Some news and thoughts on care during pregnancy

I’ve been rather quiet for a few weeks. I have been a bit preoccupied … I’m actually pregnant with our third baby, and I’ve been contending with morning sickness, tiredness, and grumpy children!

I’m now 19 weeks and through the worst of the sickness (though it still comes in panic-inducing waves) and being pregnant again has made me reflect a bit more on my other delivery experiences.

My first son was born at 30 weeks gestation, and spent the first five weeks of his life in hospital, fed by tubes and kept alive (for a week or so at least) by machines. He did really well, but nothing can quite prepare you for that experience of having your helpless newborn isolated from you in a plastic box, wearing an arterial line, and having to leave them there every night.

I try to suppress the memories, but if I’m honest with myself, I’m terrified it’s going to happen again.

My second son was born naturally at almost full term. I had no pre-eclamsia, or other complications. But that’s no guarantee that it won’t happen again.

This time around the medical professionals seem quite unconcerned. I’m basically being left to cook. I’ll be scanned regularly from next week to make sure the baby is growing well, and like all pregnant women I’ll have my blood pressure and urine checked routinely, but today I’m feeling very uncared for. I think what has struck me most lately is the massive difference that a single medical professional can make to their patients.

I suppose what I want to do here is appeal to medical staff caring for pregnant mothers who’ve had traumatic deliveries in the past. It doesn’t matter if right now she is ok. That mother will be haunted by the terror of having her own life and the life of her fragile baby hanging in the balance. She remembers the bleeping machines, the tubes of blood, the wires, the alarms, and the fear. She remembers the smell of the hand gel on the ward, and just a whiff of it now makes her feel sick. She remembers the feeling of empty arms, and the ache of coming home to an empty cot, once full of expectation, now overflowing with anxiety.

Be gentle with her. If she is worried, acknowledge her fears instead of just dismissing them.

“I understand why you’re worried,” would be enough. With a little gentle reassurance: “But we’re going to take good care of you.”

Listen to her fears, even if you think they are unfounded. Chances are she’s been researching online whatever landed her baby in the NICU, and has come across the many exceptions to the rule that exist. Besides, even if her risk factor of it happening again is only 1%, to a mother that is 1% too high.

Don’t tell her that the slight rise in her blood pressure over the last few appointments is due to her anxiety. This is not going to help her relax in the slightest.

Don’t tell her that you have no idea why she feels breathless and nauseous because her iron levels are fine. At least suggest further investigation.

When she says that actually, she’s not felt very well through the whole pregnancy and sometimes feels as she did when she had complications, listen and acknowledge, and show some concern.

Do make eye contact and be patient. I know you are under time pressure, and probably have a list of patients the length of your arm. I know you may not have had a cup of tea for a few hours, and perhaps you had to skip lunch today. I know the pressures that rest on medical staff these days.

But this woman might have been waiting desperately for this five minutes of your time to be reassured and listened to. She might have fears that she cannot express to anyone else because they do not have the expertise to help her. Just giving her time to express those fears can help her massively.

You could be the difference between a mother feeling confident and safe, and sobbing in the car park because she feels all alone and that no one is listening to her.

Guilt-free parenting (3) The Principle!

What I wish to offer in this blog is a single principle which will simplify our parenting choices.

I have explored our history and concluded that much of our modern guilt in parenting springs from our culture not having fixed ‘rules’ about how women and children fit into this new ‘information age’. We have so many different voices telling us how to parent our children that we are confused, and can be left feeling guilty for almost any decision we make.

The problem we seem to be wrestling with most of all is what to do with the very small and most needy in our society – babies and toddlers.

Unlike previous generations, the mother who stays home is alone for most of the day – she has no servants, extended family are often remote (or working), and few neighbours who are also at home. Toddler groups are her uncertain refuge, where she can sometimes meet with judgement and unfriendliness, and which actually offer no escape from the demands of parenting. In no other society has a ‘housewife’s’ role been so limited, and a mother’s role so rigorous and isolated (if you see my previous blog you will realise that previous generations of mothers have been supported by extended family, servants, and neighbours).

