The Birth Room Is the Last Bastion of Misogyny. Here's Why That Makes Your Work Matter.
By Clare Maddalena, LushTums Founder
In September 2016, I found myself at the Findhorn Foundation in northern Scotland for a week that I can only describe as a turning point.
The conference was called Healthy Birth, Healthy Earth — and it gathered some of the most extraordinary minds in birth, perinatal psychology and maternal health from around the world. Michel Odent was there. Robin Grille, author of Parenting for a Peaceful World. Robbie Davis-Floyd. Ibu Robin Lim. Elena Tonetti-Vladimirova. Binnie Dansby. Ray Castellino. In the house where I stayed for the week, Michel Odent himself was in the next room. I went in as someone already deeply committed to this work. I came out with my understanding of pregnancy, birth and motherhood transformed.
It was during that week that I first heard the phrase that has stayed with me ever since: the birth room is the last bastion of misogyny.
It landed like a bell being struck. Clear, resonant, and — the more I have sat with it over the years — completely, demonstrably true.
I want to talk about why. Not because it makes comfortable reading. But because if you're drawn to working with pregnant women — or already do — understanding this feels like the bedrock of everything.
This Isn't About Individual Villains
Before I go further, I want to be clear: this isn't an attack on midwives, doctors or maternity staff. The vast majority of people working in maternity care are doing their best under enormous pressure, in an underfunded, overstretched system.
But the system itself — the culture, the hierarchy, the historic roots of obstetrics — is deeply, demonstrably patriarchal in origin.
The specialist field of obstetrics emerged from a model that treated birth as a pathology — a medical problem requiring expert management rather than a physiological process that women's bodies are designed for. Women were progressively removed from positions of knowledge and authority. Midwifery was sidelined, female wisdom 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 was the foundation. And foundations matter, because they shape everything built on top of them.
The Numbers Are Hard to Ignore
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 have is already alarming, and researchers believe it doesn't yet capture the full picture.
The term "obstetric violence" covers a wide spectrum — and AIMS defines it clearly: 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 additional people admitted to the birth room without being asked. It also includes subtler forms — the withholding of information, the use of fear to override preferences, the quiet dismissal of a woman's stated wishes.
None of this requires malicious intent. Much of it is normalised. That's precisely the problem. And it's precisely why the people who sit with women before they reach that room matter so much.
What Informed Consent Actually Means
Informed consent is not the same as being told what is going to happen to you.
Genuine informed consent means being given balanced information — the benefits and the risks — and having your decision respected, whether or not it aligns with what the medical team recommends. It means not being subjected to repeated rounds of risk-emphasising language designed to wear down resistance. It means not having a senior consultant appear at the foot of the bed as a form of institutional pressure.
The 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 guide to the legal rights women hold during maternity care — and I think every birth worker should know it as well as their clients do.
Because a woman who arrives in that room already knowing her rights, already having practised using her voice, already having been held in a space where her instincts were respected — she is in a fundamentally different position. You can be part of creating that, weeks and months before she ever gets there.
Why the Environment of Birth Matters
The Birthplace in England study followed over 64,000 low-risk births and found that 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%, over 50% in our local hospital. The WHO recommends 10–15%. We are nearly three times that. (Interestingly it was 7% in the US before CTG monitoring was invented, then it jumped to 35-40% in one year).
This isn't simply about surgical risk. It's about what happens when women labour in environments where they don't feel safe, unobserved, or in control. Oxytocin — the hormone that drives labour — is exquisitely sensitive to exactly those conditions. The medicalised birth environment doesn't just reflect intervention. In many cases, it produces it.
As a pregnancy yoga teacher, antenatal educator or birth worker, you are shaping that internal environment long before labour begins. The way you hold your space. The way you invite questions rather than deliver answers. The way you quietly, consistently demonstrate that a woman's instincts are worth listening to. All of it lands in her nervous system. All of it matters.
The Research Case for This Work
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 broke the data down by who provided that support, the results were unambiguous: the greatest benefits came from someone in a doula role — not hospital staff, and not a member of the woman's own social network. Someone trained. Someone present. Someone whose only job was to hold the space for her.
That is what good birth work does. Not because it feels meaningful — though it does — but because the evidence says it genuinely changes outcomes.
A Note for Birth Workers Reading This
If you work with pregnant women, you are on the front line of this.
Every time you create a space where a woman's instincts are respected and her questions are welcomed, you are doing something quietly powerful. Every time you help a woman articulate what she wants from her birth, you are handing her a tool. Every time you stay curious about her experience rather than directing it, you are modelling a different kind of care.
Organisations like Make Birth Better and AIMS are doing vital work at a systemic level. But the grassroots layer — the yoga classes, the antenatal circles, the postnatal groups — is where women actually feel the change. Where it lives in the body, not just on paper.
That's the work we care about deeply at LushTums. If it's the kind of work you feel called to do too, you might find our Pregnancy Yoga Teacher Training is a good place to start exploring. We'd love to have that conversation with you.
Clare Maddalena is the founder of LushTums and has been working in the pregnancy and postnatal space for over twenty years.