“When You Ghost Your Midwife” by Helena Guerin

Content warning: this is a birth story. (All birth stories should come with content warnings.) Would you read an essay about birth in a literary magazine? A question you don’t stop to consider until you’ve already written one. (The answer is no.)

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How do you know your birth was traumatic? 

You feel like a failure. Even as you hold your healthy baby for whom the milk, and the love, have come in completely on schedule.

You react to other people’s positive birth stories as assaults on your person. Friends, for whom you have nothing but love (usually), for whom you wished a labour nothing like your own (in theory), say things like ‘It wasn’t that bad, really’ or ‘It was all quite straightforward in the end’ and you are unsure who you hate more – them or yourself. 

You develop a spidey sense around portrayals of birth on the screen and on the page which sees you pre-emptively (and quite sensibly) skim ahead, fast forward or put your fingers in your ears to avoid. 

You compare your labour to watching your first parent die (and the good one at that). Maybe there is poetry in that. Symmetry of some kind. Death and birth and glimpses into the abyss. But it doesn’t feel like it. It just feels like now there are two horrendously dreadful before-and-after events in your life, instead of just the one.

You ghost your midwife. You even manage to forget her name (though it comes back to you as you write). 

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A traumatic birthing experience is a loss. There is grief afterwards. Somewhere behind, underneath, in between all the joy.

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Want to know what a ‘natural’ labour and birth feel like? Wholly unnatural. Aberrant. An offensive launched against your whole body. Like the most wrong thing that has ever and could ever happen to your person. Like your body is doing something it was most definitely not born to do. Like your body doesn’t have a clue how to respond to the attack. Like something you will never get over.

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And what of the debriefing arrangement? To process pain that is ‘natural’? Pain that your mother must have also gone through and didn’t spend her life wringing her hands over (to your knowledge). Pain that you knew was coming (that some might say you asked for, even). Is surprise or shock even allowed? Indignation? Rage? 

Enquiries about your labour in the immediate aftermath, the How was it?s and the How do you feel now?s seem to come with the addendum ‘In three sentences or less.’ Willingly, you minimise and gloss over. You politely reassure the person enquiring. Eager to convey competence and priorities fully in order. Would you respond differently if you knew that this door of enquiry into your birthing experience, so hesitantly opened – just a smidge – will soon be shut and never again reopened? Who asks a mother pushing a pre-schooler on a swing – right up to the moon and back – about the pain she went through bringing her into the world? Who says to a mother at the school gate, ‘Do you want to talk about the birth?’ (Not you.) 

You pay a professional sixty euros to allow you to sit in her front room and talk about it. And here also is the pressure to conform to the grateful martyr narrative. And the silencing power of But isn’t he worth it? You are copping on to something: that it is not very sporting of a new mother with a healthy baby to complain about the pain, the grief, the disappointment. 

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Your body knows how to give birth.

You listen to the supreme wisdom of your body.

You let your body and your baby set the pace.

Your body was designed for this.

Your body opens, your mind quiets, you baby descends.

Every wave you ride brings you closer to your baby.

The hypnobirthing mantras give you the impression that your body, like some wise spirit guide, will take the lead when the time comes. You imagine it confidently assuring you, ‘I’ve got this.’ (You see yourself as a supporting player of sorts.)

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The mantras are nice for pregnant people. (Positive thinking helps with the pre-labour anxiety.) 

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Knowledge is power, right? It is super empowering to learn how fear and anxiety intensify and prolong physical pain. All you have to do is learn to control them and free your body to do the job it was born to do.

Only you are a woman in the patriarchy, and your mind and body are not really on speaking terms. A good little girl, you learned to distrust and dismiss your body and your emotions. A modern woman, you can gaslight yourself, thank you very much. Check in with your body, your feelings? You can no more intuit what is going on in your body than summon forth the wishes of a malevolent spirit via a Ouija board. 

The homework for labour seems a bit light. On review. Most of it is done from a prone position. The man who has engaged in some hopeful procreation with you diligently reads out the Body Scan script: Imagine a warm light above your head travelling down. Notice your limbs loosen. You are Loosey Limp (seriously). Hear the calming sound of a bubbling brook. Feel the sunlight on your face. See yourself opening up. (It’s quite sexy, actually, your partner telling you to relax for twenty minutes straight. You make a note to carry this routine forward into post-partum life.) 

