The deadly omertà of childbirth Why aren't women allowed to talk about how dangerous reproduction can be?

It is unfashionable to talk about female reproduction and its often-fatal endings. You could blame the obsession with gender identity, but this is unfair. It has never been fashionable to discuss female reproduction, and women — and pity — are often to blame: better, surely, to discuss the colour of the nursery?

For much of this, I blame the Madonna, a piece of public art existing for millennia to deny reality: a woman so serene she is functionally absent. I can never look at her portrait without thinking: where is the blood? The Madonna tells you nothing about childbirth; and she asks you nothing. Today’s mothering-themed adverts are her descendants: the ever-capable, happy mother, adrift in her own bliss. It is really nothing like that.

Rather, it is life threatening. The data is so extraordinary I am surprised it isn’t more widely known. In 2017 — the last year the WHO has published data for — 295,000 women died during pregnancy and childbirth globally. In 2016, there were 7,000 new-born deaths every day; or 2.6 million in all. The number of still births chimes with that: 2.6 million. So that is almost a third of a million women and 5.2 million dead babies each year. It rather mutes the cries of the anti-abortion, anti-choice lobby. If they cared about babies rather than controlling women, perhaps they might address this, for much of it is due to lack of healthcare provision; as with many calamities, it disproportionately affects the poor, who have less access to medical care. But I am not surprised by anti-abortion activists’ emphasis. They tend to deal in dreams, not practicalities. Dreams are cheaper — and lovely.

Some have no choice. Last week, Chrissy Teigen, a former model — an “influencer” — posted a photograph of herself and her baby on Instagram. She had miscarried, she wrote, and the baby was dead. She was swiftly condemned for her testimony. Instagram is too trivial a platform, some wrote, ignoring the fact that it had, with Teigen’s post, become less so.

Others – including a Republican candidate for Congress – wrote that perhaps Teigen should now change her opinions on abortion, since she is pro-choice. This position is such a tangle of woman-hatred, I struggle to even analyse it. But I am grateful Teigen wrote her story. Women are often discouraged from speaking about miscarriage, and rates have spiked under pandemic.

It seems that it is not Covid-19 that drives it but the fear of it. Women had less access to medical care or were nervous of contacting their midwives; by the time they did, it was often too late. The Lancet reported that in Nepal hospital births halved, but the rate of stillborn babies in the hospital increased by 50%. Scotland also reported a spike, as did India. St George’s hospital in London reported four times as many still-births during lockdown. One healthcare worker suggested that in Britain women did not want “to burden” the NHS at such a time. I can believe that.

If you know nothing about miscarriage, I urge you to read Ariel Levy’s New Yorker essay Thanksgiving in Mongolia, in which she discusses the creation of her son, which she thought magical, and then his loss at 19 weeks. She blamed herself: “I was still a witch, but my powers were all gone.” It is painful to read Levy chide herself, but I understand it. It is a truism that there are no good mothers of any kind. We are all, in our own ways, failures.

Shame thrives in darkness, and women almost never discuss miscarriage. I have always wondered why it is considered impolite to disclose a pregnancy until 12 weeks. Who does this convention protect? Women, or a delusion of what it means to birth a child?

I also pondered Levy’s summoning of “magic” to explain her own body to herself. Is it a kind of sanctioned naiveté? Another kind of denial, substituting Madonna for witch? I think it is; and I shared it willingly. From the queasy discovery of menstruation, to grave illness in childbirth, I had an idea that the world was less interested in my reproductive processes than my reproductive possibilities: perhaps because men are involved in the last. In the final days of my pregnancy I looked for a nursing bra in a department store. There were none. But there was a glut of thongs.

My own experience was prosaic, horrifying and lucky: I produced a live child. But I developed a life-threatening complication after an emergency caesarean section. I should have listened to myself, and not the doctors, and had a planned caesarean section — but what do pregnant women know? Childbirth left me so shocked that, by the time I could imagine doing it again, it was almost certainly too late. I doubt I will have other children, though I want them.

I was traumatised, but such is the myth of child production, I couldn’t have said that at the time. You are supposed to feel monomaniacal gratitude for just surviving. Partial gratitude is not enough. I did not feel gratitude after birth. My body swelled and I turned putty coloured. I was in agonising pain, and the doctors didn’t believe me. I was given Gaviscon for ileus, a condition where your intestines cease to function. I vomited it over myself, which pleased me, because it was a piece of criticism. I considered staggering down to the Underground and throwing myself in front of a train. It was probably the comedown from the morphine, but I didn’t know anything about that either. I knew nothing; I had seen the Madonnas.

Silence on the reality of female reproduction can be fatal; if we cannot even speak for ourselves who will help us? The maternal death rate in America has actually doubled in the last 30 years – who will speak for them? The silence should be broken. So, I am grateful to Levy for writing in the New Yorker and to Teigen for prodding the Madonna too, and where she would be if she had ever existed: on Instagram.

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Tanya Gold is a freelance journalist.

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