Last night a South African athlete, Caster Semenya, won the women's 800m at the World Athletics Championships. She won by a whopping 2.4 seconds, and is only 18 years old.
Both of those factors alone would be worthy of comment for sports fans - she was almost unheard of, yet clearly the best runner in that distance competing in the women's events by some distance. Now, however, there is even more chatter surrounding Semenya amid widespread reports that she is to undergo a complex 'gender identity test', to prove that she is in fact a woman and eligible to run in women's events.
Semenya is certainly strong and muscular, with a build that is different to many of her rivals' lean physiques. At first sight it is easy to see why she is considered to be unfeminine; she does not sport long hair and has not been 'blessed' with a narrow waist or noticeable bust. Comment has centred on whether she is 'male' or 'female', as if she could only ever be one or t'other. Her coach and South African officials have insisted that they are 'completely sure that she is female', suggesting that doubters should enlist Semenya's roommates for corroborating evidence. 'They have already seen her naked in the showers', said one official, 'and she has nothing to hide.' Meanwhile, media outlets have taken great delight in asking the question, 'Is she a MAN?' (or, its variant, 'Is SHE a HE?'). The only indication that it may be more complex than that comes from those who admit that determining gender can be a fraught business; it has been reported that Caster Semenya will have to undergo a series of tests involving a gynaecologist, internal medicine, a geneticist, an endocrinologist and a psychologist. If we are all absolutely male or female, how come it will take all of that to decide which Semenya should be classified as?
The fact is that there is a group of people who are neither male nor female, but who are accorded no recognition by our society at all. These people are intersex. I do not mean to suggest that Semenya herself is necessarily intersex - I am no gender scientist, and I am less interested in her gender identity as such than I am in the absence of the word 'intersex' from what has been a pretty loud and sensationalised debate so far. In fact, this omission nothing new. Intersexuality has long been misunderstood, overlooked and ignored, so much so that I feel obliged to give a definition of it here. The Intersex Society of North America defines intersexuality as 'a general term used for a variety of conditions in which a person is born with a reproductive or sexual anatomy that doesn’t seem to fit the typical definitions of female or male.' In practice this means that intersex persons display physical attributes that are considered 'male' as well as physical attributes that are 'female'. It is estimated that 1 in 100 live births can fall into the category, with 1 in 1000 undergoing 'corrective' surgery to restore 'normal' gender identity. Thus, although intersexuality is rare, it is not that rare. It's not so rare as to be completely ignored by wider society, I'd have thought.
Of course, there are many reasons why Caster Semenya and her team's officials would be reluctant to even suggest such a possibility in her case. She would be disqualified from racing against women, given that women's events have to be contested by people who are determined to be female. This would end both her reign as world champion and her career. But again, I sense more than this is at stake. For many newspaper reporters and their readers, there seems to be a reluctance to even countenance the possibility of anything other than male and female. After, all our society is built on the importance of the heterosexual pair, the organisation of men and women into individual partnerships. We simply don't have a place for intersexual politics, an identity that falls outside of the male/female binary.
As well as leading to injustice and discrimination meted out to intersex people - ranging from social ostracism to invasive surgery - there are other, possibly even larger implications resulting from our reliance on a binary understanding of gender. If we as a society really do think that everyone is male or female, we are closing down the possibility of 'playing' with gender, the possibility of seeing more variety than we currently admit to. This is the sort of rigid thinking that leads to women and men being considered inherently different to each other, and being assigned complementary roles, e.g. women as nurturers and men as providers. I don't mean to argue that all men and all women fall into those roles in an uncomplicated way, but as long as we rely on this way of viewing gender, we will have trouble giving each other the flexibility we might well benefit from. For example, I would like very much for Simon and I to both be considered nurturers and providers; and yet it is only I that is questioned as to my career plans after the baby is born.
I wish Caster Semenya all the best in what is about to happen to her - invasive tests, international scrutiny and perhaps being stigmatised for the rest of her career. I also wish we could perhaps move to a more empathic level of comment and debate when such people come to our attention. We could all benefit from widening our horizons on gender, I reckon.
Thursday, August 20, 2009
Wednesday, August 19, 2009
Preggers photos
Well, thar she blows! I'm getting to be quite proud of my bump, especially as for so long I just looked like a fatty. Note the blinding Alice Springs sunshine, a feature of many photographs taken here. Also note the beard (not pictured).
Monday, August 17, 2009
The lighter side of pregnancy, I: I have a beard
I did promise to return and give light-hearted pregnancy updates as and when they occurred to me - as opposed to agonising updates covering mental health and existentialism - and I have one today.
I'm sure some of you are sick of hearing about my pregnancy symptoms. Heck, I'm sick of hearing about them. But get this.
Last night I had finished brushing my teeth and was examining myself critically under the flourescent tube that looms over the bathroom mirror, when I noticed something. Turning to Simon, who was gravely brushing his own teeth while reading a book (a fascinating habit, which sometimes sees him brush his teeth for more than half an hour), I said,
'Could I get you to look at this?'
