Mother and Baby

Am I allowed? The language of permission in birth

Section: Labour & Birth

Fear can make prisoners of us, and birth is no different, says Milli Hill. 

In the months and years that followed I began to listen to other women’s birth stories with a keen ear, waiting to hear for the tipping point where they had either triumphed or, as I had, slipped beneath the waves. In every story from across the Western world I heard the same words over and over: ‘They did not let me’, and ‘I was not allowed’. I heard it so much so that I gave this phenomenon its own special name, ‘The Language of Permission’.

‘I had to have a vaginal exam, as soon as I arrived at the hospital, to check if I was in labour.’

‘I wanted to have a water birth, but I was not allowed to use the birth centre because of my BMI, so I had to be on labour ward.’

‘Because I was trying for a VBAC , I was not allowed to eat or drink in labour, in case I ended up having another caesarean.’

‘My partner wanted to come with me for that part, but he was not allowed.’

‘They don’t let you have skin to skin with your baby after a caesarean in my hospital.’

‘They told me not to push yet even though I was desperate to.’

…and so it went on.

I began to wonder how these phrases were tripping so readily off our tongues as women of the twenty-first century? We would not accept being restricted in this way in our relationships or marriages, in our educational choices, or in our career paths. Why, when it came to giving birth – arguably a pretty significant moment in a woman’s life – were we using such passive language, casting ourselves as the ‘permission seekers’, rather than the ‘permission givers’?

The answer to why we have this imbalance of power, I’ve discovered, is complex, and emotional, but, if you put it in a big pot and simmer it for a long time, it boils down to a few interconnected essentials:

  • Fear of birth is at an all-time high
  • Confusion over the rights of the fetus can cause ‘risk’ to trump ‘autonomy’
  • And finally, we live in a patriarchy.

Let’s start with the fear.

In the twenty-first-century birth room, everyone – women, partners, midwives and doctors alike – is, either consciously or unconsciously, terrified of birth.

This fear, which a hundred years ago may have taken the form of low-level anxiety or healthy respect, has transmogrified in recent decades into full-scale panic. Where birth was once a large stray dog that you generally expect to be friendly but approach with caution, it now seems to have evolved into a many-headed monster-hound, rumoured to be loose on The Moor, with occasional sightings reported in hushed tones. Like death, birth has become something we’ve lost touch with, that no longer takes place in our communities and that we therefore rarely see or hear.

Women go to the hospital and come back with a baby, and what happens in the intervening day or two remains a somewhat terrifying mystery. If we do see birth, it’s quite likely to be a representation on TV, maybe a long way from accurate.

In all areas of life, fear can make prisoners of us, and birth is no different. Our fear may shape our behaviour, our expectations, and, in turn, our actual reality. In fear, we may not prepare for birth, believing it to be ‘unpredictable’, or we may decline to ask questions, feeling that we are powerless. In modern maternity care, medical professionals and parents-to-be alike are often found erring on the side of caution, and this defensive behaviour can be at the expense of personal freedom. Which brings us to the overlapping concern of point two, the safety of the unborn child, another key player in the birth room power imbalance.

Modern maternity care is rightly focused on birth outcomes, but a good outcome is most often measured not in terms of the woman, her feelings, her experience, and her postnatal mental health, but on the idea of the ‘healthy baby’ – indeed, women are frequently told that this is all that matters.

This is a book extract from Milli Hill’s new book Give Birth Like a Feminist

Now read:

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10 things to ask for to get the caesarean *you* want 

How to have the best-ever water birth

  • Author: Milli Hill Milli Hill
  • Job Title: Freelance writer and founder of the Positive Birth Movement

Milli Hill is a freelance writer and the founder of the Positive Birth Movement. The mum of three is author of The Positive Birth Book: A New Approach to Pregnancy, Birth and the Early Weeks.

She writes tips and advice on how to have happier labour experiences.


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