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Birth trauma must be taken seriously

Women in labour need more care and respect

Artillery Row

In the Vale of Leven hospital in September 1993, a pregnant woman was induced and spent countless gruelling hours enduring a brutal labour without pain relief. She did her level best not to scream, instead emitting long, lowing sounds. It was still deemed too loud for the midwife’s liking, who told her to keep the noise down and laughed in her face when she asked for an epidural, saying she’d left it too late. When her agony hit a certain, unmistakable note, she pleaded with the midwife to take her to the delivery room. The midwife shook her head and, again, with cackling condensation, cooed, “You’re nowhere near ready yet.” Less than five minutes later, she was bolted to the delivery room. No apology was forthcoming.

After the patient delivered, she was given no option as to whether she preferred a male or female doctor to do her post-birth stitches. She found herself with two male doctors talking about her as though she were a piece of butcher meat to be trimmed. When the senior doctor left the room, the male doctor performing the procedure was so aggressive, actually shouting at her for wincing and flinching as he sewed the most sensitive and private part of her body, she was reduced to tears and left traumatised by the experience.

The mistreated woman in question was my mum. I was her firstborn child. When she talks of my birth, she talks of the joy and momentousness of it, how she suddenly felt a profound connection with every mother in her ancestry, every female mammal. Yet there is a haunted sadness behind her eyes. To this day, she still cries remembering the male doctor’s misconduct, the midwife’s sneering.

She is far, far from alone.

Recently in The Metro, freelance writer Kat Romero published a comment piece on the dismissal and humiliation she experienced from a male midwife who told her to “calm down” during her excruciating early labour, suggesting she was overreacting and too weak to cope with “real labour”. She gave birth two years ago, and her experience left her “haunted”.

Women’s birth trauma has become one of those subjects people are constantly saying needs to be “talked about more”, despite its being talked about non-stop. I caught myself saying it the other day in response to a woman who was literally talking about it with me. I’ve had conversations about it with almost every woman I know who has given birth and read countless harrowing testimonies of mistreatment during childbirth. Romero’s piece has attracted many more. There are 30,000 recorded cases of birth trauma in the UK, and that’s in no way representative of the real numbers. Women who have been subjected to it constantly talk about it. The problem is it’s not taken seriously, written off as a uniquely bad experience.

Why is this? Why isn’t mistreatment of women at their most physically vulnerable and whilst going through the most female of experiences it’s possible to have, not at the forefront of feminist priorities? In 2018, The Guardian ran an opinion piece calling for the abuse on the maternity ward to have a #MeToo reckoning. It didn’t happen. Where are the libfem “It’s my body, my choice” consent fanatics when women are being painfully touched against their will and denied pain relief they are entitled to? There are a lot of reasons but I’ll focus on two.

Could the world of maternity have a bit of a toxic femininity problem?

Romero ends her Metro piece with the Rachel Green line from Friends: “No uterus, no opinion.” Whilst there is a particular audacity and chauvinism to a male health professional diminishing women’s pain in labour, I’ve read enough accounts of birth trauma to know that female midwives — who naturally make up the vast majority of the profession — are no less guilty of misconduct and bullying. Female-on-female nastiness is, much like psychological differences in men and women, something that mainstream feminist theory has sidestepped to its detriment. Medicine, historically, was a chillingly patriarchal institution that exercised practices now correctly recognised as hideously misogynistic and harmful to women — particularly in the fields of psychiatry and maternity. Is there still a cultural hangover from that legacy? I imagine so. This isn’t Victorian Britain, though, and it hasn’t been for some time. The doctor overseeing my mother’s stitches was a world-class misogynist, but I refuse to believe the midwife, who so icily patronised her, did so because she was harbouring “internalised misogyny” — not in a way that excuses her behaviour. She too was a tactless, heartless health worker with a seriously poor bedside manner.

I’ve observed that when mistreatment of labouring women is alluded to, the feminist focus tends to be on expectant mothers being over-medicated against their will, something male-led practices are responsible for. There is less enthusiasm for dissecting what’s become known as “the cult of natural childbirth”, the shaming of labouring women who want epidurals and pethidine or who — God forbid — even opt for elective caesarean (I’ve only ever heard women use the phrase “Too posh to push”). Whisper it, but could the world of maternity have a bit of a toxic femininity problem, as well as a misogyny one? This complicates the approved feminist narrative.

This is also a squeamish topic due to the perceived demonisation of NHS workers. I’ve lost count of the amount of times I’ve seen a woman give an account of a negative experience with a midwife, only to be told she’s unfairly blaming an overworked, underpaid individual and overlooking all the wonderful, attentive, supportive midwives (translation: shut up). This partly stems from the irrational reverence of the NHS as an institution — “Our NHS”, as though it were a cherubic golden baby we should all dote on and fiercely protect, exemplified when we stood clapping for it during the pandemic. I am as grateful as the next person with any sense of perspective that I was born into a country with nationalised healthcare, but too often this romanticised image prevents practical, material problems being addressed. Positioning all public sector workers as the default oppressed is unhelpful and, frankly, ludicrous — especially in health and especially in the maternity ward, when a patient is at the most physically (and emotionally) vulnerable it’s possible to be. Are you seriously telling me that in the scenario Romero described with her male midwife, he was the real victim? An unduly stressful job does not justify misconduct towards vulnerable clients, any more than it justifies slapping around your wife or kids as a result.

One campaigner who does passionately advocate for women’s autonomy and respect in childbirth is Milli Hill. Her books Give Birth Like A Feminist and The Positive Birth Book are revolutionary in their message. They dare to assert something generations of women have been denied: not just the expectation of a safe birth, but a positive experience. A birth where they are consulted and given the lead, equipped with the knowledge to say what they are and aren’t comfortable with, what they do and don’t consent to — and to recognise and put in complaints if and when mistreatment happens.

Isn’t it surreal that such a sensible message feels revolutionary? That it’s right for a woman to want to minimise suffering and feel in control during the most transformative day of her life? The neglecting of this issue merits ferocious anger — but it has to be the kind of anger that looks forward and improves things, not back in resentment and wallowing. Women, you can and should make as much noise as you need to during pregnancy, labour and birth — and not because you’re in agony.

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