This story talks about obstetric violence and infant death. If this is too much for you, please skip it. There is no collection of helpful resources that I have found, but feel free to reach out and I may be able to help you find the right people to reach out to.
There has been so much noise in my social media bubble over this past week that it has been hard to ignore, even in my current breastfeeding, sort-of-on-maternity-leave status.
The noise came from Italy. The story, which I was keen to ignore, told of a newborn’s death in a hospital in Rome. The headlines, which I had to look at over and over again in disbelief, blamed the newborn’s mother for what happened.
The investigation is ongoing, but what emerged is that a nurse found the baby, who was three days old and was apparently healthy, dead next to the mother who was asleep.
What most media decided to go with was headlines like this one, from Ansa news agency: “Mother falls asleep while breastfeeding, infant dies in Rome.” Or this, from Italian daily La Stampa: “Rome, mother falls asleep while breastfeeding, infant dies: manslaughter investigation launched.”
Some other media at least added that the infant had died in a hospital, but other stories didn’t mention the hospital until a few paragraphs down.
This story exists at a messy intersection of many issues women face giving birth: not being taken seriously, debates around breastfeeding, and outright exhaustion without the right support.
The needs of newborns and parents during a vulnerable time
In turn, some people on social media took up new roles as neonatologists, the newest trend now that armchair epidemiologists and experts in Eastern European warfare are not as much in demand. Breastfeeding was to be blamed, said some. Others pointed at rooming-in as a problem — the practice followed in hospitals and maternity wards where the baby is kept in a crib by the side of the mother’s bed, which is encouraged by the World Health Organization.
Others had a go at co-sleeping, which consists in having an infant in the bed with the mother while breastfeeding. I will come back to co-sleeping in another newsletter because it is a hugely controversial issue. Of course co-sleeping can be dangerous, especially with small infants, but it seems to me also inevitable when breastfeeding, unless we expect women to be constantly alert and sitting up during the many hours they breastfeed.
But this story has nothing to do with breastfeeding, rooming-in or co-sleeping. This story has to do with how little equipped our hospitals are for the needs of newborns and their parents. With COVID-19 restrictions still in place in many places around the world, new mothers like the one in Rome are left alone in an incredibly vulnerable period.
Understaffed hospitals don’t step in to take care of them. And, more importantly, most hospital staff do not listen to those who have just given birth because there is a prevailing culture of believing that women are hormone-filled, irrational, weak beings that like to complain about “natural” events like giving birth. As if giving birth wasn’t a highly risky, exhausting and overwhelming experience that most of us are not ready for, that’s compounded by the fact that talking about pain and fear are often taboo.
The mother of the newborn told Corriere Della Sera newspaper that she was exhausted: her labour had lasted 17 hours, and then she was left alone with her baby to breastfeed — which is far from easy for a new mother. Nobody was around to help her. She had asked the nurses to take the baby overnight so that she could sleep, but the third night she was simply exhausted and fell into a deep sleep. Newspapers were keen to say that her toxicologic exams were clear: no, she had not drugged herself — she was just exhausted, deeply and utterly drained.
Obstetric violence
This week I was going to write about my beautiful birth experience, and the last thing I wanted was to shake myself out of my oxytocin-filled state to read about a newborn’s tragic death (yes, tragic).
But we need to talk about this because this episode shows many things. First, how media, genuinely or for click-bait, create headlines blaming a mother in a case that is still being investigated. Second, pundits who have no knowledge about this issue jump on board to blame important practices (such as breastfeeding), creating more confusion, disinformation and noise among parents and the general public.
If we filter through the noise, we notice a few important voices. The father of the newborn who says his partner was exhausted. The mother who says she had asked for help but the nurses did not take her baby to the nursery so that she could sleep. A midwife association that has rung the alarm bells: there are only half of the needed midwives available in public hospitals.
