Anticipating the birth
The seduction of formal, medicalised preparation is discernible in the
narratives constructed by all the women as they contemplate the birth.
This seduction is rooted in notions of risk, safety and being seen to act
responsibly. The women produce narratives based on their perceptions
of what ‘good’ mothers do, which is to achieve a safe birth without pain
relief, and what their own experiences might entail. The contrasting
threads of resistance and engagement are apparent in many accounts.
These are interwoven with the contradictory implications of it being a
‘natural’ process and therefore one that a body can bear, or has the
capacity to bear. The words ‘natural’, ‘naturally’ and ‘instincts’ are
repeatedly used within the context of anticipating (hoping for) a ‘good’
(easy) birth, and acceptance of what the medical profession and technology
may be able to offer. Hopes then were carefully and tentatively voiced
in these anticipatory narratives. Yet as will become clear in the following
two chapters, in contrast to what is voiced here, many of the women had
thought they would be able to cope with the birth. All the women were
well versed and informed about the different forms of pain relief that were
available to them. Most had ranked them according to their perception of
their acceptability. In the following extract, Gillian anticipates the birth of
her child. The complexities of constructing an acceptable, culturally
recognisable narrative around an experience which is unknown, uncertain
and also inevitable, is clear:
And also you don’t want to be induced either. I’m sure that’s a strong feeling that
one, you want to do it yourself naturally and second, you have a higher incidence
of forceps . . . and pethidine. Talking with a very open mind on the matter, yes,
my instincts say that your body will look after itself . . . it might need a little help
and that’s all. Ehm . . . but at the same time if things go wrong I’m quite
happy . . . I’m going to hospital [name], if things go wrong then . . . have an
epidural, do this, do that . . . then I will. I don’t think, ‘no, I don’t want an
epidural’ . . . in my mind I think ‘no, I shall manage’. I might try this TENS
thing, and I’m quite happy to have some gas and air, so I feel in control. I don’t
like the feeling of being out of control, ehm and I’m not happy about having
pethidine, I think I’d rather have TENS, or gas and air or if things go badly wrong
then I’ll have an epidural . . . pethidine, I think that with a lot of people it makes
them out of control and I don’t like that feeling . . . I think it’s the lack of control
for me, I think I might be physically and mentally so well under that I wouldn’t be
on the planet, whereas with gas and air you can just stop it if you feel you’re getting
out of control and with epidural although physically you lose a lot of control,
mentally you still keep it, in fact probably better because you are not distracted by
the pain . . . But I don’t want to be so pushed over having a natural birth that
I shall be terribly disappointed if something goes wrong and I need help. I want to
try and keep it very open.
In this extract, Gillian rehearses various scenarios, balancing the need to
keep an ‘open mind’ within the belief that ‘your body will look after
itself ’. Interwoven within the account is the acknowledgement that she
might ‘need help’ and doesn’t want to feel ‘terribly disappointed’ if she
does. The complex interweaving of contrasting hopes and anticipated
outcomes were discernible in all the accounts, for example:
I thought right at the beginning when I thought I was having one (twin pregnancy
since confirmed) I didn’t . . . I wanted to try for natural labour . . . well, I would
like (a) go, see if I can do it. But then obviously I’m . . . I’m not . . . I’m not a fool.
I know that if I did get in pain then I’d rather have anything that will help me. I’m
not sort of this person who wants to be perfect and do it all properly. (Sheila)
Yes, it scares me, it does, it does scare me. I’m not too worried about the
pain . . . I think I can handle the pain, but as I said it’s, you know, the thought
of the body coming out of that little hole. I wasn’t quite sure what to go for as
they’ve got so many different things you can take . . . I was going to have pethidine,
’cos I thought I don’t really want a lot of pain if I can help it, but then at the
last antenatal class they said the [hospital name] don’t sort of push that, so now I
am going for gas and air . . . so, but it all depends how it goes, really, itmight be a
piece of cake. (Angela)
I mean my whole instinct is to crawl away and to have it on my own . . . I mean
obviously . . . I would absolutely love to be one of these people that just floats
through and gets by with a few puffs of gas and air . . . And I’d . . . I’d like that but
I’m not going to say that’s what I’m going to do because then I’d be really disappointed
if I need something else . . . I don’t like the idea of an epidural at all but
then I don’t know . . . Imight think it’s the best thing everwhen I cometo it. (Peggy)
If you are tense and nervous and not particularly positive you can create, you
know, problems of anxiety . . . I don’t condemn anybody [but] I think that our
bodies were geared, and made in a certain way that we can give birth naturally.
(Helen – interesting because Helen eventually had to have a caesarean birth)
. . . and I don’t really want any of their drugs. I don’t want to have an epidural or
any of that . . . I don’t mind anything else, but I don’t want that, and I mean, hey,
nature you know. (Sarah)
The women construct narratives by drawing on their own hopes and
fears, grounded in essentialist constructions of maternal bodies, that
women can naturally give birth without medical intervention. At the
same time there is acknowledgment that some ‘help’ may be necessary.
