Q&A with Milli Hill, author of Give Birth Like a Feminist
Published on 22 August, Give Birth Like a Feminist encourages women everywhere to stand and deliver, insisting that birth is no longer left off the list in discussions about female power, control and agency.
From the importance of birth plans to your human rights in childbirth, and including birth stories from women across the world, Give Birth Like a Feminist is a call-to-arms that will help you find your voice, take an active role in your choices, and change the way you think about birth.
We spoke to Milli about the issues women face in the birthing room, what a ‘feminist birth’ should feel like, and what maternity services can do to ensure that all women are listened to, taken seriously, and treated with respect during labour.
Why has birth traditionally been forgotten in feminist conversations about women’s health, particularly when reproductive rights are otherwise such a big part of that agenda?
I think there are a few reasons for this. Firstly, feminism has been mainly focused on equality, so some topics that only affect women’s bodies – such as birth and breastfeeding – find it hard to fit into this discussion.
Secondly, leading feminist voices have not always been mothers, although it is surprising when you discover that some high profile feminists like Germaine Greer and Caitlin Moran have raised important issues about the experience of childbirth – but have seemed to make little impact.
Finally, and possibly most importantly, I think that many of us remain under a cultural spell when it comes to birth. We are repeatedly told that ‘a healthy baby is all that matters’, and that we have to ‘leave our dignity at the door’. These cultural messages instill in us the expectation that birth will be unpleasant or even traumatic, but that it is not the done thing to complain about this, because ‘that’s just what birth is like’.
Added to this, you have further cultural messages that motherhood is all about sacrifice, and that good mothers don’t complain, but instead put the needs of their baby first. It’s a pretty toxic cocktail, and the upshot of it all is that birth as a feminist issue has been largely overlooked.
What are the biggest and most common forms of sexism that women face in the birth room, and why do you think they’re so prevalent?
Women often report feeling infantilised or patronised in their birth experience, for example by being called a ‘good girl’ – even during labour and birth itself – or by being belittled, for example with jokes being made about the length or detail of their birth plan, or their attempts to join the discussion about their care being mocked.
One woman in my book, who had a BSc in Biology, offered her view on the evidence for induction and was laughingly asked: “Where did you hear that, Netmums?” We saw Meghan Markle being publicly mocked for her birth plans at a conference of doctors: “A doula and a willow tree, let’s see how that goes!” said the speaker, and everyone erupted into laughter. I think these attitudes are deeply sexist, suggesting that women are stupid, misguided, or don’t know their own minds or what they are doing.
Other times women are accused of being dangerous, bad mothers, or even mad if they wish to take a lead role in their birth choices. There are several examples in my book of women being referred to social services or to psychologists because of their birth choices.
Then there is some of the language used about women and their birthing bodies. We joke that, for men, childbirth is ‘like watching your favourite pub burn down’ – and this is supposed to be funny; a woman being reduced to a location for her partner’s entertainment, which is then destroyed by having a baby… hmmm, I’m not sure I get the joke?! Several women have told me about ‘banter’ around their vagina being repaired after birth, too, with jokes about ‘making you tight for daddy’ or giving you a ‘designer vagina’.
Unfortunately the list of sexist situations in the birth room is extremely long! And that is not even to mention the way that women feel coerced or forced into birth choices they don’t feel comfortable about; being examined roughly; having things happen to them without their consent; or simply not being properly informed about their choices.
Why do I think all this is so prevalent? In short, because we live in a patriarchy! We’d be foolish to think that the same sexism and misogyny that impacts on women’s lives outside of the birth room, doesn’t follow them into it.
Why is it so important for women to expect and demand more from their birth experiences?
I don’t think all the emphasis should be on women to improve birth and make change happen, but I do think that raising their voices, having more of a sense of their autonomy, their rights, and their entitlement, will have an impact and force things to improve.
We all know that everyone getting out of birth alive is the top priority for women and care providers alike, but what I’m suggesting is that this should be the baseline of our expectations, not the pinnacle. So many other aspects of birth matter to women, and it is ok for these things to matter. It does not make you a selfish or bad mother to want to be treated with dignity and respect, and to be the lead decision maker over what happens to your body.
We know that women who have a positive experience of birth take this empowered feeling forwards into motherhood and the rest of their lives. By the same token, we know that there are big problems with women’s postnatal mental health, with around 1 in 3 women experiencing birth trauma, and about 1 in 25 reporting PTSD. The mental health issues this brings has a direct impact not just on them but on their families and their babies. We have to do better for women than this.
What would a ‘feminist birth’ experience look like?
I think it would ‘look’ very different to different women. There is no one right or wrong way to give birth, and there is certainly no right or wrong location or mode of delivery. However, I think a ‘feminist birth’ would ‘feel’ the same to all women: it would ‘feel’ empowering, strong, informed; like they were in the driving seat of what was happening to them, and being listened to and treated with respect.
How can healthcare professionals (HCPs) support more positive birthing experiences?
By listening to women, and by upping their empathy levels. At every moment of their day, health professionals need to be asking, how does this feel for the woman? Some trusts have even encouraged this with ideas like the #lithotomychallenge or the #theatrechallenge, getting HCPs to literally put their feet in stirrups or be wheeled into theatre, just to help them imagine what this experience is really like.
I also think that, just like pregnant women, HCPs can benefit from really ‘unpicking’ their preconceptions about birth (which are entirely built for us by our culture), and starting again with a blank slate. Then we can ask, what are the possibilities here?
Often we are putting women in situations where no self respecting mammal would be able to have a straightforward birth, and then wondering why women’s bodies don’t work very well. So we need to ask what could birth be like? What might women need? What might we be doing that is hampering women’s efforts? What are we doing that is helpful? And yes, you can ask women – they will tell you the answers to these questions, and more. Just listen.
Who do you hope reads this book, and what would you like them to take away from it?
I hope anyone involved in maternity care reads the book, and I hope anyone who has ever had a baby, or is having a baby, or will have a baby will read it! I would like the book to make them think, to switch on a light for them and make them see birth through a feminist lens – not necessarily to agree with everything I say, but to come away feeling, ‘this book made me think’. Then I will feel, job done!
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