At a time when maternity services across the UK face much needed scrutiny via the Ockenden review, the conversation about social mobility and maternity is one we also need to have.
With studies proving that women of lower socio-economic status experience an increased risk of multiple adverse pregnancy outcomes*, I wonder how much we talk about attitudes towards mothers-to-be based on their background?
My experience of upward social mobility and maternity services
Achieving upward social mobility gave me access to the knowledge that NCT (National Childbirth Trust) classes exist and the money to pay for them. These equipped me with the language and confidence to ask for what I wanted when preparing for childbirth (and, after just one session, put my husband off attending the rest – not everyone enjoys being told to link arms with people you’ve only just met and “Pretend to be a uterus”).
Of course, birthing plans are not worth the paper you’ve lovingly written them on BUT I went into the experience feeling equipped, listened to and within driving distance of two NHS birthing centres. Whilst these are not designed for women with complicated pregnancies (and I had to be rushed to the nearest main hospital after the birth of our son), they come with the kind of 1:1 care and attention that you would expect exists at the Portland Hospital; as favoured by the Royal Family no less. Believe it or not, I was offered a lavender bath alongside tea and toast after the protracted delivery of my daughter. On the NHS. I know, I couldn’t believe it either!
Attitudes in maternity services to people from lower socioeconomic backgrounds
Contrast this to when I accompanied my brother’s then-partner to a town centre maternity ward when she thought she had gone into labour during a day out. Young, inexperienced, lacking confidence and with no income, she was loudly berated by the midwife for “wearing black knickers – how can you even tell if you’ve had a show?!” and again for not carrying her notes. Shouted at and spoken down to whilst thinking she was about to give birth… I saw this played out again when supporting another family member who doesn’t have the financial, social or cultural capital that I’ve managed to accrue. Another busy maternity unit, another being talked down to. This time whilst giving birth.
The lesson is don’t grow up in a poor household. Or if you do, make sure you become financially stable before embarking on having a family. As brutal as it sounds I made the decision to do the latter based on seeing my own mother’s struggles.
What my experiences have taught me (I’ve been a birthing partner three times and given birth twice) or 😉 is the way you speak and dress impacts the way in which you’re responded to in a healthcare setting as much as it does in a workplace or social situation.
I’ve been told by one of my mum’s friends that I talk “like a teacher” and by social workers that I talk “like a professional” and I know that this serves me well – even if it shouldn’t give me advantages in what are ‘universal’ settings. That upward social mobility experience and the resources, language and assets that came with it gave me access to a set of privileges that you wouldn’t know are there unless you’ve seen what it’s like not to have them.
The difficulty of discussing inequality in maternity care
Experiencing first hand the differences that exist is another layer of why social mobility and the class system is difficult to discuss. If you haven’t been through it, it’s hard to understand and I find myself in a unique position in that I’ve not only witnessed and experienced some of life’s biggest moments from different positions on the socioeconomic scale – I’m also able to speak and write about them with humility and candour. If you’d like a bit of help doing that within your organisation, pop your details in the contact form and let’s arrange a time to talk.
1: Source: Socioeconomic inequalities and adverse pregnancy outcomes in the UK and Republic of Ireland: a systematic review and meta-analysis | BMJ Open
And if you’re wondering – yep, that is me with my firstborn and my not insignificant second ‘baby bump’! Doesn’t quite seem possible that both of them are now working and driving…..
Looking for a speaker on Social Mobility and Maternity?
Maternity care and class is a topic I don’t shy away from on stage, in panels or in writing. If you’d like me to bring it into your event, see what a booking with Toni looks like, or drop your details in the contact form.