It is no wonder that mothers are looking for more. Long ago, a housewife was a vital cog in the machinery of society. Now, full-time mothers are labelled as economically redundant, and their role is little valued by society. Also, mothers are left ‘holding the baby’ all alone for nine hours a day, a situation which is guaranteed to leave them exhausted and desperate for a break.

What is the answer? How can we, as a society, answer the needs of mothers and children? We need to work out new ‘rules’ for society that protect the mother’s need for validation and significance, without trampling over the needs of small children.

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I want to suggest a principle that we can use to make these bigger decisions, but also the smaller decisions we face as parents. Should I breastfeed or bottle feed? Should I leave my child to cry to sleep or let them into my bed? Should I return to work full or part time, or stay at home?

I want to explore this principle further tomorrow, but for now I just want to outline it. I think, if we ask one simple question, we can clarify the issues that we are wrestling with and make decisions as parents with confidence. We can withstand the aggression of people who think we have made a wrong choice.

This is the question: What is the most loving thing to do?

That’s it.

The reason I believe this question will resolve the guilt we feel as parents is that it is a secure base from which to choose and move forward. If I am confident that I have chosen what is most loving for my husband and children, and if my husband is looking out for my needs and the children then together we will be sure that the whole family’s needs are being served.

If we face criticism or judgement, we can feel secure that this is unjust; we have done what was most loving, not what was most expedient, or what was ‘best for me’. Love is never a bad motive.

I am convinced that a great deal of the guilt we feel is because, somewhere deep down, I think I have put myself first, not my children. That is what has lain behind all my guilt as a parent – I felt I should have done more or could have done more, or should have done something differently. I should have put up with the baby’s need for cuddles at 2 a.m., 3 a.m. and 4 a.m. Looking back, I realise that the most loving thing for all of us was the choice we made in the end – to leave our son to cry until he fell asleep. None of us were getting a good night’s sleep, our son included. Unfortunately, we made the decision really based on expediency and sheer desperation, and only afterwards realised that it happened to be the right choice. If we had thought it through and concluded together that the most loving thing for all of us was to have a good night’s sleep I would still have found it hard to leave my boy to cry, but I would have had peace that it was the best thing.

I had not learned to ask the right question, but since I understood its simplicity it has saved me from a great deal of anxiety.

Asking ‘what is the most loving thing’ cuts through the crap. I can’t hide behind ‘what’s best for me is best for baby’ any more. I am forced to look at the situation through objective eyes and think through the consequences for me, for my husband, and for the children. I have a standard by which to measure my choices – am I being loving here, or selfish?

(And before you panic and think I am going to tell you to be a doormat, sometimes the most loving thing is to dump the kids on your husband and go out for a coffee before you completely lose your sanity. Sometimes the most loving thing is to insist on a strict bedtime, so that you and your husband can have a glass of wine in peace, and so that you can read a book, or write a blog, or whatever. It is not loving to always give a child their way.)

Tomorrow I want to look into this principle in a bit more depth and explore it. I hope you’ll find it frees you from much of the self-doubt and guilt that plagues us today.

Guilt-free Parenting (2)

This is my second entry in a series I have bravely titled ‘guilt-free parenting’. I’m writing in response to the enormous amount of guilt I hear expressed every day by other parents, and which I have experienced myself.

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History is a wonderful subject. It reminds us that things have not always been done the way we do them. The basic assumptions of our society have not always been accepted; in fact, our culture even a generation ago had very different beliefs about family life and society.

One of the reasons I believe we are struggling so much as parents today is because we are on the beginnings of a wave of change in our society. We are trying to work out how to live in this new ‘age of information’. We don’t know yet know how the family unit fits into it. We haven’t worked out how best to fit small children into this new structure. And so we are full of guilt because our society has not yet established ‘the rules’.

