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Pregnant women today are at the mercy of paternalism dressed up as fact

Instead of judgemental finger pointing, isn’t it time we had an honest, nuanced conversation about the things that really matter, asks Rebecca Schiller

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By Rebecca Schiller on

This week, the pregnancy police have been out in force with such a barrage of women-shaming, inaccurate and judgemental headlines that I wonder if I missed a memo from the patriarchy.

First in the firing line were women with depression. A study found that some babies born to women who took SSRIs during pregnancy had differently shaped brains compared with those whose mothers didn’t. Based on MRI scans and studies in mice there is currently no hard evidence linking these brain changes with any negative consequences. Yet the accompanying headlines would have us think that women taking antidepressants are poisoning their babies and setting them up for a future of depression and anxiety.

Women are already understandably anxious about the risks of antidepressants in pregnancy, but stopping their medication abruptly before talking to their doctor can cause relapses at a time when they are at their greatest risk of mental ill health. These scaremongering stories shoulder a burden of responsibility for adding to anxiety without concrete facts. Perhaps a more useful media focus would be decrying the fact that suicide is the leading cause of death among women in the 12 months after birth.

A second target this week were those who considered their own pain management above the potential fertility of their imaginary grandchildren. Accompanying research, based on tissue samples and animal studies, Dr Rod Mitchell of the University of Edinburgh encouraged “women to think carefully before taking painkillers in pregnancy”. This might be great advice for women stuffing themselves with paracetamol because they can’t get enough of its gritty bitter taste, but in the real world women have to get relief from debilitating pregnancy-induced conditions, such as pelvic girdle pain, and current guidance already warns against the use of ibuprofen. They are already thinking carefully, weighing up risks and benefits and making difficult decisions based on facts not fiction.

But the coup de grâce came yesterday, as British women were berated for being “woefully unprepared for pregnancy”. It’s true, we haven’t been thinking about our capacity for becoming baby-carrying devices during every waking moment since puberty – and the pregnancy police don’t like that. Instead of supporting us to make the best decisions in our individual situations if we choose to become mothers, they angrily remind us of the cigarettes we smoked years ago behind the bike sheds before we realised we were supposed to stay pristine.

Whether we have a difficult time during pregnancy – or the more usual rollercoaster of joy and fear – perfection always turns out to be a lie, even if we follow the rules

That is what makes this so difficult to choke down with our folic acid. Set hard against the opinion and censure is a lack of concern for the real challenges pregnant women face in the context of their wildly different lives. For some, this lack of health isn’t a choice. It’s been forced on them by inequality, poor housing, migration status or race. Black British women are significantly more likely to die in childbirth than their white counterparts regardless of their socio-economic group. When you look at the facts, the party line about selfish women and their silly choices just doesn’t stand up.

We seem afraid to give women accurate, unbiased information about pregnancy in case it scares them – while forgetting motherhood isn’t mandatory. We don’t trust them to make decisions in case they make the wrong ones. And we encourage women to prepare for motherhood with a list of must-have products, narrow goals, judgement and the promise of a perfect birth if they follow it. Whether we have a difficult time during pregnancy – or the more usual rollercoaster of joy and fear – perfection always turns out to be a lie, even if we follow the rules. But society simply shrugs and tells us it was our fault for being too old, fat, depressed or using a non-stick pan.

Pregnant women today are at the mercy of a barrage of confusing, low-grade and often spurious science and paternalism dressed up as fact. Wouldn’t it be wonderful if, instead of baseless finger pointing, we had an honest conversation about the things that really matter? Our mental health, our work, our relationships. Positivity about our changing bodies – and a nuanced conversation about all that’s wonderful, unexpected and difficult in the complicated reality of becoming a mother. Let’s start a revolution and insist on a more realistic, truthful and human way to support and talk about women if they choose to take the wonderful, terrifying, love-filled, visceral, gut-punch of a ride towards motherhood.


Your No Guilt Pregnancy Plan: A Revolutionary Guide To Pregnancy Birth And The Weeks That Follow by Rebecca Schiller is published by Penguin Life on 3 May 2018.

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