'Loo' a' wha'?' he managed.
'This. My jawline. I seem to be growing a pregnancy beard. Don't you think?'
He started laughing then quickly spat his toothpaste, I presume to prevent choking.
'Have I always had this? Tell me the truth!'
He laughed and laughed. And then said, 'No you haven't always had that. But I must say, it's a fine set of whiskers.' And then sauntered out, giggling. (It wasn't that funny.)
So I followed him. Many people assume that having a GP in the house at all times must be a great advantage, and indeed it can be when one wants to, I don't know, take one's own blood pressure with a fancy blood pressure machine. (I do this most days.) It can also be handy when there is an urgent need for a prescription, such as when a dog we were looking after was savaged and needed antibiotics, and Simon just wrote a child-size prescription so we wouldn't have to pay vet fees. For many other situations, however, having a GP in the house is just infuriating.
'Will it go away?' I asked my GP-partner-man-boy, who looks after numerous pregnant women every day with what I assume is a professional attitude. He just laughed.
'Simon, will my beard go away?'. More cackling.
'SIMON, AM I A BEARDED LADY FOR LIFE?' He sobered up.
'Well,' he began. 'It really depends on how your homones settle after the birth. The whiskers might go away, they might not. Some women have grown really impressive beards after being pregnant.'
I was horrified. 'Have any of the mothers that come into your clinic had a beard?'
'Oh, sure. The other day I saw one lady who had dyed hers rainbow colours.'
I saw the glint in his eye. 'You're lying, right?'
He couldn't help it. 'Yeah.'
'So my beard is temporary?'
'Definitely.' We both started laughing at that point.
'And I think it looks good on you anyway. You're a hot bearded pregnant lady.'
(OK, he didn't say the last part, but he would have if he'd thought of it, I'm sure.)
So I am temporarily a bearded lady. The hairs are fine and blonde (another anomaly - I am as brunette as they come) and long and numerous. Just another experience to add to the list of weird bodily experiences, I guess. And now everyone reading this will examine me closely and not necessarily covertly when we next meet - hopefully by then I won't have resorted to combing or braiding or dyeing my whiskers, but you never know. He might have been lying about lying, after all.
I'm sure some of you are sick of hearing about my pregnancy symptoms. Heck, I'm sick of hearing about them. But get this.
Last night I had finished brushing my teeth and was examining myself critically under the flourescent tube that looms over the bathroom mirror, when I noticed something. Turning to Simon, who was gravely brushing his own teeth while reading a book (a fascinating habit, which sometimes sees him brush his teeth for more than half an hour), I said,
'Could I get you to look at this?'
'Loo' a' wha'?' he managed.
'This. My jawline. I seem to be growing a pregnancy beard. Don't you think?'
He started laughing then quickly spat his toothpaste, I presume to prevent choking.
'Have I always had this? Tell me the truth!'
He laughed and laughed. And then said, 'No you haven't always had that. But I must say, it's a fine set of whiskers.' And then sauntered out, giggling. (It wasn't that funny.)
So I followed him. Many people assume that having a GP in the house at all times must be a great advantage, and indeed it can be when one wants to, I don't know, take one's own blood pressure with a fancy blood pressure machine. (I do this most days.) It can also be handy when there is an urgent need for a prescription, such as when a dog we were looking after was savaged and needed antibiotics, and Simon just wrote a child-size prescription so we wouldn't have to pay vet fees. For many other situations, however, having a GP in the house is just infuriating.
'Will it go away?' I asked my GP-partner-man-boy, who looks after numerous pregnant women every day with what I assume is a professional attitude. He just laughed.
'Simon, will my beard go away?'. More cackling.
'SIMON, AM I A BEARDED LADY FOR LIFE?' He sobered up.
'Well,' he began. 'It really depends on how your homones settle after the birth. The whiskers might go away, they might not. Some women have grown really impressive beards after being pregnant.'
I was horrified. 'Have any of the mothers that come into your clinic had a beard?'
'Oh, sure. The other day I saw one lady who had dyed hers rainbow colours.'
I saw the glint in his eye. 'You're lying, right?'
He couldn't help it. 'Yeah.'
'So my beard is temporary?'
'Definitely.' We both started laughing at that point.
'And I think it looks good on you anyway. You're a hot bearded pregnant lady.'
(OK, he didn't say the last part, but he would have if he'd thought of it, I'm sure.)
So I am temporarily a bearded lady. The hairs are fine and blonde (another anomaly - I am as brunette as they come) and long and numerous. Just another experience to add to the list of weird bodily experiences, I guess. And now everyone reading this will examine me closely and not necessarily covertly when we next meet - hopefully by then I won't have resorted to combing or braiding or dyeing my whiskers, but you never know. He might have been lying about lying, after all.
