Midwifery, Childbirth and the Media

The media plays an important role in providing us with information about a range of topics and issues, including pregnancy and childbirth. The visual media, such as television, can provide planned information (education), for example, in documentaries, advertising and the news. But the information can also be unplanned (through socialisation), for example, through the way issues are portrayed in soap operas, “fly-on-the-wall” programs, panel shows and drama. There has been a considerable debate regarding the influence the media has on first-time pregnant women. Much of the academic literature discusses the influence of (reality) television, which often portrays childbirth as risky, dramatic and painful. The truth is that most of pregnancy and childbirth is slow, relatively ‘uneventful’, and marked by long periods of waiting. Therefore, normal childbirth is not great for visual media such as television. There is anecdotal evidence to suggest that the dramatic portrayal of childbirth has a negative effect on childbirth in society, generating fear of childbirth through the increasing anticipation of negative outcomes. At the same time, it has been suggested that women seek out such programmes to help understand what could happen during the birth. This chapter will introduce the current thinking by health professionals about the role of media in how women perceive birth.

Childbirth is highly visible on television at a time when few people see birth in the family or community and access to antenatal education is declining. One Born Every Minute (OBEM) is the most high-profile example of this programming in the United Kingdom. Now on its ninth series, the series won a BAFTA in its first year and now exports programmes to the United States and France. However, such programming is controversial within the birth community. This chapter examines objections to the series—drawing on an analysis of published commentaries and opinion pieces from midwives, doulas and activists. Firstly we evaluate claims that televised birth promotes fear among women and damages the midwifery profession in the light of available research evidence. Secondly we explore the dominant conceptual questions that emerged from the analysis around the identity of OBEM as educational programming or entertainment, and its claims to represent reality. The birth community has raised important questions about birth on television and we draw together insights from a range of disciplines to argue for further research that is theoretically grounded to move the debate forward and tackle the complex question of how televised birth might be influencing women’s experiences of pregnancy and birth. The commentaries and opinion pieces from within the ‘birth community’ raise vital questions about the impact of televised childbirth on women’s experiences and on wider birth culture. However, some of the claims identified—that OBEM increases fear of birth, that it damages the profession of midwifery—need a stronger empirical basis if they are to be supported. We argue that interdisciplinary, theoretically informed research has potential to further the debate and inform interventions in popular culture.

A free press is held to be a benchmark of healthy society—but this chapter explores how British newspapers may contribute to adverse birth outcomes. Social theory about news-making suggests that the experience of having a baby has emotive human interest, and editors tend to favour those which are unusual. Hence the deliveries which make it into print are out-of-the-ordinary, often frightening and likely to distort readers’ risk perceptions. Such a dynamic may be a factor in increased rates of caesarean section, which has been associated with fearful future mothers, medicalised care and interventionist policymakers. This prompts a call for midwives to engage with journalists in order to represent vaginal birth as a normal bodily function which has benefits for both mother and baby. Giving interviews is acknowledged to be an intimidating prospect for most clinicians; hence high-quality media training is essential. Maclean concludes by giving insights about how a newsroom works, and suggests that if editors are given sufficiently interesting material, they may find space for more normal birth stories. There is no expectation for newspapers to stop holding clinicians to account or to ‘change’ the media. Rather, advocates of normal birth might better understand how news-making works, so as to help meet the aforementioned criteria for a good story. Maclean concedes that even as a former journalist, it is stressful being a midwife who grants media requests. But her experience of such exposure suggests this is an opportunity not to be wasted.

Infant feeding is a fundamental element in the childbirth continuum. A woman’s decision about whether to breastfeed, and the duration and exclusivity of this, has the potential to affect short and long term health for both herself and her baby (Vitora et al. 2016). When making infant-feeding choices mothers often feel obliged to conform to the expectations of their family, social group and culture (Angell et al. 2011). In addition, women are influenced by the wider society in which they live, and many report feeling pressurized, shamed and marginalised by other people in relation to their infant feeding (Thomson et al. in Maternal & Child Nutrition 11: 33–46, 2015). Although women’s choices are essentially personal and private, strong public opinions on the subject transform it into ‘everybody’s business’. This is exacerbated by mass media, which has become a conduit through which social and individual views on infant feeding are presented and debated. Curiously, the ‘everyday’ nature of this subject means that it often appears in the media in a covert manner, when it is unconsciously included as a minor element in a wider story. In other cases infant feeding is the story, and it appears in the media as a problematic issue and the focus of discussion (Henderson et al. in British Medical Journal 321: 1196–1198, 2000). During the past two decades a small body of research has emerged which has explored how infant feeding is presented in newspapers, magazines and television, in a range different countries and cultures. This chapter will review the existing literature and consider how the media might influence infant feeding behaviour, both currently and in the future.

