In our society where childbirth is medicalised and breast feeding in public can be socially unacceptable, how do picture books depict pregnancy and birth? Midwife Sarah Hunt investigates.
‘What have we done to childbirth if women feel they have to have a major operation to avoid it? We should change the approach. We need to promote normal birth… The assumption should be that births take place within a birthing centre, a midwifery-led unit, or at home’ (Hansard, 15 January 2003). So said Baroness Cumberlege in January this year, in a House of Lords debate about the poor state of UK Maternity Services. She was talking about the fact that the Caesarean section rate is increasing by 1% a year, and 1% adds £5 million to the already overstretched NHS bill.
Pregnancy, labour and birth are all normal physiological processes, but we treat them as things that need medical attention in a hospital. And when it comes to breastfeeding, how many mothers have had the experience of being ostracised by some members of society and made to feel that giving their babies the perfect food is somehow socially unacceptable?
How are these ideas perpetuated? If we believe that books read in childhood could influence the way we think as adults, it is interesting to look at what images of pregnancy, birth and breastfeeding appear in picture books. I’ve been collecting picture books on these subjects over the last few years and this article is based on 35 titles.
Of course, most of these picture books centre on emotional responses – separation and sibling rivalry – rather than on the actual processes of birth, but there are a lot of incidental details that reveal underlying attitudes.
The depiction of pregnancy
Pregnancy is shown as something natural in Jean and Gareth Adamson’s Topsy and Tim and the New Baby and in Jan Ormerod’s Mum and Me, the pregnant women wear normal clothes and carry on a normal life. While the idea behind There’s a House inside my Mummy by Giles Andreae and Vanessa Cabban may seem a little eccentric, the first child is fully engaged with his mother’s pregnancy, the scan, the way the baby moves, the mother’s changed eating habits – and nausea! There is no mention of any negative aspects of the arrival of a new sibling, only an atmosphere of positive anticipation.
But the depiction of the pregnant women can be less than flattering – as in Bob Graham’s Brand New Baby, where Mrs Arnold wears ‘dresses as big as tents’, or Rebecca Hunter’s My New Sister where the implication is that the mother is virtually incapacitated – she ‘is often tired and can’t always play with me’, and has to sit on the sofa while dad gets out the baby things.
Separation is difficult for both mothers and older siblings, and most books deal with this issue in a sensitive and positive way, as in I’m Still Important! by Jen Green and Mike Gordon, which also has sensible ‘Notes for Parents and Teachers’. In Wendy McCormick and Sophy Williams’s The Night You Were Born, Jamie, while initially feeling the loneliness of separation from his mother, is cared for lovingly by his Aunt Isabel who lies on his bed with him and provides the human contact so needed by young children.
One notable and quite distressing exception to this is found in A Baby for Grace by Ian Whybrow and Christian Birmingham. Grace’s mother ‘will be back home tomorrow’ with the baby, but instead of being reassured by her father when she wakes in the night, Grace is sent back to bed: the message is that the child must deal with her anxiety alone, reinforcing the concept of separation on which our society now seems to be based.
In picture books, hospital is the normal place for birth. In Shirley Hughes’s Angel Mae, Mae and her brother Frankie go to the hospital and ‘they looked into the cot and saw their tiny baby sister wrapped up in a white shawl’ – separated from its mother. And there are more, very clinical looking hospital settings. The Baby Dances by Kathy Henderson and Tony Kerins, opens with a view into a ‘delivery room’ with shadowy figures in green theatre outfits and some kind of machine in the background. In Happy Birth Day! by Robie H Harris and Michael Emberley (which has a dedication to ‘The Baby Doctors and the Baby Nurses’!), the mother lies back in a bed and is handed her newborn baby by a gloved and gowned attendant. This mother even has a drip inserted in the back of her hand (something that is only likely to be noted by those who scrutinise picture books closely and repeatedly – children). Perhaps I shouldn’t be surprised but even cartoon Zebras are now caught up in the medicalisation of childbirth, as in Za-za’s Baby Brother by Lucy Cousins which shows the mother Zebra in a hospital bed.
At least in Happy Birth Day!, it is a midwife attending the birth; midwives, after all, are the clinical specialists in normal birth, and are clinically responsible for the mothers even when a doctor’s expertise is required. But they feature only three times in my sample. A particularly good example is given in My Amazing Journey by Pat Thomas: ‘During labour, a midwife was there to check that you and your mum were all right.’ In striking contrast is Babette Coles’s witty exploration of taboos, Mummy Never Told Me. The illustration following the question ‘What is my tummy button for…’ has a completely naked mother lying virtually flat on her back, attended by what appear to be a male doctor and a male nurse, all wearing full theatre gear including, caps, sterile gloves and masks, and a tray of instruments. At least it looks like this baby is going to get skin-to-skin contact with its mother who has her arms outstretched to hold the baby.
Even when there is a comic touch then, the implied message is that the medical model of childbirth is the norm.
Of all the books I looked at, only Hello Baby by Jenni Overend and Julie Vivas shows birth as a normal physiological event, in the family surroundings which we know allow the mother to labour instinctively. The midwife is clearly a family friend; the baby is born and instead of the cord being instantly cut by a doctor and the baby given to its mother, the mother is the first person to pick up her baby and hold him to her naked body. Afterwards the whole family remain together sleeping by the fire with no suggestion of separation; when the youngest child wants extra reassurance: ‘I sneak out of my bag and hop in next to Dad. It’s warm. He cuddles me in. I bet the baby’s warm too.’ Hello Baby provides the antidote to the medicalisation and invisibility of childbirth, but it is a rarity.
