It feels trite to say that pregnancy and birth can be the most vulnerable experiences in a woman’s life, and yet there is a need to say it, still, because so much of that physical experience feels untranslatable. There was certainly a moment while I was giving birth when I felt acutely that my future sanity was in jeopardy. What saved me was my husband, my birth partner.
The role of the birth partner has increased in importance in recent decades; we are far removed from the days when our grandfathers were told to stay outside the birthing room because of the old belief that men would faint. Women being forced to give birth alone during the pandemic has rightly been a source of outrage, and yet this is the situation facing some single women every day. This is especially true of migrant women, who lack the support network so many of us are lucky to have. Yet I have rarely heard anyone express concern about the lonely births that asylum seekers often endure.
A birth partner serves many functions – they ask for water, pain relief, examinations when you can’t. They seek clarification from medical professionals about what is happening. They stroke your back and absorb your fears and your fury. Migrant women are especially vulnerable and disadvantaged, because they do not know the healthcare system, may not speak the language, and often have no family support. Many will have a history of trauma, compounded by negotiating what is an increasingly hostile environment. To give birth alone in this context is a daunting prospect indeed.
It is in response to this set of circumstances that Amma Birth Companions, a Glasgow charity, was founded. The project trains volunteers to support women who would otherwise give birth alone. Since it was founded in 2019, it has supported almost 300 women, most of whom are in the asylum process and at least a third of whom are survivors of trafficking. Language, cultural barriers and poverty are factors in their lack of access to services, and they need help navigating the system. Pregnancy and childbirth can interact with pre-existing mental health conditions such as PTSD to cause perinatal mental health problems, so such support is vital.
The project is flourishing, and has now expanded beyond its original remit, offering postnatal support, antenatal education and advocacy. It’s an inspiring example of women supporting women in the community, recognising that it is inhumane for any woman to give birth alone. When it comes to childbirth, this is what solidarity looks like.
There is no one type of volunteer: there are mothers, grandmothers, students and those who don’t want to have children. Once a pregnant woman has been matched with one of their pool of 60 volunteers, ideally one who speaks the same language, that volunteer might visit her at home two or three times during the third trimester, assisting with planning for the birth, packing a hospital bag, signposting to other services, and providing antenatal education, as well as crucial emotional and moral support.
Then, from 37 weeks, the birth companion is on call to attend the birth. To know there is someone waiting, only a phone call away, to be your advocate must be a weight off any expectant mother’s mind, but especially so in a strange, often hostile country. We all need someone to hold our hand at times like these.
Comfort was one of the first women to be supported by Amma when she delivered her son Simon by planned caesarean section three years ago. At the time, she had serious mental health problems and support had fallen away due to the pandemic. “Just to have somebody there was good, as I was really worried about how it was just me. It was really scary. They stayed by me, stood by me, spoke to the midwife and the doctor on my behalf. They were more like family,” she told me.
She hadn’t intended to breastfeed but with support she decided to do it and ended up loving the experience, breastfeeding Simon for 18 months. It goes to show how the work of birthing partners can help to shape a mother and child’s lives. Comfort was so moved by the support she received she is now an active volunteer and a member of the board, advocating for other women.
Amma is not the only organisation offering birth companionship – they exist elsewhere, from Project Mama in Bristol to London’s Happy Baby Community. If the illegal migration bill passes (it heads to the House of Lords next week), pressure on these organisations is likely to increase as they try to fill the gaps in support provision. Women fleeing persecution who arrive in the UK via “irregular” means will be prevented from claiming asylum and detained indefinitely, with no exemption for those who are pregnant, removing the vital protection introduced in 2016 by the 72-hour time limit on the detention of pregnant women.
This will only increase the barriers these women face, from not accessing services for fear of deportation to the life-threatening implications of being placed in detention. In the House of Lords, Ruth Lister is planning to table an amendment to the bill to preserve the 72-hour detention time limit for pregnant women. Hopefully, it will pass, but many more women still need support and companionship during pregnancy and childbirth. To choose to give that, as Comfort and her fellow volunteers are doing, is a powerful gift indeed.
What’s working
I have been reading the work of another Scottish-based woman this week, midwife Leah Hazard. Her book Womb: The Inside Story of Where We All Began is humane, intelligent but accessible, and full of fascinating insights. I am realising just how little we are taught about the female body.
What’s not
Now that many of my friends with babies are returning to full-time work, the bairn and I find ourselves increasingly without company. There must be other freelance, part-time women with one-year-olds out there at a loose end in the daytime, but I haven’t found them yet and am slightly missing the camaraderie of maternity leave.
Rhiannon Lucy Cosslett is a Guardian columnist and author
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