In January I was honoured to be asked to speak at the Oxford Feminist Union at an event called ‘Amplifying Women: The Healthcare Gap’. You can now watch the talk on youtube, and below is a transcript of my talk.

Thank you so much for inviting me to this amazing event, it is an absolute honour to be a part of it and to sit on a panel with these women, who are all icons in my eyes.

It’s also very lovely to be asked to be on a platform, when, in recent months, you have been on the receiving end of a concerted campaign to be silenced, and ‘deplatformed’.

So I thought I would begin by saying a little bit about that.

So I’ve been involved in the world of maternity for over a decade, first as a mum – my eldest is 14 and I have 3 children – and then as a writer, author and journalist, and the founder of The Positive Birth Movement, a global network of support groups for pregnant women.

My passion for all this time has been to challenge the negative narrative around women’s bodies, and encourage the idea that the female body is something that works, something to be proud of. Never that women’s horizons should be limited by their biology, but simply that when or if they come to give birth, they should not only have first class, respectful care, but also have an inbuilt confidence in their bodies and their ability to access their own life-giving power. They should come to the other side of birth empowered rather than traumatised. In more recent times I’ve also written about menstruation for preteen girls with the same message, your female body is interesting, it’s something powerful and clever, and it’s something to understand, appreciate and love.

Like many of us, the awareness of the effect of gender ideology on the language of female biology crept onto my radar very slowly and gradually. It’s been interesting, for this talk, to retrace my steps somewhat and work out how I became the ‘outspoken TERF’ that stands before you today.

What interests me particularly about the story when I look back on it is how my own opinion was consistently clouded by other people’s misogyny and ageism – the ‘spin’ that is put on any woman speaking out for women’s language and women’s rights. They are portrayed, at best, as old and therefore out of touch, at worst, as hateful and bigoted. Often, as I rushed through a busy life, I failed to question this narrative – a narrative that is of course now used against me. Now I try much harder to make it my habit to consciously notice when women are being discredited in this way – on any topic – and to try to listen to what they are actually saying, rather than what others are saying about them.

I think the first time I noticed that something ‘controversial’ was happening was possibly in 2015, when world famous midwife Ina May Gaskin signed an open letter to MANA - the Midwives Alliance of North America. The letter expressed concern that MANA had ‘erased’ the word ‘woman’ from the MANA Core Competencies document and replaced it with “pregnant individual” and “birthing parent”.

The letter applauds MANA for their attempts at inclusivity but raises concerns about “prioritising gender identity above biological reality”, which the letter authors see as part of a cultural trend to “deny material biological reality and further disconnect ourselves from nature and the body”.

“The root of female oppression is derived from biology”, they also point out, adding, “Women have a right to bodily autonomy and to speak about their bodies and lives without the demand that we couch this self-expression in language which suits the agenda of others who were not born female.”

They also talk about female biology, not just as the root of our oppression, but as our ‘life giving power’. They are midwives, remember?! If women are erased from the language of birth, they argue, “women as a class lose recognition of and connection to this power.”

I must admit that at the time of this letter – in 2015 - I was absolutely in the thick of it with three children aged about 2, 5 and 7, and various other stuff going on in my life, and the ideas within it, which resonate so strongly with me today, felt really quite new and alien. Added to this, the dominant narrative was of course that Ina May Gaskin was a transphobe and should be ‘cancelled’. As a key signatory, in spite of her contribution to midwifery, she was clearly now prejudiced and out of touch with the inclusivity and progressiveness of a new generation. As an old woman – 75 at the time of the letter - her views were no longer relevant.

Of course in 2015 I had only just turned 40 and was therefore only just on the cusp of becoming irrelevant myself – although of course I did not realise this at the time!

Over the next few years I wrote The Positive Birth Book – published in 2017 - and Give Birth like a Feminist – published in 2019. In the two years between those two books there was a shift in the UK world of birth and maternity, towards the use of the term ‘birthing people’ or ‘women and birthing people’. When writing Give Birth like a Feminist, I debated at length whether or not to use the phrase, or to write some kind of ‘disclaimer’ at the front of the book as to what I meant by the word ‘woman’ – I’d seen others do this.

But something nagged at me. Maybe I’d taken in more of the MANA letter than I thought! I eventually decided that a book about sex based oppression, a book about how women are basically kept from the power of their own biology by a maternity system built by patriarchy - ought to use sex based language. I stuck to ‘woman’ and thankfully the publishers did not object.

When I was writing Give Birth like a Feminist I also accidentally discovered gender critical twitter. I’d read a paper about obstetric violence that referenced a UK paper about the polarised interpretations of the medicalisation of childbirth. I began following the author on twitter, a feminist philosopher that some of you may have heard of: Jane Clare Jones.

As I was starting to have my eyes opened by Jane’s tweets, Lynsey McCarthy Calvert, who is here tonight, was being ostracised by Doula UK. Responding to a reference by Cancer Research to ‘everyone with a cervix’, Lynsey wrote: “I am not a “cervix owner” I am not a “menstruator” I am not a “feeling”. I am not defined by wearing a dress and lipstick. I am a woman: an adult human female. Women birth all the people, make up half the population, but less than a third of the seats in the House of Commons are occupied by us.’

