Open Letter to the NMC

open letter to NMC freedom for independent midwives

I’ve mentioned this in passing in a few posts recently, finally I’m able to sit down and write a full post about the farcical treatment of independent midwives by their governing body, the Nursing and Midwifery Council (NMC). The backstory to this goes back years. In very brief summary, in 2014, it became mandatory for all health professionals to have indemnity insurance. Prior to this, independent midwives (IMs) were practicing without insurance. Clients would simply sign a declaration stating that they understood this, myself and the husbeast signed such a document when we hired our IM in 2011.

This worked absolutely fine in the overwhelming majority of cases. For two main reasons; first, the client entered into this arrangement with full knowledge and acceptance of it. If it had been a deal-breaker for a client/couple, then they simply wouldn’t have hired the IM and would have sought midwifery services elsewhere, either through the NHS, or a private provider (note: independent and private midwives are very different. Private midwives are employed by a corporate/private maternity care provider. IMs are self employed, totally independent and traditionally free from corporate/insurance interests).

Second, it is generally recognised that IMs provide the gold standard of midwifery care, therefore adverse outcomes are extremely rare. In the exceptional circumstances where something did go wrong, AND the IM was found to be negligent, it was up to the client whether to pursue a legal case or not. With the relationship typically built up between woman and IM, it seems inconceivable that the woman would decide to bankrupt the midwife. Of course, there are a couple of cases of this happening, but it is essential to look at the big picture and assess whether broad strokes that affect nearly 100 midwives and the many thousands of women that they care for are proportionate to the tiny number of cases where lack of insurance was a serious problem.

The reason that IMs were practicing without insurance was that there wasn’t an insurance product available to them. Insurers, with no knowledge of birth or midwifery, considered it too high a (financial) risk.

In 2014, however, when IMs were left with no choice in the matter, they found a provider who was able to create a custom policy tailored to their practice. Any IM registered with IMUK was covered by this insurance. Everything seemed to be going smoothly, until late last year, when the NMC suddenly decided that the insurance they had in place was not adequate. To date, they have refused to explain in what way it is inadequate, or what additional coverage would make it adequate. There have been muddled statements about there not being enough money in the pot to make a single large payout. However, it is my understanding that this isn’t true, and that if a claim were successfully made against an IM, there would, in fact be adequate funds available by the time the payout was expected to be made.

The NMC refuse to accept this and simply forced all IMs to sign a contract, under duress, stating that they would no longer attend births. The lack of warning left hundreds of women without their midwife for their births. Apparently, the NMC found this acceptable.

Birthrights and other organisations have been working tirelessly on this issue. Below is an open letter, written by Birthplace Matters founders, Paula, Jeannette, and Anna. The complete document and correspondence history can be found here. Please feel free to share widely. Tweet the NMC @nmcnews and #savethemidwife and make your voice heard. IMs and birthing women need our support.

Open reply to the NMC from Birthplace Matters – March 2017

Dear Catherine Evans and Emma Broadbent,

Thank you for your response to our letter. It is clear that your goal is to focus on compensating mothers after the event of their birth. We wish to explore this in broader terms and discuss what really matters to the many mothers we hear from at Birthplace Matters.

It strikes us that when a woman is hiring an independent midwife, it is often done as an act of insurance, to protect herself and her baby from damage which she does not want to repeat from an earlier birth. Sadly, the damage we hear about is occurring far too often as a result of ‘routine’ or commonplace procedures which are happening every single day up and down the country.

As such, far from being a luxury lifestyle choice for a wealthy and privileged elite, a woman’s decision to hire an independent midwife is much more often an act of desperation following anxiety attacks, symptoms of PTSD, and feelings of anger and sadness following an experience of giving birth under NHS care. Often, they just want to avoid the same ‘routine’ procedures and treatment again.

