This blog is part of a series, celebrating the publication of Narratives of Consent and Reproductive Subjects: Tales of Invisibility. The blogs highlight the contributions and rich analysis offered within the edited collection, as the authors reflect upon their chapters. In this blog Dr Anna Nelson reflects upon what motivated her to write her chapter.
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Dr Anna Nelson
During the COVID-19 pandemic many stories emerged about the challenges facing maternity and birthing services, and those who sought to access them. These included the withdrawal of homebirth services, the suspension of some midwifery led units, the blanket denial of request caesarean sections by some trusts, (at times severe) restrictions on birth partners and the exacerbation of the midwifery staffing crisis. At the time, I was in the first year of my PhD doing a project which sought to explore the relationship between speculative reproductive technology and autonomy during childbirth. However, I found that I could not ignore the impact that the pandemic was having on birth choices in the present - rather than in some imagined future.
I shifted the focus of my research and writing to address these topical concerns, examining the intersection between COVID-19 policies and restrictions, and the rights of birthing people. Here I must give credit to my wonderful PhD supervisors - Alex Mullock and Becki Bennett - for giving me the freedom and support that I needed to do so.
From this came a stark realisation about just how fragile the rights of birthing people were, and how quickly justifications could be found to undermine these in a novel situation. This chapter is a culmination of that work, exposing the fragility laid bare by COVID-19 and providing some suggestions as to how we can shore up the commitment to placing to women and birthing people’s rights and voices at the heart of policy and policy-making. This, I contend, is vital. The pandemic will not be the last event which disrupts the status quo of maternity care; environmental concerns, developing reproductive technology and future pandemics (to name a few) all have the potential to do so. However, while future disruptions are inevitable, harmful responses need not be.
A challenge which could be leveled against this work is whether we can really hope to learn broader, transferable lessons from the response to an unprecedented emergency like COVID-19. Though I understand why this question might be asked, I suggest that the answer is unequivocally yes. While the pandemic did create some unique problems, in many cases it instead acted to magnify and heighten existing problems and inequalities.
Policy made during COVID-19 differed from the norm, in that it could not claim to be grounded on solid evidence. While undoubtedly incredibly stressful for those involved in making policy at the time, this usefully created an opportunity for us to critically interrogate policy’s (false, or at least overblown) claims to neutrality. The absence of the usual layer of evidence facilitated a ‘look behind the curtain’ at those foundational yet more nebulous considerations which can play a hidden role in shaping policy and its implementation. It also helped us to identify where important considerations were absent from the decision making processes, and where decisions were being made without full understanding of the challenges facing those accessing maternity services and the ways in which the implementation of particular policies may compound these. In my chapter, I outline some of the key factors which work to render women and birthing people’s voices insufficiently visible in the process of making and scrutinising maternity policy, exposing how these manifested in the COVID-19 maternity policy response.
Pandemic policy, far from being merely a product of its time, provides us with a unique and important opportunity to learn valuable lessons which can help ensure that we are able to respond to future disruptive events in a manner which better protects both women and birthing people, and those who care for them. My chapter in this collection seeks to harness those lessons in order to answer the question: what steps can we take to refocus the lens more securely on the importance of ensuring consent as a central consideration when making maternity policy?
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