Thursday, August 13, 2009
Some good news for the capitalist within
Finally, at the age of 31, I have bitten the bullet and gone down the capitalist road of home ownership. And in style. Simon and I went to Victoria last week to look for a house, and we found a giant one with lots of land, beautiful kitchen, incomplete studio and wood fire. And horse boxes. And dams. Eh? Dams...? Anyway, this morning our offer was accepted on the property, and we have entered into the process of pre-purchase inspections, final home loan arrangements, contracts and looking for movers.
(This sort of development makes a mockery of antenatal depression. Feeling blue? Borrow heaps of money and buy a giant house! It will make you feel giddy and excited and powerful!)
If you'd like to see photos, here is the address:
http://www.domain.com.au/Public/PropertyDetails.aspx?adid=2007527844
And you are all invited to come and join us for visits whenever you want. We will have a baby to squeeze as well, you know....
(This sort of development makes a mockery of antenatal depression. Feeling blue? Borrow heaps of money and buy a giant house! It will make you feel giddy and excited and powerful!)
If you'd like to see photos, here is the address:
http://www.domain.com.au/Public/PropertyDetails.aspx?adid=2007527844
And you are all invited to come and join us for visits whenever you want. We will have a baby to squeeze as well, you know....
Wednesday, August 12, 2009
Antenatal Depression, part II, or, How can one person be so lucky and yet feel so doomed?
It's taken a while to work up the courage to write this post. I've thought about it often: what I would write, what the narrative arc would be, how I would explain myself. But waiting for inspiration hasn't worked; I still don't know how to do this. I've just decided to take the plunge, see what comes out, and hope that it makes sense.
My previous post laid out in somewhat impersonal terms the fruits of my research into antenatal (or prenatal) depression. It should be fairly obvious that the interest I have in the topic is not impersonal at all, but rather touches on some of the darker moments of my pregnancy. I am now in my seventeenth week, which is just over three months of real time given that two weeks is added to the date of conception when calculating how 'far along' a pregnancy is. It's been a really hard few months, I must say, and not how I expected it to be at all.
I've written before, repeatedly, about the physical challenges associated with early pregnancy. For me, these have been accompanied by a noticeable if uneven descent into emotional volatility that was unexpected and difficult to deal with. After all, this was a planned pregnancy; we were successful at our first attempt at pregnancy; and we are financially secure. What's not to be excited about? My love of lists dictates I must set this out in a list form for clarity, so here goes:
1) Dependence/independence. The physical symptoms of pregnancy have been so debilitating as to make me dependent on Simon for almost everything- at one stage he had to shower me and wash my hair because I couldn't do it myself. He has consistently done the food shopping, the cooking and the dishes since my earliest symptoms and has been pretty good at laundry and house-cleaning as well. While on the one hand I rejoice in having bagged such a good man, on the other I have found myself feeling quite helpless and weak, unable (or unwilling?) to complete the basic household tasks that have been part of my life for over a decade. This has not been good for my confidence or self-esteem. (How do single women who are pregnant do it? I salute them and what surely must be their untidy houses, stacks of empty takeaway containers and frustrations at having run out of milk/shampoo/washing powder, again.)
2) Control. The control that I have lost during this process has been shocking. If this is what it means to put another being first - by which I mean that the baby has been taking my energy first, leaving me with whatever is left over, forcing me to acknowledge that I am not important after all - then I am not sure I want to be a parent! So many of my former pleasures have been foresaken for this pregnancy. I do not enjoy eating, even the junk food that occasionally is the only thing the baby will accept as fuel. I do not enjoy sleeping, as the baby will wake me whenever it needs me to eat more. I do not enjoy choosing an outfit in the morning, as I have packed away my civilian clothes for a time when I am less rotund. I do not enjoy sex, as my libido has almost entirely disappeared. And so on. My life is just not my own any more, and working out what to do for fun is difficult indeed.
3) Finally, and I reckon this may actually be the crux of it, I am absolutely terrified of being a parent. My appalled reaction to the issues of discomfort and dependence has lent itself to a suspicion that actually, I am too selfish to be a parent. My own mother faced similar soul-searching questions when I and then my brother were born, and was not always successful in negotiating the balance between her needs and ours. I grew up with the notion that children are a lot of hard and at times unrewarding work, and that they are a drain on one's professional and social opportunities. Not suprisingly, this resulted in my a) feeling somewhat in the way, and b) feeling that I wouldn't be having any children of my own, thankyou very much. Meeting Simon dissolved my conviction about the latter, and it has only been pregnancy that has reminded me of the former, in vivid terms. I do not want my children to feel like they are a burden or a drain on me; and yet, that is how I have experienced this pregnancy, as something to be endured until it is all over.
As a result of all of these things, self-doubt has taken over my mind and functioned to dilute my excitement about the prospect of having a child, to the point of its being almost non-existent. Sometimes I can hear my inner voice saying, 'I don't want this child'; at this point, weeping is common and apocalyptic predictions are rife. ('What if I am not cut out for this and have to leave the baby with Simon and run away, like that woman does in The Riders?') Which is terrible - what has this child done wrong? Come to that, what has Simon done wrong? (Answer: absolutely nothing.) The baby may be oblivious (though I suspect my depression must impact on it in some way) but Simon is not; he is living it all with me, the lack of enthusiasm, the fear, the pessimism. He is as shocked and possibly more bruised than I am. This is not how it was meant to be.