Your statement that women still have the option of choosing non-IMUK midwives, fine though they may be, is not actually viable for some – since some women live too far from one for that to be a safe option for birth – especially for 2nd, 3rd, or 4th babies etc, who may come too quickly for a midwife to drive 3 hours to her. In such cases women are left facing the option of going back under NHS care, choosing to birth alone with no midwives, or, as we have been hearing more and more recently, actually choosing not to have any more children. All three of these options are unacceptable when taken as acts of desperation. Do you see now what peril women are in because of this insurance fiasco?

Without exaggeration, some stories we have heard by women describe their birth in the language that rape victims use about the violation of their bodies by strangers. Some are triggered for weeks, months and even years afterwards, often suffering silently. Even if a birth appears on paper to have been a success, with no legal category for suing a hospital, it doesn’t always mean that a woman walked away from her birth experience unscarred. There are invisible wounds which cannot be accounted for in a tick-box on an insurance claim form. Some feel too beaten down to fight anyway.

We are hearing frequently from women who say they were ignored, laughed at and even abused by NHS staff – ironically, your actions in preventing IMs from practising is pushing some women to have to go back to the same place and potentially go through the same traumas all over again.

When we allow insurance companies, governments, and lawyers to determine the T&C’s of birth, it can be interpreted as a carte-blanche to behave appallingly, in the arrogant guise of rescuing women and protecting babies by a highly interventionist approach. The onus on deciding what is safe is therefore shifted away from the mother, where it rightfully belongs, and is assumed by her care team. When a woman is not trusted to make informed decisions, but is instead bullied, this undermines/violates her rights over her own body and her own baby.

This is why so many women seek out an independent midwife – because the word independent means just that – they know full well that whilst their midwife is insured for what is to most mothers, a reasonable and reassuring sum, these midwives are not entirely in the pocket of insurance companies so are not motivated primarily to satisfy insurance company tick boxes over and above the wishes of the mother. They often avoid the same knee-jerk interventionism that is offered within NHS settings, providing instead truly 1:1 watchful, continuous care with the time and space to be with-woman in the way that midwives in hospitals cannot due to restraints outside of their own control. Without wishing to offend individual midwives within the NHS who offer sterling care, we feel that this continuity actually makes independent midwifery a much safer model.

Even the very best NHS midwives will sometimes admit they are just too busy to truly give the full care and attention they would wish they could give to women, knowing that CTG monitors are a poor substitute for 1:1 care and have not been shown to have saved even one life. Even in those places where the NHS aspires to offer truly holistic care, it is not always consistently available for all women coming through the doors. When women are lucky enough to receive truly individualised and holistic care it is more often than not at a personal cost to a midwife’s career progression.

There are so many good NHS midwives working within the system who are being disciplined and over-ruled to satisfy bosses who are thinking of insurance and malpractice tick-boxes first and foremost. Many are leaving the system altogether due to stress and burnout in their attempt to balance gold standard care with restrictions from on high. As well as working within ever more restrictive insurance company T&C’s, it must also be said that the over-riding of mothers’ wishes within the NHS is done in a spirit of old-fashioned paternalism which is very tiring for women to have to put up with in 2017 after all the gains we have made to improve women’s rights elsewhere.

In the light of what we have discussed above, we at Birthplace Matters feel that the NMC’s definition of what it means to protect women and their babies needs to be re-evaluated. In 2017, it ought to mean so much more than a woman’s ability to claim financial reimbursement in the event of lifechanging birth complications – since no insurance company should have a monopoly on defining what those complications are. Clearly, many women are left scarred by their birth experiences in ways that are invisible, but are very real and life-changing for themselves and their babies in ways that affect whole families. Offering a wildly inflated sum like £10m is meaningless to a mother who has to drive a 10 mile detour so she doesn’t have to go past a hospital where she gave birth and who does not want to relive the trauma all over again by pursuing a legal case – especially if the hospital closes ranks and proposes what constitutes harm by their own definition only, ignoring or belittling her complaints.

