My daughter’s birth

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This post is a bit different from my usual blogging, and it’s long, but I’m writing it because I think it’s important for the experiences I’m writing about to be discussed. Last Sunday morning – Mothering Sunday – my partner Emma gave birth to our baby daughter Elisabeth. Elisabeth is, of course, delightful and gorgeous, wise and mature beyond her years, judicious in her calculated emissions and possessed of a frown promising Socratean wisdom. I’m very proud of her, and of her mama, who was and is absolutely amazing.

However, they both had a rough ride to get here. Emma had a complicated pregnancy. Two sweeps failed to get her labour started, although they got her dilated to a centimetre, and on Thursday 23rd (her due date), she went in to hospital for medicated induction of labour. 48 hours of painful contractions later, she was still only just over a centimetre dilated. Her waters were broken and she was put on a drip to induce contractions. Several hours later she was still only just three centimetres. By Saturday night, she was in a lot of pain, and eventually had an epidural, which worked. She became fully dilated in a very short time, and by the early hours of Sunday morning she was in a lot of pain again, and ready to push. Emma pushed for an hour, but the baby was barely moving down the birth canal as she was lying back to back with Emma, with her head tilted at an angle. Meanwhile, Emma’s heart rate was regularly spiking into the dangerous range, and at one stage spiking higher than the baby’s heart rate. After an hour, it was found that Emma had a temperature, and because of the danger to the baby, we were told she had to deliver as soon as possible. After a failed forceps delivery, Emma had an emergency c section, and Elisabeth was delivered (wiggling and crying!) at 7.58 am, almost three days and 70 hours after induction of labour.

Initially, Elisabeth seemed fine, and Emma was in worse shape. Both were put on antibiotics for the presumed infection causing Emma’s temperature to rise, through cannulas in their hands. Soon, however, Elisabeth started struggling: she was failing to feed, and when she latched on to the breast she wasn’t strong enough to carry on sucking. She had swallowed a lot of amniotic fluid during the section and was constantly coughing and vomiting it up. Her crying was weak and she never really slept, although she closed her eyes a lot. Both she and Emma were monitored, with checks for different things every few hours or minutes. By Monday, Elisabeth was very sleepy, and refused to feed from breast, bottle, cup or even syringe, while Emma was finding it very hard to get a position to breast feed as she was in a lot of pain from her c section and forceps, and Elisabeth’s cannula in her hand was obviously also painful when she brushed up against Emma’s body. She kept trying to pull it out (succeeding twice), and had to have it re-inserted, which was difficult to see. At this point, Emma was on a cocktail of drugs including codeine and morphine, which was making her very anxious and managing her pain very unevenly. In the middle of the night, tests came backs showing Elisabeth’s viral count was abnormally high. She was taken for a lumbar puncture, where spinal fluid is taken with a needle, and we were warned she might have viral menigitis or a related infection. Over the next day, Elisabeth became worse, and had to be given a nasal tube to feed, although she was vomiting up a lot of her feeds. She became very sleepy and floppy. Her viral count had increased again, and she was put on more, stronger antibiotics.

We seem to have been lucky. Yesterday, Elisabeth became to improve. Some tests are back – some are not – but she seems to be getting much better. Today, she was able to cry (loudly!), and was much more alert and engaged, and she drank a good amount. Emma, who had been painfully expressing colostrum, got her milk in, and, amazingly, Elisabeth managed to go entirely onto breast feeding today. Around midday she pulled her own nasal tube out (!), but so far it hasn’t needed to be replaced as she hasn’t needed top-up feeds. She might be able to come home quite soon.

Most of what I’m describing here, though it’s horrible, is not ‘my’ experience alone. The labour isn’t my experience at all, and a huge number of people have got in touch to share stories of their experiences of difficult births and newborn baby illnesses, and to reassure us that we will soon forget quite how horrible and frightening all of this has been.

What I wanted to post about, though, is a slightly separate strand of experience. It’s, obviously, not the most traumatic part. But it is an experience which, unlike the complicated labour or Elisabeth’s illness, is one I’ve never read about. No one got in touch to share stories. But lots of women will have had this experience, and so I want to explain what happened, partly so women in my situation can be prepared, and partly because I think the medical professionals were saw were really completely unaware of what was going on.