And of course, the vicious circle that is depression makes escape difficult, much more so than one can understand, I sometimes think, from the outside. I often fall into the trap of presuming that the power of positive thinking must help me. So when I am unable to do this, unable to convince myself through repetition or just blind determination, that I will be happy and it will all be fine, then I blame myself again, for being weak, or disorganised, or ill-disciplined. Which in turn brings on further self-hatred and despair, in the face of a looming deadline (only 23 weeks to go!) when I really do have to pull myself together and take responsibility for another little human.
Having said all this, I do not wish to leave you with a completely bleak outlook. I am actively engaging with the things I can do to help myself and help Simon, according to all the prevailing wisdom. I am swimming at one of the hotel pools and doing antenatal yoga for exercise; I am eating reasonably well; I cooked dinner last night and experienced the gratification of a job well done; and I am having counselling. We are also in negotiations to buy a house in Castlemaine, which may lead us to finally move to a place we can settle down. Simon and I, though frustrated and experiencing some hard times emotionally, seem to be getting through it ok by keeping lines of communication open, and being as honest and as gentle as we can be with each other. And although I avoided my friends for a long time so as to not have to admit to being ungrateful or unappreciative of my good fortune in being pregnant with a wonderful man, I have now started to make contact again.
Indeed, if you are reading this and have recently been aware of a certain lack of communicatory zeal from me... please forgive me. I need you all, even if it doesn't look like it from where you are. I certainly haven't forgotten you. I've just been fighting these inner demons that have crept up on me and made me feel overwhelmed, trapped and unworthy.
May none of you experience such darkness at what is, rationally speaking, an exciting time in life. And may I be able to return at some point in the not-too-distant future and report that I have recovered, been emancipated, and am back to where I expected to be, happy and planning for a bright if complex future of parenthood and responsibility.
My previous post laid out in somewhat impersonal terms the fruits of my research into antenatal (or prenatal) depression. It should be fairly obvious that the interest I have in the topic is not impersonal at all, but rather touches on some of the darker moments of my pregnancy. I am now in my seventeenth week, which is just over three months of real time given that two weeks is added to the date of conception when calculating how 'far along' a pregnancy is. It's been a really hard few months, I must say, and not how I expected it to be at all.
I've written before, repeatedly, about the physical challenges associated with early pregnancy. For me, these have been accompanied by a noticeable if uneven descent into emotional volatility that was unexpected and difficult to deal with. After all, this was a planned pregnancy; we were successful at our first attempt at pregnancy; and we are financially secure. What's not to be excited about? My love of lists dictates I must set this out in a list form for clarity, so here goes:
1) Dependence/independence. The physical symptoms of pregnancy have been so debilitating as to make me dependent on Simon for almost everything- at one stage he had to shower me and wash my hair because I couldn't do it myself. He has consistently done the food shopping, the cooking and the dishes since my earliest symptoms and has been pretty good at laundry and house-cleaning as well. While on the one hand I rejoice in having bagged such a good man, on the other I have found myself feeling quite helpless and weak, unable (or unwilling?) to complete the basic household tasks that have been part of my life for over a decade. This has not been good for my confidence or self-esteem. (How do single women who are pregnant do it? I salute them and what surely must be their untidy houses, stacks of empty takeaway containers and frustrations at having run out of milk/shampoo/washing powder, again.)
2) Control. The control that I have lost during this process has been shocking. If this is what it means to put another being first - by which I mean that the baby has been taking my energy first, leaving me with whatever is left over, forcing me to acknowledge that I am not important after all - then I am not sure I want to be a parent! So many of my former pleasures have been foresaken for this pregnancy. I do not enjoy eating, even the junk food that occasionally is the only thing the baby will accept as fuel. I do not enjoy sleeping, as the baby will wake me whenever it needs me to eat more. I do not enjoy choosing an outfit in the morning, as I have packed away my civilian clothes for a time when I am less rotund. I do not enjoy sex, as my libido has almost entirely disappeared. And so on. My life is just not my own any more, and working out what to do for fun is difficult indeed.
3) Finally, and I reckon this may actually be the crux of it, I am absolutely terrified of being a parent. My appalled reaction to the issues of discomfort and dependence has lent itself to a suspicion that actually, I am too selfish to be a parent. My own mother faced similar soul-searching questions when I and then my brother were born, and was not always successful in negotiating the balance between her needs and ours. I grew up with the notion that children are a lot of hard and at times unrewarding work, and that they are a drain on one's professional and social opportunities. Not suprisingly, this resulted in my a) feeling somewhat in the way, and b) feeling that I wouldn't be having any children of my own, thankyou very much. Meeting Simon dissolved my conviction about the latter, and it has only been pregnancy that has reminded me of the former, in vivid terms. I do not want my children to feel like they are a burden or a drain on me; and yet, that is how I have experienced this pregnancy, as something to be endured until it is all over.