The insurance cartel that is taking over birth practice is turning this very natural process into an increasingly clinical event with unhappy consequences for many mothers and babies. If such insurance-dominated practice was translating into safer and more satisfying birth it would make sense – yet the opposite seems to be true, judging by the soaring rate of inductions and other interventions which drive up the cesarean rate.

We ask that you pay attention to the voices in the #savethemidwife campaign and recognise the ridiculousness of telling independent midwives they are not insured for enough without stating what ‘enough’ is, leaving them and their clients in a state of confusion and despair. Why not let mothers decide on what level of insurance they want to choose rather than letting the insurance companies dictate whether a woman can afford an independent midwife, or not? Independent should mean just that – forcing them to fall in line with the NHS suggests you do not appreciate the difference between the two uniquely different models. They should remain separate as they have been to date, and women should rightfully be at the helm in choosing what they need.

Yours in frustration,

Paula, Jeanette and Anna – The Birthplace Matters Team

Change Your Visual Diet & Learn To Love Your Body

This year I’m going to learn to love my body. These are my top tips for anyone else who wants to break the bad habit of negative self-talk and poor body image.

visual-diet

As I mentioned in my last post, I’ve been doing a 30 Days of Yoga challenge. This particular challenge is really great because each session is really short, just 10 to 15 minutes, so it’s super easy to fit into my busy day. I aim to do one session each morning as part of my hacked Miracle Morning (more on this in a later post!)

The first two weeks or so were so great. I had taken a long hiatus from really any kind of exercise, so this was a beautiful way to introduce some movement back into my day. I’ve always loved yoga and for some periods of my life I have taken regular classes and gotten into really strong and flexible shape through it. But I started to struggle with this challenge once the novelty wore off and I started getting into the habit-forming part of the challenge (2-3 weeks in). I’m still doing it daily and will see out the 30 days, because it’s important for me personally to finish what I start. But after that, I’m going to be finding a new virtual instructor.

My struggle with this challenge has nothing to do with the difficulty, although parts of it are very physically challenging, but hey, it IS a “challenge” after all, so there is no problem inherent with that. No, unfortunately the struggle I am having is with my size. I am now by far the biggest I have ever been. Luckily I’m still pretty flexible, but there are definitely some yoga poses that simply aren’t achievable for me because my belly, for example, gets in the way! Basically any twist where I need to cross my arm over my body and bring my elbow to meet the opposite knee. Not gonna happen.

yoga-frog

The instructor, while adorable, perky and encouraging, is pencil thin. I mean this in the nicest possible way and am in no way trying to body shame her AT ALL. We are all different and beautiful and that’s great, but I’m finding it really difficult to look at the screen and see a svelte instructor with a thigh gap the same size as one of her thighs. It’s totally MY issue, and nothing to do with her, really. It’s my body issue, my unhealthy mindset. I look up at the screen and get upset that my reflection looks nothing like the person I am aiming to copy.

Yesterday I did something new… after my yoga practice I collapsed on the floor, feeling defeated and negative about my size, on the brink of giving up, when I remembered something. At the start of this year I set myself some goals, not resolutions, goals, real and achievable with detailed action steps. One of those goals was “This is the year I learn to love my body”. I had started putting some of the action steps into practice, doing the yoga challenge itself was intended to be part of it. Having discovered that the challenge was hindering my development in that area, I looked at the other steps. The very first one hadn’t been touched yet: Change My Visual Diet.

Visual Diet

Visual diet is simply the images we consume in day to day life; in the media, on social media, in entertainment and so on. In modern, developed society, we are fed a visual diet heavy in the same kinds of bodies; slim, athletic, styled. When you flick through a clothing catalogue, what do you see? Do you see your body type represented? Even so-called “plus size” models are comparatively slim and tall. They still have flat tummies and smooth thighs, they’re just a couple of dress sizes bigger than mainstream fashion models.

