Invisible pregnant Queers

As I said in my last post, one topic I am very passionate about is LGBT+ people's experiences of pregnancy and birth.

As a doula, I have supported the pregnancies, births and early postnatal days of a whole variety of families. I've seen first hand how good, respectful care can protect a pregnant person and their family, even in the worst of circumstances. I've also seen how poor care can lead to traumatic births.

As a researcher, I have been having a look at what we actually know about queer birth and traumatic birth, and the answer so far is 'not a lot'. We know that pregnant trans men and lesbian couples do sometimes experience poor care linked to the fact they are Queer - whether that's outright homophobia or transphobia, or whether it comes from a lack of knowledge or experience in providing care to pregnant LGBT+ people. But there are - so far - no studies looking specifically at how this difference in care may impact birth trauma. Here is an academic article I've written, highlighting just how much we don't know about the experiences of LGBT+ people giving birth.

Gender: unexpected

I am passionate about supporting the reproductive journeys of all parents. As a doula I have helped to support the pregnancies, births and early postnatal days of a range of different families - single heterosexual and lesbian mums, single non-binary parents, heterosexual couples, lesbian couples, and gay male couples where one dad was a trans man. I am have been privileged to see some very respectful maternity care, but unfortunately have also seen some very poor care.

In my experience, all parents-to-be and new parents are uniquely vulnerable. Whether this is the first baby in a family, or whether this baby already has siblings, pregnancy and birth is a time of much change. There are hormonal changes, changes to personal and family relationships, and changes to jobs. Pregnancy and birth is often a time of both hopes and fears. Research already shows that poor care during this time can have a significant impact, and can lead to trauma for the person giving birth, their partner, and others present at the birth. We know that sometimes this trauma can impact longer term perinatal mental health difficulties, such as post-natal depression, anxiety, and post-traumatic stress disorder.

So far, there seem to be few discussions about how a pregnant person's sexual orientation or gender can affect the quality of maternity service care that they receive. To start some of those discussions, I wrote an article for The Conversation which you can read here

Taking Big Birthas to Med Soc

Last year, I got involved in a wonderfully exciting research project called the Parenting Science Gang. This involved parents being recruited, trained in research techniques, and then deciding what to research, how to do it, and carrying out the research and analysing the data. The particular strand of the Parenting Science Gang I was involved in was the Big Birthas project - investgating choices for pregnant women who had a 'high BMI'.

When the project ended, we Parents Scientists were left with the data and the findings. My day job then was as both a doula and a researcher, and I am passionate about choices in birth for all, regardless of BMI. I also had a high BMI in one of my own pregnancies. Some of the stories women had shared with us were heartbreaking - stories of having choice and power taken away from them, and of being upset and traumatised as a result. Some of the stories were also uplifting, when women took power back, through asserting their rights to make choices and decisions about themselves, their bodies, and their babies. Women had shared so much with us, giving up time and investing work into telling us their stories, and I wanted to make sure we do justice to that. 

One way I could do that was to present our findings to a diverse range of audiences. In my day job, I frequently present research findings to conferences of academics, so I applied to present the Big Birthas findings to a conference. The conference I chose was the British Sociological Association’s ‘Medical Sociology’ conference. It is a brilliant conference, focused not on what we do medically within health care, but how we do things, why we do things, and how we could do health care better.

My talk was accepted, in a format called Pecha Kucha. These presentations allow you to present 20 slides, and talk about each one for 20 seconds. It’s a challenging format because it makes you really focus hard on what the key points are that you want to make. There is no room for waffle! I wrote the both the initial application and the presentation collaboratively with several of the other Parent Scientist, using the Facebook group to refine ideas and try things out, in the same way we had used it during the Parenting Science Gang project. It was lovely to have that very supportive and equal way of working, which is quite different from how most academic and medical presentations are created.

I chose to focus on one of our findings, the idea of the ‘high BMI box’. Many women told us about how, once they were in this box, their BMI was the only thing that anyone seemed interested in. They told tales of having serious medical conditions ignored, because so much focus was on the 'high BMI box'. One woman explained how the difference between her starting weight in her two pregnancies was objectively only 7 pounds, but one made her ‘normal BMI’, and the other saw her put into the ‘high BMI box’. She eloquently described the differences this made to her care.

The presentation was well received, and questions were asked after the talk about both the Parenting Science Gang methodology, and the Big Birthas methodology and findings. People talked about how our research overlapped with bits of the work they were doing.

The Parenting Science Gang’s project may be over, but the journey for the stories we collected as Parent Scientists is not. Next, I am hoping to work with some of the other Parent Scientists to turn our findings into a piece that can be published in a midwifery journal. Watch this space…

First day as a post-doctoral researcher

Today is my first day in my new job as a post-doctoral researcher, at King's College, London.

I came into this job by a rather twisty route. 10 years ago I started working as a doula. I LOVE working as a doula, being able to travel with parents on their journey through pregnancy, being with them offering support during labour, and seeing them settle as a new family, or as a newly enlarged family. However, I was saddened by how many of the lovely parents I worked with hired me because they had previously had a birth which was upsetting, traumatic, or a birth where they didn't feel properly cared for. When I looked to the research to find out what helped parents who had experienced this in their next pregnancy, I couldn't find much good quality evidence. Eventually I decided that if the evidence wasn't there, I would do the research myself.

I spent just over 3 years carrying our research into the choices that women made during pregnancy, birth, and the early postnatal period, when they had previously had a traumatic birth. I followed a number of amazing women from early pregnancy until their babies were a few weeks old, interviewing them at various points. I am hugely grateful to them for giving me their time, and sharing their thoughts, experiences and feelings. During this time I published several articles about choices after a traumatic birth, and was awarded my PhD last year.

Carrying out the research was interesting, terrifying, frustrating, and deeply satisfying, all at once. I decided that I wanted to do more of that, and so began applying for post-doctoral fellowships. It's a tough area to break into, with far more people with brilliant ideas than there is funding for the research. Eventually I was lucky enough to get funding to carry on publishing from my research, and do a little bit of new research, for the next 2 years. This blog is one way that I will spread the findings from my own research, and discuss what all the latest pregnancy, birth and early parenthood research actually means for parents.

(With many thanks to the Economic and Social Research Council for funding me).