If you look at how complex this issue is, and how we cannot blame one person, or one event, we realise that this story is yet another example of obstetric violence. What is obstetric violence? It is a systemic type of violence when the voice of the birthing person — traditionally women at birth, but it is even harder for trans and non-binary people — is not heard.
This can take many forms and shapes. A few months ago, I told the story of Laura, who was not given the possibility to spend time with her newborn in hospital. But the other side of the coin is a woman who does not want to room-in with her baby 24/7 in hospital because she is exhausted and for the hospital staff not to respect that.
Italy’s first survey on women and their birthing experiences, which was carried out in 2017, showed that 21% of mothers declared to have been a victim of obstetric violence; 41%, or 4 in 10 women, say they were subjected to practices detrimental to their mental and physical integrity; 33% did not feel adequately cared for; and 6% of women, as a result of their bad experience, decided not to have any more children.
Worldwide, the data is similar. A study led by the WHO concluded that around 42% of women they surveyed said they had experienced physical or verbal abuse or discrimination during childbirth in health centres.
Just last week, the Inter-American Court of Human Rights held Argentina responsible for the 1992 death of Cristina Brítez Arce, who was nine months pregnant, in a case of obstetric violence (thanks to Nabeelah, a member of The First 1,000 Days community, for flagging this). This is a milestone in the international recognition of obstetric violence. The fight of activists in putting obstetric violence on the agenda has been fundamental in landmark rulings like last week’s. These activists are often women who have experienced obstetric violence on their own skin, as I wrote in my reportage (in Italian) about obstetric violence.
Building a healthy society
For several weeks, all I wanted to do was write about the birth of my son León at the end of October because it was such a great experience. I came out of it feeling proud of myself, incredibly happy of the support I had received, and amazed at how positive an experience it had been. My midwife joked that my body is made to give birth and I should have more children, but I must say that even soon after giving birth, I thought to myself that I could do it again, if I knew I could feel so well afterwards.
Now, it’s important to point out that every birth is unique. I was lucky and not everyone may want a natural, water birth with no painkillers. My pain threshold is different from other people. But what I felt was incredible was the amount of attention and care that was dedicated to me. This happened in a private hospital setting in Greece, but my previous experience — with Lorenzo, in a public hospital in Italy — was also positive.
And I have felt good since. Of course, this is my second child, and I trust myself more, plus this was a much-desired pregnancy. There are obvious moments of frustration, for instance, when I try to work and León won’t settle down. And there is tiredness with two children and little space to myself. But I have been well, and I am sure that a lot of it has to do with how positive my birth experience was.
This emerges clearly even in research. Consistency of support is cited as one of the factors that make a birth experience of first-time mothers positive. Conversely, the lack of support is one of the elements that contribute to childbirth-related posttraumatic stress.
When a mother is left alone and exhausted to look after a newborn with its unpredictable needs, we need to provide support — even more so, if she explicitly asks for help. We can’t blame breastfeeding, rooming-in, or co-sleeping. The problem is leaving parents alone. The problem is that our society expects children, even newborns, to be a private matter of their parents and to look away when there are difficulties. But that is not the way we can build a healthy society completely ignoring the needs of a third of the world’s population (yes, a third, if we consider under-18s, or a tenth when we consider under-5s).
So, yes, I was hoping to hide behind my oxytocin-filled, dreamy experience of a newborn. But the more I look back at my wonderful birth experience, the more I know how lucky I was. Mine was an exception, and it shouldn’t be. Like many other women said on social networks, that mother in Rome could have easily been me.
With love and care,
Irene
P.S. I am still figuring out childcare for León to come back to work. My recommendations will be back in my upcoming newsletter in a fortnight. And some time in the coming weeks, I will go back to publishing weekly. In the meantime, thanks for understanding how important it is to have flexibility with a newborn.
📣 The First 1,000 Days is edited by community member and friend, Shaun Lavelle.
📸 Solen Feyissa on Unsplash, woman holding her newborn child.
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