Leachman discusses how new media have an opportunity to interrupt the fear-mongering pattern of traditional media to change how women feel about birth. Leachman uses her experience of her Fear Free Childbirth podcast to explain how new media represents an opportunity for women’s perceptions of birth to be challenged in a positive way. Her podcast, which has been downloaded over 300‚000 times worldwide, helps women around the world to unlearn their childbirth fears and helps them to prepare for a positive birth experience. The podcast does this through sharing extensive interviews with birth professionals and experts, positive birth stories told by the mothers themselves and Leachman helping mothers to shift their mindset around birth. Leachman argues that media need to take responsibility for their reluctant role in educating women on pregnancy and childbirth. Leachman discusses how the portrayal of birth in the media currently tends toward the negative or frivolous, and how information that can help women to prepare in a meaningful way is widely lacking. Through her work as a therapeutic coach, she witnesses first hand how the childbirth myths perpetuated by the media are feeding women’s fears around birth. She explores some common childbirth fears and some of these fears can lead to traumatic birth experiences, and the potential consequences for family health and wellbeing. Given the impact that fear has on birth, Leachman calls for more to be done to educate women. She explains that this can be done creatively in ways that will engage and have impact, and that the media are well-placed to have a part to play in a broader integrated solution in helping women to birth without fear.

The authors explore the information needs and preferences of pregnant women through a study of health-promotion strategies employed in an antenatal clinic waiting room at a tertiary hospital in the Northern suburbs of Adelaide, Australia. Conducted as part of a wider health communication project (‘Health-e Baby’), the chapter provides a detailed assessment of how these spaces are used by staff to convey health messages related to pregnancy and how pregnant women interacted with these materials whilst waiting for their appointments. Rodger, Skuse and Wilmore’s observational data is complimented by data drawn from semi-structured interviews (n = 35), which enables them to explore how waiting rooms can be used to maximise the potential efficacy of health promotion interventions at these important sites of interaction with antenatal patients. Preliminary insights from this chapter challenge assumptions about the efficacy of current uses of antenatal waiting rooms as a setting for the communication of health information.

Historically, women have learned about childbirth from their mothers and sisters, and from seeing childbirth in the family or community. In the more recent past, women would have gone to books for advice. Today, we see that women are turning to media to learn about what the experience of childbirth is like. This poses an interesting dilemma for midwives who support mothers during their pregnancy. This chapter will discuss the findings from two closely linked research projects that speak to midwives about their experience with women who are allegedly influenced by the media in their decisions about childbirth. The chapter will explore how midwives understand their profession to be depicted in the media and will also explore how midwives engage with the media. We will provide some suggestions for midwives moving forward who wish to create more positive representations of childbirth and early labour in the media.

Hannah G. Dahlen has been working with the media as spokesperson for the Australian College of Midwives for 20 years now and has undertaken research into media representations of midwives and obstetricians. There is enormous potential power when midwives work effectively with the media. Having a public voice enables you to shift thinking about childbirth and can be a part of shifting paradigms of understanding around the profession of midwifery. The political power of a positive midwifery presence in the media cannot be underestimated. However, working with the media also takes persistence, patience, resilience and an understanding about how messages are best delivered to be effective. There are significant pitfalls; and the media can turn quickly and demonise midwives. In the world of every-expanding social media, effective messages can be delivered quickly and effectively but cyber bullying is ever present and can be very distressing to deal with. The higher profile midwives become in the media the more they are exposed to this. This chapter will focus on tips for midwives in learning to deal with the media and present themselves in the best possible light. It will explore the pitfalls and help midwives identify skills that can help them maximise their message and realise the possibilities. It will also reflect on research undertaken into the representations of midwives and obstetricians in the media and how negative stereotypes can be altered.

In this chapter social media will be presented and reviewed by exploring its impact on midwifery and maternity services, considering global perspectives. It will begin by positioning the opportunities social media presents to midwives, maternity care workers, in addition to childbearing women and their families. A summary of the range of social media platforms available will be presented, and will include an analysis of the increasing utilisation of social media as an important aspect of health promotion and health care. The ongoing maturation of social media technology has broadened the scope for individuals to be heard, and to voice their opinions. This has huge implications for those using and providing maternity care, as service users can share their feedback on the care they’ve received to the whole world, at the touch of the button. Online blogging is competing with written academic articles for disseminating research and opinion, and the use of social media in increasing readership of high-quality papers through making them more accessible. Social media offers opportunities to maternity workers to access influential leaders and experts, as there are no hierarchies in cyberspace. This in itself presents unlimited opportunities for all parties, and maximises potential for increased social capital through community engagement. It also increases visibility, the chance for student and newly qualified midwives to test out ideas, and then to gain support for taking them forwards. But there needs to be caution, and some health care professionals lack knowledge of the importance of professional integrity and the power or demise of their digital footprint. The chapter will offer a practical guide for midwives on how best to access, utilise and maximise social media avenues for learning from conference and events, networking, lobbying for change, professional development, research, relationship building, communication and midwifery promotion. It will include examples of how social media has acted as a change agent in health care arenas, where the digital space has offered a platform for innovation and engagement, enabling radical change through building supportive networks. The chapter will explore the importance of modelling positive behaviours online, how to stay safe, and to remain within professional boundaries for both personal and professional cyber identities. Social media is here to stay, and the overall focus of this chapter will be about how to use it well.