But of course the prevailing narrative was that Lynsey was bigoted, transphobic, unkind, out of touch. An article from Pink News drew a line of association from Lynsey, to Posie Parker, to white nationalist extremists. And of course, perhaps worse still - she was also over 40.

I think these negative narratives were quite effective in making me tow the line for as long as I did. Lynsey. Maya. Julie Bindel. JK Rowling. Kathleen Stock. Allison Bailey. Raquel Rosario Sanchez. A Woman’s Place. Rosie Kay (who is here tonight). You get the general impression there is something unsavoury there, but you’re never quite sure what. I would reiterate: read the actual words these women say.

So what did I say?

Well, everyone had a lockdown project, and for pretty much the whole of 2020 mine became reading everything I could find about ‘gender’. I wanted to know WHY I was supposed to say ‘birthing people’, and ‘assigned female or male at birth’. I asked these questions in birth and midwifery groups and every time I did, the reaction was off the scale. It was clear these questions were not acceptable. This only spurred me on and made me ever more curious.

What happened next, some of you may have read about. To cut a long story short, in November 2020, I commented on an Instagram post which said:

“Obstetric violence is about power and patriarchy. Birthing people are seen as the ‘fragile sex’ who need to be kept under patriarchal authority by doctors.”

This jarred. So I challenged it: “It is women who are seen as the ‘fragile sex’ etc, and obstetric violence is violence against women. Let’s not forget who the oppressed are here, and why.”

And as some of you may know, all hell broke loose. In what can only be described as a social media bin fire, I was called “violent”, “a piece of shit”, “TERF”, “toxic”, “dangerous”, a “vile creature”, “wilfully harmful” and more and more and more.

As the bin fire blazed, the charity Birthrights made a social media post about ‘inclusivity’ which everyone in the world of maternity could immediately identify as being pointed at me. Later that night, as I sat on my sofa in utter shock at what was happening, I received an email from the CEO of Birthrights, effectively saying that they would no longer associate with me.

Birthrights and others who are similarly ideologically captured may have uncoupled the word ‘woman’ from material reality, but I have not. It is NOT ‘birthing people’ who are seen as ‘the fragile sex’, or as ‘vessels’, disposable containers for the next generation whose feelings and experiences are secondary. It is WOMEN! And I am using the word woman in its SEXED sense. FEMALE PEOPLE. The oppression of women in childbirth, and in particular obstetric violence, is SEX based. It happens to women, not because of their gender identity, but because of their SEX. As in so many other situations, denying this biological reality, and taking away the words to describe it, will only enable it to go unchallenged.

Female biology is an area which we have consistently overlooked. The female body is a mystery, even to many of us who inhabit one!

In a recent survey, only 9% of Britons could label all parts of the vulva.

37% mislabelled the clitoris.

And less than half – 46% - knew that women have three holes.

In another recent survey, almost half of women didn’t know where their cervix was.

And don’t even ask David Lammy any of these questions.

In the past 10 to 15 years, social media, for all its ills, has offered an opportunity for women to learn more about their bodies, and to share and explore the biological experience of being female. I’ve been proud to be a part of that. Running the Positive Birth Movement, some of my activism was centred around sharing images of labour and birth that challenged the dominant narrative that women in labour were weak, helpless, and in need of rescue.

And it used to get me banned from social media! There were a couple of high profile occasions when I was kicked off Facebook for it, most memorably on the day in November 2014 when Kim Kardashian’s bottom was supposed to be ‘breaking the internet’. Remember that?!

By coincidence I had shared a picture of a ‘birthing bottom’ that day and got banned for it. The opportunity to ask, ‘why are some bottoms acceptable but others, not so much?’ was too tempting! This resulted in a conversation happening around the world about the power of birth and why we might want to censor such images. Writing at the time, I pointed out that women needed to see such images precisely because they challenged the standard sterile, controlled, managed images of births, and that at the same time, the way the images challenged this status quo was precisely why they were censored.

And as well as birth images, women have used social media to share lactation, breastfeeding, pubic hair, period blood, fat, cellulite, miscarriage and baby loss, and more.

All these uniquely female experiences have for so long been completely unspoken, and taboo. And so many of the images of them on social media were taken down and censored, and women fought battles for them to be restored and allowed. And yet now, just as that seemed to be somewhat resolved, we have a new censorship. Even the phrase ‘uniquely female experiences’ itself will be problematic to some. We have to watch our words around these topics of women’s bodies again. Is this a coincidence?

Germaine Greer.

In her book, The Whole Woman, she writes:

Women are driven through the health system like sheep through a dip. The disease they are being treated for is womanhood.

Greer jokes that women spend their entire lives, ‘under the doctor’. When it comes to birth, many women assume their bodies are not ‘fit for purpose’, and that they will struggle. But is this true?

