Articles about birth: help or stoking fear?

Here we are again responding to another unbalanced article written about birth. Another article with a catchy title, designed to grab the attention of birthing people, and - well adding nothing useful to the discourse.

It’s not a big revelation to say that media about birth lately has done nothing but talk negatively about both the NHS and private maternity options. Politicians have weighed in on their social media. The Green Party even tried to put something about maternity in their manifesto, which got summarily shot down.

Why can’t we get the messaging about birth right?

The latest offering by Rosie Kinchen in June 23rds Sunday Times had all the same pitfalls we’ve already seen. The NHS is failing, the NHS is underfunded, so here’s the other side - but, oh wait - it’s no good either, so I guess you’re screwed. Where does this kind of messaging leave women and birthing people who are entering the system? Or looking for ways to avoid the, what now seems inevitable, trauma associated with giving birth.

A lot of what she says in the article is true, just that the message is nothing new. We know that there are problems in the NHS maternity system right now, and that private maternity services are becoming more visible and accessible. Birthkeepers, doulas, lactation consultants, antenatal educators have always been there. In the past, these private maternity workers have been considered a part of the natural mummy world, one of many misrepresentations of birth workers. The reality is that birth workers are becoming more popular because of the lack of trust in the NHS, not coming JUST from the media, but from peoples experiences of using the NHS, either antenatally or prior experience. Many Doulas will tell you that they were approached by potential clients because of a previous experience of medical gaslighting, poor communication or lack of listening or understanding by NHS care practitioners. Before even knowing how challenging NHS maternity is now, they are afraid of what entering NHS maternity care will be like based on their previous experiences.

The article highlights some experiences of Doulas being “as useful as a chocolate teapot”, or behaving like a sulky teenager and creating a weird energy. Focussing on the negative experiences, without creating the balance by discussing the studies that show that having a trained Doula present improves outcomes. The 2017 Cochrane Review found that continuous support from a practitioner, not a member of staff at the hospital and not a part of their social network (ie a Doula), reduced the likelihood of a caesarean birth and increased the likelihood of a spontaneous vaginal birth. Continuous support also shortened labour by up to 41 minutes, and increased satisfaction in the birth experience.

In our discourse on birth, would it not be helpful to create balance in how we represent the options available to birthing people, and give them the information that empowers them to know their choices. You don’t have to hire the first Doula you meet, if you don’t get along with them, don’t hire them, meet more. You can do the same with your midwives (limited by how much you might want to travel - conversely most Doulas will come to you!) These articles could highlight the multiple points to access birth education, there are antenatal educators in most areas, and many birthworkers will do free coffee mornings locally to discuss your options.

The author of the Times piece also really makes a point of highlighting the cost of each of the birth workers that she quoted. The implication that this support is expensive AND unnecessary. This suggestion that birth workers shouldn’t be charging is narrow minded and unfeminist. Why is charging to support birth viewed so negatively? Are physiotherapists and counsellors and acupuncturists treated with the same disdain for charging for their work? Is it because birth is seen as womens work? Is it a lack of understanding of the level of training most birthworkers have? Are they considered untrained or unprofessional? It is naive to think that money doesn’t impact any part of birth, your NHS midwife is getting paid to work. Your obstetrician is getting paid to work. We can love the job and believe in it, and ask for appropriate remuneration for our work. Finally, suggesting that any birth worker charges too much is another ploy to devalue independent birth workers.

A lot of the language used in the articles we’re reading about birth are about trying to find blame. No doubt NHS maternity services needs to do better, but it’s bigger than even lack of funding or staffing. Yes, there are medical failings at the point of care. But also, medical intervention is under researched, and short and long term impacts of decisions made in the name of care are not well enough understood. The accuracy of technologies is often called into question, with aspects like late pregnancy scans having a wide margin of error, often confusing matters rather than clearing them up. Ultimately, decisions need to be made by the birthing person, but they need balanced and clear information, this is difficult to come by when the research and the technologies actually make decision making more difficult.

Media articles about birth have a long way to go to actually inform birthing people rather than sensationalise the state of affairs and terrify them. There is so much misinformation, many birthing people don’t know where to look for balanced and helpful information. We’ve been taught that we should trust and cherish the NHS, and we should - free healthcare is invaluable. But should that trust be blind? This isn’t an issue unique to birth, it’s in conversations we’re seeing in end-of-life care, in care for long term illnesses, and most commonly, in care for women.