Emma’s pregnancy gave both of us a tiny warning call about how most people interpret our relationship. Everyone was loudly surprised Emma was having a baby, not me. A pretty typical illustration of that attitude was our (lovely, and otherwise highly competent) fertility clinic, who made us fill in forms twice as they were sure we’d filled in the ‘wrong’ section for birth mother and partner, and then still managed to get confused about which of us planned to get pregnant and to run blood tests for the mother-to-be on my blood, not Emma’s. Responses from people we knew ranged from casual surprise to outright questioning, and even our midwife (again: otherwise lovely) thought it was perfectly ok to break off in the middle of our booking-in visit to ask why I hadn’t got pregnant. I will say, at this point, that while I know infertility and pregnancy loss attract insensitive comments across the board, I think people are particularly bad at assuming that, if you’re in a lesbian relationship and not pregnant, it must have been purely a fun choice you made.

These sorts of comments had made both of us very aware that 9 people out of 10 will assume I ought to be the pregnant and maternal partner, while Emma strikes them as less likely to want to be pregnant. So we had become a little used to misunderstandings. We thought we were prepared. We weren’t.

A basic issue was access. In the hospital where Emma gave birth, partners must leave the ward to go to the loo or to eat (food can be brought for labouring women, but if you want to bring your partner something at a different time of day, or to bring her drinks, you need to go to buy them). This means that when you come back to the ward, you press a buzzer and wait for someone to hear the buzzer, see you on the camera they have at reception, and ask you who you’re coming to see. Each time, I faced a barrage of questions and misunderstandings. No, you can’t come in, no visitors. Who are you? No, who are you? No, who are you coming to see? No, you can’t come to see your partner, he is not allowed in. No. Eventually, I would be let in. But, also, it was fairly clear that sometimes, whoever was watching the camera would see me (a woman) waiting at the door and simply not answer – I could tell this because several times, when I had been waiting, a man would turn up behind me, and the door would be buzzed open for him. Twice, a midwife came hurrying to intercept me at this point, insisting I wasn’t allowed in. The longest wait was nearly half an hour.

This was stressful, because I was genuinely worried about Emma while I was gone. She was very upset, in a lot of pain, and not remotely compos mentis because of the codeine and gas and air she had been given – and when Emma is in pain, she is often silent or incomprenhsible, so I needed to be there. I was also, of course, worried about missing the birth. As a result, I more or less stopped eating and drinking so that I could stay on the ward.

Throughout all of this time, new people – several midwives, doctors and nurses – came and went. Most of them wanted to know who I was, understandably. But many of them were not satisfied with a simple ‘who are you,’ and repeated questions. Some shut doors in my face; others refused to speak to me and spoke entirely and only to Emma, even when there were questions I could answer, and even when Emma actually asked them to ask me. This was important, because as the pain and contractions became stronger, Emma was finding it hard to talk and push.

Throughout Emma’s induction, we had been told that a c-section was a likely outcome. We’d known for a long time a section might be needed, as Emma’s sister had preeclampsia and had had to have one, and Emma was being monitored for the same condition. Each time, we discussed it and Emma told me she wanted to try for a vaginal birth, but knew it might not be possible. By the time Emma was in active labour, we were well aware it might come to a section. But when Emma had been pushing for an hour, a surgeon came to talk to her. He questioned me aggressively about who I was, and then spoke entirely to Emma (who was contracting every minute or so). She was finding it very hard to reply, and feels that he could have communicated much more clearly, as he constantly trailed off with statements such as ‘of course, vaginal birth is ideal …,’ without completing his sentence. At the same time, the midwife was telling Emma when to push, and Emma was asking him to stop talking so she could push instead of talking. He explained that he wanted to attempt a forceps delivery, but thought there were likely to be problems with that. He wanted her to sign consent to a forceps and episiotomy procedure and also to a c-section, so that if the forceps failed, the c-section could be done immediately. Emma asked if she could avoid the episiotomy and forceps, and have a c-section. This seemed reasonable, as we’d been given to understand the c-section had been an option for around 18 hours at this point, and Emma had been reassured by previous doctors that she could simply say yes, and they would do it. But this surgeon continued to insist that a c-section was, of course, not ideal, and vaginal delivery was ideal, and Emma needed to consent to both at the same time. Emma kept asking the midwife if she could push now. I could understand what she was saying, and attempted to explain it to him: that she wanted a section and not the forceps and episiotomy. He ignored me. Emma was coerced to sign the consent as we knew the baby was at risk if she did not deliver.

Emma was taken to theatre, and I was taken to the male partners’ room to be given some scrubs to wear. In theatre, the surgeon attempted to turn the baby with his hand. A colleague asked whether it was likely he could deliver using forceps. He replied ‘no, but the mother is very keen for a vaginal delivery’.