There’s often a set-up that occurs: women are placed into environments that are built without their physiology in mind. In fact, most modern birth rooms are built with the needs of midwives and doctors uppermost – bright lights so they can see, beds so that they can easily reach. Sterile environments, interruptions, strangers – not what women, who are mammals, need to produce the hormones of birth. But when, placed in this environment, their bodies then don’t labour in a straightforward way, women most often blame themselves, and their faulty female physiology. This is yet another kind of ‘victim blaming’.

Sometimes birth units are built differently, with birth pools or double beds, pretty lighting, art on the walls etc. When I recently praised one such room on social media for being ‘built with female physiology in mind’, someone corrected me and told me I should say, “Birth rooms built with birthing people’s physiology in mind”.

But again – this erasure of women from the language – in fact this time it’s the word FEMALE, not women, they are objecting to – obscures biological reality and removes the words we need to highlight specific female needs.

And it sets back the progress of all the women who have been trying FOR DECADES to highlight that FEMALE physiology is being overlooked. And who have repeatedly been pointing out that paying more attention to female physiology would almost certainly dramatically reduce the huge numbers of difficult and traumatic births.

At the start of this talk I described myself as ‘outspoken’, a word I like to reclaim because it was used about me by the people who campaigned to have me deplatformed from a conference in New Zealand. There’s a barely hidden misogyny in calling me this that slightly amuses me, given the fact that the people doing so think they are the ‘progressive’ ones who are apparently freeing themselves from the confines of ‘gender’. It also reminds me of the obstetrician who described women with birth plans as ‘middle class Birthzillas’, or of the doctor and writer Adam Kay, who wrote in his book This is Going to Hurt, about women with ‘full colour, laminated plans’: “Two centuries of obstetricians have found no way of predicting the course of a labour, but a certain denomination of floaty-dressed mother seems to think she can manage it easily”. Women I’ve spoken to have been told by their doctors, “I am the expert here”, or “I have delivered hundreds of babies, you have not delivered any.”. All of the women who report these stories of a birth room power clash are women like me. Educated. Articulate. Privileged. Middle Class. Floaty dressed. Outspoken.

Women like me cause a problem because we have a voice. In Ireland, they’ve only recently repealed the 8th Amendment. Many of you will know that this amendment gave the foetus and the mother equal rights under law, and most people primarily understand it’s effect on abortion law. But this attitude, that a woman’s rights and autonomy are diminished when she becomes pregnant, is played out in maternity care for those women who wish to keep their babies as well as for those who don’t. A midwife in a Dublin maternity hospital tells me women with a birth plan there are known as the ‘difficult women’. One woman who gave birth there in 2015 said to me, ‘They told me, “You will give birth when, how and where we decide.” When I questioned their decisions they said, “Clearly someone has to be the voice for your baby since you are not being very rational”.’

Women with a voice are irrational, or mad, and must be brought under control – and this idea goes far beyond Ireland. One of my neighbours in Somerset was referred to a psychologist because she challenged the advice of her obstetrician.

Sometimes husbands or partners are brought in: in one case I’ve written about, a woman decided to decline routine pregnancy scans and the midwife telephoned her husband. “I felt this was a huge breach of my privacy and it made me feel like a child”, she said. Another woman reported being asked by her doctor, “What’s more important to you, a natural birth, or being a mother to your other children?”, but that the doctor looked pointedly at her husband as he said it. In another case, a woman refused to get out of the birth pool to be examined during labour. Her husband was told to ‘persuade her’, which he dutifully did. The woman then experienced an extremely violating vaginal exam, which he had to witness having been somehow complicit in.

If women cannot be brought to their senses by their husbands, the authorities or the police may be called upon. My book, Give Birth like a Feminist, is filled with such stories. In Brazil, a woman called Adelir, taken from her house under arrest and made to have a caesarean, because the doctors deemed her to be making the wrong decision to have her breech baby vaginally. In the USA, sock puppet accounts infiltrating a freebirth group and reporting a woman who had announced she was in labour – the police arrived at her door. Women in the UK who have free birthed (at home without midwives) facing questioning from social workers and even police. And in Eastern Europe, where women’s bodily autonomy in pregnancy is treated with extreme disregard, the story of a woman who gave birth whilst being restrained by police because she refused to follow doctors orders and give birth on the bed.

This is obstetric violence. Like all violence against women, it happens to women not because of their identity, but because of their sex, and nowhere is a woman’s sex more obvious than in labour and birth. Women like me were trying to use our platform to challenge this situation, but now we are being deplatformed and discredited, and quite frankly, distracted from our work, if we will not agree that womanhood has no basis in biology. Throw at me all the slurs you wish, outspoken, TERF, middle class, floaty dressed, old, and all the rest of it, I won’t deny biological reality, and I won’t be stripped of the words I need to describe it. Nor will I be dehumanised by terms such as ‘cervix haver’, ‘vagina owner’, ‘body with a vagina’ or ‘non man’. Women need words to describe and challenge the health gap. And we need words to describe our unique female experiences without hesitation or censorship, and to bloody well celebrate them. We will not be silenced!

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The Mule

"We need words to challenge the health gap …