‘It’s all in the timing’: 100 days not out - my reflections on fatherhood so far (Part A)

Our son, Sachin, arrived following a home pool birth at 17:57, Monday 19th April. This beauty was on repeat as he made his lower lip shaking, legs cycling, wailing, welcome. According to the NHS health professionals, he was nearly three weeks overdue.

My writing is usually fuelled by a socially progressive agenda in the face of actual, or perceived, injustice. This piece, about our child’s safe, healthy and beautiful birth is no different (work with me!). Part A below is a reflective critique of the medicalised process of childbirth that is the unhealthy norm in the UK. Part B will share my thoughts on fatherhood so far through the lens of my paradoxically antinatalist philosophy.

‘If you engage the social context of the mother — her family — you are tuning in to the way human beings behave. Extracting a mother and sticking her in a health facility is less effective, but that is the worldwide global norm; that is the model that is being exported and distributed around the world, and changing it is very complicated, it is ridiculous’ — Duncan Fisher, Family Initiative (as cited in Machin, 2018, p. 262).

Nowhere in the 88 pages of the National Institute for Health and Care Excellence (NICE) ‘Guideline for care of women during birth’ (2014) does it mention the words ‘father’, ‘dad’ or ‘partner’. According to NICE, I, as sperminator, have no bearing upon the wellbeing of the mother during birth. Go figure. As evolutionary anthropologist, Anna Machin, acutely observes:

‘the sole aim of medicalized childbirth is to increase the chances of survival of mum and baby. When a major factor that positively impacts this chance — having an involved and informed father — is excluded, that should be of concern’ (p. 261).

At the start of the pregnancy (unplanned, I must add, and therefore a process about which I had only a passing knowledge), I was like all fathers I knew: ‘births are supposed to take place in hospitals, and epidurals are a blessing — praise Jah’. I’d read enough Michel Foucault over the years (in this context, most relevant are Madness and civilization and Discipline and punish), as well as been subject to perpetual (and, actually spot on) rants from my cynical uncle Sukhdev, to know that the medical and pharmaceutical industry were not only interested in the health of their service users. Rather, there were always (rather nefarious) political and economic interests and agendas at work.

So, as my partner Vikki and I descended into the rabbit hole of antenatal awareness, most deeply through midwife (although that description fails to adequately convey her range of expertise) Karis Annette’s enlightening guidance, we fast became disillusioned with the prospect of a hospital birth. ‘Dis-illusion’, however, can be a wonderful, albeit challenging, awakening; for example, in a manner after Plato’s allegory of the cave. In the context of a hospital birth, through increasing our health literacy based on Karis’s Hypnobirthing ‘homework’ tasks, Vikki and I came to realise that a home birth, with a pool in particular, would likely lead to healthier outcomes in both the short, as well as long, term for both mother and child.

To reiterate, I began the pregnancy process as a staunch advocate of hospitalisation and a medicalised birth. Most strikingly shown through the famous Stanley Milgram ‘Obedience to authority’ test, for far too long now, in the Global North, and of course myself included, we’ve almost exclusively conceded the rights to our health to so-called experts who are invariably under political and economic pressures that guide ‘health’ decisions. It became apparent through our research that during the active stages of labour, once the mother goes down the hospitalised, medical intervention road, it’s a slippery (or perhaps not so in the case of the labouring mother agonising to ‘get the baby out’ of her) slope to delivery, whereby the natural production of oxytocin (crudely put, the ‘happy’ hormone) is stymied, and there’s a greater risk of a traumatic and/or emotionally stunted arrival. So, our processual decision to steadfastly pursue a home pool birth, without medical intervention, wasn’t based on some Gwyneth Paltrow-esque fad, nor simply a hippie philosophy, nor a holier-than-thou smugness in the face of medical evidence and authority. Rather, we came to sound conclusions following diligent research, introspection, and a consideration of the wider context.

Amidst COVID-19 protocol about as consistent as Sinead O’Connor’s religious beliefs, fuck was I going to wait for 3 days in Grimsby hospital car park, whilst Vikki laboured under strobe lights alone, repeatedly having to fend off the injunction to be unnecessarily pumped full of hormones. Even if/when our son had arrived safely, I would’ve got a mask covered hour with him, before being told to jog on whilst Vikki was left alone with, or perhaps without, Sachin.

Owing to Sachin’s three week overdue-ness, and with Vikki in an understandably painful physical and heightened emotional state, I found myself in numerous stand-offs with medical consultants, all of whom stood by flawed empirical data to pressure us into forced induction for the ‘safety’ of mother and child. I remembered (and this is a really useful takeaway) to continually ask the consultants three questions as recommended by Karis:

