Give Birth Like a Feminist. Milli Hill

– but not a lot of people know this. You would think it would be obvious – of course nobody can put their fingers inside your vagina if you don’t want them to, right? But the majority of women are unaware that they are perfectly entitled to decline. Furthermore, some women report a nagging sense that they are entitled to decline, but are unable to voice their refusal, whereas others do manage to decline but are then either directly or indirectly coerced, for example by being told they cannot be admitted to the ward or use the birth pool unless they comply, or by simply being told they ‘have to’ – which is of course incorrect, as you don’t ‘have to’ allow anything to happen to your body against your wishes. Still others consent to the VE but are told afterwards that the midwife or doctor gave them a ‘sweep’ or broke their waters ‘while they were in there’. Women to whom this happens report finding it extremely violating and yet rarely complain formally about it, perhaps because there is a widespread and unspoken acceptance that maternity care requires you to ‘leave your dignity at the door’ and can at times be violating by its very nature.

      Of course, you may actively want a VE, or indeed any other birth intervention. Giving birth like a feminist isn’t about declining everything, it’s about knowing that you can, and the shift in the power dynamic this brings. To use another example, in your sexual relationship, you hopefully know that if you say no to your partner at any point, they will respect your wishes. You may have been with your partner for just a few years, or for decades, and in all that time you might never have said no to them, not once. You might have said yes, yes, YES to everything! But all along, you have known that, if you wanted to say no, you could say it, and be respected. Just think how the power balance of your relationship would change if this fundamental and often unspoken understanding was not in place? And yet this is the exact dynamic in which the majority of Western women give birth.

      Good girls

      There is a wider issue of compliance to those in ‘white coats’ that can affect all of us and is not purely a women’s issue. Most of us, male and female, have been conditioned to accept without question that ‘doctor knows best’ and to follow their ‘orders’. However, there is something about being female that makes challenging authority of any kind particularly difficult, perhaps because, as young girls looking around us as we grow, most of ‘authority’ is male. Politicians, lawyers, scientists, doctors, artists, philosophers: the default human-on-a-plinth is almost always male, and we grow up looking up to them and, consciously or unconsciously, absorbing maleness as synonymous with ‘leader’. The feminist campaigner Caroline Criado Perez has tackled this head-on, getting the first statue of a woman – Millicent Fawcett – in Parliament Square, along with Jane Austen commemorated on the new £10 note, but even in the twenty-first century, these are notable exceptions – and it’s worth remembering too that Criado Perez has been vilified in the media[16] and even sent death threats for her activism in this area.

      As women, the social conditioning of a world dominated by men comes in tandem with consistent messages that compliance makes us more favourable humans. From birth, or even before, our culture encourages us to give girls toys, books and movies that suggest that being a girl has some connection to being passive rather than active, and conformist rather than confrontational. Even if we try to escape this as parents, our daughters will inevitably be given ‘home and beauty’ based toys of mirrors, cleaning equipment and plastic food, and often taught to sit neatly with their legs together, quite literally taking up less space than their male counterparts. Shoes, bags and even duvet sets are targeted at specific genders and carry similar messages: the emblem of the girl is the shy and gentle butterfly, while boys have dinosaurs and sharks as their totem animals. Even the clothes we are socially encouraged to choose for our daughters, and that they in turn are encouraged to choose for themselves, hold them back – and I speak as a mother who has spent many hours in parks watching little girls struggle to navigate climbing frames in a dress, while the boys are already ahead in their more practical and durable fabrics. Perhaps due to this early conditioning, once they hit school age girls are generally better at ‘self-control’ than boys,[17] and hence will be praised more consistently for being ‘good’, which tends to mean, ‘quiet’, ‘still’ and ‘not challenging’.[18]

      Believe it or not, although you may not have been referred to as a ‘good girl’ for at least a couple of decades, you may well find the phrase returning to your life if you are pregnant, and even – yes, really – you may hear it loud and clear while you are ‘pushing’ your baby out. In February 2018 medical student Natalie Mobbs, NICE fellow Catherine Williams, and Professor of Maternal Health at the University of Liverpool Andrew Weeks – wrote an opinion piece for the British Medical Journal entitled ‘Humanising Birth’,[19] about the use of language in maternity care. In it they called on health professionals to consider more carefully the words they used to pregnant and labouring women, and alongside several other problematic examples, they called out the phrase ‘good girl’ as disrespectful to women as autonomous adults.

      ‘While some may mourn the days when the doctor was in charge and their advice was gratefully received and unchallenged, there are now multiple, alternative sources of healthcare advice available to women both before and after consultations. With improved knowledge among women and a renewed recognition of respect for human rights in childbirth, comes an equalisation of status between doctor and woman,’ they wrote, concluding, ‘The role of birth attendant is no longer “owner” of the situation but “facilitator” of the health services.’

       LANGUAGE OF MATERNITY CARE TO CALL OUT OR CHALLENGE

Language Used	Why it’s wrong	Alternatives
Delivered	Pizzas are delivered, babies are born. And if they are delivered, it’s the woman who delivers them, nobody else!	Gave birth Caught e.g. ‘Dad caught the baby’
Am I allowed? They did not let me	Women have the moral and legal right to make decisions about their birth. They cannot be compelled to make certain choices, nor should they have options denied to them. If anyone does any ‘allowing’, it’s the woman.	I am allowed
Failure to progress	Nobody ‘fails’ at birth	Slow labour
Only three centimetres	Using negative language to describe the progress of labour can make some women feel discouraged, at a time when they need to be positive.	Three centimetres already, that’s great!
My induction in room 3	Reducing women to the intervention they are experiencing or the type of birth, etc. dehumanises them. Saying ‘my’ implies possession.	Say her name
Trial of scar	Used to describe a VBAC. Will there be a judge in a wig?	VBAC or just ‘birth’
Good girl	It’s infantilising. Is this Saint Trinians?	Fantastic, that’s really helpful, thanks
I consented her	Consent is actively given by the woman, not obtained while she remains passive.	She gave her consent
I just need to get your consent	Decisions should be made by the woman after full information is given and she should be made aware that she can decline or consent.	These are your choices … the