Media Storm - Blame, shame and pain: Maternity, midwives and the media

Episode Date: April 2, 2026

Care about independent and ethical news? Support Media Storm on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Patreon⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠! Warning: this episode mentions baby loss and birth trauma. How many times have you read a headline that tells you UK maternity services are in ‘crisis’? And how many times have you really understood why they're in crisis? A recent interim report into England's maternity and neonatal care had some brutal findings: hospital mistake 'cover-ups', negligent care from frontline workers, lack of staff and poorer maternal outcomes for ethnic minority women. But identifying the problems is just the beginning – understanding their root cause is harder, and something our press repeatedly fails to do. Financial incentive schemes that reward units whose data meets certain 'safety' targets put the lives of pregnant people on the line – but midwives with low morale, burnout, unsustainable working hours and stress take the brunt of the blame in the media, even when their voices are notably missing from the coverage about them. What's really behind headlines about a lack of staff? Is there really a woo-woo 'normal birth ideology' killing mothers and babies? And why are outcomes so different depending on skin colour? Here to answer all those questions is Leah Hazard, NHS midwife and author of 'Hard Pushed: A Midwife's Story', and Illiyin Morrison, perinatal trauma specialist midwife and author of 'The Birth Debrief'. You can sign Leah's petition for legal limits on midwives working hours here. This episode is hosted and produced by Mathilda Mallinson (⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@mathildamall⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠) and Helena Wadia (⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@helenawadia⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠)  The music is by⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ @soundofsamfire⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Follow us on⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Bluesky⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, and⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ TikTok ⁠⁠⁠⁠⁠ Learn more about your ad choices. Visit podcastchoices.com/adchoices

When WestJet first took flight in 1996, the vibes were a bit different. People thought denim on denim was peak fashion, inline skates were everywhere, and two out of three women rocked, the Rachel. While those things stayed in the 90s, one thing that hasn't is that fuzzy feeling you get when WestJet welcomes you on board. Here's to WestJetting since 96. Travel back in time with us and actually travel with us at westjet.com slash 30 years. Hello. Hey!

Look at you with your new shiny media store microphone head. Look at you with your new shiny Media Storm microphone cover. It only took us eight series, but we've got Media Storm branded mic covers for anyone who cares. I came home from work and there was a little squishy little parcel in the post for me from with Helena's handwriting on and I opened it up and it's like blue little fluffy microphone cover popped out and it's the cutest thing in the world. They are so cute.

I just realized we really need to stop going on about this because you guys can't see us. Yeah, I mean, like maybe on social media, you'll be able to see them. But do you guys even want to see our... This is something I'm really curious about. There's a lot of chat about should podcasts remain audio only. It's not even chat. It's now just like the future of podcasting is video. There's no future for podcasting without video.

But why did we go into podcasting? You guys don't want to see our faces, do you? Yeah. They also say that and there's also a lot of research that shows that listeners, especially in the like news and current affairs sphere don't particularly care about video. So Media Stormers, we do have a question for you. Do you care?

Yeah, Patrons, let us know if you've ever been like, I wish I could see this. We say it in a mocking tone, but we will listen. And if you do care, maybe we'll get our act together. Yes. Okay, now time for another Media Storm update. Yep, a big one. Guys, this is the last episode of Series 8.

And look, I know it's not been that long since our last break, and so I want to emphasize this is a quick break, and there's a really good reason for it. And I think we've given you the heads up about this in the past. Our funding over the last couple of years has come from one primary source, and it's a US-based democracy group. When they renewed our funding this time last year, they said that due to a certain Donald Trump,

coming into the White House and slashing US aid, as well as research and development in their country, they were going to have to redirect funding coming to us, towards these more local causes the next time around. And so April was always sort of our deadline when we knew that our funding was running out. The good news is we have a new backer and it's a partnership we are really excited about. So we just need a few weeks to sort of finalise the details. It shouldn't be much longer than that.

And in the meantime, if you could let us know what you want us to cover in the new season, message us on Patreon. Then we can start working in the background until we're ready. to come back on your podcast feeds. So if you haven't gathered already, our patron is very, very important to us. It's absolutely essential. And we see all of you signing up,

increasing your donations, and it means so much. So if there was ever a time that you thought, should I support independent and ethical news, now is the time. You can sign up to our patron for less than a cup of coffee a month or more, please more. And the link is in the show.

notes as always. It actually is, it's not just essential. Like, we are really seeing how viable it could be for us to rely on you guys in the future and be accountable to no one except for you. Now, on with the show. On with the show. Matilda, how do you feel about having children? Helena, you're not supposed to ask women, that question.

