March with Midwives – Inclusion and Exclusion

Midwives working conditions

Anna is a midwife and part of the With Woman collective. She writes about the challenges facing midwifery in the UK; the grassroots movement March with Midwives; and their exclusion of women who hold and express feminist beliefs.

March with Midwives

Last Sunday, 20,000 people, mostly women, took to the streets to ‘March With Midwives’. A grassroots movement started by a group of doulas (birth companions) the idea quickly spread. It was as if a dam holding back frustration, desperation and passion had burst open. There were self-organised demos and vigils in towns all over Britain with hand-made placards, songs, dances and speeches.

Burn-out and despair

I am a midwife and know the work pressures first hand. We have NHS underfunding and Covid pressures – which have brought us nearly to breaking point. As many of our wonderful European colleagues left in the Brexit / Covid whirlwind, and were not recruited back with bribes (unlike the truckers); as the job got harder and the workforce smaller; what we got were claps and posters declaring us ‘heroes and angels’. My NHS trust gave me a poem and a sunflower seed to plant. The RCM, part-union and part-professional body, has not acted to harness the anger and despair building up.

Ina May Gaskin

There is a UK shortage of 3,500 full-time midwives, but for every 30 qualifying the profession, the equivalent of 29 leave. Sickness is high and burn-out is common. We provide a 24 hour, 365 days a year service. The NHS bursary for student midwives was scrapped in 2016, meaning students are paying, and getting into debt while working on the wards. Pay has remained below inflation for over a decade, meaning an effective pay cut of up to £7500. A recent report by the RCM found that a majority of the midwives surveyed had serious concerns about delivering safe care and were leaving or considering leaving the profession as a result. The  fear of litigation  and the weight of responsibility to keep women and babies safe under such difficult conditions adds to the pressure.

Midwifery under the patriarchy

Midwifery is women doing work for women. Birth workers, the community of workers in the field of birth – not just midwives, but maternity support workers, doulas, antenatal teachers, breastfeeding supporters and more, have long been advocating for respectful midwifery care, and against obstetric violence, which is a form of sex-based violence.

The work conditions, and the way women are often treated, is a result of patriarchy. It explains the lack of priority for this group of workers and the way we are expected to give more and more of our good-will. It is as if care work is an innate quality, not a task to be paid for because ‘women’s work’ is not seen as real work. It explains the way women are treated in the medical-industrial complex.

We are used to seeing women’s bodies as not fully human, and having things done to them, so obstetric disrespect is an easy step from porn, prostitution, sexist advertising and so on. The intersection of patriarchy, racism and class inequality is laid bare by the fact that black women are four times more likely to die in the childbearing year than white women in the UK. The problems in midwifery cannot be isolated from the political context.

Exclusion in the name of ‘inclusivity’

The organisers of March With Midwives (MWM) state:

“This is an intersectional feminist grassroots movement. We are unapologetically INCLUSIVE and will not tolerate any racist, homophobic or anti-trans rhetoric in this group. Admin will take a zero tolerance approach to managing this group.”

Ironically, women were excluded from the main MWM Facebook group of 20,000 for seeing the problem as one of sex-based oppression. Lynsey McCarthy-Calvert, doula and service-users’ voice in the NHS, transgressed when she stated the suffragette colours were not transphobic. When author Milli Hill pointed out the exclusion she too was out, having become persona non grata last year for pointing out that obstetric violence is a form of sex-based violence. It’s unknown if others were kicked out for holding and expressing feminist beliefs, nor how many more are too afraid to speak up.

By ‘inclusive’, the organisers mean exclusive of those that don’t subscribe to a belief in gender identity, and by ‘feminist’ they mean not speaking about sex-based oppression. The desire to demonstrate inclusivity by using language according to gender identity rather than sex does not work when the work relates to uteri, vaginas and vulvas. In midwifery sex, not gender, is the appropriate category of women.

‘With woman’

Despite this, the vigils organised under the MWM banner are important, the midwifery work we all do is vital. The conditions under which we work, are the conditions in which women are birthing, and into which babies are being born. As the renowned US midwife, Ina May Gaskin says “The way a culture treats women in birth is a good indicator of how well women and their contributions to society are valued and honoured.”

Midwives want to be ‘with woman’ and women want us with them. One beautiful aspect about Sunday was the solidarity between mothers, midwives, and other birth workers. We want to give good care, ultimately because we want women to birth in respectful, loving, safe environments. We were out on Sunday to fight for the midwives’ rights as workers and also for respectful care for all women.

Anna, midwife and part of the With Woman collective


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