Empowering women

I read with interest Dr Kate Redman's letter 'Birth pain and trauma' in the December issue in response to Dr Emma's Svanberg's September article 'Changing the culture of birth'. As both a mother and a Counselling Psychologist I agree with both writers that pregnancy and childbirth unfold in an un-reflected sociocultural landscape that has little understanding of psychological processes and the dynamics of trauma.

A mother's negative birth experience impacts her child and can have implications for their bond, which ripples out affecting partners, siblings and other family members. As a society we can't really afford to misunderstand, misrepresent or mistreat such an important event as birth, yet it is something that keeps happening, as Dr Emma Svanberg clearly explains.

I have encountered a small handful of gems in my 15+ years as a mother and woman reliant on NHS care, but my experiences sadly have all too often been coloured by inconsistent, inconsiderate, misinformed, contradictory and disempowering care mostly to do with an outdated medical model and unconscious power structures resistant to change. The trauma I have experienced during childbirth, miscarriages and women's health issues were amplified by childhood experiences.

Pain is a complex phenomenon and can't only be viewed through the lens of medical pain relief or intervention. Of equal importance, if not more, is the quality of relationship between caregivers and users. The prevention or reduction of pain, both physical and psychological, can be achieved with informed, kind and professional care, that genuinely works at the service of women. With regards to childbirth this would give mothers a sense of pride, achievement and above all ownership. Such a sense of empowerment would go a long way in the journey of parenting.

In my dreams every mother-to-be would have an in depth conversation with a psychologist at the start of her pregnancy who would take a bio-psycho-social-spiritual and co-operative approach, with the aim to construct a multidisciplinary care plan that works towards the best possible outcome of her pregnancy, the birth and the first very crucial months of the beginnings of her mothering relationship to her child or children.

In reality, I know this requires more resources that are in place at present and in many cases might well uncover complex needs that would require highly skilled input, not just for that period, but beyond. However, there is a trained and experienced workforce already available, not just in psychology but also in the form of psychotherapists, but they are often not employed or poorly substituted. Psychological understanding and care are not a luxury but a necessity.

Wouldn't our world be a better place if we treated the start of life with the understanding and care it requires?

Sara Angelini
Counselling Psychologist/Psychotherapist UKCP
London