Oh, yeah, sorry, sorry about that. But for the purposes of this episode, how do you feel about having children? theoretically and more specifically about potentially theoretically at some point maybe potentially giving birth uh god they feel like quite different questions like having children theoretically i feel okay i feel quite nice about that financially i feel absolutely terrified especially after our episode on parental leave that was demoralizing but the birth giving birth i don't I don't really think about that part. I feel like that's how it's supposed to be.

I feel like we're not really supposed to think about it. Like it's obviously not going to be pleasant, but it's not going to be the end of the world either. You just got to get it done. Okay, that is so interesting because I feel quite differently about that. Yeah. Like, I'm genuinely quite terrified about the whole birth part worth that to happen at some point in the future.

I think, like, a lot of that is to do with the press. There's a lot of headlines about maternity services that genuinely terrify me. And there's a lot of nuances about race that scare me. I mean, I was browsing the news the other day and I came across this article in The Guardian, Asian women in England almost twice as likely to suffer severe childbirth tears.

And I tried to read into it. And yet all I was presented with was the reasons for this are complex, but no like real answers. And I think this feeds into what scares me so much, which is just generally, how much I don't know about birth and how much we like as society still don't really know about it because nobody really cares about like women's health quote unquote and they don't really put like the time or the funding into it um this is going to be a scary episode isn't it yeah okay maybe

slightly brace ourselves but i also hope it's going to be a solutions focused episode so listeners How many times have you read or seen a headline that our maternity services are in crisis? Ooh, I did. I read that like just a couple weeks ago? Yes, you must be referring to the Amos Inquiry. So Baroness Amos was selected by the Health Secretary Wes Streeting to lead the independent investigation into NHS maternity and neonatal care. We'll refer to it throughout this episode as the Amos Inquiry. This month, her interim report was published, and the findings were pretty brutal.

The report found that hospitals that cause harm and injury to women and babies during childbirth often resort to a cover-up of their mistakes. It found negligent care has devastating emotional and psychological consequences for families. Disputes between maternity staff have a disastrous impact on mothers, and a lack of staff can affect every stage of a pregnant person's maternity care. And ethnic minority and poorer women have worse outcomes because of racism and discrimination. The report concluded that NHS trusts continue to provide poor care because they're doing too little to improve its quality and safety as a result of not learning lessons from previous

maternity scandals. Okay, there's a lot to delve into there. Certainly some scary conclusions. Quite a lot of staff blame, but the end there was focused on the NHS not learning. lessons from previous scandals. So my question is why are we not learning lessons from previous scandals? And that's the key question we'll try to get to the bottom of this episode. Because identifying the problems is only the beginning, but understanding their root cause and addressing them is quite another thing. Take, for example, the falsification of data and cover-ups that were in the interim report. This is addressed in the inquiry as commonplace. But what is not addressed is that this behaviour

can be driven by numerous financial incentive schemes that operate within maternity care. So these schemes reward units whose data meets certain safety targets and then this secures funding for the continuation of the service. So the lives of women and pregnant people are on the line for these targets?

Basically, yes. The Amos Inquiry also identified, again, a shortage of staff. But dig into the data and it shows that we have more midwives and obstetricians than ever before. Yet more often, clinically trained staff are working in back office roles rather than in patient care, again, likely due to the amount of data needed to be collected for these maternity financial incentive schemes. Another example, the Amos Inquiry identified numerous incidents of shocking racism directed at black and Asian women within maternity and neonatal care.

In the report, I read that in some instances, Asian women were stereotyped as princesses, implying that they were unable to cope with pain and they're excessively demanding. And by contrast, black women were described as having tough skin and being able to tolerate excessive pain whilst being stereotyped as angry or aggressive. Now, ignorance, racism and stereotyping

definitely exists in maternity care from frontline staff. There's no denying that. But again, what's behind it? What drives that? What are the systemic issues? and how do we address them? Plus, language barriers, familial and cultural practices, poor engagement with services and poor compliance with general healthcare advice also play their part. Now, these behaviours are more common in certain demographics, but it's not just a black and ethnic

minority issue. There are poor outcomes in refugee women, asylum seekers, women who have been trafficked, people who are homeless and the traveller community. Yet these groups, are barely ever mentioned in maternity reporting. This topic struck me as a media storm because time and time again, there seems to be a fundamental misunderstanding of what is actually wrong with maternity services. Midwives with low morale, burnout, long hours and stress

are taking the brunt of blame in the press, but their voices are notably missing. The media, getting their information based on maternity inquiries, seem to skip out the crucial element, the voices and experiences of frontline staff who deliver babies every day. The Health Secretary West Streeting has announced a rapid national investigation into NHS maternity services. Such an ideology can become deadly for both mother and baby. Third of newly qualified midwives, they're unable to find work. NHS maternity services are failing women and babies through a reluctance to admit mistakes,

a lack of kindness and compassion. Welcome to Media Storm, the news podcast that starts with the people who are normally asked last. I'm Matilda Mallinson. I'm Helena Wadia. This week's Media Storm. Giving Birth, Midwives and the Media. Welcome to the Media Storm Studio. Our first guest is an NHS midwife and the author of the Sunday Times bestseller,

