Childbirth 4: On Being a Childless Childbirth Attendant

Women often ask me how many children I have.  "None," I say.  "I have cats."  This is the truth; I have four cats, one dog, and no children, and yet my professional life is very much tied up with issues relating to pregnancy, childbirth, child development, women's health during the reproductive years, and the social/caregiving responsibilities of families.  People are often surprised that I have no children:  "None? Really?" they say, and I reassure them of my certainty on the issue.  The conversational awkwardness soon blows over, but I am left with the insecurity of the original question and its underlying accusation:  You have never had children.  You have nothing to offer to women who want children.

I've struggled with insecurity about my childless state for most of my adult life.  First, it must be understood that I am childless by choice.  In early adulthood, I considered having children but later abandoned the idea--with relief--when I realized my motivation for doing so was to appease social expectations rather than any profound desire to be a mother.  I think parenting well is a great accomplishment and the task itself should not be attempted by anyone lacking a real commitment.  I used to give this explanation when, in my mid-twenties, everyone assumed I would eventually want children:  "Oh, you'll change your mind," they said.

Well, I didn't.  Now that I am forty, I have outgrown the time frame for changing my mind and, I suppose, I should be suffering regrets.  At least, that is what is implied in the "None? Really?" people say when I tell them I have no children.  Yet I have no regrets, only a nagging sense that I must somehow justify my commitment to serving pregnant women and their children in some way that my colleagues--all parents themselves--do not.

In one role or another, I have been attending births for ten years and I've learned that a woman with no children can offer a lot to a woman expecting a child.

1. Flexibility:  there is a certain fluidity in my schedule and time commitments which enables me to be present earlier, longer, and outside the constraints of the printed call schedule.
2. Experience:  in the ten years of attending births, I have been present at thousands of labors, witnessed both medicated and unmedicated births, seen and performed both uncomplicated and highly technical births, and observed a host of different childbirth philosophies at work.
3. Lack of Agenda:  among doctors at least, once you become a parent, you tend to get imprinted with the parenting/pregnancy style you adopt yourself.  Patients who come to you with an alternative perspective can be put off by your own choices, no matter how open-minded you are.  My colleagues have discussed this issue many times.  I seem to stand outside the circles marked "Pregnancy Type X" and "Pregnancy Type Y" simply for never having been pregnant.
4. An Empathic Outsider's Perspective: this is related to #3 but deserves its own discussion.  As you can probably tell from the content of this blog, I'm interested in all perspectives on birth and have a deep curiosity about the psychological arc of pregnancy, labor, and delivery.  Not that parents can't have a similar perspective, but I have noticed a greater engagement at this level on my part than on my colleagues, perhaps because I have more time to write and wonder about birth.

Once I shared my insecurity about being, as I called it, a "childless spinster" in a world of pregnant and parenting women, and how this might limit what I could offer as a birth attendant, with Kathleen, who is an experienced home birth midwife and childbirth educator.  She merely laughed at me.  "You don't just come to a birth as a parent or a person without children," she told me.  "You come as yourself, and that person has a lot to offer."

I think I'm finally coming around to Kathleen's way of thinking.  After all, if the content of a doctor's personal life were a main criteria for having faith in her ability to be of service, it might be disconcerting to find, say, a Harley-Davidson parked in your cardiologist's garage, or an empty bottle of Drano and a plumbing snake in your gastroenterologist's garbage can.  Far better, I suspect, to look at what she brings to your birth, whether or not her shirt is stained with baby spit-up or cat hair.

Comments

[AnnR]

I think the lack of personal agenda is probably a very good recommendation.

Having just read of another blogger who parked her babysitterless children with the nurses will delivering a middle of the night baby I'd guess that your lack of baggage when arriving unexpectedly probably makes you popular with the staff.

[CountryMidwife]

I worked in SE Asia for a few years. There, I was introduced as "the midwife who has no children". Here in Amish-land, I'm called an "alte maidel" - old maid - aka "leftover blessing" (!) I totally understand the complexity of feelings involved. I often take the humble route and say "yes, I may be a better midwife if I was a mother, but I have all my time and energy to give to you" and everyone agrees. I too have been attending women in birth for a long time - 15 years. I know I don't know what it feels like: I know that it's harder than I can understand it to be. Sometimes I say "a brain surgeon doesn't have to have had brain cancer to take great care of you!". One midwife I know calls herself "childless by choice" every time she's asked, and presents it as a strength rather than a weakness. One female OB I know has planned c/sections with her children, for no indication. Mothers and midwives and doctors all have a wide variety of life experiences. Find one that fits well with you and don't sweat the small stuff. I loved Molly's comments above!

