normal birth
sara wickham
A version of this article was also published in
The Birthkit; a publication of Midwifery Today,
Do we need a new language of birth?
'Normal birth' is not a term which is clearly defined.
When we say a woman had a normal birth, do we mean she
had an intervention-free labour and birth in her own home,
with food, drink and support freely available, or do we mean
she had her baby in hospital, with an induced or accelerated
labour, CTG monitoring and an episiotomy?
Both of these are described as a 'normal birth'
if this term is used synonymously with
'spontaneous vaginal delivery'.
But is this really what we mean?
When we talk about "keeping birth normal", do we actually
mean we are wanting to "keep birth natural"?
Yet even that isn't clear enough. As the guardians of birth,
midwives have the skills to intervene in order to
ensure birth remains within "normal limits", and if
midwifery intervention is needed, then this is done
in order to bring birth within these limits. So a birth
that is not entirely 'natural' may still be
'normal' at the end of the day.
If by 'normal', we mean 'average', then the norm for
most women is to have their baby in hospital, with a
managed labour, oxytocic drugs for the third stage,
and often the withholding of food and drink (at a time
when nourishment for energy may be vital). This way
of conceiving normality has emerged fairly recently,
as we have become able to quantify and measure occurrences
and outcomes. Frankly, no woman fits the average in
every respect, and who would want to be plain average anyway?!
Each pregnancy or labour is 'normal' for that woman,
and equally each is special and unique for families
(and their midwife).
One of the threads on a midwifery internet list which I
belonged to debated the paucity of words for birth.
Someone recalled that the eskimos have many words for snow,
and yet we only have one word for birth.
There are many different types of birth, and maybe now
is the time to begin to expand our vocabulary and
consider what kind of language we need in order to
debate these issues.
What is a normal birth?
If we want to continue to move birth,
perhaps now is the time to consider the language
we need in order to do this.