Hard Pushed, a midwife's story. And Woon, the inside story of where we all began. She's a trustee for Emma Birth Companions, a charity that's a charity that's. supports women and birthing people in Glasgow, facing barriers like poverty, isolation or language. Most recently, Leah's petition to establish safer midwives' working hours hit 50,000 signatures, and she helped shape workforce policy

in the National Maternity and Neonatal Collective's Plan for Change. Her third book, Birth Wars, is out next year. Welcome to Media Storm Leah Hazard. Thank you so much. Our second guest is a perinatal trauma specialist midwife, author and podcast hosts based in Norfolk. After working in a busy South London hospital and becoming a mother herself, she supports mothers, non-birthing parents and professionals

to unpack their perinatal experiences. She has spoken widely on the topics of birth trauma, advocacy and racism and bias in healthcare. Welcome to Media Storm, Ilyan Morrison. Thank you so much. Now, there's been a lot of press about the most recent damning report into NHS maternity units led by Baroness Amos. We outlined this in our introduction. The report's key findings included a lack of staff, negligent care,

and hospitals that cause harm and injury to women and babies during childbirth, often resorting to a cover-up. We'll go through what is behind these findings in more detail throughout this episode. But firstly, Leah, how did you feel when reading about these findings in the media? Do we get given the full story? I mean, the short answer is sad and no. I mean, unfortunately, anybody who is in or around the maternity space would not have been surprised by Baroness Amos's interim report. We know those of us who work inside the system that it's incredibly pressurized and that it can cause harm. And while I absolutely don't want to, you know, come on the show and be an apologist for that harm, I also know that that harm and the state that we're currently in, you know, they're multifamily. factorial. They're really complicated. And to the second part of your question, that's why we don't often get the full story in the media because it is so complex. These investigations are not

always communicated in the most balanced, nuanced way in the mainstream media. So that's how we've got to kind of where we are today, where the discourse is incredibly polarized and not always helpful. And Ilian, the same question to you. Do you feel like these damning maternity reports get to the heart of the issue? I don't think the intention is ever to get to the heart of the issue. Because I think if we were trying to get to the heart of the issue, it would place the responsibility where it lies. And actually, we don't want to do that. Placing the responsibility where it lies would require the government to actually place money into maternity services to see women's health as a priority. And we can see across the board when speaking about women's health, it's not a priority.

So it's much easier to blame women themselves, blame families, and also blame services or individuals within those services, rather than blaming the systems as the issue is systemic. So we have a systemic issue that is being fuelled by chronic underfunding and midwives and people who are maintaining said system and service being scapegoated as the sole perpetrators of harms. And so actually, are we going to get the full story? Because the full story requires full action and full action requires full care.

Yeah, midwives definitely seem to take the brunt of the blame when these reports come out and then some of the full story. subsequently in the press. I wonder something that we don't see in the press is a realistic day in the life of an NHS midwife. Can you help us to understand what's actually going on within these maternity services? Perhaps Leah, you first? Can I, can I just answer that? Sorry, the only reason I'm going to answer that is because Leo is actually perfectly positioned to do this. I left NHS midwifery partly because of all of this. So the day that she is going to describe to you is very, very difficult to sustain.

And the pressure and the weight of it is so significant that it is causing lots of people to make very difficult decisions and to leave things that they're actually really, really love and are very passionate about. Well, thank you. But I will say nobody is more surprised than I am that I am still at NHS midwife. I probably will leave in the next few years, if not much sooner, because of the pressures that Alien has just referred to. The point I really want to make before going into any of that detail is that, you know, we, we, we, talking quite rightly about the conditions for pregnancy and birth within the NHS service, how that's pressurized, underfunded, under-resourced, industrialized. Those same words can be applied to my working day or the working day of any midwife in this system. We are swimming in the same water. So, you know, if there's a system that doesn't serve birthing people, you know,

the staff who provide that service are also laboring, pardon the pun, under those same pressures and strictures. So then if we're going to talk about what is a typical working day for an NHS midwife, in a sense that's an impossible question because looking after people in labour and catching or delivering babies, you know, there's roughly nine months of pregnancy before that happens and about six weeks of postnatal care afterwards. So most of us actually are doing other jobs. We're working in community clinics, antenatal or postnatal wards, doing home visits, working in triage. And the amazing thing about NHS midwives is generally we are rotational. So we are trained in all of those areas of the surface. And at the drop of a hat, quite literally, we could be told,

