How lack of empathy in postnatal care is screwing us all

By Lucy, who is mother to Namo. Read more about Lucy here.

Three days after I give birth, I stand up after feeding my son to a stomach-churning lurch. A potent mix of sleep deprivation and the haze of new-baby-love means I haven’t registered the onset of cold sweats or shivering, but as the lurch subsides, I sure as hell register the wodge of organic matter that is suddenly hanging out of me.

Figuring that something is up, I call the hospital and am told to high-tail it in. On the bus, my husband and I joke weakly that I had it coming. Our son was born on our sofa under a portrait of David Bowie, following an empowering 12-hour labour with no interventions, all the hypnobirthing and a whiff of gas and air. It was about time something crap happened.

I’d been so determined to have a home birth I hadn’t even done the hospital tour, so I had no idea what to expect. I also haven’t left the house since giving birth and doing so now feels like being ripped from the womb myself and flung into an inexorably altered world: all the sounds too loud, the light too bright, the motion too fast.

I tell the doctor before he examines me that I’m a sexual abuse survivor, so could I please have a minute to get myself together before he touches me. He shows no signs of acknowledgement, calls over his shoulder to a student midwife: “get me a speculum.”

“Just relax”, he sighs, exasperated as my face blanches and my shivering body shrinks up the bed. Eventually, I’m knocked out with gas and air while he scrapes out whatever is inside me. At least, that’s what my husband tells me – the doctor is gone by the time I fully come round.

We wait a few hours. The student midwife comes and goes, and eventually we ask her what they think is wrong. “Oh”, she says, seemingly surprised at the question. “The doctor thinks you’ve got sepsis.” She leaves, we Google, we panic. She comes back to explain that she probably shouldn’t have said that; that ‘sepsis’ is an umbrella term and it might be anything really.

In the week that I am kept in hospital, I never receive an answer to what exactly is wrong and I repeat the phrase ‘”Sorry, I’m a sexual abuse survivor” at least once a day. I am met with a variety of reactions ranging from blank silence to sighs to an actual
eye roll.

The first doctor lodges in my brain, and for a long while after my discharge I think of him every day. I replay his reaction obsessively, trying to tally how he could work in women’s health and yet seemingly not understand how a strange man knocking out a survivor in order to penetrate her with a blunt object then fuck off afterwards without talking to her, might make her head go a bit skewiff.

I mean, I’m not thick: I may not have been told exactly what was wrong, but I’ve enough about me to deduce that some kind of infection under the ‘umbrella’ of sepsis might well have finished me off 100 years ago. Also, people will need to look at your vag after birth — it would be negligent not to and I had taken steps to deal with how this might affect me given my history. I should also say that I am incredibly grateful to live in a time and place where free healthcare is available to me.

But all I really wanted was basic empathy.

In this case, to be acknowledged when I spoke, and given the time I had politely requested. I also don’t believe that anyone (bar the odd psychopath) balls-out enters obstetrics or midwifery with the intention of not showing such basic empathy. So how have we got the point where – as reports, surveys and a whole lot of anecdotal experience demonstrate – the lack of it is fast becoming the norm?

I’ve never worked on a postnatal ward, but as a Humanities graduate living in London, if there’s one thing I can claim some authority on is pulling shifts in an understaffed restaurant. It was of this dark chapter of my life that I was unnervingly reminded during my time on the ward.

Picture the scene: you’ve been working illegal double shifts for some days now, your feet and lower back feel like they’ve been bludgeoned and your vision is going wibbly. At this point, everyone in the place is existing on caffeine and their nerve ends but the boss won’t hire more staff, give you your legal breaks or get off her arse and actually help because reasons.

So here you are, taking the order for 2 Pad Thais, one no peanuts, for Table 5. Table 5 stress that it’s really important there are no peanuts due to her severe allergy and oh – can they get a carafe of house red and some prawn crackers on the side?

You schlep your aching feet over to the till and tap in the order, except some of the buttons on the touch screen aren’t programmed properly and enter the wrong thing so you end up having to re-enter them 15 times then take a hand-written amendment to the gakked-up chef who responds by chucking his tongs at you and declaring you a useless tart.

