An open letter to my midwives

ISSN 2516-5852 (Online)

AIMS Journal, 2021, Vol 33, No 3

To read or download this Journal in a magazine format on ISSUU, please click here.

Heather Spain holding baby

By Heather Spain

Dear Midwives,

My boy is now 22 weeks old, but there’s not a day that goes by when I don’t wonder what you were thinking when you held me and my then four-day-old newborn captive on the maternity ward, when you initiated the child abduction protocol, resulting in three male security officers physically blocking my path. All I wanted to do – as I explained and begged with you at the time – was to take my broken, bleeding body and shattered soul home to heal; to reunite my baby with his father; and to remove my baby and I from the hospital’s increased COVID risk. My son’s phototherapy treatment had finished, I wasn’t receiving any treatment and there was no need for us to stay in hospital, except to wait for my baby to have a repeat blood test in 12 to 16 hours. I made the wise and fully informed decision to leave the hospital and requested that either the community midwives repeat the test or I’d bring my son back in. You said no. Your Concerns Team have since admitted that it has wrongly become common practice to require babies to wait in hospital for this test, simply for administrative ease. I knew that without a safeguarding court order in place there was no legal way you could compel me to stay. I calmly explained this to you and my reasons for needing to leave. You said no. I went to leave anyway. You punished me for my audacity. You refused to unlock the doors; you pushed in front of me and barred my exit when I tried to slip out; you threatened me with social services and the police; and finally, you used three big burly men to physically intimidate and block me. I tried to exercise my power to make informed decisions. There I stood: four days postpartum; anaemic and physically wrecked from a post-partum haemorrhage; having not slept for five days; having barely eaten. There I stood: struggling to hold myself upright, struggling to carry my sleeping baby in his carseat, deprived of my partner’s support by ludicrous COVID rules. There I stood: just a new mother, trying to do the best for her new, precious, tiny love.

There I stood at my weakest and most vulnerable, trying to exercise my power.

You demolished me.

You committed a crime.

What were you thinking?

The strangest thing was that except for one awful midwife who sneered and belittled me, the rest of you subjected me to this cruelty whilst treating me politely and kindly. You offered me tissues and words of reassurance whilst simultaneously imprisoning me and my baby. What was that about? I think I know. You operate in a broken system, and in this system your behaviour was exactly right. Knowingly or not, you are a layer of enforcement for a system that demands women’s unquestioning cooperation and powerlessness. You help to ensure, as the system requires, that women ultimately conform to hospital protocol, whether that is right for her unique circumstances or not. That is how you were able to behave so unthinkingly cruelly with such kindness and conviction. I’ve since realised that I wasn’t shocked or surprised by your behaviour: your antenatal care and treatment of me during the birth had prepared me for this moment. Your attempts to plunder my power and your barely concealed coercion were the sad, ragged threads that ran throughout my pregnancy.

My antenatal care was presented as a given; there was no discussion of choices or decisions. I did not see it that way. I’m someone who compulsively overprepares and overthinks: the minute those two lines appeared on the pregnancy test, I began reading everything I could get my hands on. I knew I had human rights and choices, and that I should be the central and ultimate decision-maker. You disagreed. The first time I made an informed decision – to refuse fundal height measurements – you immediately became flustered and panicked: telling me that I was increasing the chances of my baby dying and literally running for help as if my baby might be in immediate danger. I faced a similar response when I made it clear that I would be declining vaginal exams and, if it came to it, that I would opt for a caesarean before an instrumental birth. You drafted in the consultant midwife and then the consultant obstetrician, who even in the face of my clearly well-researched decision continued to pressure and coerce me into agreeing to have fingers and instruments inserted into my vagina. Why wouldn’t you listen to me? You held my homebirth hostage, forcing me into a scan I didn’t want to prove to you that my baby was head down, even though I (and you!) could feel his feet in my ribs, the flutter of his fingers deep in my pelvis. I could put my hand on his bottom and wiggle it around. Why wouldn’t you believe me?

I didn’t necessarily set out on this journey intent on a homebirth, but as my pregnancy progressed, I increasingly lost trust in your ability to do the right thing for me as an autonomous being with her own unique circumstances and not some medicalised birthing object. Yes, I knew you would help keep me and my baby alive, for which I’m immensely grateful, but that is a low bar to set. I should also have had faith that you wouldn’t cause me harm, that you would support me to soar – this I couldn’t do. I intuitively knew you would cause me harm, that you would be detrimental to my birth. I was right. It is for these reasons that I kept you at arm’s length throughout my labour and birth. Luckily, I had a wonderful doula to gate-keep for me. I found out afterwards that after only a few hours of labour you already wanted to transfer me to hospital for augmentation[1]. I was quietly and peacefully labouring and the baby was happy: Why would you disrupt this to send me into a vicious spiral of interventions? What were you scared of? When my strength and confidence began to falter, as is normal, all you could offer was a vaginal exam or a transfer to hospital. It was my doula who saved me – offering genuine reassurance and suggesting movement and counterpressure. This was exactly what I needed. When it became clear my baby was near, in you barged, wanting the lights on and your hands between my legs. I fought back, knowing all was well. I told you all was well. My baby and I were a team, working carefully together to give us both the gentlest of transitions. We did exactly that, a sturdy 9lb baby born happy and, having refused to push and allow my body to do its thing, without a tear to me. Giving birth was awe-inspiring; yes astonishingly hard, but being largely uninterrupted, I have never felt more capable, more powerful - like Mother Nature herself, plunging into the depths of physical possibility in order to guide a new soul and new mother into the world. Why don’t you trust birthing women? Why didn’t you trust us?