I came across the idea of changing my visual diet about a year ago, when I saw this video of a Tedx Talk by burlesque performer, Lillian Bustle. It’s well worth a watch, but if you only have a few minutes, this one is also great (only if you don’t mind profanity!). Despite discovering the importance of visual diet, I didn’t do anything about it. I kept on consuming a diet of thinness. And I kept on hating my body because it didn’t measure up to what my brain kept being told: THIN IS NORMAL. FAT IS BAD AND UGLY.

So yesterday, when I recalled this action step, I did something about it. I immediately turned to YouTube and searched for “plus size yoga”. What I found was a real eye-opener. There are women my size rocking yoga! They are strong, supple and have great balance. They look like me, there is epic diversity out there!

I had stumbled upon this short video a while back, but had forgotten it and needed the reminder. Apologies, it is an ad, but my link goes to doyouyoga.com where there is an interview with the fantastic yogi in the video.

Anyway, I ended up sitting watching inspiring videos for ages and fed myself a healthy dose of alternative body types. I’m going to make sure I keep feeding myself a varied diet, because research has proven that the more you see a body type, the more likely you are to have a preference for it. If I want to learn to love my body, just as it is, then I can start with seeing more bodies like mine.

Now, as it happens, I do also want to lose some weight and that is high on my priority list right now, but I think it’s so important to love my body whatever size it is. My mental health is even more important than my physical health right now, so I’m tackling that too. The beautiful thing is, in learning to not only accept but love my body as it is, I should also see a side benefit of breaking some unhealthy habits that are causing me to gain weight; such as emotional eating. Research has also shown that the more shame and negativity a person feels around their weight, the harder it will be for them to lose weight. This is a big part of why fat-shaming is so wrong. Not only is it fundamentally unethical, it is totally counter productive. You can’t shame someone into changing their behaviour to tackle weight loss. Shaming them is one way to make sure they DON’T lose weight! Some fat-shaming is disguised as “concern”. I have seen comments on social media that seem well-intentioned, but are actually fat-shaming in disguise. The comments can come across as incredibly patronising and ignorant, even if the commenter genuinely does mean well.

One of the best ways to change your visual diet, is to check out #effyourbeautystandards on Instagram or Facebook. A hashtag created by model Tess Holliday intended to open up people’s minds to what “beauty” is and can be.

Change the Voices

I’m a huge fan of P!nk, crazy huge. I adore her. There are various lyrics from her songs that have inspired me over the years. On this subject, there is one that stands out:

Change the voices, in your head,

Make them like you instead

~ F***ing Perfect

For as long as I can remember, the voices in my head have been telling me things like “you’re so clumsy”, “you’re so stupid”, “you’re so fat and ugly”. It would so totally unacceptable for me to talk to another person like that. So why do I let myself talk to me that way?! It’s awful. I’ve been working on that for a while now. If I catch myself saying those things, I check myself and stop it. I say something affirming immediately. I do daily affirmations as part of my Miracle Morning too, often including something about my body, such as “My body is filled with energy”, or “I am beautiful”. I’m finding it incredibly powerful and my mindset is changing. It’s obviously a slow process to undo 30 years of negative self-talk, but I will crack it. I will make those bullying voices in my head go away for good.

Gratitude

One of my other daily actions is to practice gratitude. Every day I write down something I am grateful for in my bullet journal. I’m finding that focusing on things that are actually important stops me worrying about the more trivial things and things I simply can’t control. Also, accepting that no matter what I feel about my body right now, it IS amazing and something to be grateful for. Just pause for a moment to think about all of the functions that your body performs automatically; breathing, circulating blood, memory. Then add in the rather extraordinary feat of growing another human life! My body has done that twice! And nurtured said new lives once born, having breastfed both my children – the Bean only stopped nursing this month. All bodies are incredible and should be acknowledged as such. So today I am grateful for a body that is living and (more or less) healthy and functioning well.

love-yourself

So this is truly the start of a new journey for me; the destination: self-acceptance. I hope you find these tips helpful in your own journey. I love to hear from readers, so leave a comment below if you have any further suggestions on learning to love your body.

If you want to hear more from me, please do connect on social media.

