EnglishSheila Kitzinger talks about the need for women to have much greater control over their bodies during pregnancy and childbirth.
What is an episiotomy?An episiotomy (artificial rupture of membranes) is a cut made by a doctor or midwife in the skin that separates a woman’s vagina and anus in order to provide a slightly wider opening through which a baby can be born. Despite being very uncomfortable and mostly unnecessary, episiotomies were carried out almost as a matter of routine in the ‘70s: 54% of hospital deliveries used the procedure in 1978. Sheila Kitzinger carried out research for the National Childbirth Trust into the effects of episiotomy on women and published her findings, as well as women’s responses to her work, in her book The Experience of Childbirth (1962).
Induced labourIn the 1970s it was also common for pregnant women in the UK to have their labour induced by breaking the sac surrounding the baby (an amniotomy), letting the amniotic fluid escape (which happens naturally when a woman’s waters break during childbirth). This in turn stimulates contractions. Although it was sometimes required for medical reasons, midwives working in the 1960s and ‘70s felt that it should not be commonly relied upon. There are several potential complications and an amniotomy often makes labour more difficult. According to 2008 guidelines published by the National Institute for Health and Clinical Excellence, amniotomy should not be used as a primary method by which to induce labour unless there are specific clinical circumstances. This change was the result of feminist initiatives that changed medical and social attitudes towards women and childbirth between the 1970s and 2008.
What changes did feminists in the 1970s want to effect?Sheila Kitzinger felt that women were always told what to do when it came to pregnancy, labour and birth; their own wishes were seldom taken into account. Increasing levels of medication and intervention in maternity care and birth was coupled with a lack of understanding by women of their own bodies. This often led to unhappy, traumatic birth experiences and inadequate pre- and post-natal care. Sheila Kitzinger recognises that many women were not used to asking questions about their bodies and their babies, and that this contributed to the lack of knowledge about birth. Several other interviewees in Sisterhood and After talk movingly about their personal battles to control how they gave birth, including Ann Oakley and Jenni Murray.
In 1976 two midwives set up the Association of Radical Midwives, and Jo Robinson quickly became a member. One of their key aims was to encourage midwives in their support of a woman’s active participation in birth.
What is the situation like today?Since the 1970s attitudes towards pregnancy and birth have been changing. The last 40 years have seen a rise in home births and water births. Many hospital birthing suites are now also equipped with a birthing pool. The importance of early physical connection with a baby, for both the mother and the father, has also been recognised. Instead of a newborn baby being taken away and ‘cleaned up’ before being handed to the mother, whenever possible the baby is given skin-to-skin contact with the mother straight away. Fathers are also encouraged to hold their newborn babies against their naked skin so that the baby starts to recognise them. One of the first aims of feminists in the WLM was to encourage and enable men to be more involved with the process of birth and fatherhood altogether.
The work of feminists such as Sheila Kitzinger, and many other feminist doctors, midwives and nurses, as well as mothers, on pregnancy and childbirth were integral to affecting these changes in childbirth. Their work combined with the campaigns to shift attitudes towards mothering that you can find out more about in Family and Children. The result was a fundamental change in the way in which the physical and emotional aspects of parenting are generally viewed and experienced.
The experiences of mothers, fathers and newborn infants will always be subject to changing conditions, and the rights of each involved will always have to be safeguarded by future generations.
If you have ever given birth did you feel you were given adequate information and choice in the birth you wanted?
Do you know how your mother or grandmother experienced childbirth? Can you find out?
What role could and should men play in childbirth?
Sheila Kitzinger, Giving Birth: The parents’ emotions in childbirth (London: Sphere, 1973) © Little, Brown Book Group
Birth was getting more and more mechanised. Doctors were trying to find ways of doing ‘just in case’ obstetrics, which they got rather good at and many of the times these problems would never have cropped up, but they did something so it couldn’t possibly anyway. But of course then another problem probably cropped up that they’d caused by doing the things like rupturing the membranes or getting the woman to push before she was really ready. So all unnecessary intervention can lead to other interventions and it’s cumulative. And that was happening a lot then.
How were midwives trained at this period?
Training didn’t begin until, ooh, my mother left midwifery just as the registration of midwifery came in and she couldn’t have registered as a midwife, although she had vast experience, because she hadn’t been to college to study midwifery. So the training was very much to do with how midwives must toe the line, really, I think. They were hardly encouraged to be independently thinking and more and more it turned into doing what the doctor told you and obeying the obstetrician.
So the hospitals at this time, in the sixties, what sort of service were they providing?
Well, they provided a bed and it was often assumed that the woman would be on the bed, which when women had been in their own homes, it wasn’t assumed. Women would go up and down stairs or out in the garden or into the kitchen and do things and often keep quite busy because they needed to sort out the house before they had the baby. And this is why it made a great impression on me, this whole business of episiotomy, that this was often assumed. And so I decided to try and find out what episiotomy rates were in different hospitals and asked a whole lot of ‘em. The management didn’t know. They weren’t recording it. And so then I went to a lot of obstetricians. They hadn’t a clue either. So nobody knew why or how or when women were having episiotomies. So that was a very important early study of mine and I, as it were, gave it to the National Childbirth Trust and they publicised it, to ask women what their experiences were and looking back on it how it felt and how it affected the whole experience of birth and what happened afterwards of course, the women who were, huh, mutilated.
What did you find out, what effects did it have on the woman, both physical and emotional?
Oh, there were often short term effects, but often also long term effects. Some women felt they could never have sex again. Women often had heavy bleeds, they were stitched up all wrong. They really felt less and less adequate with birth because after all, if you can’t get a baby out, you must be at fault somewhere, what’s wrong with you? And this all tied in with different editions of my book, The Experience of Childbirth, because I could add research material as I went on and did other research too.
It was serialised in The Observer. And I got hundreds and hundreds of letters from women from that.
Can you give me the gist of some of those letters?
For some it was simple relief that we could talk about these things and for others a sense of yes, there’s a movement starting here and I’m going to be in on it. And I think it encouraged many women to ask questions where they hadn’t dared question before. But you know, this is an ongoing thing. It’s not as if women are terribly brave about asking questions now or they may be told, you know, you don’t want to harm your baby, do you? And they feel put down by this and less and less able to cope. That’s why it’s to do with women’s liberation, with feminism. It isn’t just about being nice to mums or mums even bonding with their babies, although I think that’s very important, it’s a worldwide movement and a worldwide challenge as women everywhere, in developing societies too, learn how to take control of their bodies, not in the sense of gymnastic exercises and ordering their bodies to behave in certain ways, but trusting them, living through them, expressing themselves. And that affects sex of course and our feelings about our sexuality, whatever it is, as well as childbirth.
- Sheila Kitzinger discusses childbirth and midwives
- 28 May 2012
- Sound recording
- Sisterhood and After: The Women's Liberation Oral History Project
- © British Library
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- Article by:
- Sisterhood and After Research Team
- Bodies, minds and spirits
From reproductive rights to body image and women’s therapy groups, the Women’s Liberation Movement challenged perceptions, laws and popular culture regarding women’s bodies and minds. Discover the many ways in which feminists attempted to reclaim, explore and control their bodies.
- Article by:
- Sisterhood and After Research Team
- Bodies, minds and spirits
In the 1960s and 70s the medical profession was still dominated by men and consequently women had little or no say in the medical treatment of their own bodies. Explore the WLM’s relationship to subjects like fertility, contraception, abortion, sexual desire and relationships.