As a child of the 70s and 80s I was raised with the idea that women could (and did) do anything, and always eschewed the ‘traditional’ feminine trappings of makeup, skirts and heels. As I got older I became aware that this slogan was frequently understood to mean that women should do everything, including juggling work and family, but it was not until I started thinking about whether – and if – I wanted children that I fully realised the extent to which social attitudes towards motherhood remain among the most potent and pervasive constraints on female (and male) identity and freedom.
For a start there is the expectation that women will/should/want to have children. Those who choose not to become mothers are frequently, and unfairly, regarded as selfish or unnatural (unless you are poor, in which case the predjudice works the other way, and choosing to have a baby is seen as irresponsible or a way to bludge off the state). Rich or poor, if we do have babies we are supposed to both treasure our time with them and, as soon as practicable, to return to our jobs and leave them in the care of others, presumably because looking after one’s own child is not legitimate work. Meanwhile men who choose to be the primary caregiver are often looked at askance.
The idealisation of ‘natural’ motherhood also puts immense pressure on women. We must abstain from alcohol and other drugs, gain enough weight (but not too much), eat the right foods and take vitamins to ensure the foetus has all the nutrients required for optimal physical and mental development. We go along to antenatal scans looking forward to meeting our new child without thinking about the fact that their true purpose is to detect abnormalities, and are thus unprepared for the possibility that they may find something is wrong. We make birth plans that will almost certainly be overtaken by circumstances beyond our control. Then, once the baby is born, we are told that ‘breast is best’ and that bottle feeding has many undesirable sequalae, including reduced immunity, impaired appetite regulation, excessive weight gain and ‘nipple confusion’ (meaning the baby will forget how to breastfeed properly if breast milk is supplemented by bottle feeding).
All of these expectations are predicated on the idea that we will act in the best interests of the baby, based on a certain set of preconceived ideas about what that ‘best’ is, and fail to take into account the complex cultural, social, political, physiological, psychological and emotional factors that are involved in every aspect of pregnancy and childbirth. My own experiences are a case in point.
I went into labour with my first child two months early and, because she was breech, was advised to have a caeserian section. As anybody who knows me will testify, I am stroppy individual with no fear of standing up to authority. At the time I was also working on a masters degree in Bioethics and Health Law and had a clear understanding of my rights as a patient, but I have never in my life felt so helpless. I knew there were dangers associated with a vaginal delivery, but the prospect of both a premature birth and abandoning my plans for a natural delivery was emotionally devastating. Despite repeatedly asking for an explanation of the risks in order to make an informed decision, I was told by the obstetrician that “I have delivered plenty of breech babies safely but think you should have a caesarian”, leaving me completely unable to make any decision at all. (Note to medical students reading this, informed consent is situational and different people require different information.) Fortunately my midwife found a doctor willing to talk me through exactly what could go wrong and how the risks could be minimised, and my daughter was safely delivered by a terrified but perfectly competent registrar.
My second child arrived on schedule but with a sublingual tongue-tie that was not discovered until two weeks after her birth, by which time my milk had all but disappeared. Although I was able to restore my supply through a combination of domperidone and a breast pump, she never learned to suck effectively. For the first six months of her life I fed her (ineffectually) and expressed every three hours in order to provide her with breast milk. I still vividly remember sitting attached to the pump, watching my husband topping our daughter up with the expressed milk by bottle (complete with ‘nipple-equivalent’ teat) while I cried inconsolably for failing her.
Although I am incredibly grateful to all those who supported me during these incredibly difficult days and months, in retrospect the decisions I made may NOT have been in my children’s (or my) best interests, and nobody would, I think, blame me if I had opted for a caeserian birth or formula feeding. But my choices were shaped as much by my emotional needs as by rationality, and by internalised ideas about what I as a woman and a mother should do. While there are good reasons for promoting ‘natural’ birth and breastfeeding, it is important to remember that in fighting to make these options easier for women, choices that meet the mental and emotional needs of mother, baby and family are at least as important as those that provide physical benefits. We need to recognise that these are not easy decisions to make at the best of times, let alone in the midst of the physiological and psychological maelstrom of pregnancy and childbirth. Adding a burden of guilt for failing to meet social and cultural expectations is at best counterproductive and at worst actively harmful. If we want to truly empower women, we need to give them the freedom to make choices about how – and whether – to ‘do’ motherhood, in whatever manner best meets their own situation.
Cushla McKinney is a research scientist at the University of Otago, Dunedin, New Zealand.