Present the Whole Picture

We believe tackling the huge rise in perinatal mental illness will take a WHOLE PICTURE approach across every level of the Maternity & therapeutic system.  Just tackling one part is great, but it will not solve the whole problem.  

This starts with commissioners & the NHS providing & funding enough staff, those staff being really well supported, staff having enough time to get to know women & their individual needs in the community, continuity of carer, care during pregnancy that identifies & treats things that may present risk factors early & follows them up, brilliant informed ante-natal care, fabulous care during labour with the best physical & crucially 'emotional care' (with an emphasis on choice, options, evidence based care, respect, dignity, privacy, kindness, consent, individual woman centred care), brilliant postnatal care, support & investment in feeding support, midwives who are trained in perinatal mental illness & know what signs to look out for, flagging up Mums who have had a difficult or traumatic birth & following them up, the NHS providing enough Health Visitors to be able to spend time with Mums who are suffering & to signpost them early for help, enough trained specialist therapeutic professionals to be able to see women early without long waiting lists with the most appropriate specialist care, families looking out for one another & a whole family approach to wellness, early care during a subsequent pregnancy!


There’s no smoke without fire, no day without night,
No courage without fear, no dark without light.
No life without risk, & no joy without pain,
No dawn without dusk, & no sun without rain.
But for some unheard reason in 'birth' we can think
Caring for just ‘bodies’ means we are in synch,
But we’re not ‘walking wombs’, & we’re not ‘talking heads’
We’re not detached flesh, we’re a tapestry of threads.
We’re souls & emotions, we’re spirit & prayer,
We’re hopes, dreams & nightmares, elation, despair.
We’re history & mystery, we’re sadness & pain,
We’re sexual & sensual, in this we’re the same.
Birth without ‘feelings’ denies who we are,
And yet in technology we’ve come so far,
But we’ve forgotten the human basics of life,
To preference the ‘physical’ can cut like a knife.
It leaves deeper wounds than the ones we can see,
It denies we have souls, what makes us ‘me,’
You don’t know it’s missing until it’s not there,
We’ve got to remember ‘emotional care!’
Emotional care is ‘with woman,’ right here,
It sees to our souls… it notices fear,
It offers respect, & it trusts & believes,
It sees beyond physical, it deeply perceives.
It gives explanations, it asks for consent,
It gracefully accepts a ‘decline’ when it’s meant.
It asks how we’re ‘feeling’ beyond what we feel,
It knows that emotional pain scars so real.
Emotional absence is storing up danger,
In a system of risks, it’s a chance we can’t wager,
You don’t know its value until it is missing,
It’s like falling in love, but never kissing!
Absurd & unheard, we can’t divide parts
Of ourselves within labour, we are whole, we’re like stars
in the night, although unseen in day due to light,
Our emotions are there, our emotions are bright!
You might not perceive a woman’s dream,
You may not hear her inner scream,
You might not behold a woman’s fears,
You may not see inner rivers of tears.
So we need intuition, we need wisdom to see
With the ‘eye of our heart’, with compassion, to be
Someone deeply perceiving, beyond fleshy measures,
To read between lines, to dig out inner treasures
That are there to be found when we contemplate deeper,
We must be ‘emotional care giver’ seekers.
The wounds of its absence can last many years,
In phobias, illness, depression & fears.
So let’s be more aware, ‘kindness matters!’ we’ll shout,
It's essential promotion, to all talk about
The importance of caring for minds, bodies, souls
‘Emotional care’ is midwifery gold!
(Copyright Claire Kay)
(The poem 'LISTEN' below was written using the words of hundreds of women from the Birth Trauma Association in response to this question:
"If you could recommend just ONE CHANGE to your care providers that may have lessened the severity of the trauma you experienced, what would it be?"
Claire wrote this poem while their responses were still fresh in her mind.  I she hopes you'll agree that it is very moving & carries important & relevant lessons for all to learn.  She also made the Listen Word Cloud from these words too.)
“Listen” please won’t you, don’t forget to explain,
I know my own body, you don’t feel my pain.
Respect me with kindness, dignity, care,
as if I was family, with compassion, and fair
to all of us women; for us, this is new.
You may do this everyday, but we need staff who
will support us, not interfere, hold back and wait,
not rush, shout or bully us, coerce us with bait
of a healthy baby, yes we want that too!
But we need more 'emotional care' carers who
understand we are human, not statistics, machines;
women with feelings, Mothers with dreams.
Minds, bodies, souls who deserve your best care.
Listen to us women and just “be there”
to support us when needed, speak honesty, truth;
communication, respect choices, don’t soothe
with false information, cover up, lie.
Speak to us clearly, look us in the eye.
Believe us and trust us ’cause we are in charge,
We welcome your presence because birth is hard!
But we need more support from you cheer-lead us too,
understand when we’re frightened, hope to win through!
We need less interventions less surgery, sweeps,
better pain relief, privacy, less induction, belief
that we can get through this, not watching the clock,
And by the way “no means no” when we tell you – stop!
‘Cause this is “our” body, and “we” call the shots.
You may have the titles, you may know the lot
but you don’t feel my feelings, you don’t feel my pain,
you don’t know my body, you don’t feel my strain.
Please don’t restrict me allow me to move!
Give me choice of position, read my birth plan, exude
a sensitive presence; be aware of my past,
if I’ve had a bad time before… PTSD…at last…
we get to the crux of it, PTSD is real!
The way you look after me, the way I ‘feel’
makes a mighty big difference to the way I’ll recover,
how I bond with my baby, how I start out as “Mother.”
We know many traumas just happen, aren’t planned,
emergencies, surgeries, blood loss …and
if these things do happen, please stay by our side;
explain what just happened, hold our hands, wipe our eyes.
And remember our partners – for we need them too..
don’t send them away, we need our loved ones who
will be there when we leave here, they too may be scared,
they too need compassion they too to be heard.
So “listen” just “listen”, when you do “really hear.”
We trust you’ll remember this thank you kindly dear
dear midwives and doctors, surgeons, GPs,
anaesthetists, class leaders, feeding specialists, trainees.
Please do remember this, and if you do
we’ll avoid the worst trauma, we’ll be Mothers who
can start out with confidence, hope, not despair,
less nightmares and flashbacks, tears, fears, guilt to bare
for our lost birth experiences; soreness, bleeding,
infection, distress, mental illness, un-healing
wounds that remain in our minds, in our hearts.
Enable us, equip us, give us the best starts.
And if we do suffer – please do not tell us to
"put it all far behind us”, to “push on through
with our new healthy babies,” that’s not all that counts,
for we matter too!
Hear our voice,
hear our shouts!
PTSD awareness, raise up, make it known,
then we’ll be more equipped, we won’t feel so alone.
So thank you for listening to this chapter, this verse,
we trust you’ll take heed of this, take time to converse
on your courses, in staff rooms, with family, friends;
for it’s time PTSD in Mothers ends!
(Copyright Claire Kay)


