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Guest post: “When we hear about birth we often hear two very distinct stories”

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MumsnetGuestPosts · 08/07/2019 14:48

If you’ve had a difficult birth in the past, or are preparing to give birth at the moment, you may want to read this post with someone you feel able to talk to about any feelings that arise.

When we hear about birth we often hear two very distinct stories – that it’s either terrible, or wonderful. People talk about birth ‘horror stories’ that leave women and their families suffering, or they talk about the beautiful empowering experience of birth. When we talk in such dichotomies, there’s little room for those in the middle whose experience is often a little bit terrible and a little bit wonderful (and sometimes a little bit exciting and a little bit terrifying and at times even pretty boring). This can leave many people feeling unable to talk openly about their experiences – and whether birth is terrible, wonderful, or somewhere in the middle, we know that it can leave a huge impact on us. It’s the entryway into our parenting experience, and if we come out feeling that it hasn’t gone the way we had hoped, it can mean the start of that journey is complicated.

A year ago, I set up an organisation called Make Birth Better with my colleague psychiatrist Dr Rebecca Moore. We’d noticed this black and white way of talking about birth and wanted to provide a platform to showcase the wide variety of stories and experiences that exist around birth – from both parents, healthcare and birth professionals. We also noticed how few birth stories exist from people who, research shows, might face additional stigma from maternity services such as Black and Minority Ethnic women, same sex couples, trans individuals, non gender conforming people, those with physical or learning disabilities, women living with disadvantages. It’s only by showing how varied birth can be that we can start to speak about every kind of birth story.

Over the past year, we’ve met with women, partners and professionals to ask them what they felt could make birth better. While often antenatal education and stories about birth focus on the women or birthing person’s responsibility to educate and empower themselves, we heard stories about how ineffective preparation can feel when you enter a system which is, in itself, traumatised. Overstretched and overstressed maternity services can feel like they are reactive, rather than proactive, with midwives often dealing with more than one person in labour simultaneously, without time for a loo break let alone to learn about a person’s birth plans.

We’ve started to create a new story around birth. One which includes not only the woman or birthing person and her partner, but also the staff who will travel that journey with a family. And if we’re to include staff, we also need to include the systems that exist around them – the teams which support them, the organisations which treat them with either kindness or blame. If we begin to see birth not as a solo affair but a collaboration between all of these different layers of the system, then we can create a new narrative. That includes all of us too, of course. So that we not only share the different and varied birth experiences that we have (being mindful of any parts that could be emotive), but we ask to hear others’ experiences too. Then we can hear about births that are neither horror stories or fairytales, neither black or white, but full of colour.

If you’re reading this currently preparing for birth, do take a look at the online resources at www.makebirthbetter.org and take a look at the Positive Birth Movement, Association for Improvements in Maternity Services & Birthrights. If you’re reading this and you think you might have some symptoms of trauma following your birth, do take a look at those resources too as well as the Birth Trauma Association who have an active peer support group on Facebook.

Emma’s new book ‘Why Birth Trauma Matters’ (Pinter & Martin) is published on 11 July.

EDITED BY MNHQ Emma will now be coming back on Thursday at midday

RowanMumsnet · 09/07/2019 14:47

Hello

It was us on the campaigns team who asked Emma to write this post about birth trauma - Make Birth Better are making some waves in this field at the moment and we on Mumsnet Campaigns know how deeply lots of MNers feel about birth experiences, especially those that go badly and have lifelong health impacts for mothers, so we asked Emma to write something for us.

With that in mind I just wanted to speak up for Emma's language here - I spend a lot of my time talking to maternity professionals and helping trans men to give birth is a standard part of their professional duties. As part of their professional duty to respect the person they're caring for they absolutely respect their gender identity - after all it would be quite odd (and inappropriate) to start disputing with someone about their gender identity in the course of delivering maternity care.

Emma will be coming back to the thread to chat at midday on Friday so she can express her own viewpoint then. It just would feel a bit of a shame if birth trauma (an issue of extreme significance to so many MNers) gets lost in this thread.

Thanks, and peace and love and all that

RowanMumsnet · 10/07/2019 10:08

@SinkGirl

Tears are more common now because episiotomy is not done routinely. Episiotomy was previously done in the majority of births - by 1979, up to 80% of all births in the US involved an episiotomy, so more than that will have involved stitches. It started being used more commonly in the 1920s gizmodo.com/a-brief-history-of-vaginal-cutting-during-childbirth-1710537581

Higher rates of epidural also leads to increased intervention and therefore episiotomy and tearing.

I recently went to a presentation about a new clinical trial looking at the prevention of third and fourth degree tears (and specifically anal sphincter injuries), and this particular trial recommended episiotomy in cases where women looked likely to have very bad tearing - which was controversial among some HCPs taking part, apparently. I thought it was interesting that we could be seeing the rehabilitation of the episiotomy (albeit in really specific circumstances)

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