You psych yourself up daily. Your body is a boxer steeling itself for the career-defining big fight. You tell your body it is kick-ass, shit-hot, Mother Earth incarnate. At night, you soundtrack your sleep with guided meditations where you stroll through peaceful forests feeling calm and free of fear. (He sleeps like a baby.)

It’s all quite dissimilar to the onset of labour. Learning to calm your body and let go, while lying safe and warm in your comfortable bed, free from pain – horny even – might not be the best preparation for the challenge of managing labour pain and anxiety. Practising big belly breaths and positive visualisations while a gang of thugs rain kicks on our back and stomach might be more instructive, as labour preparation goes. (Something for the comment card at the end of the hypnobirthing course.) 

And who is to blame when it all goes wrong? What does it say about you? Were you not positive enough? Did you not believe in your body enough? Did you not want your baby enough? Do you fail at labour if you find the pain unbearable, the fear all-consuming, the grief enduring? (It feels like it.)

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More reason to feel unentitled to complaint, to grief. To trauma. Did you not bring it all upon yourself? Who feels sorry for a stupid bitch who tries to have a home birth on her first pregnancy? (Not you.) 

A cloak of silence over the whole endeavour. A confinement of concealment and deceit. You are not brave enough to share your birth plan with your family. People have strong opinions about home births. (People in general are awfully interested in women’s wombs and what they do with them.) You are petrified of judgement. (Though you wonder if your siblings see it in your eyes when they visit you in the maternity ward afterwards, that thing you saw the first time you looked in the mirror after your father died.) 

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Positive thinking, mind over matter, is what it’s all about. Trust in your body. The most unhelpful thought to have during a home birth: I can’t do this. (But also, the most reasonable reaction?) 

Your body must not have been listening to the positive mantras. It doesn’t have a clue what to do when the time comes. By the looks of it. By the feel of it. 

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Report into the efficacy of homeopathy for the management of home birth.

Trial date: 20-21 September 2013

Subject’s presentation: Floored /on the floor. First pregnancy. Full-term spontaneous labour.

Location: Your living room and kitchen / birthing pool / occasional harrowing trips to the toilet. 

Administration: By the midwife, as and when she saw fit. It’s possible her box of tricks may have been a generic plastic one, as per the pregnancy and birth homeopathy kits on Amazon, but you recall a heavy, ornate wooden box, authority and ceremony in the dispensing.

Method: Teeny tiny pills carefully placed under the tongue. You are on your knees, echoes of ‘This is the Body of Christ’ to the exchange.

Reception: Initially eager and hopeful. Docile opening of the mouth, puppy dog trusting eyes. Notable level of fear. Gradual dejection and despair. Eventual abandonment of the charade by all parties.

Remedies administered: Disclaimer: your memory is unreliable (trauma!), and you instructed your partner to incinerate the labour report when it letter bombed its way into your home. The following homeopathic preparations seem likely:

• Aconite napellus. For fear and anxiety due to horrific pain, both current and forthcoming.
• Gelsemium sempervirens. For weakness and all-over shaking.
• Chamomilla. For intense pain in early labour. May also have been used – WTF? – to treat your cold hands and feet. This seems doubtful now. You were quite sure you no longer possessed limbs; you had at this stage been reduced to a giant throbbing cervix.
• Arsenicum album. For anxiety (even more of it); for restlessness evinced by your attempts to move into an imagined place or position that might provide ease – the stairs, the couch, the floor, on the toilet, over the sink, on all fours, crouching, squatting, kneeling, spatchcock chickened on the kitchen island; for physical exhaustion (no wonder).
• Caulophyllumor Cimicifuga racemose. For regular contractions and cervix dilation; for an end to the interminable cycle of false hope and despair every time the midwife painfully inserted her stubby hand (too harsh?) into your vagina to confirm the lack of progress. 
• Pulsatilla pratensis. For your endless sobbing and desperate need for comfort.
• Kali-carbonicum. For the times you felt like you were going to die.

Final comments: Complete crock of shite.

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You had a home birth? What did you do that to yourself for?

God you’re brave, I just couldn’t take a risk like that.

The years go by and how remiss of you, you still do not have a pat answer ready to trot out. All the familiar reactions. The pressure to explain and justify yourself. The shame. Off you trot. Down the well-worn path of inauthenticity and self-deprecation and deflections. Jokes. Well, I wouldn’t recommend it. I was young and idealistic. It was a shit show. Yeah, my kitchen floor, just over there (dramatic shudder for effect). Yes, I must have been mad alright. Because it’s hilarious, how the most important event of your life broke your heart.

