Guilt, or not

Slate published an interview yesterday with the “Skeptical OB”, a critic of the natural childbirth movement. Link is here. It’s an interesting contrast to the Radical Doula article I discussed last week.

Childbirth has always been risky. People used to die giving birth, and people used to die being born. In the days before antibiotics, mastitis (or “milk fever”) could also be deadly. Death in infancy was common. Breastfeeding has been done many different ways in different cultures. In most times and places it was fairly common for women to feed children other than their own. The use of animal milks for infants also has a long history (goats, apparently).

The Skeptical OB is critical of the way the pro-natural birth, pro-breastfeeding stuff can promote “unnecessary guilt in women who don’t abide by its standards.”

I haven’t read the book, just the interview above and the free online sample which includes the introduction. The introduction frames the issue around guilt as well, “I have made it my mission to help women escape the feelings of guilt about their birth experience that trap them long after their children are born” and “My goal in this book is to release women from the guilt trap…”

I’d probably quite like a lot of this book, but I wish that guilt wasn’t presented as the problem. I don’t feel guilty about the birth I had with the little dude – I don’t feel like I failed at anything; I feel like I was failed by the system of healthcare, which didn’t respond properly to my needs, and didn’t give me the medical options that I wish I’d had. Guilt isn’t the problem.

The natural childbirth narrative might tell me that my birth with the little dude could have been fine if I’d be supported better at home, that the slow progress was the result of stress, etc. There may be some truth in that. The obstetrician I had with the new bub said she would have given me syntocinon sooner, which is what I had always thought should happen – both during labour and especially afterwards.

If childbirth without synthetic hormones or pain relief or incision is considered the gold standard, it’s probably because of the possibility of births like my most recent one, which was so totally fine that I can’t get over how fine it was. I sound like a hippy dippy earth mama when I say that the pain felt productive – but it’s true. I was glad not to have an epidural, I was glad to be able to feel the sensations properly so that I could respond to their signals. If we have a third child, I hope to have a similar labour.

Breastfeeding the little dude was hell at first. He couldn’t latch or suckle until he had his tongue tie and lip tie op. Breastfeeding the new bub was immediately fine. I hadn’t realised that breastfeeding could be so easy straight off the bat. Bub’s feeding now is about the same as the little dude at nine weeks. He just seems to know what to do. The little dude at two weeks old, well, I wrote about it at the time: The one about the milk. I called it a “horrendous ordeal” and “soul destroying”. His ability to feed was so compromised by his tongue and lip issues that the dentist who did the oral surgery told me he would have struggled to take milk from a bottle as well (he also said that the lip tie was extreme, and that we were saving ourselves thousands in braces down the line). There’s been some controversy lately about the rates of tongue and lip tie diagnosis, and the possibility that some babies are having unnecessary intervention. The new bub was diagnosed by the hospital midwife as having a tongue tie, but he was feeding fine from the start, so we haven’t sought any surgical intervention.

If things had been slightly different, I might have ended up feeding the little dude formula. It was very significant that my mother and my mother-in-law had both breastfed their own children. I saw it as normal. And while I was pregnant, my mother-in-law had told my husband that his job was to do everything else so I could get feeding established. But even so, if I hadn’t been able to see a lactation consultant quickly enough, I might have resorted to formula because it was such rough going, and after the trauma of the birth I didn’t have much emotional fortitude left. Had that happened, I’d have been gutted, because I really wanted to breastfeed. I’m not sure I’d have felt guilty though. I probably would have felt deeply disappointed at the outcome, maybe let down by a lack of resources for assistance. I don’t think I’d have blamed myself.

I have a theory that maternal guilt is often sublimated anger and disappointment. Women shouldn’t feel guilty for having epidurals or caesarean sections or for formula feeding (our bodies our choices). But women should be able to honestly express sadness about painful or disappointing experiences, and anger when we think those things could have been prevented had things been different and has better support been available. It’s important to be able to express those emotions.

If someone says “there’s no need to feel guilty”, the subtext can be “it’s not legitimate to feel anything negative about that experience”. Even tiny examples reflect this – such as telling a mother that she doesn’t need to feel guilty for letting her kid watch heaps of tv and eat nothing but toast and bananas last Thursday because she was having a really rough day and just needed to sit down. If the mother tells someone “I was so tired the other day we just watched videos non stop and I didn’t even give my kids proper food”, she might receive a supposedly reassuring response like “you’re a good mum and you did what you needed to do, they’ll be fine”. The response presumes that she feels guilty and that she’s mentioning what happened so she can assuage the guilt. These responses reinforce the normalisation of guilt as a pervasive mothering emotion, and are a disservice to mothers. Because maybe if the emotion is examined more closely, guilt falls away anyway and she’s actually feeling overwhelmed by everything and under-supported and ripped off by expectations of perfect motherhood, and in need of a proper break.When we tell her “it’s ok, you don’t need to feel bad about it”, the subtext is “buck up, truck on, do what you gotta do to get through the day, don’t focus on your own feelings”. This makes it harder to allow space for negative feelings to come to the surface.

Negative feelings about childbirth and breastfeeding are particularly important to acknowledge, away from the framework of guilt. It’s totally reasonable to be distressed by an unexpected cesareans or episiotomy. It’s not buying into mother-guilt to say “I feel terrible that I couldn’t get breastfeeding to work, I feel like I missed out on an aspect of motherhood that was important to me”. Glib extortions to let go of guilt can silence women who are struggling to find language for their emotions, or struggling to process their emotions, and who therefore fall into patterns of speech that graft onto the primary negative emotion that women are allowed to express without being seen as bad mothers: guilt. Instead of telling women not to feel guilty, we should make space for women to express other negative emotions about motherhood. We need to stop assuming that when a mother says “I feel bad”, she means “I feel like a bad mother”.