To have hated ‘This is going to hurt’ by Adam Kay?

[SweetMelodies]

Just that really. So many recommendations to read it from others, it seems to have so much praise and is a number 1 seller.

I like to think I have a good sense of humour and sometimes a pretty dark one at that but I just found the book absolutely dripping in misogyny. Sure it IS well-written and he is obviously a very talented writer and some bits were indeed funny... but a lot of it really turned my stomach, the language, the way he speaks about women, his really narrow-minded attitude towards birth that isn’t evidence-based at all, just based the very limited picture of birth he has. He clearly puts the women in a category of ‘other’ and ‘less than’.

I did feel terrible for him having experienced the dreadful situation at the end and it did highlight how overworked drs can be... but at the same time I think the language and attitudes displayed in it really summarised the paternal and disrespectful attitudes in the maternity system that lead to so many women traumatised by childbirth.

Despite this I appear to be completely alone in this way of thinking, did anyone else not get a great feel from this (or parts of this) book?

But you have to question why a woman has so little trust in her attendants that she feels she must laminate a nine page birth plan.

This conversation reminds me of the time Princess Diana was giving birth. One of the Consultants at the time said words to the effect that you had to remember, this was the Princess of Wales and not Mrs Thing from .....

My DM heard that, and blew up in absolute fury - that's the trouble, she said, too often women are treated as Mrs Thing.

I don't expect perfection or emotionlessness. I do expect doctors not to assault their patients

But, again, the entire point of the book is to illustrate the burnout and eventual breakdown he experienced due to the pressure of work. And, again, I am not defending the tattoo incident. But what I would say is that you have no idea how you would behave if experiencing similar conditions. I did many things as a hospital doctor (not including assault) that I would not have done if I hadn't been sleep-deprived and psychologically broken. Adam Kay is a whistleblower for the effects on doctors, but some patients would rather not face up to the truth that it is impossible to deliver compassionate care while yourself being treated in a way that literally constitutes torture (extreme sleep deprivation). Rather than being angry with him, be angry with the system that treated him like that, and that is continuing to damage young doctors today.

But you do expect professionals doing their best for their patients to just turn the other cheek when offered racial abuse? I don’t think deliberately spoiling the tattoo was something to be proud of but I can completely see why he did it.

I didn't like this book, it was sneery, although it was thought provoking in terms of seeing just what life is like for doctors in the NHS. It could have achieved the latter without the former, such a wasted opportunity.

I loved it. I was amazed at the skill and strength of the people who work in the NHS and also appalled at the stories of sleep deprivation and trauma. People talk about the NHS being under-staffed, but it's worse than that - even if there were enough people for the existing setup, they would still be working long hours with terrible shift patterns and no mental health support.

Adam Kay was in obs and gynae, so of course his storied are mostly about women. I don't see anyone complaining about his retelling of the de-gloving. I think it's normal to get exasperated with some patients and frankly I would be laughing at a 9 page birth plan too.

I work in healthcare, have given hideous birth, and am a feminist. My NHS colleagues are all female and have read the book and we all love it. I think the main point he wants to get across is the unbelievable pressure everyone in the NHS is under, due to chronic underfunding, and how badly junior doctors have been treated by the Tories. He tells it through the lens of his specialty, and because it's funny it's been read widely. Mission accomplished.

It's not a book about women. Or childbirth. It's a book about the NHS. It's a political statement.

It's not a book about women. Or childbirth. It's a book about the NHS. It's a political statement.

Well put!

I'm pretty aware of misogyny & didn't detect it. Really enjoyed the book but found it v sad.

I can imagine some with a full on birth plan might be rather annoying for dr who would generally only arrive when the birth plan is mostly out the window.

I think birth plans are so helpful (and something too few women have) when they're used to plan where to give birth, who'll be with you, what to do if x happens and what to expect but also the risks. I really wish I'd had one, I had a relatively straightforward birth luckily but there were things that went not so well that could have been avoided with a plan. That said, even if a woman is with a team she feels uncomfortable with and doesn't trust to grant reasonable requests without something set in writing (eg abuse survivor requesting certain measures), she needs a clear, previously agreed plan, not the example Adam Kay gives of a lengthy series of unnecessary requests which is all but guaranteed to go out of the window.

I felt the opposite he was admiring of women. His diatribe about the woman who was refused a c section by the system and he stated what she had been through with her first birth ending with “she was so hard you could skate on her” stayed with me.

But you have to question why a woman has so little trust in her attendants that she feels she must laminate a nine page birth plan.

