. While initially it was what I learnt about childbirth that was interesting, after a few weeks I realised that the classes were changing the way I thought. My mental image of active birth had simply been of women being physically active. But I soon understood that active birth is also about being actively engaged in the decisions and process of your baby’s birth, rather than ceding control to others. And the more I understood the decisions that might need to be taken in labour, the more I felt I would be able to participate in those decisions if the need arose. Soon childbirth seemed a less scary place.
Vivien led us; she didn’t tell us what was ‘right’. We learned that different solutions suited different people, and we found answers to our own questions by exploring the possibilities. We would read women’s birth stories and talk about how they had journeyed through their babies’ births, and how they had made decisions in a wide range of circumstances. Importantly, we understood that childbirth might not run to an ‘idealised’ plan, but that even epidurals and caesarean sections can be centred around a mother who is actively involved, making decisions, and not a passive ‘victim’.
By the time I was seven months pregnant, I had gained confidence that my body could do things for itself. I had begun to question the need to have a baby in hospital, and in fact whether hospital was the best place to have a baby. Supported by a team of local NHS midwives who encouraged home births, I made my plans to try and do just that.
Thursday 20 May 2004 was the most wonderfully empowering day of my life. It was the day I learned what my body could do; it was a day of extremely hard work, but also the most rewarding day: the day I became a woman and a mother and met my first-born. Even looking back now, I feel the elation that I had done it, that I had given birth to a baby, and that no one had done it for me.
As my midwife from a later pregnancy said, it changed my family’s birth story, the legend that is passed down from generation to generation of what birth is like and should be, and of who is ‘in charge’. Most fundamentally it has asserted that giving birth is a joyful, uplifting process, and one where I can say that pain, while present, was not paramount. Thankfully, it was armed with this hugely positive birth experience that I greeted my second labour, two years later. A searing whirlwind of less than two hours, it bore little superficial resemblance to the first labour. But through active birth teaching I knew not to expect a repeat performance, and as I clutched at household fittings during contractions so intense I could not breathe, I could stay grounded and listen to my body when otherwise I might have dissolved into panic.
However, it was my final pregnancy that proved the most challenging mentally, and called most upon my active birth skills. Two things had changed. First, I had moved to a rural area where not only was home birth a comparative novelty, but also the hospital was much further away. Secondly, I had turned 40, which is a tick box on an NHS spreadsheet that triggers all sorts of procedures.
While I never for a moment expected any guarantee that I would have a home birth, it became clear that an NHS midwife wouldn’t necessarily attend me if I laboured at home, even if I had no complications. Particularly unnerving was a policy of inducing women of my age at term (exactly 40 weeks) – both my babies had been a few days late. The midwife simply wouldn’t discuss what would happen if I went into labour at home after 40 weeks, and I could only assume I would be expected to get to hospital. Again and again I would explain that if baby number three arrived with anything approaching the speed of baby number two, I would not get to hospital. Would anyone help me at home?
I didn’t dare dwell on the thought of being totally unsupported. Whenever an ambulance whizzed past, my mind would race – “One day that will be for us” – and I would push the thought away and swallow hard. Eventually, the feeling that I simply didn’t fit into a scenario that the NHS could easily support led me to book an independent midwife. Unfortunately, the nearest one lived 45 minutes’ drive away. I tried not to dwell on that either. It was the best compromise. At least she would come.
I would relate all these developments at my weekly active birth sessions. Vivien would test my reasoning with wellchosen questions and the occasional ‘look’, to check I wasn’t stubbornly determined to have a home birth. She doesn’t advocate risk-taking, and wanted to make sure I was comfortable with my reasons for challenging the received wisdom of the NHS. I don’t like risk-taking either, and re-examining my reasoning helped me rebuild my shattered confidence that I would ultimately find a safe place to labour.
And, oh boy, was that important! I woke that May morning without a twinge or a gripe. At 9am, there was the gentlest sensation of contractions. I phoned my midwife, who was eating her breakfast some 25 miles away. At 10am, it all kicked in. My husband luckily came in from an errand and rang the midwife, who leapt into her car. At 10.40 I told him to call an ambulance. At 10.44 he caught the baby, at 10.47 the paramedics arrived, and at 10.50 so did the midwife. With me throughout were the active birth principles about how to recognise what was happening and how to listen to my body.
Vivien later asked if I was angry the midwife was late. No, I said, because if she hadn’t been coming and there was no NHS midwife either, I would have been taken away in that ambulance, babe still attached to her cord, trying to breastfeed, and that was not the start I wanted for her life.
While I had not allowed myself to dwell on what would happen if I were left to birth alone, subconsciously I had foreseen this danger in all its detail and made the best plan I could to mitigate it. That plan involved everything I knew about birthing actively and being the mother, not the victim – and one day I will make sure my three girls know this story too.
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Caroline Brewser is a freelance writer and editor. She lives in South Gloucestershire with her husband David and daughters Charlotte, 8, Isobel, 6, and Bryony, 2. Her interests include native plants, history and folk customs, and she and David are restoring an old orchard.
Janet Balaskas runs active birth weekend courses at The Active Birth Centre in London. You can also find a teacher local to you at activebirthcentre.com. 020 7281 6760
Illustration by Veronica Petrie • studiovink.co.uk
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First published in Issue 31 of JUNO. Accurate at the time this issue went to print.