As a result of all of these things, self-doubt has taken over my mind and functioned to dilute my excitement about the prospect of having a child, to the point of its being almost non-existent. Sometimes I can hear my inner voice saying, 'I don't want this child'; at this point, weeping is common and apocalyptic predictions are rife. ('What if I am not cut out for this and have to leave the baby with Simon and run away, like that woman does in The Riders?') Which is terrible - what has this child done wrong? Come to that, what has Simon done wrong? (Answer: absolutely nothing.) The baby may be oblivious (though I suspect my depression must impact on it in some way) but Simon is not; he is living it all with me, the lack of enthusiasm, the fear, the pessimism. He is as shocked and possibly more bruised than I am. This is not how it was meant to be.
And of course, the vicious circle that is depression makes escape difficult, much more so than one can understand, I sometimes think, from the outside. I often fall into the trap of presuming that the power of positive thinking must help me. So when I am unable to do this, unable to convince myself through repetition or just blind determination, that I will be happy and it will all be fine, then I blame myself again, for being weak, or disorganised, or ill-disciplined. Which in turn brings on further self-hatred and despair, in the face of a looming deadline (only 23 weeks to go!) when I really do have to pull myself together and take responsibility for another little human.
Having said all this, I do not wish to leave you with a completely bleak outlook. I am actively engaging with the things I can do to help myself and help Simon, according to all the prevailing wisdom. I am swimming at one of the hotel pools and doing antenatal yoga for exercise; I am eating reasonably well; I cooked dinner last night and experienced the gratification of a job well done; and I am having counselling. We are also in negotiations to buy a house in Castlemaine, which may lead us to finally move to a place we can settle down. Simon and I, though frustrated and experiencing some hard times emotionally, seem to be getting through it ok by keeping lines of communication open, and being as honest and as gentle as we can be with each other. And although I avoided my friends for a long time so as to not have to admit to being ungrateful or unappreciative of my good fortune in being pregnant with a wonderful man, I have now started to make contact again.
Indeed, if you are reading this and have recently been aware of a certain lack of communicatory zeal from me... please forgive me. I need you all, even if it doesn't look like it from where you are. I certainly haven't forgotten you. I've just been fighting these inner demons that have crept up on me and made me feel overwhelmed, trapped and unworthy.
May none of you experience such darkness at what is, rationally speaking, an exciting time in life. And may I be able to return at some point in the not-too-distant future and report that I have recovered, been emancipated, and am back to where I expected to be, happy and planning for a bright if complex future of parenthood and responsibility.
Monday, July 27, 2009
Antenatal Depression, part I
If you've read the posts below, you will know that I haven't found pregnancy to be the easiest thing I've ever experienced. I won't reiterate every single point I've made already, but let's just remind ourselves that it was the physical discomfort that had been the top of my list of 'hard things about pregnancy', things that as a Proselytiser for 'Truth In Pregnancy' I felt you should know.
Now, however, I have a new offering: mental health. It is not well-known that women can suffer from depression and anxiety throughout pregnancy. When you look into it however you find that it is suggested that around 10% of all pregnancies are accompanied by serious depression. Some even suggest that around two-thirds of pregnant women will suffer depressive episodes at some point during their pregnancies. These are quite big numbers, and do not reflect the relative lack of recognition accorded to the syndrome. We all know about postnatal depression, the 'baby blues', that see women lose their stability when faced with the care of a newborn child. But I for one had never heard of antenatal depression, or if I had, would have ascribed it to women who faced unplanned or unwanted pregnancies. Indeed, unplanned or unwanted pregnancy is a major trigger for antenatal depression, but it is by no means the only one. So what could pregnant women who want to be pregnant have to be depressed about? Turns out I was, as so often the case, inexperienced, uninformed and about to embark on a steep learning curve.
So first things first: what is this antenatal depression? Well, duh: it is depression experienced during pregnancy. In some ways it presents in very similar ways to other types of depression, leading to feelings of worthlessness, an inability to lead a normal life, and even to self-harm or harm to an unborn baby. But it can be harder to diagnose than other depressions, for the following reasons.
1) Breaking news! Depression can be hormonally related.
Those of us who have had the pleasure of experiencing emotionally-charged PMT, or Pill-induced mood swings, will know that hormones are prime agents in the regulation of mood, and in some cases mental health. When pregnant and during in the first trimester especially, a woman is treated to not only an increase in hormone levels overall but also to a new mixture of them swirling around. These are, after all, what encourage the baby to grow and develop. It follows that one of the casualties of this process will be her ability to maintain equaninimity in the face of, oh, I don't know, an attempt to show her affection, let's say. Or someone giving the 'wrong' birthday present. Or someone being ill on her birthday. That sort of thing. The sort of thing that might (depending on the individual and of the individual's time of the month) be passed off as 'life' and all its charm normally, but in pregnancy takes on the hue of being Very Distressing Indeed, and which are greeted with a variety of responses, such as hissing, spitting, weeping, 'you-don't-really-care' speeches, or locking herself in the toilet to avoid all eye contact. Under such circumtances, it is difficult to tell whether the root cause is simply hormonal imbalance, or a deeper malaise involving self-doubt, self-loathing, fear and anger.
