By 
A midwife and birth debrief facilitator, known for her advocacy in birth trauma, recently shared her experiences in her first book, The Birth Debrief. Passionate about empowering women in pregnancy and childbirth, she believes that thorough antenatal education can transform birth experiences. Inspired by her own birth trauma, she started offering debriefs to help others understand their experiences, leading to her book.
In her book, she delves into the concept of gaslighting in maternity, explaining how to recognize it and respond. Gaslighting, the psychological manipulation that leads individuals to question their reality, often causes confusion, doubt, and low self-esteem. This term originates from the 1944 film Gaslight, where a husband manipulates his wife into doubting her sanity to control her and access her inheritance. While gaslighting can occur in any power-imbalanced relationship, it can also appear in medical care, including maternity care, where expectant mothers rely on healthcare professionals.
A U.S. study highlighted four categories of gaslighting in obstetric care: belittling or dismissing the mother’s perspective, questioning her judgment, invalidating her knowledge, and trivializing her concerns. This manipulation often surfaces as denial of symptoms, dismissing concerns as emotional instability, discouraging further consultations, or withholding tests without justification.
The ideal doctor-patient relationship should be consensual and collaborative, but during pregnancy, many feel as if their autonomy is dismissed. In Western societies, where childbirth is viewed medically, pregnant women are often treated as patients in need of intervention, which undermines their agency. She argues that, when medically safe, women should embrace their natural strength rather than feel subordinate to medical systems.
Her stance isn’t anti-medicine; she recognizes the critical role of medical intervention when necessary. However, the overemphasis on a medicalized approach often leads women to feel powerless. While doctors are vital for advice, they shouldn’t hold complete authority over decisions concerning a woman’s body and child, which is why advocating for empowerment in pregnancy remains crucial.
In the NHS, “defensive practice” sometimes contributes to gaslighting in post-birth debriefs. Defensive practice is when medical professionals prioritize liability protection over patient welfare. If a patient raises concerns, defensive responses can normalize abnormal experiences, preventing women from processing trauma during debriefs.
Research indicates that women report gaslighting in healthcare more frequently than men, largely due to biases that question women’s perception of pain, often viewed as overly emotional. Consequently, women may struggle to seek help, leading to more traumatic experiences during birth. Reflecting on her personal experience, she recounts feeling undermined even as a qualified midwife, doubting her decision for a home birth and feeling guilty for questioning her own knowledge.
Conversations with others revealed she wasn’t alone; many women feel compelled to comply with medical authority, even if it compromises their well-being. This isn’t about disregarding medical advice but about ensuring women are treated with dignity and respect, especially when expressing concerns. Empowerment through education about pregnancy is vital, as is respecting the expertise of healthcare providers. However, questioning medical authority when it matters isn’t “silly” or “overreacting.”
To build resilience against gaslighting, she suggests affirmations like: “I know my own mind and trust myself,” “I am worthy of respect and care,” and “I am strong and capable.” Recognizing gaslighting is the first step, but addressing it is equally essential. Here’s her advice for handling gaslighting during maternity:
- Tune into your body and monitor persistent symptoms.
- If unsatisfied, voice your concerns.
- Request documentation of conversations and decisions made.
- Seek a second opinion if needed, and remember your right to be heard.
The Birth Debrief is now available, offering further insights on the importance of respectful, empowered maternity care.