I’m sorry but that’s bollocks. She had never even met the aforementioned attendants when laminating her 9 pages, and if you read the book then it’s very clear that the woman in question had 9 pages of ludicrous requests because she’d bought into the fantasy peddled at NCT classes.

He’s not belittling someone who has had trauma in the past or who has a salient reasoning behind her lengthy plan, he is belittling whale song ffs.

If the ‘9 page laminated plan’ was actually true though, like a lot in the book I suspect that part was also an exaggeration, as I said before the woman was more like a caricature he used to represent women who want a bit of autonomy or a say in their care... so a really ridiculous and OTT creation is used.

I do agree that sometimes he have to look at WHY certain women are making the decisions that some drs may disagree with. Eg Home birth for women who are higher risk and are statistically safer at hospital... what is driving them away?

It's not a book about women. Or childbirth. It's a book about the NHS. It's a political statement.

Since when does claiming you're making a "political statement" excuse you from being as sneering and dismissive of women as you like?

That's bloody convenient isn't it. "No, no those comments I made about women and childbirth weren't actually about women and childbirth"

Why are you so determined to be right @SweetMelodies? Surely even you can see that there’s a strong likelihood of some birth plans being bonkers? Especially PFB ones where the woman hasn’t a clue what to expect.

@SweetMelodies I’m really sorry you didn’t get the birth you had planned for, but do you think perhaps it’s colouring your judgement a bit here? For what it’s worth, mine didn’t either. Which is sort of the point he’s making - the upset and sense of failure a lot of us have when our birth doesn’t go to plan can hang around for years. Some of us are still resentful we didn’t get our water birth after our children have gone off to university. So maybe if we had a list of preferences and were a bit more prepared for anything rather than adherence to our laminated plans, we’d be more able to cope with things inevitably not following our plans?

I’m not determined to be right? It’s a matter of opinion and I have enjoyed seeing a range of views, including ones that both agree and disagree with me.
Yes of course there’s a possibility that some women are going to have misguided and unrealistic birth plans but that doesn’t take away that on the whole they are very valuable tools to a lot of women (birth trauma and sexual abuse survivors included) and I do find it disheartening seeing them dismissed and the myth of the being all about candlelight and whale music peddled. I’m just pointing out the likelihood that specific woman didn’t even exist- who knows.

But it’s not about being ‘right’ or ‘wrong’- this is discussion about how we’ve read and interpreted the book. And that’s just still how I see it, even though I appreciate others don’t.

I think many women are idealistic about giving birth

For a few it’s a beautiful spiritual moment for the majority it’s overwhelmingly painful, utterly exhausting and all that they focus on is getting the baby out not the experience if birth

But not having gone through it it very easy to have these ideas that it will all go to plan and that your experience will be different from the majority

And HCP’s having to deal with people’s ideas/plans is tiresome and very often time wasting in many areas

I really don't see how he's being sneering and dismissive of women. He's describing the NHS currently available to women from the perspective of a junior doctor, who has been given a fuck-ton of responsibility but is still a human stretched to breaking point all the same. I think it's highly important that we do have these perspectives frankly, even if the woman's voice is not at the centre here.

So dismissive of women that he lied about a patient’s weight so she qualified for ivf on the NHS. What a bastard.

@Fenella it wasn’t really the case of not getting the birth I planned for, I had no birth plan for the birth that left me traumatised. I was unprepared and uneducated about labour and as a result didn’t know my rights and options. The care was disrespectful and the whole process felt absolutely violating. My 2nd birth was much better, I had a birth plan and was educated to know all the things that can happen in labour/birth and what different options there were so I could actually be involved. It wasn’t straightforward as of course labour is unpredictable, but I didn’t leave hospital the traumatised mess I was the first time round.

If the ‘9 page laminated plan’ was actually true though, like a lot in the book I suspect that part was also an exaggeration

You've clearly not worked in healthcare. These people exist.

the myth of the being all about candlelight and whale music peddled.

Adam Kay, an experienced OAG doctor, told you they exist. Multiple HCPs on this thread have told you they exist.

Yet you persist in saying this is a myth, just because you don't want it to be true.

Yes but it’s no reason to disregard birth plans a whole when like I say they help women be autonomous and are invaluable to women who have birth trauma and sexual abuse survivors- something that he, despite his extensive experience in (certain kinds of) birth could never possibly understand or relate to.

I understand some of the pressures of working in healthcare. I do, after all, work in healthcare. The birth plan comment is not my only problem with the book.

I, like many others on this thread, are able to see that gallows humour and misogyny are not mutually exclusive.