Once my baby had entered the world, I relaxed and let my guard down. This was a huge mistake that I doubt I’ll ever stop regretting. It was your way from now on. The result? You tugging on my placenta as I attempted a physiological third stage. Me unlatching my baby from his first feed so that you could complete your baby checks. I will never forgive myself for allowing this savage interruption. Light. Cold. Banal chat. Our magic bubble popped. A post-partum haemorrhage that I will forever wonder if you caused with your pre-syntocinon tugging, prodding and palpitating. A transfer to hospital – ripping my heart out as I was separated from my baby; incapable of looking after him and with immoral COVID rules forbidding my partner from accompanying us, even though he posed no more of a COVID risk than I did. Then I ceased to exist. I was nothing but a body, no longer entitled to dignity or respect – left unnecessarily uncovered, legs in stirrups. Your colleagues gained my consent for a procedure under general anaesthetic but then decided to use a spinal block. I did not consent to this. My active withdrawal of consent was ignored. I screamed, cried and shouted, until I had no fight left and lay there, humming to myself – trying to block out the violation; empty and anguished with longing for my baby.

The next day my partner brought my baby to the hospital so we could be reunited. Even then you won’t allow my partner entry, even though I was on my own in a side-room. My partner was forced to hand our baby over at reception and I had to listen to you wandering around the corridor trying to work out who the baby belonged to. Yet another unnecessary cruelty.

Do you know what haunts me the most about my experience? The fear of how you must be treating many other women. If you could treat me like this with all my white, middle-class, educated privilege and power, then how are other women faring? It’s well researched that if I were a black woman then I would have been four times more likely to die in pregnancy or childbirth. Had I been a young, single woman or from a different socio-economic background then your threats of social services would not only have cut deeper, but would potentially have had serious consequences, especially in Wales, which has the highest proportions of children looked after by the state in the UK[2]. My hospital bay was right next to your midwife station – I heard how you talked about some of the women on the ward with ridicule and disrespect. This will inevitably seep into your treatment of them and their babies. I also had a “low-risk” pregnancy: my decisions were quite straightforward and I was fortunate to be able to afford the support of a doula, but still I had to fight hard. I know from talking with other women and my doula that women branded as “high-risk” or who, God forbid, go over their arbitrary due date face even greater coercion and disempowerment. This behaviour is unacceptable. It is illegal. Every day I feel the weight of all the women on the unkind conveyer belt of birth and ache for the missed opportunities for women to experience empowering, wondrous, heroic births. I don’t mean home births for all. I’m not suggesting that any style of birth is better than any other, but I am saying that when a woman is empowered, when she is proactively enabled to access her authentic power, her instinctual wisdom, and to be the central decision-maker then her birth can be glorious. Yes, perhaps bloody and hard and painful but also glorious. Birthing women are warriors: Why do you strip them of their power? I suspect because powerful women in a patriarchal world have always been a monstrous threat. They are not allowed to exist.

So, what do you think?

I hope with all my heart that this letter acts as a new lens through which you can see the ways in which your behaviour harms women. How, intentionally or not, you are responsible for trauma, sadness, shame, guilt, powerlessness, violation, and regret. That you awaken to the fact your behaviour impacts women’s physical, mental and emotional well-being in ways that reach far into the future and affect their relationships with themselves, their partners and their children. I hope this sparks within you an urgent need to look anew at the ways in which you can empower women to have the best births possible: individualised care; providing them with the information and space to make decisions free from coercion; knowing that women can be trusted to make the best decisions for themselves and their babies; treating them with dignity and respect at all times; honouring the woman’s unique journey and this momentous moment in her life.

Your Concerns Team have responded to my formal complaint with apologies and promises of new guidelines and training. I am, of course, grateful for this, but honestly there can be no resolution for me. There is nothing anyone can do that will give me back my first days of motherhood and the lost moments of joy and wonder. My grief is an unwelcome companion that you conjured into being but left me to make peace with and learn to live alongside. All I can do now is to hope that I’m able, in my own small way, to shake the foundations of a birthing system that not only doesn’t work for or support women, but often actively works against them. I hope you’ll join me on this journey. It doesn’t have to be this way.

Yours, in hoping for a better birth for all

Heather & Ted

Heather Spain baby Ted


Author Bio: Heather Spain is a diplomat, recently returned from working in Afghanistan. She currently lives in South Wales, where she enjoys spending lots of time outdoors and by the sea with her partner and son.


[1] Editor’s note: “Augmentation of labour is the process of stimulating the uterus to increase the frequency, duration and intensity of contractions after the onset of spontaneous labour. It has commonly been used to treat delayed labour when poor uterine contractions are assessed to be the underlying cause.” WHO Recommendations for Augmentation of Labour. https://www.ncbi.nlm.nih.gov/books/NBK258881/

[2] Wales Centre for Public Policy (2021) ‘Children Looked After in Wales’. https://www.wcpp.org.uk/wp-content/uploads/2021/03/WCPP-Evidence-Briefing-Children-looked-after-in-Wales.pdf


AIMS supports all maternity service users to navigate the system as it exists, and campaigns for a system which truly meets the needs of all.

The AIMS Journal spearheads discussions about change and development in the maternity services. From the beginning of 2018, the journal has been published online and is freely available to anyone with an interest in pregnancy and birth issues. Membership of AIMS continues to support and fund our ability to create the online journal, as well as supporting our other work, including campaigning and our Helpline. To contact the editors, please email: editor@aims.org.uk

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