Health, Women / 10 Jan 2020

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

By Jem Collins, Freelance writer
Illustration: Skye Baker

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.

Sophie isn’t the only one to find herself fighting to be heard while giving birth – and for some, the consequences can be almost deadly.

Candice Brathwaite is the founder of the Make Motherhood Diverse campaign, which calls on the government to improve maternal care for black British women.

In November, she told Channel 4’s Uncovered documentary that she was left hours from death after her fears were ignored during childbirth.

“Every midwife I spoke to said ‘you’ll be fine, this is normal’,” she explained. “I was sweating through to the mattress, I’m screaming because fluid is running between my legs, black and green goo.”

Eventually, doctors diagnosed her with sepsis an infection which can kill within hours – telling her: “If we don’t operate now, we’ll sign you off as dead by the morning”. 

“I remember there being a lot of heated words,” she continued, “because my partner was like, ‘she’s been telling you for days, how did we end up here?’ I said to my mum, just please don’t let me die.”

Brathwaite’s petition, which was closed early due to the general election, gained almost 30,000 signatures. In response, the government said it is funding research into why the risk of death is higher.

NHS England has said it is “working on improving outcomes and reducing inequalities” adding that, by 2024, three-quarters of women from black, Asian, and ethnic minority backgrounds will have the same midwife throughout their pregnancy.

Croydon Health Services NHS, where Candice was treated, said they were already working towards this.

Make Motherhood Diverse is a digital campaign launched to challenge the single story of motherhood. (Image Credit via @MakeMotherhoodDiverse Instagram)

‘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.

... They may not have seen that as a human rights violation, that is what was happening.

Credit: Skye Baker

... They may not have seen that as a human rights violation, that is what was happening.

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.”



"We cannot carry on accepting that it’s OK for women to be treated like that.

Milli Hill, author of Give Birth Like A Feminist, with her children (Image Credit: Supplied)

"We cannot carry on accepting that it’s OK for women to be treated like that.

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?

Maternity services are “under as much pressure as ever before,” according to the Royal College of Midwives (RCM), with around 2,500 midwife vacancies in England alone.

In a manifesto released by the union ahead of the December general election, the RCM called on parties to review the resources that maternity services get, saying the sector “is at a virtual standstill.”

One midwife, who asked not to be named for fear of being seen as political in the wake of the unreleased death in childbirth report, told EachOther that funding shortages “impact hugely”.

“It’s not only in the sense that staff shortages mean everyone is working like crazy and that we’re constantly rushed,” they said. “It’s also equipment-wise. You have to leave your room where you’re providing one-to-one care to find a piece of equipment.

“You’re not only leaving women who may need you, but I also think it makes women trust us less as a unit as we are forever searching for things we need.”

However, they added that they “don’t know any midwife that came into this job not wanting to support women”, adding that “it only takes some negative comments from a few women to put the fear in others, and then it’s so hard for us to gain their trust back.”

They believe respecting women’s rights in childbirth is about education early on in the process.

“It all starts with antenatal education – that’s a huge part in preparing women and their partners about what they can expect. It’s lovely when women have a real idea of how they want their birth to go, however, it’s not always possible. 

There are 2,500 midwife vacancies across England (Image Credit: Christian Bowen/Unsplash)

“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.