@SMamaBlog on Twitter, & Facebook.

Why I March

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The political landscape over the last two years or so, riding on the crest of a wave that formed decades ago, has been terrifying for those of a humanitarian, liberal, compassionate persuasion. Like myself. The terrible conflict in Syria, which has displaced millions of people, thousands of whom have drowned trying to cross the Mediterranean to get to Europe, has led people to divide themselves fairly neatly into two opposing camps. There are those who are moved by the atrocities they hear about and want to help, to reach out and provide shelter and refuge for those fleeing for their lives. We see the pictures of dead babies on beaches and the tears that fall spur us to action. For some of us, it goes no further than donating a blanket and some winter boots to a collection. Others have travelled to the refugee camps and volunteered. Some, like the incredible Rob Lawrie, even attempting to do the truly humanitarian thing and unite children with their families living in Europe.

InequalityOthers, however, take a more selfish view. Preferring to fear those with different coloured skin and different faith, preferring to close borders and protect their own self-interests. They blame the innocent victims of war for the crimes of their own governments. The chronic underfunding of public services here in the UK, coupled with the vitriolic lies in the tabloid papers has meant that millions of Brits have an irrational hatred of everything foreign.

This was displayed, to the horrified astonishment of half of us last June, in the referendum result. Now, we have a far right government vowing to steer us towards economic turmoil, possible bankruptcy and social unrest.

As if all of this weren’t bad enough, we have now seen the shocking inauguration of a US President who openly mocks the disabled, brags about sexually assaulting women, is regularly having to pay off people he has swindled, and has gone bankrupt six times.

The first day of his Presidency saw the global, coordinated efforts of millions of people to demonstrate their opposition to his appointment. The Women’s March movement is just getting started. In my own town, a group of us have been campaigning locally since last summer to expose the actions of our MP, Philip Davies, who claims to want equality, but who repeatedly votes against and even blocks votes in Parliament on bills that would improve equality in this country. We organised a Sister March on Saturday 21st January, to show solidarity with American women, people of colour and those who identify as LGBTIQ, all of those groups who Trump has publicly threatened.

I marched because Davies openly supports Trump, stating that he would “vote for him in a heartbeat” if he could. He fully supports this proven liar, accused sex offender, known misogynist, and openly racist slimeball. No, I don’t mince my words.

I marched because we are standing on a precipice. Women, and all marginalised groups, are at very real risk of being further persecuted by the rise of the far right around the world.

TwitterOne of Trump’s first actions has been to sign legislation that seeks to undo decades of progress on women’s reproductive rights. In a truly disturbing image, he sits in the Oval Office, surrounded by white men watching over him as he signs away women’s bodily autonomy. It’s a troubling first step towards a very dark future. We must oppose this fiercely, so as not to lose the hard-won rights that women before us literally died for!

My MP has stated that feminists want to “have their cake and eat it”, that we want equality, but only when it suits us, and that we want “special treatment”. He claims to want equality, yet uses the word “feminist” as a pejorative term. When he corresponds with female constituents he is rude, aggressive and often sexist (many members of our group, Shipley Feminist Zealots, named tongue-in-cheek following his comments last summer, share the emails they receive from him in reply to their raised concerns). He seems totally oblivious to the fact that women do not yet have equality and that much work needs to be done to address the remaining imbalance. I’m not sure he understands the difference between equality and equity, either. He has, rather absurdly, been appointed to the Women and Equalities Commission, and stated that he would like to remove the “Women” from the title of the group. He stood unopposed, so won the seat by default. It’s disgraceful.equality-vs-equity

I’m absolutely certain that those in power are deliberately turning people against one another. It’s a proven technique to maintain the status quo of severe inequality. The rich and powerful want us afraid, compliant and too run down to have the energy to resist, and revolt.

Now, I’m not suggesting a violent revolution or rioting, but we do need a peaceful revolution. We need to march. We need to have our voices heard and not allow those in power to strip us of our civil rights, ignore our voices, sell our public services, lead us into a dark future. We need to strive for the light, for the right way forward, into a world of equality and fairness.

