Why #MeToo shows we need a new approach to maternity care

40 weeks spoke to Rebecca Schiller, CEO of the human rights in childbirth charity Birthrights, about their campaign for trauma-informed maternity care


Pregnancy and birth can be triggering for women who have experienced abuse and assault in the past. I first became aware of the problem through my work as The Hackney Doula. I found that lots of women were disclosing experiences that were affecting their thoughts about birth. I also found that women who had been through a traumatic birth talked about it in a similar way to an assault. So it felt like a live issue, and it came with me into my work with Birthrights.

Not all women feel comfortable disclosing trauma. They might not feel comfortable discussing it with their midwife or GP, or they might not realise the experience of pregnancy and birth can resurface past emotions. That’s why we’re campaigning for a shift towards trauma-informed maternity care for everyone. We need to make maternity services informed and respectful, and assume that all women need that level of sensitivity, because #MeToo has shown so many do.

An individualised care plan is crucial. Midwives and doctors need to understand that women might make requests that seem unreasonable to them, but have good reason behind them. For example, she may not be comfortable with male medical professionals in the room. There is a whole range of standard things that a woman might decline, for any number of reasons.

We need specific trauma-informed training for midwives and doctors. There needs to be an awareness of abuse and how that impacts on pregnant and post-natal women. At Birthrights, we’re working with the charity Birth Companions, looking at the challenges faced by the most disadvantaged women in our society. Part of that will be listening to their traumatic experiences and asking them what would make them feel safe.

The government has promised continuity of care for all pregnant women in England in the next five years. This means a woman will have a single midwife or small team caring for her throughout her pregnancy. This will make a big difference to women who need to build that extra level of trust. At the moment, you can self-refer to small teams of midwives, but continuity of care is not available everywhere in the UK.

The subject is on the radar internationally. Because of #MeToo, there’s a global awareness that maternity provision has to change. What I have learned from the women I’ve worked with, and who we’ve supported through Birthrights, is that it’s important we make this a priority. The more noise we can make, the better.

My advice to pregnant women in the UK who have been affected by abuse is to talk to someone. If you feel you can open up to your GP or midwife, that’s a really positive first step. Birthrights has an advice service aimed at helping women who need a different care plan. There’s a great site called Make Birth Better that has a brilliant map of birth trauma services across the UK. The Birth Trauma Association is a good place for support. And don’t forget the charity Petals, which offers a great free pregnancy counselling service.

Rebecca Schiller’s book Your No Guilt Pregnancy Plan: A Revolutionary Guide to Pregnancy, Birth and the Weeks That Follow, has more information on giving birth after trauma, and is out in May (Penguin Life, £14.99).

Photo credit: Gabrielle Hall

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