A ‘Mother’s Choice’ (tick, tick, tick)

DI BAKER: Look, I knew I never wanted to push. I knew before I even met my husband so, it’s – girls plan for their perfect dream wedding. I planned for the perfect pregnancy.

I had meant to catch the 60 Minutes program on Sunday Night so that I could watch the story on childbirth entitled ‘Mother’s Choice’. Not at all because I trust 60 Minutes to help me make that ‘Mother’s Choice’, but because I was interested to see how they framed the ‘choices’. But I forgot and only caught the last half of it. When a friend of mine mentioned her displeasure at the story I decided that it was worth de-constructing. So rather than rely on my memory of the program (undoubtedly clouded by my emotional response to the story) I have dug up the transcript.

The story was presented by Tara Brown and introduced in the following terms,

There’s nothing unusual about women having babies. Understandably, though, every mother-to-be feels unique and, here, I’m speaking from personal experience. If all goes well, come October, I will be a mum for the first time. Soon, I’ll have to make that decision – how I want my baby delivered. These days, one in three Australian babies are delivered in an operating theatre. Caesareans are fast becoming the norm. Right at the other end of the spectrum, some women have their babies at home with no medical intervention at all – not a doctor or a midwife in sight. So, natural or the knife? Tonight, the intimate stories of women who’ve already made that difficult choice. And I should mention some viewers may find some scenes confronting.

So for starters giving birth is presented as a stark choice. ‘Natural’ is made to sound as though its done, home alone and sans medical support versus ‘the knife’. We are given the stats – ‘one in three’ which means ‘Caesareans are fast becoming the norm’. Ok so we completely ignore the experience of the majority of mothers who fall between the very few women in Australia who choose to give birth without a doctor or midwife present, and the one third of women who have a caesarean. It should be noted that not all caesareans are elected, (and this story conflates elected caesareans with medical emergency caesareans) a lot are decided upon during the course of labour, for the health of either the mother or the child. The experiences of the majority of mothers, vaginal birth in a hospital setting, is not even examined as one of a ‘mother’s choices’.

The story presents the opinions and birthing choices of four Australian mothers. Julie Heath, Georgia Sheahan, Tara Darlington and Di Baker. While Dr Michael Van Der Grien and Dr Garth Leslie give their opinions there were no midwives’ views in the program. Through out the story we cut to Julie Heath’s home birth. She is giving birth to baby number four and is quite confident of her ability to do so unaided by doctor or midwife, with only her husband present to catch the baby (in the intimacy of her own home surrounded by the TV crew). We are not told about the births of her other children, but we are informed that they live only a minute and a half from the hospital, in case any thing goes awry with this birth.

This birth footage is interspersed through the the story, the birth goes well and seems to be relatively quick and easy, and eventually we are given the proud parents’ reactions:

JULIE HEATH: It’s a girl.

BEN HEATH: Another bloody girl. Another bloody girl.

(And that’s really a topic for another day, but here’s the link to the ‘Because I am a girl report‘ if you are interested in the implications of being born a girl.)

TARA BROWN: The baby girl seems healthy… ..but there are anxious moments. Julie is worried by her own bleeding and calls for an ambulance. While the blood loss is not unusual they decide to take her and the baby to hospital for a check up. But sometimes it can be so much worse.

DR MICHAEL VAN DER GRIEND: Home births… ..when they go great are great. But when home births go wrong and you don’t have back up it can be a disaster.

TARA BROWN: And you are left to clean up the mess?


Let us note the juxtaposition here. We are shown the home birth pool that Julie has used to give birth in, the water stained with her blood, just as Tara Brown starts to discuss the dangers in the ‘natural’ birth scenario with the doctor. We are not told what ‘mess’ the doctor has had to clean up but we are left with the image of a pool full of blood.

TARA BROWN: But Dr Van Der Griend believes in most cases, vaginal births and elective Caesareans are equally safe. While he prefers to deliver babies normally he thinks Caesars should always be available.

DR MICHAEL VAN DER GRIEND: I think a woman has the right for choice and I think in 2008 the safety of that as an alternative to a vaginal birth or a normal delivery is still… it’s on par with it. I think women should still have that as an option.

Now we have a paradox, we are subtly made aware of the danger of the natural birthing, but are reassured by our good doctor that caesareans are as safe as natural births. The doctor feels that all mothers-to-be deserve to have a choice, but that choice needs to include the option of an elective casarean. Georgia Sheahan made the choice to have a caesarean and admitted to Tara Brown that maybe she was “too posh to push” but she chose her C-section because she was concerned about the potential for things to go wrong.