This is couched in terms of trying to retain some ‘control’, and trying to
‘enjoy’ the experience. Yet these hopes are tentatively voiced. Implicit
within the extracts is an awareness that even how women achieve birth
has implications for perceptions of the type of mother they will be: a
‘good’, ‘perfect’ mother, who gives birth ‘properly’, or a ‘guilty’ mother
who ‘fails’ and needs medical intervention. It is interesting that whilst a
‘natural’ birth (without drugs) is seen as the best type of birth, engaging
with some form of pain relief is, at the same time, seen as offering a means
of retaining control over the birth.
The hospital, as a place in which births are managed, is perceived to
offer both the possibility of a natural birth and at the same time the
possibility of a medically assisted birth enabling women to retain ‘control’:
indeed, ideas around these are conflated. Loss of control for these
women, who have experienced dimensions of agency in relation to the
world of work, was a particular concern and one that is class-related
(Lazarus, 19 97). Pain relief, then, becomes potentially liberating, offering
a means of retaining control. And whilst the extracts above suggest that
women anticipated that control and some autonomy could be retained
within the context of ‘keeping an open mind’, the medical profession were
still perceived to be the experts, experts with ‘rules’ which might have to be
followed, as Lillian says:
Yes, when I’ve found out that . . . if they’re happy about people changing positions
and things like that, because somebody was saying to me that
sometimes they get you into a position that they want you to be in rather than
you want to be in and you know, like, so I want to find out [the] rules.
Similarly, Gillian comments:
You’re going to be stuck with the medical way of doing things, but then I’m
happy to go along with that. I don’t know what to do if I have problems, I want
them to tell me what to do, and it’s only if everything goes smoothly and you
don’t have any problems that you should be perhaps allowed to do what you
want to do.
These constructions reinforce notions of expert, authoritative knowledge
and associated power. Yet the women did not resist such notions but
colluded and engaged with them. Indeed, the ways in which the
participants operated with a hierarchy of forms of pain relief and saw
potential take-up as a means of giving them control, showed the women
to be sophisticated consumers rather than passive victims. These findings
are also echoed in research from the USA and Canada and increasingly
may be less a phenomenon of class position, but rather a demonstration of
the ‘success’ of medicalisation and technological birth (Fox and Worts,
1999; Davis-Floyd, 19 92 ).
In many societies, powerful moral and legal sanctions exist for those
who are regarded as not preparing appropriately to become amother, or
more importantly, to be acting irresponsibly, and putting the life of their
unborn child ‘at risk’. The exercise of agency and choices made by the
women in this study must, then, be considered within the context of a
powerful medical/health profession and associated authoritative knowledge
and practices. These are then reinforced through culturally and
socially circumscribed beliefs in appropriate ways of becoming and
being a mother. The anticipatory narratives constructed during the
antenatal (prenatal) period were both complex and, apparently,
unproblematic. Women presented accounts in which they spoke of
their appropriate actions around preparation. They attended antenatal
clinics, went to parent-craft classes, had ultrasound scans and changed
their diets and socialising habits. Interestingly, having claimed not to
have expectations of what being pregnant would be like, the women
produced narratives which were built upon shared assumptions and
stereotypes of what pregnancy entailed. When the women described
less enjoyable aspects of their pregnancy, they quickly reverted to language
they perceived to be more acceptable. In the following extract
Linda, apparently sensing that the account she has narrated has been
rather negative, containing lengthy descriptions of how she did not like
the physical changes to her body and her sense of her body being ‘fat’,
concluded in the following way:
But I know that there’s going to be a bundle of joy at the end of the day and that’s
what I’m looking for . . .
To talk negatively about the pregnancy was construed as not preparing
appropriately, not being a ‘good’ mother-to-be, risking being
seen as irresponsible. In the following extract, Rebecca talks about
not passing her ‘apprehensive’ feelings about the pregnancy on to her
unborn baby:
But I’ve never ever throughout the whole pregnancy, and I hope I don’t, thought,
oh this is a mistake and I don’t like the baby, or anything like that. I’ve always kept
positive and talking to him or her and that kind of thing, because even in the
womb, well I think they can tell if you go off them and feel vindictive towards them
in any way, well not vindictive – it’s too strong a word, but . . . and I don’t want to
ever do that . . .
Rebecca’s own ‘policing’ of her account is interesting here. But showing
the complexities and contradictions within narratives, Rebecca had
earlier commented:
So I was just in the middle of changing my mind when I fell pregnant, so I did have
mixed emotions actually. To start with it was quite difficult, and also the hormones
bit I think made a difference, it does, doesn’t it? And so I think I was
probably quite grumpy and tearful and a bit moody, as well as all these other very
real worries and that kind of thing. So I was excited but had reservations as
well . . . in fact that was the good thing because when I first started telling people
everybody was so pleased, so pleased, that it made me pleased. That was actually
the turning point for me because up until then I’d been not exactly negative but
very, very apprehensive, I mean really apprehensive. And it was when I started
telling people that I actually felt better about it, because everybody thought,
I don’t know, I suppose they thought I would be a good mother or something,
because I do take it very seriously, and I was quite pleased that they obviously have
confidence in me.
Positive reactions to Rebecca’s disclosure of her pregnancy to family and
friends help her to envisage her self as a mother. She is reassured by their
perception of her capacity to be a ‘good mother’. The interactional
dimensions of selves are apparent here and will be returned to in subsequent
chapters.