After some vague period of time (time no do sense now, too tired), 2 Pad Thais emerge and you take them over to the couple on 5, who aren’t impressed that you’ve forgotten the wine and crackers. It’s not the first oversight of the night which means you’ve been taking flak for mistakes for a while. This both inures you to the sting of the individual complaints whilst adding to a stock of emotional resentment which is getting dangerously close to detonation.

You stomp back to the bar, returning with a carafe and a basket of crackers to be met by a seriously angry lady demanding to know why there are peanuts when she specifically said no peanuts and what the fuck and she could have fucking died, Christ.

You are mortified. You know this is a serious cock-up. You also know that when you take the dish back to the chef he will throw utensils at you again, that the manager will shout at you while refusing – for the nth time — to acknowledge that she should probably buy a new till, and that whatever else happens this meal is coming out of your below-minimum wages.

But it’s late and you’re too tired to be rational, so instead of recognising that you, the other staff and all the customers are trapped in a vicious circle of bad service, low wages and inept management, all your ire gets directed at the two people who deserve it least. You huff, puff and curse at them under your breath. You slam their carafe down and roll your eyes when they point out – with justified rage – that it is white, and not the red they ordered.

You mutter ‘good riddance’ when they storm out. They got some form of wine didn’t they, the picky twats? And she didn’t actually eat the peanuts!

As I see it, lack of empathy for postnatal women is as dangerous, both physically and emotionally, as peanuts in the Pad Thai of an anaphylactic.

A system that overworks and underpays its staff to the extent it currently does, and that offers them little to no help for the trauma they witness every single day, is robbing them of the ability to empathise.

If I had to deal with stillbirth, with maternal death, with babies born drug addicts or those forcibly removed at birth… hell, I’d probably find it a bit tricky to empathise with
some bird with a healthy baby and supportive partner who’d had a breeze of a birth and was now chatting some nonsense about no internals, when I was just trying to save her from death by blood poisoning in the 16th hour of my shift.

Too numb, too overstretched, just too damn tired to empathise, healthcare professionals are forced to see those in their care not just as numbers in beds, or inconveniences, or moaning minnies who could have it worse.

They are forced, like an overworked waitress with a lazy boss, to experience the pain of people who have just given birth as a constant reminder of their own powerlessness in a system that they know to be broken because it is failing them too.

As things stand, everyone here is losing out. Midwives and doctors cannot practice to the standard they wish to, and to which they know women deserve. Meanwhile, a baby needs a healthy mother – physically and emotionally – to meet their needs. Their potential siblings need her too.

What everyone too often gets is a traumatised woman who has internalised the message that she does not matter.

Not her body, not her dignity, not her physical or emotional health. How many of us have had accounts of our trauma met with “a healthy baby is all that matters”, as though our health and that of our baby’s was an obvious either/or? The damage that all this this does to a woman’s emotional health can and does incapacitate her.

There are no easy answers here. As the NHS inches agonisingly on towards its death by a thousand cuts, it doesn’t look likely that more cash will be magicked up for those grimly holding the front lines, or for the women relying on them.

As a society, though – one in which almost 50% of us will go through this system – there are things we can do. Too often, the realities of birth and postnatal life are kept from those yet to experience it. Older women cite not wanting to ‘frighten’ expectant mothers but the truth is that ignorance will never bring us empowerment.

But silence does not protect us, it isolates us. It stops us seeking help for birth injuries, postnatal psychosis and postnatal depression. It makes us think we must be weak, or selfish, or crazy; that our experiences must be an unfortunate exception when all the
evidence points to them having become an unacceptable norm.

As those who have come through the system, we can agree to empathise with the women in our life who are yet to do so.

We can agree not to silence them with “a healthy baby is all that matters.”

We can see this not as a war between the healthcare profession and women, but as an assault on both of us.

And we can give each other the space, the solidarity, and the empathy to heal.

By Lucy, who is mother to Namo. Read more about Lucy here.

What were your experiences of postnatal care? We would love to hear from you. Contact us, comment below, or tag #WokeMamas on social media.

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