[CJ]

My intent wasn't at all to suggest that a birth attendant who had given birth would automatically be a better birth attendant, only to comment on a trend I've observed during my own children's births. I will defer to those of you who work in the field, since you see a whole lot more birth attendants in action than I do. And maybe I'm overgeneralizing from my own experience here (which, Yehudit, I'll agree is a hazard), but I simply had no referent for the physical intensity of childbirth before I went through it. It was an initiation, despite all my attempts to prepare for it.

I do think that personal experiences can strengthen clinical skills. Before my first son went through the NICU, I did my best to provide compassionate services to families, but I didn't really get what it was like to have a seriously sick family member. (Of course every family will experience something different, but I think some things can be generalized safely. I typed up a bunch of examples, but that's not what we're talking about here so I went back and deleted them.)

None of this is meant as criticism of childless birth attendants, and I hope my earlier comment didn't sound like that. It's only meant as an explanation of why I might ask (politely) if a birth attendant has had children herself.

[ShyAsrai]

shee. anyone ever questioned a man's suitability to be a birth attendant as he's never actually given birth? like - um - the BAZILLIONS of male physicians over the centuries?

why is this even an issue? it's just plain ridiculous.

[Yehudit]

One advantage to a birth attendant who has given birth herself is that she's more likely to "get" the intensity of the birth process

+++++++++

I just don't think this is true. One disadvantage of a birth attendant who has given birth herself is that she may make a lot of assumptions that other people are like her.

In my experience, plenty of midwives (UK RMs) have given birth themselves, and yet do lots of 'busy work' around the women right through contractions. Plenty of midwives are childless and yet know how to 'hold the space'. This has to do with childbirth philosophy, the culture of the unit you work in, what you have been taught, what you have worked out for yourself - rather than your own fecundity.

In order to 'get' what another individual woman was going through in childbirth one would have to have experienced every sort of labour and birth: a premature labour and a term one, a spontaneous labour and an induced one, a long labour and a precipitate one - as well as having had all the variations in feelings about birth that are as diverse as the women served.

[CJ]

One advantage to a birth attendant who has given birth herself is that she's more likely to "get" the intensity of the birth process -- less likely to keep on talking when a big contraction hits (I'm not going to absorb what she's saying anyway), less likely to say "don't push" (which I think is akin to saying "don't vomit" -- some things are unstoppable).

Now I am wondering if this will make you roll your eyes and say, "I figured that out a long time ago," but I'll go ahead and post it, just FWIW. It doesn't seem that it would be very difficult for someone without personal childbirth experience to pick those things up, but as a patient you never know where someone is on that learning curve.

[Karin]

I was directed to your blog by googlereader. I'm a bit of a birth junkie-at least while pregnant-and I frequent blogs like rixarixa, sage femme and navelgazing midwife. I find your attitude refreshing and candid. I live in a small town and wish I could find someone with your thoughts toward birth with hospital privileges (and sufficient malpractice insurance). :-) I've been reading you for a couple of weeks now and I've been pleasantly surprised.

I must say that I've had my fair share of poor doctoring (I have a daughter that survived a stage 5 brain bleed), but I've also seen some excellent patient care, I would feel perfectly comfortable meeting you in your small hospital.

Thank you for your candor. If I ever have a hospital birth again, I would love to know where you are. :-)

[Molly]

It's interesting to hear a care provider worrying (and deciding not to worry) about this issue. I gave birth with the help of a child-free midwife; I cared so little that I didn’t even KNOW. My partner (considerably less self-centered than pregnant me) remembered what she’d mentioned about her life in bits and pieces throughout my pregnancy, so he knew she had never given birth. But I had care through a birth center with five midwives and liked and trusted them as a group, and it just did not matter to me that so-and-so was childless or so-and-so gay or so-and-so the mother of four; my prenatal care and birth were about ME. I liked that the midwives were all human and kind, but I cared about their expertise, not about their personal experiences.

I sort of wonder whether someone who imagines you need to have ‘given birth to get birth’ is working from an idea that births somehow feel the same to everyone or at least are more comparable to each other than they really are? It seems to me that giving birth offers very limited insight into another individual's pregnancy, birth, physical experiences, values, etc. Attending loads of births, reading, and thinking with empathy ... now THOSE seem promising.

[Peggikaye]

I've never understood that mentality. How long did men do this job? They never gave birth ...so suddenly a female doc must have children to do the job right?