When I attended my last birth as a doula, it was such a stark example of how broken, dehumanised, and beyond repair maternity care is in the UK. The woman I was supporting, having planned a homebirth, transferred to the hospital for an emergency caesarean. The surgical birth was needed, and this wasn’t an issue. What shocked me, despite 10 years of experience as a doula, was the total absence of humanity displayed towards her and her baby in the theatre. I wrote a poem about this called the maternity machine, which you can see me read here.
Leaving birth doula work behind, after being so deeply embedded in the birth world for 14 years, has given me several things: some much needed distance and reflection space, and the freedom to express myself more fully. I’m still a birthworker, an activist, a writer and educator in the birth world, but not being at the coal face anymore was something I needed to do because it was harming me. I explain why I left in this blog.
Throughout my years as a doula I experienced a lot of vicarious trauma when witnessing obstetric violence that is so deeply embedded within the system, that people within it cannot even see they are doing it (for instance, a doctor attempting to do a vaginal exam without even introducing themselves, talking to the mother, let alone gaining consent for the procedure). This isn’t the worst. I’ve witnessed appalling things and sometimes I’ve been more traumatised by what I saw than the mother was, because she had no idea that what had happened was completely dehumanising and unacceptable.
I’ve noticed since I left how much this has impacted me personally and created such a deep distrust of medical care. Navigating the needs my of 2 neurodivergent children within a broken health and education system has not exactly supported rebuilding trust. Attending A&E for myself with a kidney stone a few months ago only reinforced this: a care assistant asked if he could take my blood pressure whilst I was bent over in agony and vomiting. When I refused, attempted to coerce me by saying that, if I let him do it, he might be able to ask for me to get more pain relief. I was too sick to use the appropriate expletives at the time but the parallel between this situation and what I had witnessed in maternity care was really striking.
Putting space between myself and the system has given me much needed perspective, and time to think and reflect. Another reason I left doula work was because, as I approached the menopause (I still haven’t quite crossed that bridge yet despite being 53), I felt a deep sense of shift within myself. I felt the need to become an elder, holding the back of the battle line, rather than wielding the sword.
Over the last few months I have become convinced that Western maternity care is damaged beyond redemption and that change will not come from within the system, nor from the thinking that created it. I have also become convinced that fighting against the system is no longer the solution.
The rates of interventions are going up at the rate of knots, yet keep going up some more, defying logic and evidence, and yet still going up, whilst the system remains underfunded. Some UK hospitals have 47% induction of labour rates for first time mothers. How on earth are hospitals, already crumbling under the pressure, going to accommodate over half of women having their labour induced. We are headed that way sooner than you think. Some UK hospitals already have reached that rate for first time mothers. It’s not about to improve, and I expect it’s going to get a lot worse before it gets better.
What we need is a completely new paradigm, a new system, emerging from outside the system and outside the thinking that belongs to the system.
As a doula and birth educator, I often came across women who told me that they were planning to attend a meeting with an obstetrician armed with peer reviewed papers to justify their birth choices. I always reminded them that this wasn’t going to work in their favour, because the obstetrician would most likely try to pick holes in their research, and that they didn’t need to justify their choices, but stand firm in them.
The same applies here. As much as I believe educating people that their choices are valid and that the guidelines are rarely as clear cut as presented by maternity care professionals (or even based on any solid evidence at all), this type of left brain, rational thinking, which is so pervasive in Western culture, is unlikely to provide solutions to the maternity care crisis we are finding ourselves in.
What we need is to support women to stand in their power. The power that resides within themselves, in their ability to trust themselves and know what’s right for them and their babies, rather than abdicating knowledge and power over to the system. What we need is to support a feminine way of accessing knowledge.
I know it’s easier said than done, and yet there are tools available to help support this. Over the last few weeks I have been gathering information about using shamanic drumming as such a tool. What interviewing women and birthworkers has shown me is that the change in consciousness provided by drumming can act as a conduit to access inner knowledge and power.
I have taught a course to a group of pioneering birth workers, written several blog posts, one article for the International journal of birth and parent education (out in October), and an episode in the Fear Free Childbirth podcast. I am writing a book about it.
Does this resonate? What other tools do you think our world needs right now to rehumanise birth? I’d love to hear your ideas.