Dying To Be Heard: The Fight For Mothers’ Rights In Childbirth

Sophie Palmer* believes the birth of her first child was much more painful than it needed to be. Allergic to painkillers, she had requested a water birth. But on the day she went into labour, her wishes were “ignored”.

Sophie, who did not want us to use her real first name because her family work at the hospital, was 20 years old at the time.

At a first glance, this might not sound like anything out of the ordinary – after all, at this age you are entitled to vote, join the army, and are likely to have left home. But, as the average age of mothers continues to rise, she is in the minority.

Her relative youth is the reason she thinks her birth plan – an official document which lets expectant mothers specify what they would like to happen during their labour – was completely disregarded.

“Because I was only 20, I wasn’t respected and my instinct wasn’t trusted,” she said. “I was telling the midwives for hours that I felt I was in full labour. They just kept telling me I wasn’t and I had a lot more to come. 

“After about four hours of me begging them to check how dilated I was, they finally gave in and checked. I was fully dilated and had to be rushed down to the delivery suite and my daughter was born 20 minutes later.”

The delay in treatment meant there was no time for Sophie to have the water birth she specifically requested to ease her pain.

“I had an entire appointment dedicated to sorting a birth plan,” she continued, “it was such a big thing, but the midwives at the hospital weren’t interested in it at all. I really wanted a water birth, but because they wouldn’t listen to me, it was too late by the time they did.”

Her NHS Trust has been approached for comment.

‘Women Should Be Encouraged To Speak Up’

According to a 2018 report from watchdog MBRRACE UK, almost ten in every hundred thousand women die while pregnant, giving birth, or shortly afterwards. It’s a low statistic, but there’s more to these figures than meets the eye. 

Among the report’s recommendations is that “women should be encouraged to speak up, health care professionals need to challenge their own assumptions and check out concerns”. 

The figures show that Asian women are two times more likely to die than white women. For black women, the likelihood of death is five times higher.

In 2019, human rights charity Birthrights released a report revealing that women who experience “multiple disadvantages” – including mental or physical health issues, social isolation, or trauma and abuse – are at greater risk of having their rights violated.

“In many cases, we heard experiences which suggest women’s rights to safe and appropriate care, to autonomy and dignity, to a private and family life, and to equal treatment are not being protected,” the report’s authors concluded.

A survey conducted by the group last year found that more than a quarter of 1,100 disabled women felt that their rights were poorly respected during maternity care. More than half said their healthcare provider did not have “appropriate attitudes to disability”.

Birthrights is currently locked in battle with NHS England over the release of an annual report on deaths in childbirth. NHS England blocked the publication of the report in the lead up to the general election, blaming “purdah”.

Last year’s report revealed an increase in the number of deaths from 202 in 2013-15 to 225 in 2014-16.

However, putting targets and statistics aside, the issues faced by women in labour go much deeper. Campaigners say it’s about our fundamental human rights.

This ethos underpins Birthrights, a charity that exists to promote women’s human rights throughout pregnancy and childbirth. 

The group was founded in 2013, after human rights barrister Elizabeth Prochaska discovered “more and more midwives and women who had had the opposite experience” to her own labour.

“[We’re talking] poor or disrespectful care, or in some cases abusive care,” CEO Amy Gibbs told EachOther. “And while they may not have seen that as a human rights violation, that is what was happening.”

The charity now aims to fill the “real gap” between “supporting healthcare professionals who want to provide respectful care which puts women at its heart” and “supporting women so they’re more empowered about their right to choose what happens to them”.

“Basically, for us, human rights matter because they demand that women are treated with dignity and also that women are treated as individuals. 

“They remind us that pregnant women are not just a means to an end. We aren’t just a vessel for having a baby, we remain human beings with our own rights and needs.”

Milli Hill, the author of two books about giving birth, founded the Positive Birth Movement – a worldwide network of more than 300 free antenatal groups worldwide – in 2012.

She originally started blogging about her own experiences as a pregnant woman and found a “tidal wave of people getting in touch”.

“I don’t think I had too bad an experience,” she told EachOther.

“But I know it was traumatic. But some of the stories I hear from other women … they really motivate me to keep going. We cannot carry on accepting that it’s OK for women to be treated like that.”

In particular, she talks about a culture where “there is a history where women have to do what they’re told”, where women are denied the right to make decisions about their care, or they are belittled by those looking after them.

She describes it as a “pyramid” where smaller issues build up into a much bigger problem and culture.

“The phrase ‘good girl’ comes up occasionally,” she tells EachOther, “and many people cannot see the problem with some of these sorts of words. 

“I find it really infuriating, because it does paint the theme for this imbalance of power, where women are being infantilised, feel they don’t have a voice, and are not in control of what’s happening to them.”

All in all, Milli says that a “wide scale attitude shift is needed”. But just how realistic is this?

“Birth is very unpredictable,” they continued. “Things don’t always go to plan, so if women and families come into the process with enough knowledge behind them, they aren’t left to make sudden decisions in emergency situations.

“It’s all about working together in that sense of what will help them feel more comfortable and relaxed. We can have an easy discussion with a couple in a class, but when they are in pain in labour it’s harder to make an informed decision.

“Everything is their choice [though]. If they are fully informed coming into the process it makes the whole thing less scary and no one is left not understanding what happened.”

When approached by EachOther, the RCM also pointed to their best practice guidance for both women and midwives, as well as a new e-learning course about human rights and maternity care.

The Conservative government pledged in its election manifesto to make Britain “the best place in the world to give birth”.

However, the party’s spending plans have been criticised as being misleading, and no mention has been made of hiring more midwives.

For mothers in the delivery room – dying to be heard – change can’t come fast enough.

* Some names have been changed.