2) Pregnancy actually involves many of the same physical symptoms as depression.
The checklist for depression includes problems sleeping, problems concentrating, extreme fatigue, changes in appetite, loss of libido, and difficulty achieving everyday tasks. Sound familiar? For many women in their first trimester, this describes their situation pretty well, and is considered 'normal' in the context of an otherwise troublefree pregnancy. 'It will pass', the doctors, the books, the fellow mums-to-be all say. Which leaves very little lee-way for an alternative response, which might be something along the lines of 'Perhaps you need some help...'
3) Pregnancy is supposed to be this glowing, wonderful time of contentment and hope.
I have written about this before, and it is the reason for my self-proclaimed title of Proselytiser for Truth In Pregnancy. The idea that women enjoy being pregnant is endemic, even or especially among women who have had babies themselves. I am not sure if that is 'aftermath glow', by which I mean an anticipation of the happiness of a child in our lives in the future, or whether it is altogether more vague than that, a sort of universal 'wah' that mythologises and idealises the pregnant body. Either way, the expectation is that women will be over the moon about being pregnant, especially if they are not too young, too old, too sick, etc. Even if women are not the ideal candidate for pregnancy, should they decide to continue with a pregnancy it is generally assumed to be a source of happiness and positive expectation. This leads to a situation where the expectant mother's mental health is not given the support it may need, as so few people are on the lookout for potential problems.
So there you have it. Depression does happen in pregnancy, and it is often overlooked for various reasons. It is not often acknowledged by experts either: even the BeyondBlue website has only one information sheet buried in among many others devoted to postnatal depression. There is one website in Australia that specialises in both antenatal and postnatal depression: see http://www.panda.org.au/index.html
And what do I have to do with all of this? Well, folks, if you thought I was laying the groundwork here for some kind confessional post, you were absolutely right. But that will have to come another day. Right now, I have to eat some lamb carry, struggle with basic tidying, and head out for the daily highlight of a swim in one of the hotel pools. I will be back, however, with Part II soon.
Now, however, I have a new offering: mental health. It is not well-known that women can suffer from depression and anxiety throughout pregnancy. When you look into it however you find that it is suggested that around 10% of all pregnancies are accompanied by serious depression. Some even suggest that around two-thirds of pregnant women will suffer depressive episodes at some point during their pregnancies. These are quite big numbers, and do not reflect the relative lack of recognition accorded to the syndrome. We all know about postnatal depression, the 'baby blues', that see women lose their stability when faced with the care of a newborn child. But I for one had never heard of antenatal depression, or if I had, would have ascribed it to women who faced unplanned or unwanted pregnancies. Indeed, unplanned or unwanted pregnancy is a major trigger for antenatal depression, but it is by no means the only one. So what could pregnant women who want to be pregnant have to be depressed about? Turns out I was, as so often the case, inexperienced, uninformed and about to embark on a steep learning curve.
So first things first: what is this antenatal depression? Well, duh: it is depression experienced during pregnancy. In some ways it presents in very similar ways to other types of depression, leading to feelings of worthlessness, an inability to lead a normal life, and even to self-harm or harm to an unborn baby. But it can be harder to diagnose than other depressions, for the following reasons.
1) Breaking news! Depression can be hormonally related.
Those of us who have had the pleasure of experiencing emotionally-charged PMT, or Pill-induced mood swings, will know that hormones are prime agents in the regulation of mood, and in some cases mental health. When pregnant and during in the first trimester especially, a woman is treated to not only an increase in hormone levels overall but also to a new mixture of them swirling around. These are, after all, what encourage the baby to grow and develop. It follows that one of the casualties of this process will be her ability to maintain equaninimity in the face of, oh, I don't know, an attempt to show her affection, let's say. Or someone giving the 'wrong' birthday present. Or someone being ill on her birthday. That sort of thing. The sort of thing that might (depending on the individual and of the individual's time of the month) be passed off as 'life' and all its charm normally, but in pregnancy takes on the hue of being Very Distressing Indeed, and which are greeted with a variety of responses, such as hissing, spitting, weeping, 'you-don't-really-care' speeches, or locking herself in the toilet to avoid all eye contact. Under such circumtances, it is difficult to tell whether the root cause is simply hormonal imbalance, or a deeper malaise involving self-doubt, self-loathing, fear and anger.
2) Pregnancy actually involves many of the same physical symptoms as depression.
