I had just found out that I was pregnant and was visiting the midwife. I was worried because, despite having been ‘trying’ for a whole night (hubby was away after that) I hadn’t really expected it to work and wasn’t sure what my sugar levels had been.
I wanted someone to tell me they’d been OK; that the baby was alive; that it stood a fair chance of avoiding serious diabetic-linked developmental complications. I wanted to know why I hadn’t been put forward for the early scan recommended in the NICE Guidelines.
The midwife couldn’t help with these things. Fair enough: she is not a doctor. But do you know what she said? She said ‘And are you going to breastfeed your baby?’
‘Could we perhaps make sure there’s going to be a baby first?’ I’ve had an early miscarriage in the past.
‘Well, since you had your first baby we’ve changed the way we talk to you about breast-feeding. We ‘trickle’ the information every time we see you, a little bit at a time. We find that people take it in better that way. So today -‘ and here she squinted at the book of notes she’d just handed to me ‘-today we make sure you’ve realised that breast-feeding will help you to loose weight after you’ve had the baby and is a very useful way to help you bond and feel close to one another.’ She bent over the page and ticked a little box to show that she’d done it.
‘Now then: if you’ll just blow into the end of this tube for me…’
‘Er – what is it for?’
‘It’s to see how much Carbon Monoxide there is in your breath.’
‘I hope you don’t mind me saying but that feels horrible. It feels as if you didn’t believe me when you asked me whether or not I smoked.’
‘Well, it’s also a way of making sure that you aren’t being exposed to high levels of Carbon Monoxide without being aware of it. If your gas appliances were faulty, for instance.’
‘Oh right. So have midwives often found unexpectedly high levels of Carbon Monoxide on someone’s breath who didn’t smoke? Because their gas appliances weren’t working?’
The Midwife didn’t answer that. She smiled a professional smile and held out the little tube. Once it was established that I hadn’t had a fag, she bent over the notes and signed another little box.
This was the last little box that got ticked for quite a while because I avoided going to see the community midwife after that (diabetics get to see diabetic midwives too). But she didn’t need to worry about my breast-feeding education: the trickle-feeding didn’t stop with her. Posters on walls shouted BREAST IS BEST. Televisions in waiting rooms showed smiling babies latching on to smiling mother’s boobs. Ladies I chatted to at tram-stops said ‘I hope you’re going to breast-feed that baby? It’s so much better for them, you know.’
Is there a polite way to say to a stranger, ‘Who do you actually think cares more about my unborn baby, me or you? Who do you think has read up on this most recently? And whose boobs are the ones you are proposing get sucked on for six months plus? Right – so whose decision is this actually and why do you think I need your advice?’
I had always planned to breastfeed. I have enough trouble remembering to carry nappies with me, let alone pre-sterilised bottles. I like breast-feeding, even though it gives me hypos all the time. I like the sleepy little hormonal kick. I like the convenience. I like the closeness. I use the fact that it’s better for the baby as an excuse.
What I didn’t like was the constant implication that had I been a different woman who had said ‘No! Nine months of Diabetic Chaos was enough! I want stable blood sugars from now on!’ then I would have been doing badly by my child. After all, it wouldn’t have been ‘the best possible start in life’ if I’d had a breast-feeding-related-hypo while carrying him and dropped him on his head.
Even without diabetes, there are hundreds of reasons why a woman might not want to breast-feed. Some find it incredibly stressful, uncomfortable or exhausting; some want to go back to work and find it difficult, impractical or time-consuming to pump. Some physically don’t make enough milk; some babies physically don’t latch properly. And one of the bonuses of living in the Western world is that there is a choice: the pros and cons of breastfeeding versus the pros and cons of bottle. Give women the facts, yes: but there’s no need to make them feel as defensive as a woman I sat next to in the park yesterday (she was bottle-feeding, I whipped a tit out) who immediately lurched into a frantic explanation in case I’d clocked her bottle and was secretly feeling superior. It made me feel quite sad.
On the other hand, a woman is less likely to find breastfeeding stressful, uncomfortable, exhausting or degrading in the first place if she has help and support; she is more likely to understand her rights about pumping in the workplace and how to do it quickly and effectively if she has people to talk to about it. And if she can borrow a decent pump.
How many pregnant women know that breast-feeding is medically superior? All of them, ten times over. We are nagged from the moment we conceive. How many of us felt fully supported in breast-feeding or pumping for their child in the first week together? Many fewer, given a rough unscientific survey of people that I know. A recipe for churning out lots of inadequate-feeling bottle-feeders if you ask me. A redistribution of resources – less propaganda, more support (or possibly more awareness of how to get it) might work wonders.
Support to stop smoking is definitely available: I was offered help countless times. One Smoking Councillor was so matey, trendy and trying so hard to address my non-existent habit that I nearly took up her offer just to help her feel successful. The rational, medical part of me understands that by asking me to blow into a little tube, staff will find it easier to identify the women to target in this campaign and that this might help some babies somewhere. But the human part of me was alienated; I wanted to be treated with some dignity and not like a thirteen year old kid who may or may not have indulged during the lunch-break.
I am not going to offer ground-breaking Public Health solutions here: tell you how they should be handling things. I’m sure it isn’t easy. All I want to do is to tell you how I feel.
How I feel is that, when it comes to child-bearing, you are ‘trickle-fed’ the idea that your body certainly is not your own. The midwives don’t seem to consider it your own; nor do the public. A consultant actually refused to answer a question I asked when I was trying to decide whether to go for a section or induction. He wanted to make the decision for me: he said that he ‘didn’t have time’ to help me to understand it.
Talking of which I haven’t even left myself time here to describe the faces when I, at six months pregnant, had the audacity to ask for a glass of wine when I was missed out during a dinner party. I bet not one of said ‘faces’ would have been able to back their opinions up with a medical reference, either.
But I got my glass of wine eventually, so I didn’t venture to find out.