I was utterly shocked. I didn’t manage to say anything (this all happened very fast, and at this point I was very worried about Emma, who was seriously out of it, very scared and rambling, and very white with a racing heartbeat). The surgeon began the c-section. His phone alarm was going off; he asked his colleagues to ignore the music. Chattily, he asked Emma whether she’d had other surgery, as she had some scar tissue (Emma hasn’t had any surgery, and he had asked this already). Emma panicked, noticeably, but wasn’t really able to answer. He continued, casually, to advise her that she should really think about future pregnancies, and leave at least a year before conceiving again. (This advice isn’t stupid or wrong – and we did know already – but it was an utterly bizarre thing to say mid-procedure to a woman clearly terrified and not compos mentis. Especially since, as Emma points out, it is unlikely she would get tipsy one night and fall into a fertility clinic by accident …).

When the baby was out, I immediately went to see her being checked (as we’d agreed). I had been told I could take my phone into theatre and I took a quick picture and took it to Emma, as many people had told us that mothers who have emergency sections can often feel both very frightened about how the baby is when they can’t see it immediately after birth, and very disconnected later on when they don’t remember the early moments well.

At this point, the staff in the room were swapping over, and new staff discouraged me from holding the baby or doing skin-to-skin contact (again, something Emma and I had discussed, in the event she had a section). When we were taken to the recovery room, several medics spoke to us in succession, but addressed only Emma, both with congratulations and with questions, many of which she still wasn’t able to answer well, and some of which frightened her as she was panicking about some of the surgeon’s comments, which she hadn’t understood. One group, hearing Emma refer to ‘Lucy,’ assumed it was the baby and confused Emma further; another laughed merrily when they realised the mistake and told me that – in my scrubs – they had assumed I was another midwife.

After this – while it was becoming obvious that something was wrong with Elisabeth – we were taken to the post-delivery ward, and then moved within the ward. Here, it was very noisy and chaotic, and many checks and questions were repeated multiple times by different medics, so it was hard to understand who was who. However, we still faced the same problems: many medics ignored me, refused to listen to my answers, drew the curtain to shut me out of Emma’s cubicle, or became confused when Emma referred to me. Here, as in the delivery ward, partners had to go outside to use the toilet or to eat, and whenever I went to the dining room to collect food for my partner, I faced a barrage of angry refusals. When I tried to get back onto the ward, we had the same old confusions. Several times, I was asked to leave as it was ‘after visiting hours’. At this point, Emma and I had had very little sleep for three days, and neither of us had eaten or drunk properly. Emma was in a lot of pain. We both spent a lot of time crying and I think it would be fair to say neither of us was really processing anything very well – we were shocked and not yet quite aware how badly shocked we were.

On this ward, I broke down a few times and tried to say why I was upset, as I was very much aware of a constant sense that there was no place for me there. Many medics simply assumed I was breaking the rules and should not be on the ward, and it was often too chaotic and noisy even to correct them before they moved on. At one point, when Emma had explained to a midwife that I was her partner, I ended up in tears saying that I felt I constantly had to justify that I was the baby’s mother. The midwife – who must have meant well – immediately exclaimed that I was just stressed: of course I shouldn’t feel that way! She probably thought this was kindly and helpful. As it happens, though, I have never felt I wasn’t my baby’s mother. It just didn’t occur to me. It feels peculiar when people ask me whether I feel less her mother because I didn’t carry her. And, of course, this response, despite being well meant, was effectively a denial of the experience I’d been having for the past four days, which was that I had to justify that I was the baby’s mother. I had to justify that, not to myself for reasons of my own emotional inadequacies or struggles, but to all of her colleagues who had failed to accept it.

Later on, the morning after we had found out that Elisabeth was being tested for viral meningitis and when Emma was having a particularly bad time with pain and had been crying constantly, I went to fetch Emma some breakfast. The women serving refused. Your partner is not allowed food. Your partner is a he? Your partner is a he? He is not allowed food! Look: there is a sign! Really, this is not allowed, you must not try to ask. I explained, increasingly upset. My partner is a woman. She had a baby on Sunday. I repeated it several times. Eventually I burst into tears, and the server finally understood, crowing Oh! You’re so sensitive! Of course, she can have some toast!

The last time I actively became angry was when one of the senior midwives lectured me about what ‘the mother’ should do, and what the baby needed from ‘the mother’. When I snapped that I was the baby’s mother, she was very apologetic. And things did change then. Not completely; not to the point that I could get onto the ward without justifying myself (I still found that, often, the answer to my intercom buzzer was a calm ‘no, dear, no one is allowed in now,’ which often meant I had to buzz again simply in order to explain that I was, in fact, a partner and not the visitor they assumed was trying to come in outside visiting times). But things did change a bit.