The 2002 Infant Feeding Survey by the Office for National Statistics shows that six weeks after their babies are born, 42% of mothers are still breastfeeding (and by six months, only 21%). This is despite the fact that all the research shows that breastfeeding provides enormous (and long-term) health benefits for both babies and mothers – and the Government is committed to raising the number of breastfeeding mothers by 2% a year over the next three years. Clearly, we do not live in a culture that supports breastfeeding.
It seems writers of children’s books are beginning to become more aware of this issue. Authors including Melvin Burgess, Philip Pullman and Philippa Pearce recently refused to support a new teenage novel award being proposed by Nestlé because of that company’s allegedly aggressive marketing of baby milk substitutes in the Third World.
In the picture books I looked at, where babies are fed, breastfeeding is portrayed as normal (although the Earthlets in Dr Xargle’s Book of Earthlets are bottle-feeders!). Family life goes on around the feeding mothers in Topsy and Tim and the New Baby, Sophie and the New Baby by Catherine and Laurence Anholt, and Rosie’s Babies by Martin Waddell and Penny Dale. The award-winning The World is Full of Babies! (another hospital birth) puts breastfeeding first, but concedes that there is an alternative (‘Some babies drink milk from a bottle’), and in the Usborne ‘First Experiences’ book, The New Baby (another hospital birth), Mrs Bunn breastfeeds the baby while her older daughter Susie role-plays by giving her doll a bottle. All of this can be set against My New Sister, in which the baby isn’t fed, but there is a background of baby motifs on every page – and it includes a bottle! Bob Graham’s Brand New Baby sends mixed messages – what is the subliminal effect of the 37 feeding bottles on the endpapers? And what do we make of the fact that there is a picture of the mother breastfeeding inside the book, but when virtually the same picture appears on the cover, it features a bottle?
Do children’s books reflect life or affect it? Should they portray ‘best practice’ in matters such as childbirth? Is it responsible to simply portray the world as it generally is? Neither option is politically or ethically neutral – especially when you think about the power of the picture book.
Sarah Hunt is a Midwife and the Infant Feeding Specialist at Gloucester Hospital. She has an MA in Children’s Literature from Reading University, and four daughters.
Angel Mae, Shirley Hughes, Walker, 0 7445 6377 1, £4.99 pbk
The Baby Dances, Kathy Henderson, ill. Tony Kerins, Walker, 0 7445 2164 5, £9.99 hbk, 0 7445 6360 7, £4.99 pbk
A Baby for Grace, Ian Whybrow, ill. Christian Birmingham, Kingfisher, 0 7534 0376 5, £6.99 pbk
Brand New Baby, Bob Graham, Walker, 0 7445 6141 8, £9.99 hbk, 0 7445 6970 2, £4.99 pbk
Dr Xargle’s Book of Earthlets, Jeanne Willis, ill. Tony Ross, Red Fox, 0 09 964010 4, £4.99 pbk
Happy Birth Day! Robie H Harris, ill. Michael Emberley, Walker, 0 7445 5264 8, £5.99 pbk
Hello Baby, Jenni Overend, ill. Julie Vivas, ABC Books (Australia), 0 7333 0685 3, hbk, 0 7333 0786 8, pbk (available from Ace Graphics, tel: 01959524622, e-mail: www.birthinterntional.com)
I’m Still Important!, Jen Green, ill. Mike Gordon, Hodder Wayland ‘New Experiences’, 0 7502 2506 8, £8.50 hbk, 0 7502 2684 6, £4.99 pbk
Mum and Me, Jan Ormerod, Walker, 0 7445 6010 1, £4.99 pbk
Mummy Never Told Me, Babette Cole, Jonathan Cape, 0 224 04736 1, £10.99 hbk
My Amazing Journey, A First Look at Where Babies Come From, Pat Thomas, ill. Lesley Harker, Macdonald, 0 7500 2574 3, £4.99 pbk
My New Sister, Rebecca Hunter and Chris Fairclough, Evans ‘First Times’, 0 237 52020 6, £6.99 hbk
The New Baby, Anne Civardi, ill. Stephen Cartwright, Usborne ‘First Experiences’, 0 7460 4112 8, £5.99 hbk, 0 7460 4111 X, £3.99 pbk
The Night You Were Born, Wendy McCormick, ill. Sophy Williams, Orchard, 1 84121 593 7, £4.99 pbk
Rosie’s Babies, Martin Waddell, ill. Penny Dale, Walker, 0 7445 0976 9, £9.99 hbk, 0 7445 2335 4, £4.99 pbk
Sophie and the New Baby, Catherine and Laurence Anholt, Orchard, 1 84121 057 9, £4.99 pbk
There’s a House inside my Mummy, Giles Andreae, ill. Vanessa Cabban, Orchard, 1 84121 068 4, £4.99 pbk
Topsy and Tim and the New Baby, Jean and Gareth Adamson, Ladybird, 0 7214 2851 7, £2.99 pbk
The World is Full of Babies! Mick Manning and Brita Granström, Franklin Watts, 0 7496 2752 2, £4.99 pbk
Za-za’s Baby Brother, Lucy Cousins, Walker, 0 7445 4764 4, £5.99 pbk