How Risk Is Presented In Pregnancy

Today, Big Birtha was honoured to participate in a discussion about how risks are presented to women in pregnancy, organised by the British Pregnancy Advocacy Service (BPAS).

The room was filled with intelligent, interesting and influential women, from many different backgrounds, but who all share the passion that the way things are at the moment needs to change, and what can we do to bring about this change?

After years of running this blog, and feeling pretty isolated at times, it was so lovely to be in a room of like-minded people who agree that actually;

It’s not OK to make women feel failures that they are providing a ‘suboptimal’ host for their baby for whatever reason; be that because they dare to be overweight, or over 35 years of age, or have a medical issue controlled by medication, or want to enjoy the occasional glass of wine, or because they haven’t been taking folic acid and other dietary supplements religiously since reaching childbearing age just-in-case…

It’s not OK that statistics are often presented in the most alarming fashion possible – where relative risks are focused upon as routine because it’s a sure-fire way to make very small discrepancies look much more significant and scare the bejeezus out of us.

It’s not OK to unduly worry women and make them feel guilty about their situation, when that additional stress serves no purpose, can actually be detrimental, and is often at a point where the woman is not in a position to do anything about it.

It’s not OK that during a time when a woman is most apprehensive and in need of support and reassurance that she can be made to feel like she’s a bad/selfish/negligent mother who is undoubtedly doing harm to her unborn child, when she’s probably doing the best she can right now, probably has a perfectly healthy baby gestating inside her, and needs to be able to build rapport with and trust her care givers, not feel wretched every time she has contact with them.

It’s not OK that studies tend to focus exclusively on the behaviours/circumstances of the mother when drawing conclusions (usually negative!) about maternal actions and the consequences on their children (and sometimes their children’s children!), completely ignoring paternal and other societal influences role to play.

It’s not OK that when the media reports on scientific studies and research that the results are often presented with implied blame on the mother, usually from the most sensationalist angle, and that studies with poor methodology but the most sensationalist claims get more attention than those that are more balanced and better planned.

It’s not OK that women aren’t trusted to be able to look at the evidence (or sometimes lack of it!) for themselves in order to reach their own decisions about what’s best for them, their fetus, and their family, and instead are regularly presented with an oversimplified version of the available research, or worse still, a blanket ‘this is policy’ with no justification whatsoever.

It’s not OK that women routinely don’t feel supported in their ‘high-risk’ pregnancies, but that they’re a problem or ticking time bomb to be ‘managed’.

The fight for a more balanced, consultative, and respectful treatment of women in pregnancy is far from over, but this meeting really felt like the start of something positive.

If you want to see more of what BPAS have been doing on this topic, they’ve written some great press releases here:

www.bpas.org/about-our-charity/press-office/press-releases/

The Marks Of Life

I’ve had this song going round in my head for days.

In case you missed it, it’s blogger Sophie McCartney’s take on Ed Sheeran’s ‘Shape Of You’ from a Mum’s perspective; gagging at the smell of baby poo and vomit, dealing with toddler tantrums, wondering where that strange smell is coming from, dealing with fussy toddlers at mealtimes, thanking God for CBeebies. It’s all there.

It was funny the first time, and the second, and the third… And now whenever ‘Shape Of You’ comes on the radio I no longer hear Ed’s original lyrics. Even if I do sing under my breath because I don’t really want the kids singing ‘Smell of Poo’ at the top of their lungs at every opportunity; scatological humour being their very favourite, of course, they’re kids…

Except one refrain keeps jarring with me; “What have you done to my body?”, sung as she wriggles and struggles trying to fit into a pair of jeans.

I can’t blame or credit my kids for my body – it looks pretty much the same as it did before they came along; saggy bits, wobbly bits, stretch marks, flat feet; it all predates them! No blame on their little heads!

Which got me wondering… do some skinny mums resent their kids for what pregnancy has done to their figures? Even if it’s just a tiny tiny bit, buried deep in the subconscious, that’s terribly sad.

Personally, I feel it would be far better to resent society and the beauty industry for suggesting that women should conform to some unrealistic ‘spring back into shape’ notion immediately after childbirth – but it’s hard to argue with the subconscious!? I know the mum in the video is playing for laughs, but as the saying goes ‘ many a true word spoken in jest’.

I’d never considered how the flipside of pressuring new mums to get back into shape, actually subtly implies that the children are to blame; the magazines don’t tend to call it ‘pregnancy weight, but ‘baby weight’, after all and language is a very subtle but powerful manipulator.

I don’t buy magazines, nor seek this sort of thing out online, so I don’t see this on a regular basis, but now I’ve been thinking about it, I’m glad this sort of content doesn’t appeal to me. Certainly, having a quick look before writing this showed just how much judgemental content there is out there for new mums in terms of body image.

When I’d just had my babies, I was blissfully ignorant of any such pressures! In hindsight, being fat and opting out of mainstream media actually seems like a really positive life choice! I just got on with being a new mum, trying to fathom my path through the sleep-deprived, bodily-fluid-covered, chocolate-digestive-fuelled world that is early parenthood; enjoying it and being exhausted by it in roughly equal parts.

At a time of the greatest upheaval and steepest learning curve in their lives, women should be able to just be with and enjoy their babies! But seriously, could this actually affect how women bond with their babies – wasting valuable time and effort trying to get back into the pre-pregnancy skinny jeans, and potentially feeling a sense of failure if they don’t achieve that lauded goal at a time when our hormones are naturally all over the place surely can’t be ideal?

