Three Christmas Wishes

AIMS Journal, 2023, Vol 35, No 4

By Katharine Handel

Christmas is traditionally a time for wishes. It’s also, somewhat more mundanely, a time for lists. I’ve got several lists going at the moment, but I’m going to let myself make one more. This one doesn’t have things I need to do on it, or things that other people would like; instead, it’s a list both for myself and for all women, a list of things I’d like to see in perinatal care and society more broadly based on my five years of experience of supporting new mothers in the transition to motherhood.

I’ve been part of The Motherkind Café since it launched in 2019, during which time I’ve met hundreds of mothers who are adjusting to motherhood. The café is an Oxford-based peer support group which provides a space for mothers who are concerned about their mental health. Our peer supporters are local mums who have experience of struggling with some aspect of motherhood or mental health themselves and have come out the other side. Five years since its founding, it’s still going strong, and last month we trained a new group of peer supporters so we can go on supporting women in our local area. Through talking with the mums who visit us, I’ve had many opportunities to consider what I might change to make the transition to motherhood easier. So here’s my personal wish list for what I’d like to see in all perinatal care, if a pantomime fairy godmother were to appear and grant me three magic wishes…

Honesty

Honesty is a vital component of perinatal mental and emotional wellbeing, and it is necessary both for the mother and for those who are supporting her. Medical professionals need to be honest with women about their options at all stages of pregnancy and birth, setting realistic expectations without enforcing a particular care pathway. Family, friends and the wider community need to be honest about their own experiences of parenthood, offering a contrast to the idealised view of motherhood on social media or popular culture and also to the often denigrated role to which mothers are often relegated. Additionally, new parents need to be honest about the support they need and about what they’re finding difficult, and they also need people to be honest with.¹ There needs to be a culture of open, candid conversations in the perinatal period, and this can be helped by reducing social isolation and increasing connections between new parents. At The Motherkind Café, we try to bring mothers together and create a non-judgemental, confidential space where nothing is taboo and mothers can say how they’re really feeling, sometimes for the first time.

Respect

Respect is another important factor in perinatal wellbeing. One of the things that comes up in our conversations at the café is that how a woman feels about her birth experience is more influenced by how much control and choice she had rather than specific details of the experience, something that is supported by academic research.² Medical professionals can play a vital role in mediating birth trauma, as it has been shown that if they are respectful and supportive, this can help to improve how a woman views her birth experience.^3,4 Respect includes an awareness of and sensitivity to a woman’s medical, cultural and personal history in perinatal care, taking all of these factors into account so that a woman is seen as an individual in need of individual care. It also includes validating a woman’s feelings about her perinatal experience rather than attempting to impose a narrative on it.

Dignity

It's often said that you have to ‘leave your dignity at the door’ when giving birth, in a range of tones that include disparagement, pity and well-meaning advice. While pregnancy and birth certainly can involve being confronted by your body behaving in ways that it has never done before, a loss of dignity shouldn’t be a given. Discussing birth in these terms is disempowering and encourages women to feel a sense of resignation and helplessness, to accept poor care or care pathways they do not want instead of advocating for themselves. Another phrase that I would like to abandon forever is ‘nothing matters as long as you have a healthy baby.’ Of course the baby’s health is important, but the mother’s health matters too, and the idea that she can and should put up with anything as long as the baby is all right is often used to justify or downplay a mother’s negative experiences. At The Motherkind Café, we try to take a more holistic approach, encouraging mothers to value their own wellbeing and empowering them to seek further help and support when they need it.

So there you have it, my three wishes. When I was first asked to write this article, it was suggested to me that I compose it as a letter of wishes for my daughter, who was born last year, and that was how I started off. But as I was writing it, I realised that I don’t want these wishes to be granted so far in the future. Ideally, I’d like them to come true instantaneously! Is this asking too much? Perhaps. However, to quote a very wise editor, this list might feel ‘entirely like wishful thinking, but there is no change without imagination.’ So, I’m hoping that this might one day come true, sooner rather than later, perhaps with the help of more spaces like The Motherkind Café.

Author Bio: Katharine Handel is a former editor of the AIMS journal. She is one of the coordinators of The Motherkind Café, an Oxford-based postnatal peer support group for women who are concerned about their mental health. She lives in Oxfordshire with her husband and children.