1. Is the mother OK?

2. Is the baby OK?

3. Are we progressing?

If the answer was yes to all three, it was prudent to be patient (a virtue sorely lacking in our TikTok culture). The pressure that medical consultants were putting on us was at odds with the very data their paradigm had generated; the monitoring results they’d gathered throughout the pregnancy revealed all was well. In line with a dominant, rationalist and positivist narrative that reduces experience to measurable outcomes, the medicalised model was flawed: trend based data, not actual people in a holistic context. The most glaring example of this was how Sachin’s conception date was reverse engineered to tally with measurement data, even in spite of Vikki and I being the ones who actually did the deed (unless, of course, I’m not the actual father!). So, the NHS had a due date 4 days earlier than ours. Even granting 4 days, full term is 38–42 weeks. In the UK, NHS trusts are inconsistent on when they start sharpening the induction swords (apologies for the Kill Bill imagery in that one). In France, overdue is 41+ weeks. Many women worldwide go on to have healthy 10 month births. The UK increase in induction is a worrying trend. Considering the wider socio-political context, and notwithstanding the ostensible benevolence of medical intervention, could it be that that it’s in the best interests of healthcare professionals to forcibly ‘get the baby’ out to: mitigate health risk, prevent litigation, get the mother and child ‘through and off the books’, and, in a patriarchal, economically driven society, further control and make predictable the organic processes of the female body?

In the face of the above context, Vikki and I held firm in our conviction that a natural home pool birth would result in the best possible outcomes for baby and mother. Contrary to the inconsistent NHS guidelines, as well as consultant ill-wishes and warnings regarding, and I quote, ‘a dead baby’, Sachin arrived 9 lbs. and 11 oz., fit as Hugh Jackman, and with an impeccable placenta (see Sophie Messager’s excellent research on ‘the myth of the ageing placenta’). The home pool birth was a wonderfully transcendent experience, and Vikki went through it without medical intervention (barring gas, air, and a whole lotta heart!). The midwives who delivered Sachin were incredible, both during the birth, and the aftermath. Vikki’s mother and sister were awesome in helping to set up the pool, and even more so when emptying it (see exhibit A below)!

The successful home pool birth, facilitated by two midwives (in fact, it was just one midwife and myself for the six hours of active labour until 10 minutes prior to Sachin’s arrival) was not only a beautiful experience (that oxytocin really hits the spot!), but also a big up yours to the consultants who repeatedly sought to force Vikki into a medically induced birth through fear: ‘dead baby’, ‘on your hands be it’, one consultant even sternly declared ‘I’m very disappointed in you’ on speakerphone whilst Vikki was on all fours screaming and in active labour (here’s looking at you Dr. A at LCCH)! The consultants would argue that they prioritised the health of mother and baby through their evidence based practice, but, as shown through the inconsistent NHS guidelines, and NICE omission concerning the role of the birth partner above, the paradigm through which we look at childbirth in the UK is flawed. There was no acknowledgement taken by the consultants of the context in which mother and child found themselves: a safe, comfortable home environment, a supportive partner and family unit, COVID-19 restrictions wreaking havoc with ward protocol, and so on. If holistic care is the gold standard, we were dealing with myopic gangue.

The birth obviously wasn’t primarily about me. But, contrary to the medical guidance and data, I obviously did have a critical part to play (over and above following the manual and managing to, on a rare occasion, get ‘it’ up and in). The way the NHS thinks about and administers birth needs to change. Big respect and a massive thank you to the midwives who facilitated the most transformative experience of our lives. And a massive ‘do one’ to the ego driven consultants who forgot the people subjected to their fear based rhetoric.

The successful birth process and delivery wasn’t a pissing contest. Rather, it was about what the NICE guidelines and NHS protocols ostensibly sought to achieve: the healthiest outcomes for mother and baby. Asides from one midwife consultant who recognised our health literacy, provided us with data, and supported our right to choose, throughout the incredibly long few weeks prior to Sachin’s arrival, we were, from consultants, subjected to a cold, sterile and fear based medicalised approach; an approach which runs counter to the claims of the importance of encouraging oxytocin, relaxation and release. Indeed, the risks of medical induction are actually greater than waiting for nature to take its course; induction inhibits natural hormone production critical for a healthy birth, bonding, mitigating foetal distress, the list goes on.

This reflective rant doesn’t seek to outright dismiss the value of medical induction and hospital birth. It’s indisputable that medical intervention has saved lives and avoided preventable tragedy for countless families. Moreover, 99% of my loved ones, and myself, were born in a hospital environment, with some level of intervention. Rather, the aim of this post has been to empathise with those who have been subjected to unnecessary, fear based medical interventions, and encourage those considering their birthing options to study the literature, reflect upon their personal circumstances, and make an informed decision based on evidence, experience and intuition. To the birth partners: stand firm and advocate — you matter, too!

Thanks for reading Part A: how Sachin got here. Here’s a link to Part B: what the fuck do I do now that he’s here!

I’ve included a number of links below that we’ve found incredibly useful:

Books

Flood. J. 2012. Hynobirthing: the way to an easy, peaceful birth. Unknown: The Association of Hypnobirthing Midwives.

Jones, J. 2018. Newborn mothers: when a baby is born, so is a mother. Unknown: IngramSpark.

Machin, A. 2018. The life of dad. London: Simon & Schuster.

May, I. 2011. Birth matters: a midwife’s manifesta. New York: Seven Stories Press.

Websites

Better Births Lincolnshire. Available at: https://betterbirthlincolnshire.co.uk/

Red Tent. Available at: https://www.red-tent.com/about-me

Sophie Messager: https://sophiemessager.com/

Documentary

The business of being born. 2008. Info at: https://www.imdb.com/title/tt0995061/

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