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Feel free to substitute ‘an interesting turn of events’ or ‘bad fucking luck’ if the use of the word ‘ironic’ in the following is not exactly spot-on. You are not sure you understand irony (Alanis Morissette has a lot to answer for). 

You choose a home birth so you can have all that uninterrupted, calm, soft-focus one-on-one bonding time with your baby after the birth. Just the three of you in the bed that housed your first dreams of him. (The pregnancy literature has done its job: you are so scared of not bonding correctly with your baby.) 

Isn’t it ironic that you end up bundled into an ambulance and spend your first night as a family split three ways? First, your baby (and he will always come first now), alone in a clear plastic box surrounded by strangers, while you are trapped in a whole other section of the building. Forced to await both physical assistance and permission to make the arduous trip to see him. Your soundtrack for the night the cries and exclamations and endearments and mollifications and anguish of new mothers getting to know their new babies. Visuals added as a curtain is swished open by a passer-by. (After a while, you try not to look.) Your partner, a father now, home alone on his hands and knees cleaning up a crime scene. 

You choose a home birth for an intimate experience, to avoid a rotation of harassed, impersonal, distracted midwives interrupting the flow of your ‘natural’ birth. 

Isn’t it ironic that because a home birth entitles you to only one midwife until the final stage, you end up feeling shockingly alone and unsupported? That as you writhe in agony in a cooling birthing pool, terrified, your worn-out midwife and partner go for forty winks on the couch, and you feel more abandoned than ever. That you crave the energy and expertise someone new might bring to the situation. That despite your congenial meetings during your pregnancy, this one midwife on whom your whole labour depends, doesn’t seem to know you so well when the shit hits the fan, doesn’t seem to understand the comfort and reassurance you need.

You choose a home birth so your baby will have the best possible start, gentle and calm and safe from bogeyman surgeons skulking around hospital corridors with scalpels in their hands and unnecessary interventions on their minds (at least that’s the narrative you gorged on during pregnancy). 

Isn’t it ironic that a complicated protracted natural birth can also traumatise a newborn and leave them needing hospital care? (Not to mention their mother.) It’s news to you. 

You would like your money back please.

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Occasionally you admit to feeling duped. The pregnancy literature with its red top tabloid headline that natural is best, all else is less than. 

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The countdown has begun, and you are oh-so-full of hope. 

Maybe yours will be one of the hallowed stories. That will inspire others to ‘go natural’. Maybe your labour will come on like a call to action. And you will respond, galvanised, your body straining with purpose and excitement. Maybe you will manage early labour on your own, will trust that the hitherto unimaginable sensations wracking your body are normal, bearable. And not be scared shitless, the shakes all over you, unable to sit or lie still, keep anything down. 

Maybe you will go for walks outside, get fresh air into your lungs, hydrate and ingest high energy snacks, and do all the right things to help your labour progress. Maybe later you will be able to lie down and rest, conserve your energy for the really challenging bit. (Maybe early labour will not feel like the really challenging bit.) 

Maybe you will remember the hypnobirthing advice. Maybe your partner will be a step ahead, will light the scented candles, turn on the calming music, and guide you through a grounding meditation. Maybe you will be significantly dilated by the time your midwife arrives and feel buoyed by the realisation that it won’t be long now. Maybe you will feel agency over what is happening. And be able to form coherent thoughts and communicate them to others. 

Maybe the contractions will feel like waves, and you will let them wash over you. Or breathe through them. Or ride them. Or triumphantly break through the crest of each wave with the help of a friendly dolphin. Maybe your allergic-to-DIY partner, a man who suggests you ‘get a man in’ to hang up a picture frame, will manage to set up the birthing pool in record time without losing his shit. Or turning on you. Maybe the water will provide you with a sense of safety and ease. Or maybe you will take support and strength from your partner. Because in this scenario he is level-headed and purposeful and confident about what is about to go down in his sitting room. 