GEORGIA SHEAHAN: I don’t like the idea of, you know, pushing something the size of a watermelon outside something the size of a golf ball. It just sounds awful and I didn’t want any part of it.

TARA BROWN: Georgia is part of a growing trend of women opting out of labour, giving Australia one of the highest Caesarean rates in the world. And it’s not just the pain. Georgia says too many things can go wrong with a natural delivery.

GEORGIA SHEAHAN: You know you can get a cervical prolapse, you can get tears, so there’s all those unpleasant things, from a mother’s point of view. But I was also terrified of things that can go wrong for the baby. You can have, you know, shoulder dislocation, you can have the cord wrapped around the neck and, at the end of the day, I wanted a child, not a childbirth.

The way the show presents women choosing to have a caesarean, it is almost as though they are choosing a procedure equivalent to having a tooth extracted. But a caesarean is major abdominal surgery and comes with its own risks, but the doctor informs us of these.

DR MICHAEL VAN DER GRIEND: You tend to lose a little bit more blood with a Caesarean section birth compared to a straightforward delivery. Your risk of infection or wound infection or urinary tract infection is higher. But all of those things, even though I’ve named them, are significantly low in my experience in a straightforward elective Caesarean section.

But Georgia doesn’t seem to be aware that C-section carries some risks for the babies as well, their limbs can be broken as the babies are pulled from their mother’s stomach.

TARA BROWN: And for the babies, some delivered by Caesarean need special care to help with their breathing. This little boy, just five minutes old, is no exception.

DR GARTH LESLIE: That’s right, a few big breaths, that will help.

TARA BROWN: But paediatrician Dr Garth Leslie isn’t too worried. Is that a consequence of having a Caesarean or do you see the same in natural deliveries?

DR GARTH LESLIE: You see the same in natural deliveries but its a bit more common after a Caesarean because they haven’t been… ..had their lungs squeezed down through the pelvis during the labour process.

Tara Darlington had four children, her second, due to a medical emergency, was born via caesarean. For her this was not an experience that she would care to repeat.

TARA DARLINGTON: It was much harder bonding. I mean, I was laid up in hospital for longer. It was harder to carry him… So if it saves your life what can you say but if it wasn’t necessary I wouldn’t choose it.

Her attitude is in sharp contrast to that of Di Baker.

DI BAKER: In order to keep everything intact, um, I wanted to have a great sex life, I wanted to enjoy intimacy with my husband and have total fulfilment.

TARA BROWN: Well so when you say “keeping everything intact”, what do you mean exactly?

DI BAKER: It is like the unspoken myth, women don’t want to talk about it. Things certainly have to open up for baby to have to pass through and things don’t necessarily remain intact down below.

This is the part of the story that I found the most disturbing, she puts these ‘myths’ out there and these are not really corrected or explored, although Tara Darlington does say that her own sex life hasn’t been affected by the birth of her four children. What is disturbing here is the fact that whomever her doctor was they have agreed to give her a caesarean on the basis of something that is unlikely to happen. While we are discussing myths, there are also rumours that giving birth vaginally can have the opposite effect, it can give a birthing mother the biggest orgasm of her life (I can’t think of why ’60 Minutes’ didn’t explore this ‘unspoken myth’) In the circle of mothers I know it’s not the giving birth vaginally that has affected their sex life it is the looking after the baby!

There are so many demands on mothers in our culture and continuing to look sexy and nubile while managing to bring up your offspring is now one of them. The modern mummy is expected to remain ‘yummy’ and this subtle pressure on women to remain ‘intact’ and to undergo unnecessary surgery is something I find very disturbing.

This story focused on two ways to give birth, ‘naturally’ or with the knife. The story contained no exploration on giving birth vaginally in a medical setting, either in a birth centre or a delivery suite, and no mention of independent midwifery. So for a story ostensibly about a mother’s difficult choice we certainly are not given a clear picture of all the available options. According to this ‘expose’ ‘a mother’s choice’ is presented as being between danger (home birth without help) and vanity (choosing a caesarean because you are too posh to push). The subtle message seemed to be that with choices like that it seems that women would better off letting their doctor choose for them. (Some examples of the ways some doctors respect their patient’s choice are provided here by Lauredhel).