Category Archives: cissexism

How do we get midwifery research out of this heteronormative rut?

So whilst I am here writing posts about how we need to stop thinking that all the pregnant people we are caring/all people accessing reproductive healthcare around pregnancy are automatically women, on the other side of the looking glass I am training in a heteronormative world where we haven’t even got to that thought and are still referring to “fathers” rather than partners when we talk about the non-birthing partner.

I tend to use the word “partner”, with the phrase “partners of any or no gender” tripping off my tongue unless we are talking about something that *specifically* concerns non-birthing partners who are male. In which case I say “male partner”. Some other (student) midwives do this, but many just say father.

This week I went to a lunchtime event where researchers showcased their ongoing or current research around the theme of “involving partners and fathers”, and I had hoped from this wording that this would be a showcase that didn’t centre father’s experiences.

And the presentations were good! Important work is being done! But it is focussing on the experiences of fathers. After hearing the researchers speak, I realised that one of the problems we have – even *if* we talk in terms of partners so as not to centre the experiences of fathers and erase all others – is that so much of the research done into non-birthing partners/non-birthing parents is specifically research into “fathers”.

Researchers set out a hypothesis specifically about some aspect of fathers’ role in pregnancy/birth and then recruit fathers into the study and then publish this research and then there we have it, another piece contributing to the body of work that erases the experience of non-male partners, contributing to the heteronormativity of midwifery care. Another piece of research that because of its design can only be applied to fathers – despite the fact that the experiences of fathers detailed within the study may well also be the experiences of non-birthing partners of any or no genders.

I raised this point at the end of the presentations – my concern that research into partners was very heteronormative – stressing that I didn’t think it was any one researcher’s responsibility to fix, but that by continuing the centre research on “fathers” rather than partners of any or no gender, the problem perpetuates. There were a couple of points in response, the first being that it’s because male/female partnerships are traditional, and pointing to a growing minority of research into the experiences of same sex partners.

I am of course aware that heterosexual relationships are traditional. That’s not a justification for seeing them as the only relationships. Regarding the research being done into the experiences same sex partners;  it’s welcome, of course, but that is a separate point, and doesn’t get you off the hook limiting research into fathers when it could be framed as the experience of any partners. Because whilst I imagine same sex partners do have unique experiences (stemming largely from systematic homophobia?) which should totally be researched so practice can be improved, I bet they also share a lot of experiences as non-birthing partners with the fathers that we see so much (comparatively speaking) research about. And also, do you really think by covering fathers and same sex partners that we have covered everyone? Because I have some thoughts on the (falsehood of the) gender binary that you might find interesting…

Until those researching the experiences of fathers stop and ask themselves – is this really something that needs to be specifically limited to fathers, or can I ask the question more generally of partners of any or no gender – then this problem is not going to go away. If anything it’s going to get worse, as the existing body of work about “fathers” available each time someone embarks on a literature search at the start of a new project is gonna grow and grow.

I’m not a researcher (yet), so I imagine their are complexities to this I may be missing. Like what happens if we say we are studying the involvement partners of any or no gender but then only fathers come forwards to participate – can we still generalise our results? But surely it’s better make a commitment to moving away from heteronormativity, and to tackle these questions as them come up? To at least start ?

The Cissexist Language of Midwifery Care and Reproductive Justice.

I started trying to write a post on the way my pro-choice views on abortion intersect positively with my midwifery practice, but I realised that first I needed to address the way that the language of midwifery care and reproductive justice is cissexist. Lauren Rankin spells it out when she says

We must acknowledge and come to terms with the implicit cissexism in assuming that only women have abortions. Trans men have abortions. People who do not identify as women have abortions. They deserve to be represented in our advocacy and activist framework. Honestly, I am guilty of perpetuating that harmful myth, both in my rhetoric and framing. I often frame abortion restrictions as misogynistic attacks meant to control women’s reproductive lives, and that is true. But abortion restrictions also affect the lives of people who aren’t women, and they hinder trans men and gender-non-conforming people and others who were Designated Female at Birth (DFAB) from accessing abortion care, as well.

Lauren Rankin, Not Everyone Who Has an Abortion Is a Woman – How to Frame the Abortion Rights Issue

I went to a training day on abortion activism (run by Abortion Rights) last year, attended by feminists and anarchists involved or interested in grassroots activism and campaigning. And it was refreshing to talk about “people wanting/needing abortions” without the discussion stalling when the other people in the conversation couldn’t understand why we weren’t saying women, or worse refuting the fact that it’s not only women getting pregnant (radfems, I’m looking at you again). And yet even though the space we made challenged the cissexism of typical reproductive justice dialogue, the cissexist language was still was inescapable. The news clips we watched, the stats on how many abortions are performed in the UK each year all talk about women and women only. The statistics we have for UK abortion rates take into account every registered abortion, but they do not record the person’s gender because it is assumed they are women. These statistics we quote, that “1 in 3 women will have an abortion by the time they are 45 years old”… these statistics implicitly misgender all those people who are not women who have abortions.

The same happens in midwifery. Language misgenders, both implicitly and explicitly. Because, on both an individual and systematic level, the possibility of trans men and non binary people becoming pregnant is either not considered or wilfully ignored; all language is inherently cissexist.  As midwives we talk constantly about “the woman” (or worse, “the lady”) as though it had not even occurred to us that not everyone who is pregnant is a woman, or that these people do not exist, or that they are such a small minority that it is ok for our language to erase them.

It is not ok. But everyone does it. I am even finding myself doing it.

A couple of weeks into my training I started to realise I wasn’t imagining it, midwifery lecturers were constantly talking about “the woman” and as students we were picking it up too. I queried it, explaining that I realised we said “the woman” rather than  “the patient”, because midwifery is about providing care through a normal physiological event (pregnancy and birth) rather than treating illness. But what about those people who aren’t women who are pregnant..? After clarifying that I didn’t mean cis men who have a developing embryo implanted in their abdominal cavity(!), the lecturer told me there hadn’t been any non binary people or trans men who had accessed midwifery care in our city and this seemed to suggest my point was moot. I didn’t believe her (because I imagine there must have been people who were not women, but were read as such by staff who didn’t feel safe/comfortable/have the energy to come out) but the discussion moved on.

Aside from the obvious problem of potentially misgendering (implicitly or explicitly) individuals accessing maternity care by talking only about women, there is the further problem that the language we use shapes the way we think and the way we see the world. By talking only about women, we are conditioning ourselves to think only in terms of women, to assume womanhood of everyone in our care. It is both habit-forming and world-shaping. When I started my training I always said “pregnant person” but everything I read, everything I am taught is saying “women”, and I am starting to slip up, to give up, and it’s not good enough.

I want people of all genders to be able to access midwifery care if they need it, without worry that they will be misgendered. I want NHS midwifery staff to have awareness raising sessions so they understand what is meant by trans, non binary, cissexist, misgendering. I want to rid policies and guidelines of their cissexist language. I want space on the paperwork we fill in at initial midwifery booking appointments to have space to ask about the person’s gender so we don’t simply assume they are all women.

In the same way that there seems to be a slow but sure shift away from heteronormative language in midwifery care (as both policies and practitioners start to talk about “partners” rather than “husbands/fathers”) I want to see a shift away from cissexist language. A lot of the times when we are talking generally and we say women, we can instead more accurately say “people who menstruate”, “people with uteruses”, “people who are pregnant”, “people needing abortions”. Instead of saying “she” we can say “they”. We can find new ways to convey meaning.

And don’t tell me it’s too hard – it can’t be any harder than having to navigate a maternity service designed for women when you are not a woman – which is what we are essentially asking of some people unless we sort this out.