Last month the big news in birth was the Telegraph’s headline about Mumsnet stories increasing fear and requests for a caesarean birth. This wasn’t wholly unexpected, the debate around social media and mental health has been rattling on for a while, and it was only a matter of time that attention turned to the impact of social media on birth. Birth is so much more accessible than it was when I had my boys over 13 years ago. Then there was no social media, we were still on dial up and smart phones were still years away. It makes me feel old when I say that, but I’m only 45, the change has been rapid and immense.
I’ve watched Facebook evolve, then Twitter and now Instagram, how movements like Birth Takes a Village and Birth Without Fear were some of the first to raise issues around birth in this world of new media, bringing messages, and images to an audience that had been hard to circulate to the masses until then.
I did suffer from trauma with my first birth, it a wasn’t terrible birth, but the post-natal care was appalling, when I asked for the anti-coagulant to be in my leg not my arm, as it has been very painful, I was told to “stop crying like a baby” before it was stabbed in my arm without consent. I was left in cold sodden sheets for hours, after icepacks used to soothe my engorged breasts had melted. I didn’t know then that what I was feeling afterwards wasn’t normal, not until after I had my second and I felt completely different.
And that’s why social media is so exciting when it comes to birth, it’s a way of campaigning and of raising awareness, for women to know when they need help and more importantly how to avoid trauma. But it’s an issue I have mixed feelings about before.
Why? Because it’s a complex issue that I find difficult to summarise a blog. It affects so many and a different narrative exists for everyone touched by this. Women who are having babies are affected, women who have had babies are affected, it has an impact on the people who care for women and their families.
The debate that has been bubbling under the surface had to erupt, because so many women have had enough. Hannah Dahlen’s #enough, is an example, of women standing up to fight together from every part of the world on mass, on social media, it’s a new form of demonstration, taken from homes and community centres everywhere, of saying, “this is not ok”. Sheena Byrom has been a pioneer in social media campaigning, encouraging midwives and mothers to collaborate online. One of her early Twitter ideas was a Twitter Buddy project, getting people from the conference floors onto social forums to continue the debate. Rebecca Schiller and the powerful Birthrights work. Much of it, wouldn’t have reached woman on the ground before social media. These women are beacons of light campaigning for the women who have lost the will to fight – women who don’t have the will to fight against an intervention they don’t want, the women and men who have lost the will to stay in a profession they love and care about, the women who have lost the will to do simple day to day tasks when they are struggling with the after effects of a trauma. They offer hope and the possibility of change from the ground up.
However, there is the flipside, away from campaigning and the reason why my feelings around social media have been conflicted in the past about the raw nature of birth being just a hashtag click away on Instagram. On the one hand there is a necessity to normalise birth, and it’s true that many women find reassurance in seeing other women’s experiences of birth. Stories of positive births, and of birth trauma have a role to play in forming choices around birth. Yet, when we allow our curiosity to burrow under the surface, rather than skim an Instagram reel with 3 second flickers of engagement, we begin to realise that this is a much more profound shift in our society than it seems to be at first glance.
It’s huge because it’s a worldwide exposé of birth, what it could be, how it is managed differently in different cultures, what its impact is at every level of our physiology and our psyche. It empowers and educates us, yet it also opens up a deep wound in our society that is being shoved under the carpet with promises of more midwives, better services, like a plaster. I heard it once called the lipstick on the gorilla, you change how it looks but if you don’t change the system it’s the same as it was.
All over the country there are failings, like the tragic closure of the beautiful Halcyon Birth Centre in Smethwick last month, a centre originally campaigned for by the Midwife Kathryn Gutteridge and a gold standard of maternity care for families. The wounded mother archetype is there exposed, vulnerable, strong, persistent - unfailing in her determination to do what’s right for the generations that come after her despite the challenges she faces.
Do I think this type of exposure of birth trauma increases fear of birth? Yes, there is no question about that. I have women tell me as much every week. That’s not to say they weren’t anxious before, but seeing images related to an anxiety or fear, without an even basic therapeutic or learning support system in place, can make that fear worse.
In truth the things that women fearful about could, most of the time, be easily remedied by good antenatal education, and an understanding about how their bodies are working. The fear that I am seeing more in my clients is not necessarily a fear of birth itself but of their autonomy in making decisions about their birth. They are concerned they won’t be allowed, there seems to be a lot of mention of the word “compromise” and doubt whether they can trust their care provider to support them in their values. This is about the system, not the people who work to support those women each and every day, who are wonderful in my experience.
The most recent RCM report shows that despite training 2000 new midwives last year that there are only 67 more midwives registered. Other recent research shows that 29 out of every 30 midwives that are trained leave the profession. That’s huge.
These are people who LOVE the essence of their job but can’t do it properly. They put their own registration and mental, and physical, health at risk, by trying to rise above a severe lack of resources because they care so much. The trauma we hear of isn’t because a woman’s body has failed her, or because of the midwives who supported her. We know we can birth, midwives are confident in their knowledge to support and care antenatally and postnatally, but it’s about a system that is failing all of us, and that causes us to doubt that we will make it through unscathed.
And the mothers, women who are left with trauma, who don’t make it through unscathed? Before, like me, they were quiet in their homes, struggling thinking it was normal. Now, they are on social media, because there is nowhere else for them to go. The scale of this unforgiveable and the lack of resources even more so. This I find is the biggest failing of all. Social Media helps women find their tribe, but women who have been traumatised should not need to seek this out because they fail to get the support they need elsewhere. I don’t think it’s ok for women with trauma to have to turn to a medium that is now known to increase problems with mental health, because they are not heard elsewhere. Or, because of the stigma around perinatal mental health, not want to talk about it elsewhere. They have to be heard within a compassionate environment with someone that can help them process trauma in a healthy way.
And how to prevent trauma? We have to educate ourselves. When the system fails us, what have we always done? We do it ourselves. If you are pregnant, you have to be assertive in your preparation, decide what is important to you, learn about your options. You have choice. But you have to know those choices so you can ask for them. There are ways to make the most of the system, sometimes you get lucky but most of the time you have to really be prepared. This isn’t meant to scare you, but it is urging you to gather your partner, your midwife, and your plan together, to do your research and to be assertive, even when it feels like it’s too much like hard work. Knowing about doula’s, and other practical resources that can help reduce the risks of intervention and trauma are all part of this learning process.
Campain! The women who are changing things are not just midwives and birth workers, they are women who want to make a difference. Speak to your midwives, find groups online that you can help with, perhaps even join your MSLC (Maternity Support Liaison Committee) so you can help make changes at your local hospital. There are all sorts of movements begun by women and professionals, Make Birth Better initiative, The Positive Birth Movement, the incredible Save our Midwives campaign that rescued the option of independent midwives – hard fought and desperate at times but victorious.
All over the country there are actions and initiatives run by midwives, health professionals, women like you and me. Each and every one of us can make a difference and although sometimes invisible we are all there, working together towards the same goal, to make birth better for the women who come after us. Social media may not be the perfect medium but it’s raising questions and creating debate, it’s tearing off the plaster.
If you need to speak to someone and feel you are struggling please talk to your midwife or someone close to you. This page on Make Birth Better is full of good resources. You might always want to read this resource by Mind.