Women's Health, Pregnancy, Childbirth, Trauma, Healthcare Service

Why did I pick up this book? - As a pharmacist, a sister and aunty, I wanted to learn more about traumatic birth experiences themselves so as to understand the journey some women have encountered and to learn about overcoming traumatic experiences of childbirth, from case studies and examples. A traumatic birth experience can frighten women into ever becoming pregnant again in fear that the childbirth itself could jeopardise their life and leave their existing child without them. The author writes as though she is talking directly to the reader - her target audience is women who have been through traumatic childbirth. However, I would encourage other readers such as healthcare professionals and fathers to learn from the information provided to be better equipped in the aim of becoming more confident support resources to the woman affected by a traumatic birth experience. The author has a dynamic approach in writing, inviting and engaging the reader to become part of the story: “For the next part of the story, I want you to help me out.” Her clinical work suggests that birth trauma is a result of the system that women birth in. The system referred to eludes to the “patriarchal, arguably over-medicalised” follow up to birth and the “sterile environment” that triggers anxiety and inhibits the release of hormones needed during the birthing process. Valuably, the author touches on the history of the medical role in childbirth. Women were banned from being qualified medics and unqualified midwives were prohibited from the birth attendance. “Male doctors with their endowed status, formal education and tools such as forceps began to take over the birthing room a few hundred years ago”… “Forceps are a great instrument to use for the obstetrician but it’s very much at the cost of the woman”. In an indirect way the author teaches us about feminism. Mia says that “most unscheduled caesarean sections are less of an emergency and more of a change of plan”. The examples of birth trauma that Mia describes are very helpful at portraying a picture to readers so others may learn of the experiences of other women and understand where their trauma comes from. The author provides appropriate warning to readers in the preface that the book is about birth trauma and contains graphic wording in parts. It is interesting to read of some of the poor attitudes and treatments by healthcare professionals (therapists and others) - “‘Would you rather have a consultant that treats you well, or one that does his job’ - NHS therapist to patient”. As a pharmacist and reader, I would have been interested in learning more about whether there were formal complaints written, whether individual health care staff were held accountable and responsible for their actions or behaviours. The author does not go heavily into this area but focuses on writing about women’s experiences and how to manage the trauma they have suffered - which is entirely appropriate for the target audience. She does though describe the incident where a patient looked into suing the doctor but advised by lawyers that because the baby isn’t dead or injured, it would be impossible to win a case. I completely sympathise with this reality for women and families. In a private healthcare system you only have to prove that something was not done to the standards expected, however in public health service, it must be proven that significant damage or life lost by direct result of the intervention. The quality and effectiveness of healthcare needs to be looked at more. During Covid-19 I have been stunned that cancer services have been withheld for patients. This book stimulates debate in regards to our healthcare system. The content in the books is engaging - I read within 2 days. I looked up several resources the author refers to such as Jenny Joseph’s BBC Radio 4 interview Sep 2019, and Gabrielle Palmer’s ‘Why the Politics of Breastfeeding Matters’ (Pinter & Martin, 2016), amongst other interesting online resources. I didn’t know that the “leading cause of maternal death associated with having babies during the first year after birth, is maternal suicide (MBRRACE-UK)”. The author provides an insight into tools that birth trauma sufferers may try. The information is helpful to health professionals also, as we gain a better understanding of non-pharmaceutical methods of helping people recover from trauma. As a health care professional I would like to see more efforts made by GPs to identify birth trauma and for the NHS to support the methods of trauma treatments into common practice for all types of trauma. The healthcare industry wrongly supports the pharmaceutical industry to its current extent. It is disheartening as a health care provider to see people easily initiated on antidepressants and to stay on them without ever having the cause of possible trauma fully acknowledged and considered. We can do a lot better. I am encouraged by this book and would encourage others to read it because it provides a very interesting read whereby the author covers a difficult topic in a very easy to read and engaging manner.