Let me explain.

02 St Fagans

For centuries we had an ‘agricultural’ society. This means that society depended on farming for survival, and our values and choices were shaped by this. So the average family owned or rented a large field, and used it to grow their food. They would produce almost all of their food and clothing themselves; if they had any extra produce they sold it to boost the family’s resources.

The family unit was vital to this society. The man was needed to work the field – the sheer physical strength required to farm all day and manage livestock meant a man was ideally suited to this job. The wife was needed to process the produce and bear children to help with the work, and her ability to multi-task and breastfeed meant she was ideally suited to this job. This all sounds very pragmatic, but I am putting it simplistically. Gravestones and historical documents demonstrate that there was a lot of love involved!

The woman’s role was not considered secondary or menial. It was vital and highly honoured. To become a ‘housewife’ and to bear children improved your status in society. If the wife did not do her job well then the man could not do his job (and vice versa), and the whole family and community suffered. When I studied history I used to be shocked at how quickly many people remarried after their husband or wife died – love clearly wasn’t as important then as it is now, I thought. What I have realised since is that actually, the roles of men and women were interdependent. A household without a wife and mother simply could not function well (and the same could be said of the husband/father).

The role of housewife in this type of society involved a great many valuable skills. She had to manage staff – even poorer households would have at least one servant; most households had several. She had charge over the family budget. She had the keys (and therefore responsibility) for the most valuable commodities of the time – spices, salt, and (after the 15th Century) sugar. She was also in charge of manufacturing, either the spinning and weaving of the cloth itself, or at least sewing clothes for her household; not to mention the daily task of feeding everybody, which involved a far greater degree of home-processing than now (e.g. sugar entered the home as a hard block and had to be processed before it could be added to cooking).

What I am trying to get at is that the role of ‘stay at home mother’ was once a highly responsible and valuable position. It was not demeaning, or restrictive to women (though other attitudes of the time may have been). In fact, it honoured her unique abilities as a woman and gave her value in society. (If you are still doubting me, read Little House on the Prairie, and ask if Ma was in a demeaning or valueless role).

In this society, children ranked very low on the scale of importance, since they had no economic value. They were dependents, but as soon as they were old enough they were gradually introduced to employment – starting around the age of five or six they would be expected to help in the home, the field, or the workshop (if their father was a tradesman). Parents would be responsible for their education. The mother would pass to her daughter skills such as how to mix medicines for common ailments, recipes, and how to manage a budget. The father would teach his son how to work the land, or pass on his trade. The family spent a great deal of time together, and there was a lot of overlap – medieval pictures, for example, show women working at the harvest. Babies were transportable – they could be carried on the back, or laid in a basket under a tree, or (apparently) tightly swaddled and hung on a peg out of the reach of rats (!), while the mother got on with her work.

Mothers were never isolated; in fact time alone was rare in this kind of society. You had at least one servant you could call on to hold the baby if you needed to get on with your work; in all likelihood your mother or mother-in-law either lived with you or very close by, as well as your extended family. And if you couldn’t afford a servant you had an entire neighbourhood community of other women and older children who would gladly help you on a difficult day.

The only people who paid for child-care were the nobility, who employed wet-nurses to breastfeed their babies so that the mother’s fertility would not be compromised, and she could bear the next heir sooner.

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Fast forward a few centuries to the industrial revolution. We call it a revolution. In reality, between the 17th and 18th centuries agriculture gradually took a back seat, and industry became the main place of employment, and the basis of our economy. The majority of the workforce moved from the land to the factory. This led to a change in the family dynamic.

The family stopped spending so much time together. The father left the home and his family and went out to work. Women worked in the factories too, but could not continue in this form of employment once they had a baby, so they were forced to stay home and become dependents themselves. Their task-load at home was reduced – managing a household became less valuable as clothes and food were increasingly processed and produced outside the home. Bearing children prevented the woman from working, and created more mouths to feed, while her workload had become more menial, and less valuable to society.