actually, we're going to move you to this other area today. So, okay, you work in triage, but Labor Suite is short-staffed. So you're going to go and catch a baby today. Or, okay, you work in community, but you're being pulled into the postnatal ward today to look after six women who've just had complex cesarean sections. That's, you know, I don't know any other job where you have to be so immediately versatile. And so if you imagine trying to do that complex, complicated job with not enough staff, not enough resources, not enough time in the day, then you begin to understand the pressures of the role. Something else that we often talk about on Media Storm is how legacy news, mainstream news,

it works on a very fast turnaround. And really, the lack of time, the push to get as many clicks as possible leads to an incentive to put salacious headlines over accurate ones. Like clickbait. Do you see a problem in maternity services? And childbirth reporting. Ileon, let's start with you this time. Yeah, because actually the idea is to sell stories.

If a headline comes out, woman dies during homebirth. That is perfect. Because then someone turns around and goes, see, homebirth is bad because woman died during homebirth. And then if there was actually look underneath all of it, beyond the subheading and everything, you might see a story that explains why her specific situation was a little bit more complex, why actually perhaps there weren't even midwives present because this person chose for there not to be. Most of the time, in order to sell a narrative, the reason is secondary or even tertiary. The actual most important thing is to grab the attention, create the kind of furor that then goes viral and everyone's talking about it.

It creates mass hysteria. We don't need hysteria. We can't actually function very well within a space of hysteria. So actually what we then end up with as midwives is us panicking because we're like, oh my gosh, We're under like this really close lens of just criticism. And then you get the families that are coming in in hysteria. They're scared. You're out to get us.

This isn't safe. My gosh, I heard. And then you've got those at the top who are like, remove funding from home birth services because actually they're really bad. Look. Get all the midwives back in the hospital because actually it's understaffed. Look. So there's always bigger intention in media reporting in this manner.

That's so interesting because obviously like, I feel the fear. I see those headlines. I'm a woman who, you know, might give birth at some point. And it's scary. But then I don't even think about the impact that that's going to have on the service when you have panicked people coming in. I just think, wow, these media are so willing to manipulate my fear because it gets them clicks and it gets them cash. But it sounds like you think there's actually maybe even a more specific and malign agenda there about the maternity services themselves. Leah, you're nodding. Yeah, I mean, unsurprisingly, I agree with I would agree that when we're trying to, um, We fall papers. We fall back on really unhelpful tropes that you'll see recurring in these articles, like, for example, in the homebirth context, women are irresponsible, women make bad choices, women do dangerous things because they don't care about their babies and they're selfish and they just want, you know, a woo-woo fairy light experience. The system is broken because women are too fat or too old, you know. And these are really oversimplified explanations for a very complicated problem. You know, the other really simplistic trope is, you know, the other really simplistic trope is.

is midwives are non-evidence-based, malevolent, witchy woo-woo kind of practitioners who are just there to pursue their own kind of evil agenda, their ideology, if you will, and we can certainly expand on that. Again, that's not accurate. And the other thing that happens that probably makes it a lot easier to write a fast article or generate some clickbait is that journalists quite often tend to rely on interviews with the loudest voices in this arena, who are not always the most evidence. or can provide the most balanced picture. So, for example, if you have somebody who has had a terrible experience in maternity, which absolutely deserves its own airspace and time and compassion, and that voice or those voices always dominate the narrative, yes, it's important they have their arena and their space and their airplay,

but that's not the whole picture. We also need to hear from people who have had a good experience or just a kind of averaged Laceau-so experience. So, you know, again, it comes down to just generating as Ilyan said that really fast and very quick and easy to digest clickbait versus a broader, more complex picture. Yeah. Just to add to that, what I'm finding as someone who specifically works with helping people

navigate the processing of their traumatic experiences is that an unhealed voice is often very loud and is very impactful. I can talk about my birth seven years ago from a position of having processed it in a different way than I could speak about it at the time. At the time, I was like, the service is shocking. everyone's terrible, they're all out to get me. And I look back now, I was like, gosh, woman, you were a mess. Because now I can look at it through a different lens.

And so I do think that that doesn't sell. That doesn't sell. Someone saying, actually, I recognize why these things happen, that's not going to make a headline, is it? It's such a good point, like trauma-informed journalism is so necessary because journalists are drawn to traumatise people like moths to a flame. And so often that testimony is not just like harmful to the, people who may get a warped impression, it's harmful to the person who's being put under a spotlight

while they're going through that. Absolutely. It's actually really unfair. It's really unfair. And there's currently people in the media who are talking and I look and I'm like, this is harmful. Because actually, I would love to support you to process what you're talking about because someone has seen your vulnerability and has gone perfect. Feeds our narrative. And what we're seeing is again, women being exploited, their stories being exploited, they're pushed out in the press. and they can't retract them. They can't suddenly go back five years later and be like, oh my gosh, I was in the pits and no one held me there because that doesn't make money and that doesn't create interest