Yesterday, we were moved onto a ward that provides care for Elisabeth, hopefully until she is well enough to come home. It is a much less busy ward, and they have been wonderful.

I wanted to write this post because, although it sounds quite negative, I wish I had been more prepared for what happened in terms of the way we were treated as a same-sex couple. I had been prepared to advocate for Emma in labour. We had discussed a lot of things. We knew, especially, that Emma copes best with pain when she can be allowed to speak as little as possible. We knew she would probably become slightly incoherent. We discussed possibilities, such as c-section and skin-to-skin contact post-birth. In order to be a good birth partner, I should have been hydrated and well fed. I should have been calm. I should have been able to explain Emma’s decisions. Of course, at times, medics would have had to talk to Emma alone, and to ignore me. Of course, at times, I might get things wrong. And of course, how I was feeling was immensely less important than how Emma was feeling (although, even in labour, Emma was reasonably aware I hadn’t really eaten properly for three days, and because  she is a big softie, she was worried). But, despite these caveats, I came away feeling that the experiences I’m describing was cumulatively quite a big issue for me (and some issue for Emma and Elisabeth), which was totally avoidable.

Almost every single person who did or said something I’ve mentioned here, clearly did it without meaning to do anything wrong. They meant well. Some of them even thought they were being comforting and inclusive to us as a lesbian couple or to me as a non-birth mother. None of them could shake the belief that they were seeing a solitary moment of overreaction, or an understandable and isolated bit of stress. Cumulatively, though, there was a real impact. It’s hard to realise that, if we had been a straight couple, Emma might have avoided a forceps delivery she didn’t want (as the surgeon might have listened to me explaining what she was saying). She might have been better looked after in labour, which I feel horribly guilty about. She and Elisabeth might have done better after birth.

I wish I’d anticipated some of these problems. I’m writing this partly so that people can share this post and, hopefully, spread a bit of awareness about the impact of seemingly trivial decisions and assumptions by people in the medical profession. I’m also writing because there are practical points I wish I’d known, for people in my situation.

  • Get used to correcting people and not laughing off the ‘oh, I had no idea you were the partner!’ comments. I was so used to not making a fuss, and not drawing attention to my sexuality, that I wasn’t primed to do it when it mattered.
  • Be aware that you may forget to over-explain when you’re stressed. When Emma was in labour, I know I sometimes answered the question ‘who are you?’ with my name, or ‘I’m Emma’s partner’ or ‘I’m here to see my partner,’ none of which were specific enough. It’s quite possible that, had I reeled off a fluent explanation ‘I’m a lesbian coming to see my lesbian partner who is a lesbian mother who had a baby,’ people might have understood more quickly.
  • Don’t trust your birth plan to do the communicating. We had, naively, put down what seemed (at the time) like an exhibitionistic amount of detail about the fact I was Emma’s partner and I was female. No one glanced at the plan, and even people who did actually know I was Emma’s partner, tended to forget in the heat of the moment (including a midwife who asked me to ‘get the dad’).

This post has been quite depressing, I am aware, and I want to end on a positive note. I had no idea, before last week, that I would be so utterly delighted with my baby. Of course, I knew she would be wonderful. But people do tell you that you’ll struggle to bond, or you’ll be less important, or you’ll really have to work to get a relationship with the baby. I don’t think this is true. Babies, even ill ones, see and smell and take in a huge amount. They will, very soon, recognise their mothers (or, I’m sure, fathers). It was much less than 12 hours before Elisabeth would settle down for me before she would reliably do so for a stranger. She will follow me and Emma around the room with her eyes, and she will go quiet when we sing or talk (she has been listening to us talking for months on the inside!). And she is lovely, and increasingly able to respond and focus (blurrily) on us, and to do all the things that babies do, which evolution dictates must make us become huge bundles of hormonal response and gushy emotion. It’s great fun.

If you can, please do share this post. I think it matters, and I hope you’ll agree that it does show why seemingly small, trivial, well-meant heteronormative decisions are actually not just funny, coincidental or harmless: they mount up.

Thanks!

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The Invisible Labour of International Women’s Day

It’s International Women’s Day.

I’ve been reading twitter and there’s an outpouring of (mostly) celebration and mutual recognition, and lots of posts about brilliant friends and colleagues and inspirations. Lots of celebrations of supportive women, women who have held out helping hands to others, who’ve been there, who’ve listened, who’ve encouraged, who’ve given.  And lots of poignant posts, too. @thewomensquilt is the account recording the making of a quilt to commemorate the hundreds of women killed by their partners in the UK. It’s beautiful, but very sad.

