Make Birth Better Campaign | Theme 2
'Heroes & Villains'
The second theme summarises just how important birth professionals are - and often this was individual members of staff. Women often felt very let down by those who they expected to support them. There was acknowledgement that this was often due to service pressures, although not always. Women also felt cheated by the information they had received prior to birth, noting that they needed more information about labour in general, and a more balanced view of birth (including the possibilities of intervention and recovery after birth). There were shining stars mentioned in many stories, most frequently in relation to support following the birth or in planning a second delivery. It is perhaps notable too that partners were rarely mentioned as a source of support or conflict, but usually instead were mentioned in regard to their own trauma.
1. THE CARE NEVER COMES
‘You rely on those tasked with your care - but the care never comes’
The stories frequently had an ‘us and them’ feel to them, with women describing feeling unsupported and isolated - ‘nobody spoke to me…nobody comforted me when I started to shake and haemorrhage and vomit’,‘I was even told that I couldn’t have a shower…I was left waiting in a triage waiting room for my husband to collect me in blood stained PJs’…
At a particularly vulnerable time, women reported feeling abandoned by the staff around them ’39 hours of being ignored and scared’, ‘I felt very abandoned and scared…just completely uncared for’. Women felt pushed and pressured during birth, ‘we had to keep the doctors at bay who were pushing for intervention’, ‘from the very beginning I felt pressured and rushed’. Related to this, there was a sense that their own instincts were not being listened to ‘This was the first time she even thought about checking how dilated I was…I was ready to push’, ‘after lots of pleading that something wasn’t right…they asked a paediatrician to check [my son] over…we’d both got sepsis’,
‘I was told to trust medical professionals over my own instinct’
Women sometimes felt in the middle of disagreements between staff, ‘midwives were arguing’, ‘raised voices’, ‘one doctor telling me to push, midwife telling me to stop’. They also reported hearing how they were being spoken about, which could be disturbing when concerns were being raised ‘Dr shouting he couldn’t find a swab inside me’, ‘awareness of the surgeon struggling’, ‘the surgeon was saying [about my placenta] ‘it’s piecemeal’.
There were examples of staff being rude, hostile or even verbally abusive ‘Doctor began screaming at me to push’, ‘The doctor…humiliated me’, ‘She continually rolled her eyes at me’, ‘She was talking about me as if I wasn't there’. There was a lack of trust that professionals had the women’s best interests at heart, including after birth when there were a number of cases when note keeping had not been accurate: ‘She told us her shift was finishing at 7:30 and my little boy was born at 7:24pm - coincidence?’, ‘The ward nurses came and literally kicked me out of bed at 8am’, ‘there was nothing in the notes’, ‘none of this was recorded by the midwife’.
Women were also disappointed by the stories they’d heard before birth, with a sense that antenatal classes need to be more honest about the more negative possibilities of birth ‘The expectation that every woman can have a normal birth sets women up to feel rubbish post fatally if she can’t’, ‘don’t hide the truth on what to expect…could have explained how likely assistance will be, how pain relief is perfectly acceptable’, ‘Would have been easier if I’d never gone on the [hypnobirthing] course and instead spoken to women who’d had different kinds of births’.
2. THEY'RE OVERSTRETCHED
Women were all too aware of the way in which cuts to services and understaffing were impacting on their births. They reported arriving at hospital to find there was no room for them, being told no midwives were available to deliver their baby, being seen by clearly stressed staff - or not being seen because of a lack of staff, and blamed poor aftercare on service pressures. ‘I was…sent back down after 3 hours as there was no one available’, ‘[I was] without a midwife for significant chunks of time, and crucially when I was in transition’, ’The care…was affected due to workload and staffing’, ‘with the budget cuts…they are failing to provide adequate aftercare’.
3. I WILL NEVER FORGET WHAT SHE DID FOR ME
Even within the strained services though, there were shining lights. Key in this seemed to be helping women feel supported ‘obstetrician was fantastic…factual and supportive’, ‘midwives [were]…completely encouraging and supportive’,‘She listened to me and rationalised my concerns’, ’I was well supported and encouraged to allow things to unfold at their own pace’; safe ‘I felt held and safe’, ‘made me feel safe’; treated with kindness ‘[midwife] was amazing’, ‘there were a few midwives who were lovely’, ‘she truly cared about me having a positive birth’. The impact of these individuals was considerable ‘the consultant was the turning point’, ‘I got the most amazing midwife who I remember as my superhero’, ‘I will never forget what she did for me’, ‘[she] gave me back my belief in myself’.
4. THE SAFETY OF THE BABY
There was fear throughout the stories of whether the baby would be ok, sometimes due to emergency situations but not always. Forceps deliveries were ‘brutal’, ‘no baby can survive this’, ‘baby was literally pulled out of me’. Women talked about hearing about foetal distress and being told that their babies were at risk ‘I remember being told to push properly or my baby wouldn’t make it’, ‘She told me I would harm myself and the baby’. On some occasions women were certain their babies had not survived - ‘I remember thinking that if they were going to have to fight for life but end up dying it would be kinder for them to die sooner rather than later’, ‘I was scared of birthing a stillborn baby’. Some babies were born unwell and taken to NICU, and mothers described being left not knowing whether their babies were ok ‘I had no idea whether he had been born, whether he was alive’, ‘The doctors worked on her for 30 minutes before whisking her downstairs to the NICU’.
There was an experience of a baby who did not survive. It is important to note, however, that in this case the mother felt able to reach acceptance due to therapeutic support and her own coping strategies.
Reflections - There is a level of transgression here that is hard to read about. Acknowledged is the very real fear for many women that they or their baby will die during childbirth - partly due to the way we talk about birth, stories we hear about the worst possible outcomes, but also the lack of control over our bodies that might be experienced. When supported, and treated with reassurance and, it seems possible that even this worst possible fear can be resolved. Why are women and their babies in modern society still being left damaged by birth?