I want Gene Roddenberry’s vision of the future; one where humanity is united, basic needs are met, and all are free to pursue a life that satisfies them.

We can’t achieve that without upsetting the status quo.

That is #WhyIMarch, and I hope you will too.

In Support of Invisible Midwives Everywhere

Today is International Day of the Midwife. A day to honour all of the midwives who have been a part of all of our lives, after all, even those people without children of their own were born themselves once and chances are, a midwife attended their birth.

Midwives are there for women and their families on one of the most important days of their lives. Midwives nurture women in their care, guide them emotionally and physically through pregnancy, birth and early parenthood. Midwives save lives and witness daily the amazing entry into the world of new little people, quietly, confidently and with compassion. Midwives know when to sit back and be invisible, trusting women to birth their own babies and only coming to assist if the need arises.

Or at least they should.

Unfortunately the systems that midwives have to work within don’t allow them to do their job properly. They are forced to place time limits on the women in their care, to intervene unnecessarily on a regular basis and to persuade women to birth in big obstetric units if their employer is under the false impression that these units will prevent law suits from happening. The fact is that home is the safest place for women to give birth, it is also the cheapest place. Continuity of care from a trusted midwife also results in better and safer births. It’s utter madness that the system doesn’t grab hold of these facts and embrace genuine with-woman midwifery.

All over the world, women and midwives face persecution and legal action against them if they dare to step outside of that system. Agnes Gereb, Hungarian midwife and obstetrician, is currently under house arrest for attending women birthing out of hospital. Even here in the UK, NHS midwives who work with women at the centre of their care face the possibility of harassment in the workplace from their colleagues. AIMS has a Midwife Defence Fund that people can donate to, this fund helps secure legal representation and cover other costs to assist midwives facing persecution. You can donate here: http://aims.org.uk/MDF/

Independent midwifery is scheduled to become illegal as of October 2013, due to red tape. The EU has declared that IMs must have indemnity insurance, but no provider on the market is willing to insure midwives working outside the system. Therefore, by default, midwives will no longer be legally able to practice independently.

IMUK has been tirelessly searching for a solution, but there is no option available that will allow them to continue to provide care during birth for women who are anything other than “low risk”, that is, “risk” as defined by an extremely conservative legal team in charge of defining NHS protocols, which is not always the same as genuine medical risk. Even if it were, women should still have the right to choose their care provider and place of birth.

If I am ever to have another baby, I would not be able to be cared for by a skilled and experienced midwife of my choice in my own home, as I have had two previous caesareans and am therefore “high risk”. The actual risks of a home birth in my situation are tiny and I should be free to choose to birth there with a midwife of my choice. The changes in the law mean that I am extremely unlikely to ever have a third baby and if I do, I would be forced to choose between the luck of the draw NHS service, who treated myself and my husband so appallingly three years ago, or to not have a midwife present at my birth at all. Basically, I don’t want another baby at all if I can’t have the same amazing midwife that I had for the Bean’s birth.

So today, on International Day of the Midwife, I’d like to shout out my support to independent, with-woman and invisible midwives everywhere who are striving to care for women and their families despite great personal risk. You are all superstars.

I Am Woman… Hear Me Roar

Today is International Women’s Day, so I’d like to take a moment to acknowledge the wonderful women in my life and write a bit about what the event means to me.

The theme this year is “Connecting girls, inspiring futures”. I think it is so important that young girls and women are encouraged to think about their sexual health, their futures and their relationships, to value themselves enough to make positive choices. The only way that happens is through the examples of positive role models. There are far too many pop tarts gracing the magazine covers and television these days. Hyper-sexualised “singers”; super-skinny celebs who are famous for being famous and make a reputation for themselves as lacking intelligence; lost and desperate starlets who poison their bodies and have their own rooms reserved in rehab for their frequent falls from the wagon. It’s a sorry state of affairs.