I can understand why the celebratory posts need to be there, to counterbalance the sadness and to give some sense of hope. I can see why they’re part of the same issue. Women who do support other women are the ones who raise awareness of femicide, who open and run refuges, who lend an ear to friends struggling in abusive relationships, who educate young women in what a healthy relationship looks like, who provide opportunities. It’s necessary work.

But the juxtaposition also makes me uneasy. Women are constantly taught to give, to listen, to support, to encourage – and to do so voluntarily, silently and selflessly. This rhetoric is very much part of the culture of victim-blaming of women in abusive relationships, and it is very much part of the culture of reporting on femicide (and, indeed, reporting on other forms of misogyny). Women are encouraged to do invisible labour, and we all, men and women, are encouraged to interpret it in the traditional terms that reinforce misogynistic ideal of femininity. We’re encouraged to call it kind, generous, and nurturing. Occasionally, we’ll come across men who say, thinking they’re being flattering, that this is a wonderful female thing that men just don’t get.

And that’s a problem. All of this de-professionalises women’s support networks, and implicates them in a well-established set of social expectations relating to guilt.

I’ll concentrate on the workplace, for a minute, to explain what I mean. Women have been trying to build networks of support in male-dominated industries for decades (centuries, actually), and it’s easy to look to initiatives like Athena Swan in academia and to feel there’s a real solution to the problem. But then this, like other networks, requires someone to be there. And if you only have one woman at the top, or perhaps two senior women in a faculty of a hundred, then that someone is always going to be Dr X. I have several friends who are Dr X. Dr X is on the Athena Swan committee, because it was important to have a woman lead. She’s also on the big grant proposal with Professor A, because Professor A needs a woman there. And she’s running the women’s forum for the postgraduates, because Drs B, C and D agreed it should be a woman. Chances are, she’s also writing references and reading papers and mentoring ECR Drs E, F and G while listening to colleague Dr H figure out how to get to senior lecturer level. Meanwhile, the male members of the department are enthusiastic and fair-minded and understood completely the need to have women taking the lead in gender equality work. And they have rather more time for research than Dr X, somehow.

There’s a burden of guilt here – guilt piled on by well-meaning people and guilt arising from the fact that women are taught it’s particularly their job to support other women.

The other end of the scale is my own experience. I’m a woman early career academic, and I am acutely aware of the demands on my senior colleagues’ time. I know that when I email that fantastic professor who’s asked me to show her my book proposal, I am taking her away from other things. I know that when I ask my colleague, again, if she could read this chapter draft, I am giving her one more email to deal with in a heap of requests. Of course, these requests are part of normal academic life, and everyone – men and women – expects to make them and expects to receive them. So, why do I feel guilty? It’s because women asking for help, even professional support that is entirely appropriate, are interpreted as ‘needy’. That has been the conditioning I have received all my life – like other women – and so, like other women, it presses in on me when I’m trying to do my job.There’s a burden of guilt I have, because I know I’m asking colleagues who typically do not have as much free time as their male peers, who’ve had a harder time getting where they are than their male peers. And I try very hard to do without that support and that help, because I have internalised the idea that this is what I should do.

The more women’s networks of support are written off as ‘generosity,’ the more they are represented as optional extras, nice things to make women’s lives easier, rather than necessities.

So when I see these outpourings of celebration on International Women’s Day, I’m torn. Yes, we need to celebrate and thank other women who support us, and we need to shine spotlights on each other’s work and give each other recognition. But we also need to stop characterising this work as an informal outflowing of generosity. We need to stop celebrating friends for ‘going above and beyond’ or ‘doing so much more than I could have deserved’. We need to start saying, ‘I know women who work hard for me. I recognise these women who put time and effort into building a better world for women. I see that the work is time-consuming and effortful and often invisible.

Supporting other women is great, but it’s also taking its toll on us. Professionally – in my line of work, and I’m sure in others – it is quite literally taking us out of the business. It is taking away the time and the energy and the effort that we should be entitled to put into our lives and our work, and using these as sticking-plasters on wounds we didn’t cause. We should be angry about that.

I want to put time and effort into building a better world for women. I’m not doing it out of generosity or a nurturing instinct: I’m doing it because I am still furious that Karen Ingala Smith needs to run the Counting Dead Women project. I’m furious that I need to find a female colleague who’ll understand the pressures on women, instead of knowing all my colleagues face the same opportunities. I’m furious that there needs to be an International Women’s Day. Yes, I’ll celebrate, but I won’t forget.