When the state took charge of education, children over six began to spend longer hours away from home and family as well. The family unit was being forced apart.

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It was no wonder that women began to feel their secondary status in this society. Unfortunately, the early feminists made a mistake. Instead of seeking to restore honour and value to a woman’s role, they reasoned that women could regain value by becoming like men. They should be allowed to work outside the home, like men, and be ‘set free’ from the demeaning and menial task of being a baby-maker and a housewife.

This is rapidly turning into an article on women’s lib instead of parenting, but this background is important. We need to recognise that it was not really society’s values that turned a woman’s role into something secondary, but rather the way society was structured after the industrial revolution. Instead of women and men both being vital cogs in the machine of society, mothers were forced into becoming dependents, while their men went out and got on with the business of making money and providing for their families.

Society’s values came to reflect this over time – by the Victorian era women were meant to be dependent. They were considered weak and incapable of responsibility.

By the 1950s an ideal had arisen of a cardboard woman who loved nothing better than to keep house and raise babies, existing effectively as a servant to her husband’s wishes.

(Except, I do not think this stereotype reflects reality, apart from in a few middle class suburbs. Both my grandmothers worked once their children were of school age and neither had a particularly servile attitude towards their husbands!)

We can see that shifts in societal structure brought about a shift in cultural values. In an agricultural age the emphasis has to be on collaboration, on the collective. We needed each other to survive and for society to function, and men and women’s respective roles were equally valuable. The industrial revolution meant that we were no longer interdependent; instead the man was responsible for supporting his family, the wife joined the children as a financial dependent, leading to a society which devalued the woman’s role.

Towards the end of the last century there was another shift. We now live in an ‘information age’. It is possible for a person to live entirely independently of others. The roles of men and women are not so clearly defined. Apart from a few jobs which require our gender-based strengths (like building and labouring, or breastfeeding) most roles can be fulfilled equally by men and women. Brute strength is not required to grow the family’s food, household management is no longer so time-consuming. We have replaced servants with machines (think washing machine, dishwasher; there are even robots which will vacuum and mop your floors – yes really! Put it on your Christmas list!) The traditional role for a woman, as housewife, is not as valuable or fulfilling as it was five hundred years ago.

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I hope you have found this roundup of our past interesting and thought-provoking. What I have been trying to work towards is that the current trend of guilty parenting exists partly because we still have not worked out how small children fit into this new society, where male and female roles are less obvious, where work takes place outside the home, and where the family is spending more and more time apart. We still have not worked out ‘the rules’.

Instead, we are developing values in a reactionary way. We have recognised that a woman’s role at home is limited and less productive (in an economic sense) than it has been in the past. But instead of thinking about it carefully we have reacted by simply saying, “Well then, mothers must be allowed to work like men”.

We need to consider the needs of everyone involved. What does a baby or pre-school child need? What does a mother need? What does society as a whole need? What can we do to make sure that everyone’s needs are met, and the family unit is served and not lost as our society changes?

I’m sorry if you read this hoping for an answer to your guilt as a parent. I will try to answer that in the next part of this series; but at least now you understand why you feel guilty … it is because you are struggling to meet the needs and desires of your child, yourself and your family in a ‘brave new world’. We may not have crossed oceans but we are living in a new kind of society. As far as I know, no society has lived like this before, with both parents working away from home, and children educated outside the home, and so we don’t really know how best to fit child-care into this new world. We receive conflicting advice from traditionalists, who want to maintain the old family model inherited from an agricultural era; from feminists who argue that the woman’s rights are preeminent; from politicians who want to boost the economy; from blogs and forums, our parents; and ultimately from our own instincts and desires.

I am working towards suggesting a single principle which will help you make these difficult decisions as a parent, without guilt. Stay posted!