There are a small handful of alternatives out there, such as Tyra Banks, who not only represents a more healthy body type these days, but who works to help girls and young women value themselves. That’s not to say she isn’t also making a lot of money out of the good PR of her apparent altruism, but I think that’s true of most philanthropists if you look at the whole picture. Then there’s one of my favourite singers, Pink, whose attitude and music set a wonderful example to young girls, showing them that they can be themselves in the face of peer pressure.

It’s really important to me to recognise that even in the UK, there is still inequality between men and women. Women still earn less than men in the same jobs; women fill more service roles and less professional roles than men; the socially valuable role of mother is extremely undervalued financially and culturally (how many times have you heard a woman say “I’m just a mum” when asked her occupation?); women bear the brunt of the government’s spending cuts too. Women often seem to be the ones to take responsibility for their contraception too and many of the options are hormonal; that is, they work by changing our biological functioning. What are the physical and social implications of that?

Teenage girls were routinely paraded through the school nurse’s office in the last couple of years, to be given the HPV vaccine, with the promise that they would be protected from cervical cancer. There is some concern that this vaccine gives girls a green light to have unprotected sex, as they, and their male peers, may believe that being vaccinated against one STI makes it safe to have unprotected sex. Not the right message for these young people at all. A number of my friends with daughters of the appropriate age talked about the issues with their daughters and helped them come to fully informed decisions about whether to accept the vaccine or not.

As mothers we are censored and discriminated against for the way we feed our babies, both breastfeeding and formula feeding mothers report being discriminated against or judged, sometimes by businesses but all too often by other women. Whether women really are judging each other is not easy to determine, we often project our own insecurities onto onlookers and read judgement where there is none.

It’s acceptable for the female body to be depicted as a sexual object, but not as a mother growing or nourishing her child. Men’s nipples can be shown in public, but women’s nipples can’t. For a very thorough exploration of the topic of infant feeding as a feminist issue, please see this blog post by The Alpha Parent, particularly points 4 and 5. Caution: If you are offended by the facts of formula feeding it’s probably better for your blood pressure to simply not click the link.

Birth is also a feminist issue, both for the women giving birth and the women providing care. Midwives who refuse to conform to the medical model and instead provide woman-centred care, are bullied and harassed in the workplace, in some cases risking their livelihood and even imprisonment. Pregnant and birthing women are taught to expect to lose all of their dignity during birth, to have decisions about their own bodies made by someone else. This is, of course, absolutely unacceptable and untrue, it is perfectly possible to retain both one’s dignity and bodily autonomy in birth, no doctor or midwife can legally force a woman to comply with hospital protocols against her will, to do so is assault. But the language used by maternity care providers often hides this fact. Women are told that they are “not allowed to do x”, or that they “have to have y”. Care providers who use this language should be reported to their supervisors.

The global picture for women is even more bleak. The very fact that we need an International Women’s Day is itself a telling sign of the huge inequalities and difficulties that women face. I think it’s vital that we take the opportunity to reflect on the situation and see if there is anything we can do to change it. One day a year isn’t much, it’s a token gesture really, unless people really take notice and do something positive. One off events like this are intended to do that, to draw attention to an issue and have an impact reaching beyond that one day.

An individual can contribute in a number of ways, from simply letting those important women in their life know how special they are, to mounting a campaign against a sexist corporation or government! Check out the IWD website for ideas on how you can make a difference.

I’m already a birth and breastfeeding activist, albeit on maternity leave at the moment, so I will mark today with a huge thank you to some very special women:

My mum, Linzy; my dear friends, Jo R-D, Lisa S, Vicki M-W, Debs R, Lori F, Sarah C, Kellie R, Sally P, Chloe B, Gillian S; my friends and colleagues Beverley B, Nadine E, Debbie C-D, Jo W, Ruth K, Ruth W, Caroline W; fellow campaigners Emma K, “Mrs BWF” and everyone else who is working tirelessly to inform and empower other women. Thank you all for being amazing women.

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