and that doesn't fuel narratives. Something that you both have spoken about and we spoke about in our introduction is that we often hear about a lack of staff when it comes to maternity reports and news headlines. The Amos interim inquiry identified chronic staffing shortages as a central factor failing. maternity services across England. The investigation found insufficient staffing levels, high turnover and resulting service limitations, directly compromised patient safety and quality

of care. You both have alluded to lack of staff. But what isn't being told to us beyond this headline? Is the funding there to hire more staff, for example? The money is there in the NHS, but proportionally, maternity has always been the kind of poor relation of NHS budgets. It's just not seen as fundamental to public health, which is madness because each and every one of us is born, right? And men should care too, because roughly half of all babies are just really small men. It's true, it turns blib, but it's true. Each and every one of us goes through this periniddle moment. Maternity is public health, but historically maternity budgets have not. reflected that. And it's a false economy because what we also know on the flip side is that

proportionally negligence claims around maternity by far make up the biggest proportion of all specialties in the NHS and more is spent each year on settling these claims than on the service itself. So I would like to argue that the money is there somewhere and if it's not there specifically within the maternity ring fence, it should be. You say the money is that Is there not within most trusts a sort of layer of management who are being paid twice as much as any of the health staff out of the NHS budget and then we cut health staff in order to fund that? Because I don't know why we're not talking about this more. Is there not an element of money being drained into that management level? I don't want to stigmatise or demonise managers, but yes, managers get paid more than shop floor staff.

You know, NHS has a banding system and those who are bandfing. five or six on the shop floor, just simply don't get paid as much as those who are working in a desk down the corridor. But the shop floor are the midwives and the doctors and the surgeons who are saving your lives and are training for years. Sorry, that blows my mind. Yeah. And it's, well, it is mind blowing and it should blow your mind. And certainly there's something to be said about looking at structures in the NHS and who is providing the most value for money in terms of creating a service that's equitable, safe, compassionate and person. And, I mean, there are a lot of loud voices in the maternity space who say it's not about staffing, you know, staffing is just a distraction. You can't keep using that as an excuse. And it's true, it's not an excuse for harm. But the fact of the matter is, if I'm walking on to a night shift in a labor ward that's supposed to have, let's say, 14 midwives, and there are six. It doesn't matter how good my working culture is. I simply cannot provide safe care. That's it. Full stop, end of story. And that is actually the situation that so many

midwives and other staff are turning up to day and day out. So, you know, riddle me that. What's really happening and what happens to a lot of midwives and health professionals, particularly women working within women's services, is that this empathy, compassion, and strange morality is weaponized. And it's no longer just a job. It's like, this is a vocation. That same ideology is not applied to so many other areas of work. Like in a capitalist society, we are working to make money. And we have bills to pay. And for some reason, there is this idea that it is immoral or unethical for a midwife

to be like, this isn't paying me enough because this shouldn't be about money. This is about goodness. Like we're all a modern day Florence Nightingale, right? But actually, my goodness isn't paying my bills. My burnout can't survive the bank writing to me about my mortgage. I can't work 45-hour weeks and try just about to put food on the table for my family that we can actually say, yeah, we love what we do, but it shouldn't be exploited in the way that it is, especially when upper management and board members are getting paid a lot more than we are and aren't having the same struggles,

while at the same time turning around and going, that you're the problem, and say, but stay, 26 grand a year, stay, yeah, that's fine. Have you seen the cost of eggs? Have you seen the cost of eggs? £3.5.5. Exactly. And yet still, midwives are sitting there within these tiny margins of, oh yeah, you're getting a pay. increase, which actually works out to be a paid decrease. And we're supposed to go, mm-hmm, mm-hmm. And yet the reporting on that is midwives are leaving in droves, leaving women in dangerous situations without saying midwives are undervalued and underpaid. And actually it is not sufficient in this cost of living crisis for them to be able to maintain their family. Also, it's like you can't have it both ways because the media trying to paint

midwives as these like woo-woo and there's this almost this like, sexist nature of like a silly little women trying to like deliver like natural births or whatever. They want to paint them like that. But then they also want to paint them as essential to a service and essential to healthcare. Okay, but which one is it then? Should we not be incentivized by money like other people are? Are we supposed to just be incentivized by love and thanks and pats on the back? And then also be able to survive the absolute onslaught that comes as a result of something happening in a hospital that, you know, has hit. the press and it's salacious and it's wild. And yet the midwives are being so told, yeah.