I know I moan at times of the treatment of bigger mums. But actually, in this case I’m glad that my early days as a mum weren’t infected with this kind of poison. I felt no such pressure. Plenty of other pressures around keeping a tiny human alive, but none of this nonsense, and for that I am eternally glad.

For me, pregnancy and childbirth was (and should be!) a time of absolute wonder and amazement at what my not-so-little body was capable of. Well, wonder, amazement and general queasiness, but hey, that means the hormones are all working as they should, right?

Right from the first realisation that carrying a child had suddenly awakened my ‘spidey-senses’ and I was now able to detect the nauseating whiff of a tuna sandwich from half a kilometer away, to feeling the babies wriggling around inside me, to discovering that the dairy had sprung into production surprisingly early (about 20 weeks early!), through to having two awesome, pop-a-pea-out-of-a-pod births, and then feeding them well into toddlerhood, my amazing body did all of that, and I’m bloody proud of it. Wobbly bits and all.

In the Willy Russell play/film Shirley Valentine, the inveterate charmer, Costas talks about Shirley’s stretch marks:

Don’t, don’t be too stupid to try to hide these lines. They, they are lovely, because they are part of you, and you are lovely, so don’t, don’t hide, be proud. Sure. These marks show that, that you are alive, that you survive. Don’t try to hide these lines. They are the marks of life.

Shirley replies – to the audience; “Aren’t men full of shit?”, but do you know, I’m with Costas one hundred percent. Shirley reads too many magazines…

Sharing the love

The BigBirthas website has been active for a little over two years now. While I haven’t ever got as much time as I’d like to work on the site, it isn’t hard to stay motivated, as every so often I get a lovely email from someone in the BigBirthas community about how the site has helped them.

I don’t usually share them, but thought maybe it’s time I did (with permission!) so here is my most recent lovely email from ‘Jo’:

I just wanted to say an enormous THANK YOU for your website! I have just discovered I am pregnant after trying to conceive for some time so am over the moon! But am already being body-shamed and fed so many scare stories from the medics that I fear they will make me high risk purely through scaremongering! I’m certain sure my body is not high risk and needed some evidence and research to back it up!

Your wealth of information and reassuring guidance on your amazing website has calmed me down and empowered me to advocate for myself during appointments and in particular, push strongly for a water birth which I have always wanted. This must have taken an awful lot of time and effort (there is so much info there!), but it is a lifesaver for women like me. I will be visiting your page often throughout the next few months!

Thank you

Jo

So for Jo (huge congratulations!) and everyone else reading this, you are most welcome. It has been and remains truly a pleasure.

I’m only sorry I still haven’t got round to finishing researching and writing the many articles that are still languishing in my ‘draft’ box – many of which are little more than titles. I still think I will get round to it! But it seems the right time to reflect. I’ve been involved in a few campaigns over the time that BigBirthas has been active – trying to positively influence birth treatment and outcomes, for everyone, not just the larger ladies in our community, and now the Maternity Review was just published yesterday. I’ve not read all of it yet (there’s over 100 pages!) but it does seem to be suggesting more woman-centred care, which can only be a good thing, in my opinion!

So if you’ve just found out you’re pregnant and are apprehensive of what the future brings, welcome. There’s a community here. Be strong. Have faith in your body’s innate abilities. Don’t be afraid to speak up for yourself. Request to see the evidence base on which treatment is being recommended, and object/refuse/work to find an alternative where you experience prejudicial treatment that has no good evidence for its imposition.

And if you’re ever feeling low, or as though you’re not ‘supposed’ to be pregnant, do a Google image search for ‘fertility goddess’ or ‘mother goddess’. See those carvings and sculptures of women with big breasts, big hips and big tummies?

The ancient people who made those figures knew what they were talking about.

You are a goddess.

Don’t you forget it.

Halcyon Birthing Centre Facebook Plea

You may have seen this pop up on your Facebook feed.

The text reads:

This is the Tranquility room at Halcyon Birthing Centre in Smethwick, where Rosie Bo came into the world yesterday. This standalone midwife led unit is an amazing NHS facility that is at risk of closure if it doesn’t increase it’s average birth rate of just 1 per month currently (since no-one knows about it)! Open to all low risk women, regardless of area. Fixed pool in each room, flat screen TV and DVD player, double bed for both parents to share after delivery and totally unrestricted visiting. Please help us spread the word by telling anyone you know who’s pregnant! 

http://m.youtube.com/watch?v=pV7vBFkSb-o

Halcyon Birthing Centre, Smethwick

This makes me so sad.

Why is such an amazing facility so underused? What is putting women off attending there? Do they really not know about it?

I know why I didn’t go there.

I gave birth to my second child in my lounge, with an inflatable pool, my husband, and two wonderful, supportive midwives just 2.8 miles from The Halcyon Birthing Centre.

Of course, I wasn’t eligible to use the centre on the grounds of my high BMI

No other complications. None. Monitored throughout for blood pressure, diabetes, macrocosmia (big baby), all the usual suspects. None arose. Just high BMI.

It was a fabulous birth.

Knowing what I know now, I would plan for all my future births to be at home. We’ve actually decided our family is complete, but at the time of planning what became a home birth, I would have been delighted to be welcomed to this facility, but it was not to be. And so, I fought my fight for my treatment to be on my terms, got the fantastic birth I wanted, and the Big Birthas site was also born out of the process.

You probably wouldn’t be reading this now if I had given birth in the Halcyon. But I wonder if I had, would you then be reading the above plea on Facebook?

If they want to increase attendance, they could perhaps consider how they evaluate ‘high risk’ cases as a starting point. Just a thought.