Last month my novel The Birth Machine, which centres on a woman’s traumatic experience of hi-tech childbirth, was reissued by Salt Publishing. 

It’s nearly thirty years since the book was first published, and it’s amazing, I find, that arguments are still raging about the issues with which it is concerned. As you might expect, the book was triggered by my own experience: in 1974 I was one of the first women to undergo an induced labour in a British teaching hospital, and to a great extent the experience of Zelda, the woman in the novel, follows my own. At thirty-eight weeks Zelda is told that the following week she will be induced, an idea that neither she nor her doctor husband have ever heard of, and when she questions it, is merely told that this is a revolutionary new technique that will ensure the safety of her baby. Expressing doubt and questioning further, she is then told, as I was, that she’s lost weight, which indicates that her placenta may be deteriorating – though she has to worm this information out of her obstetrician, and doesn’t hear it from him directly, as happened to me. Since this is 1974, there’s no literature to hand for Zelda read up, and anxious and unknowing she’s admitted first thing on a Monday morning into a rigid, impersonal system, passed from pillar to post to be shaved and given an enema and have her waters broken, before being strapped up to the machines. However, the machines fail to bring on labour according to the ‘desired’ and predicted schedule, and the end result for Zelda are fetal distress and a C-section, and consequent difficulties in feeding and bonding. 

When the book was first published many people took it as a straight plea for natural childbirth, but that wasn’t in fact my intention: as someone who had been married to a doctor I could fully appreciate the potential dangers of childbirth and the benefits of medical technology.  No, what concerned me deeply was the lack of logic or scientific thinking in the way the obstetric technology was being employed, with the result that it could make labour not safer but more dangerous. Zelda is told (as I was) that induction will ensure that her baby is born during the hours that the hospital is fully staffed, but the doctors don’t know that, and indeed for a long time her body fails to respond to an increasing dosage of oxytocin, and when the labour finally becomes an emergency it is late in the evening. Meanwhile, during the (fully-staffed) day the increased reliance on mechanical monitoring means that during her labour Zelda is left for long periods alone. As for the medical reason for Zelda’s induction: it may be a medical fact that a deteriorating placenta will cause a woman’s weight to fall in late-term pregnancy, but it does not necessarily follow that if a woman loses weight in late-term pregnancy her placenta is deteriorating, and it is when things have gone too far and she’s well into her very difficult labour that Zelda realizes the real reason she lost weight beforehand… 

But there has been no discussion in which that would have emerged:  Zelda has not been consulted but simply told what was to happen to her. She has been medicalized, pathologized and indeed infantilized, spoken to like a child and called a ‘good girl’ and barred from knowledge that would empower her (and left frightened and lonely, a state by no means conducive to successful labour). But above all she is the victim of her obstetrician’s fudged reasoning, as she will find to her shock when finally she steals a look in her medical notes and discovers, as I did, the real reason for her induction, and the apparent reason in the first place for the introduction of the procedure… 

The Birth Machine can be obtained from The Book Depository.