I know that you've been working loads of overtime and that you're putting in the work and you're really good, but unfortunately, we're going to have to scapegoat you. We're going to have scapegoat you. Yeah, yeah. Okay. Just smile, ride the wave. Like, it doesn't make sense. It doesn't make sense. I've gone off on a whole tirade there, but, you know, you know what I'm trying to say. That's what this podcast is here for. We should just rename it, tirade. After 19 years, they're back. Frankie Munis, Brian Cranston and the rest of the family reunite in Malcolm in the middle, life's still unfair. After 10 years avoiding them, how and lowest demand Malcolm be at their anniversary party,

pulling him straight back into their chaos. Malcolm in the middle, life's still unfair. A special four-part event, streaming April 10th on Hulu on Disney Plus. Before we talk about this next topic, we just wanted to do some clarification on language, because some terms that are used in the media are natural birth, normal birth, and spontaneous birth. Are all of these terms referring to the same thing? And if so, what is that thing? This hot potato of language.

So those terms think they're all referring to the same thing, but they are not. And some of those terms are actual clinical terminology and some are not. So quite often in mainstream media will really, read terms like normal birth, natural birth, sometimes spontaneous birth. What they're really wanting to say, but too afraid to say, in the mainstream media, is a vaginal birth, right? That's what it is. So look, even my dog's barking, because I've said the V word. This is what we're talking about, the difference between a baby coming out of somebody's vagina or a baby being born surgically with cesarean section or being helped along by foreseps. Now, when people use the term,

normal birth and this has somehow become an incredibly taboo phrase. Initially, that phrase wasn't developed to stigmatize some other form of birth in contrast. What normal birth originally meant when it started being used was just a spontaneous physiological birth. And by physiological, I mean a birth process that starts without any pharmaceutical or mechanical intervention. And then the whole thing concludes just as a physiological process. Okay, so there's no moral or ethical value attached to a physiological process. Just like if we were talking to somebody about cardiology, we could talk to them about how a normal heart works. You know, the chambers pump and the ventricles work and this is the physiology of a heart.

And we could also talk about, okay, well, what happens when this pathology occurs when the, you know, the arteries are constricted or this chamber doesn't pump correctly, right? So in birth, we should also be able to talk about the physiological norm or the baseline and variations on the norm. But somehow we've come to this crazy point in culture, in discourse, in the media, where it's become completely taboo to even use the term normal birth, let alone vaginal birth. And that's when people start throwing linguistic stones at each other. And this is not productive or helpful for anyone. natural birth is not a clinical term, it's not recognized medically as a thing. And so when people talk about midwives promoting natural birth or push for a natural birth, that's not a term that I would recognize or use within my profession.

Yeah, you know, I actually think what the media is really doing, it's pitting groups against each other. So the idea of speaking about a normal birth, if you even look at the language around it, basically it diminishes. is a cesarean section birth or intervention. And it's like, that's not it. We're not looking at them against one another. And these things can exist as isolated stories.

So you have these two groups of women that we then fight it out amongst ourselves. And the media's like, that wasn't even the point of the story. But look, they're all talking about it. They're all sharing about it. There's the hot pieces and job done. Women are fighting amongst themselves and they're not looking up at who is really pulling the puppet strings and who is to blame. or perhaps an increase in cesarean sections and a decrease in vaginal birth.

That's what I think the intention is around the language use. They don't use it in context. Like if you look at it, it's like normal births, women, babies are dying because of normal birth. Can you supply context here? What do you mean by normal birth? But they don't do that because that doesn't have the impact that it wants to have. Right. So from an ignorant perspective, for me the implication I get from this media and the paradox you've just laid out is that normal births

more dangerous, C-sections safe. I think when we read about childbirth in the media, it seems the word safe has been linked more to C-sections. For anyone listening who doesn't know, C-sections stands for Caesarean section, and it's when the baby is delivered by surgeons, cutting into the mother's abdomen and womb. At the end of last year,

we saw more babies being born in England by Cesarian section than delivered normally. NHS data showed 45% of births were through C-sections, 44% through normal vaginal births, and 11% assisted with forceps or ventus, which is a vacuum-assisting delivery. The proportion of babies born by Caesarean section across England, Scotland and Wales has risen from 25% in 2015 to 2016 to 38.9% in 2023. To what do you attribute this rise in C-section delivery to? I'm someone who had an emergency cesarian section and a home birth. We have this idea that actually,

if you've had a difficult vaginal birth, the antidote to it is to have a cesarean section. And the idea behind it is more control, you know what you're doing, et cetera, et cetera. This is a narrative that is put on people without exploring the fact that safety is so subjective. What lens is it safer through? Is it safer for a clinical lens? Is it safer through a risk lens? Is it safer through a mental lens? Is it safer for a workforce lens and a staffing level lens? Are we obsessing because of litigation? So what we have now is rising intervention. And an example of this is a couple of years ago, in order to basically combat maternal mortality within the black and brown communities, there was this policy that was put through that said that all women from said communities would be induced at 39 weeks. Now, an induction is an intervention. This is when a person has not gone into spontaneous labour and who is basically put into labour. Actually, that was like, what do you mean? We're then filling up hospitals, with keeping people there, babies perhaps