Maybe you will shout, moan, moo or whatever comes naturally and feels right for you in the moment because things will come naturally to you in the moment, and you will recognise what is right for you. Maybe you will be able to move with ease and settle yourself into the squatting power position so lauded in the literature. Maybe during intense surges – and maybe you will be able to think of them as ‘surges’, as the hypnobirthing teacher suggested, and not invasions by demonic spirits – you will engage in some clitoral stimulation for natural pain relief (a strategy suggested in a couple of the hundred books you ingested in preparation for the event). And if masturbation doesn’t work, you might at least have a laugh about it. Because in this scenario, laughter is conceivable. Because in this scenario, it is possible to remember that your genitals can be a source of pleasure. 

Maybe you will know instinctively when to push and how to push and from where to push. Maybe you will have the energy and wherewithal at the crucial stage to follow your midwife’s instructions and bring your child into life without feeling like you are dying. Maybe you will still be looking forward to meeting your child.

Maybe you will not wish you were dead.

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The shame.

An ambush that comes straight after the birth. Picture the dramatic entrance of the paramedics. (A surprise for the new mother – a complicated birth can result in newborns performing poorly on the Apgar score, the measure used to assess a newborn’s health in the first five minutes of life. Your baby’s breathing is laboured and an emergency detour to the hospital is a matter of course.) The patio door wrenched open, the outside in for the first time in thirty hours. A pair of strongmen to the rescue. An exhale, ‘Jesus’, the natural response of these poor men confronted with the folly of women, their unsafety, their unholy mess, ‘Jesus, someone cover her up.’ You are splayed on the kitchen floor, devastated to find yourself unable to summon strength enough in your two arms to hold your baby, but the paramedics are concerned about your dignity. Latecomers to the party, they are under the illusion of dignity being left to protect. 

Do they bring the shame in with them, in their bulky packs stuffed to the brim with medical equipment and accoutrements? In their EMT Trauma Holdalls, which is what the internet tries to sell you when you google their name. 

You take your cue from the paramedics and over the next few years you immerse yourself in shame. Your reading of the birth as a failure is absolute, unchallengeable. Despite the ‘natural’. Despite the healthy baby. All alternative readings rejected as placatory bullshit (so strong and brave – your partner, so determined – your midwife, so well-intentioned – does it count if you pay for this opinion?). It is hard to challenge your own stories. Nigh on impossible when you don’t realise that they are stories, and you an unreliable narrator.  

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There is no mention of ‘natural’ in your subsequent birth plans. Or unicorns. Or Santa Claus. It’s straight into the operating theatre for you for rounds two and three. (Both of which converge in your memory as one and neither of which are a charm, by the way.) 

Your obstetrician (male) notes your condition post-partum – the mad head on you, the complete state of you – and sits on the side of your bed, sympathetic. There’s a Perinatal Mental Health Service here now but it’s the doctor you’re worried about. Will he take it as criticism of his performance if you tell him that you found your Caesarean births traumatic and unnatural? And so very sad.

The anaesthetist’s repeated question, ‘What are you crying for, girl?’, pressuring you to articulate a compelling reason for the hot indecorous tears streaming down your cold face, from beginning to end of the latest procedure. A procedure, a medical intervention, a cold sterile theatre, a pack of strangers masked, gloved, capped, to birth your baby. What are you crying for? 

The smiling eyes crowded round you, with their disconcerting chit chat and easy reassurances, fooled no one. Papers signed, transfer of powers complete, you understood that your body was theirs now, your puppet masters. To be wheeled around, lifted, shimmied sideways, pushed forwards, punctured, laid back, arranged, exposed, shaved, pinned down, pressed, held, cut, prodded, rummaged at, scraped (what the fuck was the scraping?) and pulled. Moving and talking so fast, a breakneck rhythm and purposefulness to their choreography. All set to a beat you were frighteningly ignorant of, you could not keep up. The highlight of their performance, your baby held up high above you. A joke made about his gender (really? what? now?). Your baby seen and touched and held by these strangers before you. Strangers still, though they have been on intimate terms with your body. You never once stopped shaking. You never once stopped crying. What are you crying for?

You had nothing to say. 

But your compassionate obstetrician sees some of it, maybe, as he sits on your bed some days later. ‘It’s hard being a woman,’ he pronounces, maintaining earnest eye contact, little understanding nods of the head. He should know. Is this actually happening? Is there a candid camera behind him, poised to clock your reaction? The hopeful part of you, the one that can foresee the retelling of hospital horrors for laughs, banks the scene for later. 

‘It is,’ you concede, as if the thought has never occurred to you. 

You take your empathy where you can get it.