We’ve had some really insightful discussions about ‘normal’ birth recently. What’s the right word for it? It’s a complex debate!
My #MatExp colleague Helen articulated the debate in this brilliant, insightful post yesterday. To sum up the extensive discussions, the post proposed calling birth just that…birth.
I thought I’d take a visual approach to explain why that makes sense.
What would you call the object in the image below?
It’s not a trick question…it’s an apple. It’s round, red, and has a stalk sticking out of the top. Apples can also be green, come in all sorts of different varieties and sizes, but we can recognise it as an apple. Despite the variations, all apples look pretty much like this one. Some of you might like apples, some of you won’t. No big deal.
…and the object in this image?
Again not a trick question – it’s a car. We know it is a car because it looks like what we understand a car to look like in shape. It’s got wheels – we assume in 3D it has two more wheels on the other side, and a steering wheel, engine, and seats inside. While this particular image looks like a VW Beetle, we can agree that generically, it is a car. Further, while the way cars are built and the technology involved in them has evolved massively during the past century or so, they are still recognisable as a car.
One final image…
Yes, a beautiful newborn baby.
I don’t know how this baby was born: whether vaginally, or C-section. If it was vaginal, whether any intervention was needed to get the baby out. Or if it was a C-section whether it was emergency or planned.
We could share images of all these possibilities. For all the diversity of such images, we would recognise each of them as birth, just as we would recognise variations of the images above as an apple, a car, or a baby.
Images of birth would create huge debate, and questions. Which was ‘right’, or ‘wrong’? What was that woman feeling at the time? Why were the staff doing/not doing that? Comparisons with our own experiences, expectations, beliefs.
As far as I understand, the concept of ‘normal’ birth is a response to an overmedicalisation of birth. Too many unnecessary interventions have been leading to trauma in women and staff alike, and some women fearing the delivery room.
Most of us would agree that we want the best possible outcomes for women and babies, for women not to have to endure unnecessary intervention during birth, and for the well being of all involved to be protected.
We all, I think, understand that ‘normal’ birth is intended to describe physiological birth – ie vaginal birth. The word ‘physiological’ is a bit of a mouthful and is unlikely to take off. And talking openly about vaginas? Gasp! No thank you, we’re British!
So, ‘normal’ birth has stuck.
The trouble with the word ‘normal’ is that it has so many connotations, as Emma recently pointed out.
@HeartMummy @SagefemmeSB @WeMidwives @leighakendall @Ghostwritermumm don't believe this applies to birth pic.twitter.com/h5NRvCvU0A
— ✨EmmaJaneSasaru✨ (@ESasaruNHS) September 5, 2015
Surely there are so many ways a baby can be born it is impossible to say birth can be ‘conforming to a standard, usual, typical, or expected’ as in the dictionary definition of ‘normal’?
Objects such as fruit and vehicles can be identified easily because they conform to a standard, usual, typical or expected shape or form. Normal.
Birth? Not so much.
There is too much emotion, and perception that is coloured by subjective views.
As Helen described in her post, our perceptions of what is ‘normal’ are constantly evolving and shifting. Apples will always be apples, just as birth is birth.
The unintended consequence of such debates is the emotional impact on women. Expectations about what the ‘right’ or ‘wrong’ way and place to give birth is. Judgement – whether inferred or actual – about whether their experience ‘right’ or ‘wrong’.
Women perhaps feeling like they have failed, or did not do well at giving birth to their baby because their experience does not fall under what is defined as ‘normal’.
‘Positive’ birth is another difficulty. Again, it is well-intended, but a positive birth experience is something no one can guarantee with the best will in the world.
My argument as expressed here is by no means perfect. It is intended to provoke thought and further discussion, and a reminder that:
There are so many ways in which a baby can be brought in to the world, so why do we think there can be an ideal that can be summed up in one phrase?
Calling birth ‘birth’ leaves it open to the woman to use any prefix she chooses to describe her experience. Yes, of course the woman will still need advice, information and support. The key is the woman can feel free to use her own words from her own personal experience and expectations – not deriving from judgement, societal expectations, or perceptions (we can’t wipe out the societal judgement, expectations, and perceptions, of course, but promoting the sense there is no such thing as a ‘normal’ birth would surely help.)
Let’s continue these discussions, to make sure we are always striving for the best, safest-possible care experience for women, babies, partners, and staff – in the labour and delivery rooms and beyond.