Once Britain’s best-known midwife, Caroline Flint says doctors have become obsessed with risk in childbirth. Natural birth, she says, can turn a traumatic experience into something mind-blowing … even orgasmic
Caroline Flint is in tears and we are only five minutes into our interview. She is remembering the birth – at home – of her first baby.
“It was the most wonderful experience of my life. It was mind-blowing. I felt so brilliant. I mean it was bloody painful and I hadn’t realised how painful it was going to be, but it was ecstatic. Some women have orgasms – I didn’t, but I was in utter ecstasy. All I’ve ever tried to do is enable other women to have such an amazingly powerful experience.”
This was 1965, when 30% of births were at home. Flint was attended by an elderly midwife who was stone deaf and didn’t do vaginal examinations. “She said: ‘If you look at a woman, you know how far on they are.’ Well, she’s right. I learned such a lot from her. She kept acknowledging me, kept saying: ‘You’d have thought this was your fourth not your first.’ She was divine. Years later, I said to her: ‘I try to be as kind to women as you were to me.'”
By this point, Flint is in floods.
The experience set her on a path to becoming Britain’s best-known midwife and vocal champion of natural birth. Now 71, Flint has had an extraordinary career. A former president of the Royal College of Midwives, she has delivered babies for many well-known people, including TV presenter Davina McCall, actor Thandie Newton and model Stella Tennant. She set up London’s first natural birth centre, for private clients, running it for 20 years. She was a regular on TV and in print, commenting on birth-related stories, putting the case for non-interventionist midwifery.
Then in 1999, at the height of her fame, Flint suffered her “annus horribilis” when she faced the midwives’ disciplinary committee (the UKCC), following the death of a breech baby. The case gave rise to shrill headlines, including “Is this the end for home birth?”, despite the fact that the case concerned a hospital delivery and Flint was exonerated in relation to the baby’s death and her care during the birth. She was, however, admonished for inadequate note-taking, failing to carry out maternal observations and failing to notice maternal collapse an hour and a half after the birth. It took Flint a year, she says, to get over it and her confidence was shattered. It was a blemish on an otherwise worthy record – she claims to have had only one obstetric emergency in 35 years of delivering babies the natural way. She has published six books aimed at the profession and gives lectures around the world. She continues to teach ante-natal classes for the National Childbirth Trust in her flat in Vauxhall, London, with its view on the Thames where we are now sitting.
Flint’s new book, Do Birth, is her first aimed at new mothers, rather than the profession. It is full of the kind of evangelising likely to incense some commentators and reignite the debate about the safety of home birth versus “medicalised” deliveries in hospital. Flint believes we have industrialised birth, that doctors have become obsessed with risk and that, as a result, more women are being traumatised.
“We have far too many obstetricians in labour wards,” she says. “Those doctors need to do something and that is not entirely appropriate for childbirth. Childbirth is something where people need to sit there and say: ‘Yes, I know it hurts, but you’re getting on fine.’ You need someone really patient.”
“We are in London, one of the richest cities in the world. And the women having babies are well nourished and are only having one, two or three babies. They are incredibly safe. They have never been at such low risk in the history of womankind, yet the intervention rate is sky high. The only hope I hold is that the government will realise that the way we do birth is so expensive, it’s ridiculous. We could quarter the cost and have better outcomes. Normal birth is becoming a rarity.”
Flint is so charismatic that it is almost impossible not to be swayed. She delivered nine of her 12 grandchildren because “my life experience is that things very, very, very, very, very, very, very rarely go wrong. The culture in hospital is, ‘What if something goes wrong?’ and there is this frantic, barely suppressed level of panic everywhere, and because women in labour are so sensitive, they pick it up. That produces adrenalin, which suppresses oxytocin and that slows the labour down.”
The problem with her book is that she idealises natural birth with talk of transcendental bliss and orgasm, and it begins to feel like moralising.
“A brutal entry into the world,” she writes, “where the baby is pulled out of his mother’s body, accompanied by loud voices and bright lights, and then rubbed with a rough towel, teaches this oh-so-sensitive baby that the world is a tough place where he may not always be welcome.”
She claims medicalising birth is as absurd as medicalising defecation, though, to my knowledge, doing a poo has never caused risk to life. She claims the baby in utero is in a state of “utter bliss” (on what evidence?) sucking on “sweet amniotic fluid” (in fact, amniotic fluid is fluid the baby has urinated).
“Think of every genius you have ever heard of,” she writes, “and the likelihood is that they will have been born at home – Mozart, Beethoven, Einstein, Elgar.”
Flint maintains that women in labour need darkness, privacy, comfort and to zone into the sexual side of birth, to move and groan and moo while their partner gently stimulates their nipples and clitoris to get the oxytocin flowing. (I conducted a straw poll of mothers and they agreed that labour was about the least sexy thing they had ever experienced and their partners would have been liable to get a punch in the face if they’d tried any funny business.)
Home, Flint maintains, is the best possible place for this to happen, even for first-time mothers. “I can’t imagine becoming sexually aroused in a brightly lit hospital. Can you?”
“After the birth,” she writes, “you will snuggle in bed with your beloved partner and gaze at your baby, telling each other how very clever you are … fragrant, joyful and transcendant.”
It is a book that will appeal to first-time mothers who desperately want to get everything right and who have the farthest to fall when reality kicks in.
Consultant obstetrician Shreelata Datta is worried that new mothers “are not informed about what labour entails. It is sad when you see a woman cry because they have asked for an epidural. What scares me is that those who don’t achieve the gold standard of a normal natural birth feel something has gone wrong. Labour is unpredictable. I want women to understand that the most important thing is that they and the baby are well at the end of the process.”
Datta says it is unsurprising that there has been an historic stand-off between midwives and doctors on birth. “I’m not aware of many obstetricians who would go for a home birth for their first delivery. Doctors are pessimistic because they see the worst. We are focusing on the outcome rather than the process. Our main concern is protecting both mum and baby.”
Flint is genuinely aghast when I suggest she might be assisting in piling guilt on to mothers, who are already being harangued by the breastfeeding lobby.
“Oh, I’m sad to hear you say that,” she says, and I’m worried she may cry again. “I would hate to feel that. The reason I said that about geniuses is because there is this worry about home birth, that it’s going to affect the baby. I was trying to say that throughout history babies were born at home.”
It is such a shame that she has played up the transcendental gubbins, the foreplay, the mooing and frying up the placenta for a light snack, because Flint is no crackpot and has important wisdom to impart, based on a formidable 35-year career.
She is practical. She is not at all against epidurals, for example. “They are wonderful. Even in our birth centre, 9% of women needed an epidural, whereas in hospital it’s about 85%. Why is it so painful in hospital? If childbirth was such agony, the human race would have died out years ago. It is being made extra painful because women are frightened and they’re in extra uncomfortable situations.”
The counter-melody of the book is a call to women to take control and play the system to get the best one-on-one care for themselves. Book yourself a home birth, Flint is saying, which will immediately get you care from a more engaged midwife, free on the NHS – a midwife who is interested in you and who wants you to have a great experience. Then, by all means go to hospital down the line, but go with your midwife by your side.
“Most women can give birth perfectly well on their own without interference. Of course, some need a caesarean, some need extra medical care but most don’t. I think if women could start off with a midwife in their home, whether they are high-risk or low-risk, and then if she needs to go into hospital, she can go with them. Much less intimidating.”
• Susie Steiner’s novel Homecoming is published by Faber & Faber, £12.99. To order a copy for £9.99, including free UK p&p, go to guardian.co.uk/bookshop or call 0330 333 6846