The checklist for depression includes problems sleeping, problems concentrating, extreme fatigue, changes in appetite, loss of libido, and difficulty achieving everyday tasks. Sound familiar? For many women in their first trimester, this describes their situation pretty well, and is considered 'normal' in the context of an otherwise troublefree pregnancy. 'It will pass', the doctors, the books, the fellow mums-to-be all say. Which leaves very little lee-way for an alternative response, which might be something along the lines of 'Perhaps you need some help...'
3) Pregnancy is supposed to be this glowing, wonderful time of contentment and hope.
I have written about this before, and it is the reason for my self-proclaimed title of Proselytiser for Truth In Pregnancy. The idea that women enjoy being pregnant is endemic, even or especially among women who have had babies themselves. I am not sure if that is 'aftermath glow', by which I mean an anticipation of the happiness of a child in our lives in the future, or whether it is altogether more vague than that, a sort of universal 'wah' that mythologises and idealises the pregnant body. Either way, the expectation is that women will be over the moon about being pregnant, especially if they are not too young, too old, too sick, etc. Even if women are not the ideal candidate for pregnancy, should they decide to continue with a pregnancy it is generally assumed to be a source of happiness and positive expectation. This leads to a situation where the expectant mother's mental health is not given the support it may need, as so few people are on the lookout for potential problems.
So there you have it. Depression does happen in pregnancy, and it is often overlooked for various reasons. It is not often acknowledged by experts either: even the BeyondBlue website has only one information sheet buried in among many others devoted to postnatal depression. There is one website in Australia that specialises in both antenatal and postnatal depression: see http://www.panda.org.au/index.html
And what do I have to do with all of this? Well, folks, if you thought I was laying the groundwork here for some kind confessional post, you were absolutely right. But that will have to come another day. Right now, I have to eat some lamb carry, struggle with basic tidying, and head out for the daily highlight of a swim in one of the hotel pools. I will be back, however, with Part II soon.
Friday, July 24, 2009
Home births threatened in Australia
Not enough noise is being made over plans that will threaten Australian women's right to give birth at home with the help of a midwife. Proposals contained in the draft Health Practitioner Regulation National Law, due to come into force in July 2010, will effectively eliminate midwives' ability to legally attend home births in a professional capacity. As I understand it the bill requires midwives to be able to access insurance to be able to be registered, insurance that in turn is only available for midwives working in hospitals. This precludes the possibility of registered midwives attending home births, and for good measure the bill proposes a $30 000 fine for midwives who do attend home births in professional (but unregistered) capacity. (More information on the bill is found at http://www.joyousbirth.info/homebirth-is-not-a-crime.html , with further links at the bottom of the page.)
I find this proposal absolutely abhorrent, for three reasons.
1) It isolates and stigmatises the work that midwives do at homebirths by implying that it is dangerous and unreliable medicine, and thus cannot be insured.
Midwives are highly trained professionals with specialist knowledge. Those that attend home births have particular knowledge of how to make women comfortable in their own home and how to encourage women to listen to their bodies. There is plenty of evidence to suggest that such elements of birth - safety, familiarity, autonomy and control - are crucial to positive outcomes from the birth process. There is also plenty of evidence to suggest that hospitals often do not have or exercise such knowledge, preferring to implement protocols and regulations, often against women's wishes. In particular, women giving birth in hospitals frequently complain of being prevented from moving around during labour, of being given interventions they do not want, and of being given set time-limits in which to give birth. This sort of medicine should not be considered any more 'safe' or 'reliable' than giving birth at home, given the emotional and physical trauma that can be involved.
2) It penalises women who wish to exercise their choice to give birth at home.
Women have been fighting for decades to increase their choices and autonomy throughout the reproductive process. In 1973 the Boston Women's Health Book Collective published their ground-breaking and best-selling guide/polemic, Our Bodies Ourselves, which not only taught women about their bodies but also proposed radical alternatives to conventional Western medicine. Central to their analysis was the importance of autonomy: a woman's ability to choose according to her needs, needs which she herself determined. The book drew upon and inspired the work of many women setting up alternative healthcare services for women (and by 'alternative' I don't necessarily mean anti-Western, I mean services for women run by women) and was part of a wave of women demanding that their rights around healthcare be recognised.
Against this backdrop, the move to restrict homebirths to those that are either a) unassisted or b) illegally assisted by midwives, risking a $30 000 fine, is a major step backwards. It is paternalistic and patronising, and assumes that women (and midwives) do not know what is best for women giving birth. It prevents women from trusting their bodies, and will damage some women's ability to have an empowering experience.
3) It sends the message that home birthing is not a natural or safe practice.
This is simply not true. Women experience complications in childbirth wherever they happen to be, at home or in hospital. If a professional midwife is in attendance at home, it is her responsibility to make the decision to move a woman to hospital, should she need intervention, with plenty of time. This is a crucial part of her job. Thankfully, such cases are in the minority, and usually result in a positive outcome. Of course, hospitals cannot guarantee a live birth, and every year women face the tragedy of the death of the baby even when they have followed all conventional advice. Furthermore, as mentioned above, there is evidence to suggest that women experience less trauma when made comfortable in their own home, than they do within the unfamiliar and at times confronting environment of a hospital. Naomi Wolf (Misconceptions) and Sheila Kitzinger (Birth Crisis) have both written considered but passionate critiques of the ability of hospitals to bring about anxiety and stress during childbirth, seeking to change the very attitudes that are contained in this draft legistlation: that doctors know best, that hospitals are the best (only) place to give birth, and that women who argue otherwise are ignorant. They are not alone, and there are thousands of books, pamphlets, websites and support groups designed to push for greater recognition of the relatie benefits and/or dangers of both hospital-assisted and home births.