(Just to clarrify this poem is about the 'attitude & character' of nursing in terms of it being a personal attibute.  It is not the profession itself, & is not suggesting that Midwives should train to be Nurses first.)




‘Be a nurse first’ dear midwives,

Someone caring, professional, kind.

Who puts us at ease, asks permission, says please,

Attentive to pain, our wounds bind.


Remember that friend on the playground

When we fell over, scraped hands & knees?

They were first to attend, got us up, on the mend

Wiped our tears, rubbed our wound, our pain eased.


We need that kind soul during labour.

We need their compassionate care.

We know they have loads to remember

But above all we know they are ‘there.’


They are there when we need some encouragement

They are there when need a kind touch.

They are there when we’re struggling, suffering,

Nothing for them is too much.


Even though they’re a fountain of learning

Of knowledge hard won through exams,

They know that the single most important thing

Is to smile, encourage, hold hands.


Without her, (or him - in this day & age)

We struggle to cope on our own.

Without her, or him, we may feel abandoned,

Afraid, maybe anxious, alone.


Gentle touch is ‘always’ what’s needed.

Attentive to physical care.

But not just the physical, emotional too,

With compassion, supportive, & ‘there!’


There - when we think we can’t do it,

There - when we’re scared & afraid.

There - when we need explanations,

There - when decisions are made.


There - to soothe, & to rub our back,

There - to hear us when we’re lost.

There - to change sheets & to help in the shower,

There - by our side through the lot.


Basic nursing is what we’re lamenting,

And we know that you know so much more.

But the highest quality we’re looking for

Is the help of a nurse - last & first - ‘always nurse’,

It’s YOU, loving you, we need more.


(Copyright Claire Kay)