aren't ready to come out and we know trying to force a baby out that perhaps doesn't want to or isn't ready with intervention can lead to further intervention being needed. And we create more of an issue, but what we also do is we take away agency from a person to be able to choose. If you say to them, your baby is more likely to die at 40 weeks, so let us intervene at 39. What is that actually backed by? Is that backed by actual knowledge? Or is it backed by the idea of reducing risk in terms of the data that is collected for that trust? But wait, because technically there should be like a legitimate and significant medical reason, right,

as to why somebody has to have a C-section rather than give birth vaginally. but if there are these financial incentive schemes and hitting targets, like if women are being told to have C-sections to meet targets rather than because it's better for them, isn't this like hugely scandalous? Like, isn't this a huge scandal? That would have to be admitted. I mean, no obstetrician is going to turn around and be like,

I need to meet a target, babes. That is not going to happen. Leah, I want to ask you more than about the demonisation of normal births that is happening alongside this. And you mentioned earlier the word, ideology and I was like, huh, yes. Have I been given the impression that midwives are pushing a woo-woo ideology? I suppose I have been given that. So here are a few headlines about natural birth. Former health secretary Jeremy Hunt wrote in the Sunday Times at the end of last year,

normal birth ideology is killing babies. He writes, as health secretary, I vividly recall meetings with NHS England maternity leaders where I asked whether midwives were being encouraged to push too hard for normal births. The answer was always to play down the concern, but my own experience told me otherwise. At the births of my children, I saw how the NHS often steered mothers away from C-sections. This was despite growing evidence from inquiries that babies were dying because intervention came too late. Also at the end of last year, Sean Linton, health editor for the Times, repeatedly linked stillborn and newborn baby deaths to low C-section rates. Leah, do you feel like the news reporting around childbirth is making women fearful of normal non-selection births?

Yeah, just give me a minute while I study my blood pressure after those headlines, because I know exactly the articles and the journalists you're referring to. And it's really difficult because there are certain voices, Jeremy Hunt included, for example, who are very, very loud in this space and who have been arguably promoting an equally one-sided and inaccurate ideology, if I can use their word, not mine. This is a really complex issue, so complex, in fact, that there's a whole chapter about it in my next book because I think it deserves time and space

and it's more than I can sufficiently explain here. But what I will say is that another fundamental misunderstanding and miscommunication in the media is that student midwives are somehow trained to promote one mode of birth over another. This is not true. This is fundamentally a lie and a conscious, persistent misrepresentation

of midwifery training in this country. So as I said earlier with the sort of cardiology analogy, you know, if you were going to be a doctor specializing in the heart, it would be expected that you would first learn about the normal healthy physiological function of the heart and how to promote that, you know, how to get your heart to function, to pump blood around your body in an optimal physiological way. Now, after you learn that normal baseline, you would, of course, then learn about diseases of the heart, structural anomalies, medications, interventions, surgeries, and you would then learn how to judiciously apply those when appropriate. Okay? Nobody can argue with that. But somehow we've come to this crazy point in the media and in the discourse in this country

where we cannot accept the fact that student midwives also learn about the normal physiological process of pregnancy and birth before they then also learn about diseases, emergencies, complications, I would argue that it's quite important to know about that straightforward physiological baseline before you can then understand and start dealing with high risk cases. But we've come to this crazy kind of polarized, inaccurate point in the discourse where you have journalists, like the one you just mentioned, leading campaigns to eliminate even the terminology normal birth from student midwife curricula. Now that when you spell it out, I think in sort of the clear light of day logically, black and white, it makes no sense. And yet somehow we've come

to the point where it's widely accepted and promoted in the media that midwives are promoting this normal birth ideology. Well, my question would be, if we're so good at promoting our evil agenda, why are more births in England now, cesarean sections, why are roughly 30% of all births induced with medication? You know, we're not doing a very good job, are we? So, you know, it's just an example of completely skewed, I would say really agenda-driven and in some cases quite personally targeted reporting. And this is something that we really need to move away from because at the end of the day, it's all about the woman and the birthing person. And that woman or that birthing person can only suffer if the discourse continues to be so inaccurate.

We want to move the conversation on to a nuance in maternity care that has in recent years been more frequently reported on, but not necessarily delve to. into. This is that there are often poorer maternity outcomes for black women, Asian women and women of colour who give birth. Black women are nearly four times more likely to die during childbirth compared to their white counterparts. We hear this statistic, but we're not really told why. Ilya, can you help our listeners understand why this might be? As a black woman, I think this is being done wrong. The media reporting on this is, you know, black women are five times more likely to die, Black women are nearly four times more likely to die.