Many women value their ability to give birth at home and will be devastated if this option is taken away from them. I myself have been put off this option due to the uncertainty surrounding the future of home-births (and it must be said, the prospect of making arrangements for a birth in Castlemaine from Alice Springs). I hope that for future pregnancies I will be more settled (waiting to settle down, after all) and will be able access a registered, legal midwife to help me labour at home. But this won't happen if we don't fight. To make your opposition to this bill known, write to:
The Health Minister, Nicola Roxon (Nicola.Roxon.MP@aph.gov.au)
Your state or territory Health Minister - they are all in this together.
Sign the petition here
And tell your friends and family all about this - it's vital we make MORE NOISE!!
I find this proposal absolutely abhorrent, for three reasons.
1) It isolates and stigmatises the work that midwives do at homebirths by implying that it is dangerous and unreliable medicine, and thus cannot be insured.
Midwives are highly trained professionals with specialist knowledge. Those that attend home births have particular knowledge of how to make women comfortable in their own home and how to encourage women to listen to their bodies. There is plenty of evidence to suggest that such elements of birth - safety, familiarity, autonomy and control - are crucial to positive outcomes from the birth process. There is also plenty of evidence to suggest that hospitals often do not have or exercise such knowledge, preferring to implement protocols and regulations, often against women's wishes. In particular, women giving birth in hospitals frequently complain of being prevented from moving around during labour, of being given interventions they do not want, and of being given set time-limits in which to give birth. This sort of medicine should not be considered any more 'safe' or 'reliable' than giving birth at home, given the emotional and physical trauma that can be involved.
2) It penalises women who wish to exercise their choice to give birth at home.
Women have been fighting for decades to increase their choices and autonomy throughout the reproductive process. In 1973 the Boston Women's Health Book Collective published their ground-breaking and best-selling guide/polemic, Our Bodies Ourselves, which not only taught women about their bodies but also proposed radical alternatives to conventional Western medicine. Central to their analysis was the importance of autonomy: a woman's ability to choose according to her needs, needs which she herself determined. The book drew upon and inspired the work of many women setting up alternative healthcare services for women (and by 'alternative' I don't necessarily mean anti-Western, I mean services for women run by women) and was part of a wave of women demanding that their rights around healthcare be recognised.
Against this backdrop, the move to restrict homebirths to those that are either a) unassisted or b) illegally assisted by midwives, risking a $30 000 fine, is a major step backwards. It is paternalistic and patronising, and assumes that women (and midwives) do not know what is best for women giving birth. It prevents women from trusting their bodies, and will damage some women's ability to have an empowering experience.
3) It sends the message that home birthing is not a natural or safe practice.
This is simply not true. Women experience complications in childbirth wherever they happen to be, at home or in hospital. If a professional midwife is in attendance at home, it is her responsibility to make the decision to move a woman to hospital, should she need intervention, with plenty of time. This is a crucial part of her job. Thankfully, such cases are in the minority, and usually result in a positive outcome. Of course, hospitals cannot guarantee a live birth, and every year women face the tragedy of the death of the baby even when they have followed all conventional advice. Furthermore, as mentioned above, there is evidence to suggest that women experience less trauma when made comfortable in their own home, than they do within the unfamiliar and at times confronting environment of a hospital. Naomi Wolf (Misconceptions) and Sheila Kitzinger (Birth Crisis) have both written considered but passionate critiques of the ability of hospitals to bring about anxiety and stress during childbirth, seeking to change the very attitudes that are contained in this draft legistlation: that doctors know best, that hospitals are the best (only) place to give birth, and that women who argue otherwise are ignorant. They are not alone, and there are thousands of books, pamphlets, websites and support groups designed to push for greater recognition of the relatie benefits and/or dangers of both hospital-assisted and home births.
Many women value their ability to give birth at home and will be devastated if this option is taken away from them. I myself have been put off this option due to the uncertainty surrounding the future of home-births (and it must be said, the prospect of making arrangements for a birth in Castlemaine from Alice Springs). I hope that for future pregnancies I will be more settled (waiting to settle down, after all) and will be able access a registered, legal midwife to help me labour at home. But this won't happen if we don't fight. To make your opposition to this bill known, write to:
The Health Minister, Nicola Roxon (Nicola.Roxon.MP@aph.gov.au)
Your state or territory Health Minister - they are all in this together.
Sign the petition here
And tell your friends and family all about this - it's vital we make MORE NOISE!!
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