The Birth Room Is the Last Bastion of Misogyny — And Here's What You Can Do About It

By Clare Maddalena, Founder of LushTums

There's a phrase I heard at a birth conference in Scotland in 2016 that I haven't been able to stop thinking about since.

The birth room is the last bastion of misogyny.

I know that sounds stark. But the birth room — the space where you will be at your most open, your most vulnerable, your most instinctive self — remains one of the last places in modern life where a woman's voice can be routinely overridden, her body treated as a medical problem to be managed, and her instincts dismissed without consequence.

We've made enormous strides in so many areas of equality. And yet in the room where women birth their babies, the power dynamics can look startlingly similar to how they did fifty years ago.

I want to talk about why — and more importantly, what you can actually do about it before you ever set foot in that room.

This Isn't About Villains

Let me be clear from the start: this isn't an attack on midwives, doctors or maternity staff. Most people working in maternity care are doing their absolute best under enormous pressure, in an underfunded, overstretched system. I have enormous respect for them.

But the system itself carries a history. Obstetrics emerged from a model that treated birth as a pathology — a medical problem to be managed — rather than the profound physiological process that women's bodies are built for. Midwifery was sidelined. Female wisdom was dismissed. And what replaced it was a structure that scholars of reproductive history have described as deeply patriarchal in its origins — one that, in the words of one analysis, resulted in nothing less than a colonisation of the womb.

That's not bad luck. It's structural. And knowing that is the first step to navigating it with your eyes open.

The Numbers

Around one in three women in the UK describe their birth as traumatic. One in three.

A 2013 Birthrights survey found that over 12% of women reported not giving consent to examinations or procedures during their maternity care. Research from King's College London, launched in 2024, is now specifically investigating the prevalence of obstetric violence in the UK — because the data we already have is alarming, and researchers believe it doesn't yet capture the full picture.

AIMS — the Association for Improvements in the Maternity Services — is clear about what obstetric violence includes: being touched without consent, being denied information needed to make a real decision, being subjected to repeated pressure to accept interventions, being told to stay quiet while in pain, having people admitted to your birth room without being asked. And subtler forms too — the withholding of information, the use of fear to override your preferences, the quiet dismissal of what you've said you want.

None of this requires malicious intent. Much of it is so normalised it passes unremarked. That's exactly the problem.

Your Rights Don't Disappear When You're in Labour

Informed consent is not the same as being told what's going to happen to you.

Real informed consent means being given balanced information — benefits and risks — and having your decision respected, even when it's not what the medical team would choose. It means not being worn down by repeated rounds of risk-focused language. It means not having a senior consultant appear at the foot of your bed as a subtle form of pressure.

Your right to make decisions about your own body doesn't pause because you're in labour. It doesn't dissolve because there's a medical degree in the room. Birthrights has a clear, free guide to your legal rights during maternity care — I'd encourage every pregnant woman to read it before she gives birth. Knowing your rights, before you need them, is one of the most grounding things you can do.

You May Not Have to Be in That Room At All

Here's something that rarely comes up in standard antenatal appointments: for women with low-risk pregnancies, the hospital obstetric unit is not automatically the safest or the best place to give birth. And choosing a different setting doesn't just change the atmosphere — it can fundamentally change what happens to your body and your autonomy.

The Birthplace in England study followed over 64,000 low-risk births across different settings. Women who planned birth in a midwifery unit had significantly fewer interventions — including substantially fewer caesarean sections — with no difference in outcomes for babies.

England's overall caesarean rate has now hit 42%. The WHO recommends 10–15% as the optimal population-level rate. We are nearly three times that.

This isn't a judgment on individual caesarean births — many are necessary, wanted, and life-saving. But at a population level, those numbers are not a sign that women are being well-served. They're a sign that the environment in which women are giving birth is shaping what happens to them.

Because birth is hormonal. Oxytocin — the hormone that makes labour work — is exquisitely sensitive to how safe and unobserved you feel. Walk into a bright, clinical, unfamiliar room where you feel you need to perform and comply, and your body will know. It will respond.

Women who choose homebirth or a midwife-led unit consistently describe feeling more empowered, calmer, more themselves. Not because nothing can go wrong — it can, and transfers happen — but because they are the central figure in their own birth rather than a patient being managed through a system.

For higher-risk pregnancies, or where complications mean you need doctors and theatres close by, the obstetric unit is absolutely the right place. But for the majority of women with healthy, low-risk pregnancies, the default assumption that hospital is best deserves to be gently, thoughtfully questioned. The NCT has a helpful guide to planning your place of birth if you want to start exploring what your options actually are.

Who You Have in That Room Matters

Research consistently shows that having a supportive birth companion significantly reduces the likelihood of a woman experiencing disrespectful care. One study found a 75% reduction in the likelihood of obstetric violence among women who had a birth companion present.

Your partner's love is real and their presence matters deeply. But they may also be frightened, out of their depth, managing their own emotions while trying to hold yours. That's not a failing — birth is intense for everyone in that room. It's simply human.

A doula is something different. A doula is a trained birth support person whose sole focus is you. They're not managing their own fear. They've seen birth before. They know how rooms work, how to ask the right questions, and — crucially — how to help you find your voice when you feel like you've lost it.

The Cochrane Review on continuous support in labour analysed over 15,000 women across 17 countries and found that continuous labour support reduced caesarean births, shortened labours, decreased pain medication use, and improved birth experience. When researchers looked at who made the biggest difference, the answer was someone in a doula role — not hospital staff, and not a member of the woman's own social network. Someone trained. Someone present. Someone there just for her.

Doula UK is a good place to find an accredited doula near you.

The Change That Happens Person by Person

Organisations like Make Birth Better and AIMS are doing vital work — campaigning, researching, pushing for the systemic change that's long overdue.

But some of the most important change happens quietly, in small rooms, long before labour begins. In a pregnancy yoga class where a woman first learns to slow down and listen to her body. In a circle where she hears that her questions are valid and her instincts are worth trusting. In any space that treats her as the expert in her own experience — because she is.

That's what we try to create at LushTums, week by week and breath by breath. If you're pregnant and looking for that kind of support, we'd love to welcome you. See you on the mat soon.

Clare Maddalena is the founder of LushTums and has been working in the pregnancy and postnatal space for over twenty years.