What does that do for the black woman who can't change being black? What does that do for the brown woman who can't change being brown? If all we're doing is telling them, here's the headline, here's the headline, here's the headline, and oh well, what does it mean, right, when we really look into it. And what I will say is by highlighting poor care to black and brown women, it is not going, oh, they're getting all of the attention. It's going, care will be better for every single person. If we change care for black and brown women, care gets changed for every woman. So, you know, equity is what we're seeking. This idea of equality, we don't want it. We don't want it because we're not all coming from the same starting point. We want equitable care and that is what we're not getting. The statistics are not shifting because the conversation requires way more than clickbait stories of my baby died or I nearly died. I wasn't listened to. That was the result. I have been begging for this conversation to move beyond we weren't listened to and to.

understand even the historical context of how racism shows up within healthcare. But that doesn't sell papers. That doesn't create stories. That doesn't get people creating viral videos. We know that within our institutions, we have a systemic racism problem. And we're trying to say we're going to shift the statistics because we're going to listen to women. We're going to say it's just because we're not being listened to. Why are we not being listened to? We're not being listened to because we have no desire to understand how different cultures, different race and different ethnicities might communicate their needs. We are still reporting up until 2017 that black people had a higher pain threshold than white people. And I was at university where I was told, be careful of the Asian man in

bereaved families. He is often controlling and he does not allow his wife to express herself and rushes to bury the baby because he doesn't want to deal with it. That was what I was taught on study day on bereavement. So you're trying to tell me that the issue is that we're not being listened to? Is that really the issue? Really, it is racism. Thank you so much. That's, yeah, basically what I've been waiting to hear. You're welcome. Race is clearly a problem. Socioeconomic factors play a role. Women from the most deprived areas are twice as likely to die during childbirth compared with their more affluent counterparts. Migrant women, particularly those with insecure immigration status such as asylum seekers, refugees, those with no recourse to

public funds. They face significant barriers in accessing antinatal care, leading to higher risks of mortality. Leah, can you tell us about your role at Amabirth Companions and what that charity does? I would love to tell you about Amma Birth Companions because this is an organisation that really fills my midwifery heart and aligns so closely to my values as a midwife and just as I hope a good human being. AMA provides support and pregnancy, birth and early parenthood for women and people who are going through social isolation. So AMA trains volunteers, just lay people who are so good to give their time to support them with accessing the services that they need, with understanding their birth choices and with actually going with them into hospital or to home or wherever they're

having their baby, and then supporting them not only in the postnatal period, but for the first few years. The women and people who use AMA say that it really feels like a family because AMA jumps in to fill that gap that the NHS, unfortunately, in its current state, cannot fill. It provides that empowerment, that information helps people from any background and experience feel special and valued and uplifted. It's doing incredibly important work, especially in this increasingly hostile environment towards people with that kind of background. And that has made our work more difficult tangibly over the last year or so, but it makes it even more important now as well. Well, let's move on to our final thoughts.

Ilya, if you could say anything to the powers that be or want to talk about any immediate measures that could be implicated or any solutions, what would you say? I think we have to start broadening our lens on choice but also on trauma. We have to put agency back in the hands of the service user, but also those who are maintaining the service. So the midwives, these are the heart of this service. And yes, that does not diminish the fact that actually midwives can contribute to harm. That does not diminish the fact that racism exists within maternity service workers, etc. It's all, it all exists together. But at the moment, what we're doing is we are driving a divide without filling a gap. So we're going, oh, this is a really

dangerous service. But we're not giving an alternative. To more informed, racially conscious, equitable care is what we should be seeking. That is what I will always be driving. And Leah, your final thoughts. I'd love to just finish with two truth bombs, I guess, one of which I've kind of already alluded to, which is that maternity is public health. It affects each and every one of us. It's not just some silly little niche women's issue, not that that's not important enough on its own, but it does affect each and every one of us. And the other thing I'd like to say is that this chronic, consistent, conscious choice to underfund and undervalue maternity. is nothing less than institutional violence against women, girls and birthing people.

It is a choice and it is a choice that can be reversed. Thank you for listening. If you want to support Media Storm, you can do so on Patreon for less than a cup of coffee a month. The link is in the show notes and a special shout-outs to everyone in our Patreon community already. We appreciate you so much. And if you enjoyed this episode, please send it to someone. Word of mouth is still the best way to grow a podcast. so please do tell your friends.

You can follow us on social media at Matilda Mal at Helen Awadia and follow the show at MediaStorm Pod. MediaStorm is an award-winning podcast produced by Helena Wadia and Matilda Malinson. The music is by Samfire.