Challenging the Maternity System: Collective Voices, Activism, and Building a Better Birth Experience, with Mars Lord
By Alexia Leachman, founder of Fear Free Childbirth.
Alexia healed her own tokophobia and developed the method she used to do it – and has helped women clear theirs for over 10 years.
Mars Lord once did a birth at the Portland. Everyone told her it would be a caesarean before her client knew it. Instead they arrived to the lights down, a birth pool, the client’s things from home around her, and a doctor who walked in and said, “Oh, this looks lovely. You don’t need me. Chances are by the time I come back to check on you, you’ll have given birth.”
She gave birth in the water. When he came back he said, “I knew it.”
Mars went outside to ask him how. He told her he goes home every year to watch the traditional midwives. “I’ve just learned that with all the knowledge that I have, the thing that I hadn’t learned was that women can give birth without me,” he said. “If you need my hands, if you need my expertise, I’m in. But if you don’t, I’m not going to force you to need me.”
Mars wanted to know how to package him. I said copy and paste. I think he’s the clearest picture I’ve heard of what physiological birth needs from the people around it.
In this article:
Still the goddess of war
This is Mars’s third time on the show. The first time we talked about twins, the second time ethnicity scans. She’s a good friend, and I wanted to ask her what’s changed, because her work has moved on and so has mine.
Mars trained as a doula in 2004 and specialised in twins. These days she trains doulas and does one or two births a year. She’s also a life coach, because “life coaching and doula-ing are just the same path with slightly different outcomes,” and she coaches Black-bodied women on misogynoir, “the intersection of racism and misogyny, and how it affects their lives and their work.” In the middle of all of that, she’s a birth activist.
Last time she called herself the goddess of war. She still is. Being that outspoken was hard at the beginning, she told me, “until the day I woke up and went, fuck it.” What keeps her going is simple: “I am a mother of children who are now starting to have children. I just want my children, their children, their friends to birth safely and with the minimal amount of trauma possible.”
What lockdown did, and what never came back
I asked what had happened to birth trauma in the last decade. Mars started with COVID: “Things that felt like they were getting better got exponentially worse.” Partners who had locked down with you couldn’t come into the hospital. Women were left on their own, and she says the trauma rates rose.
She doesn’t think anything has turned that clock back. “We’ve still got places in the UK, hospital trusts, that only want one birth partner in because they like it that way. Birth centres are closing left, right and centre, which is why I train doulas,” she said, “so that each family have got someone who’s in with them who is outside of the system and fully there for the parents and the baby.”
What women want, she says, is more midwives. “And what the midwives want is to be paid and to be supported. Not stretched, understaffed, and then sent into the fray.” She isn’t promising that trauma and tragedy disappear, “because life.” But she thinks we’d see an awful lot of happier people.
We’d just painted a pretty crap picture, and I said so. But the thing I always say about fear is that you don’t ignore it. You deal with it head on.
Physiological birth is being called an ideology
I asked Mars what in the birth world needs a light shining on it right now. Her answer was the demonisation of women who want a physiological birth.
“A natural birth and a physiological birth are two different things,” she said, “because within the hospitals, a natural birth is the baby comes out vaginally. They’re not talking about whether that involves induction, forceps, or any instruments.”
So a woman who knows her stuff gets, as Mars hears it, “oh, another one that signed up to that dangerous ideology.” She plays it out: “I want to give birth at home. Whoa, why would you do that? I don’t want you to cut the cord. I want all the blood to go to my baby. Oh, that’s dangerous.”
Her name for the people repeating the phrase is “strong and wrong”. And she’s clear about intervention: “If medical intervention is necessary and needed, we all welcome it.”
I think where we’ve lost our way is that we’ve treated pregnancy like it’s a medical event. It should only go to the hospital when it does become one. Mars said she loves doctors and midwives, and that doctors and hospitals are “absolutely wonderful when they’re needed”.
There’s a part of this some of you will recognise. When you have a lot of fear, you probably don’t trust that your body can do this, so you want to feel like someone’s got your back. Mars thinks that’s what we’re taught by everything we see. Some women have birth fear or tokophobia and need help with that, she said, but “if we realised what we were capable of, I think we’d lean into that more.”
If fear is the bit that’s loudest for you
The free Tokophobia Test takes about five minutes and gives you a picture of what you’re dealing with, whether or not you’re pregnant.
Take the free Tokophobia Test › (Provided by our partner Fearless Birthing.)
What a narrower gap is hiding
A couple of weeks before we recorded, her dentist asked what she did and wanted an example. She gave him one: being told that Black people have tougher skin and higher pain thresholds. “And he said, but they do have tougher skin. I said, how do you know? He goes, well, that’s what I was taught.”
“We’ve got to talk actual fact,” she said, “not eugenics that decided this was the way it was, and it bleeds into our curriculums and then is stated as fact.”
Someone told Mars recently that at least the disparity for Black women has shrunk. It would be good news, she said, “except for the fact that maternity’s gotten worse for everyone.” Her reading is that the gap has narrowed because things have got worse for white women. “This is why I think if you look after the Black women, everyone gets looked after.”
The plan we hatched (all four points of it)
By the end we had a plan. I called it a five-point plan. I’ve counted since, and there are four.
- Burn the system down and rebuild it around the person giving birth. Mars loves the NHS. She thinks the way it started isn’t the way it looks now, and she’d rebuild it the way she coaches clients: what went well, what didn’t work, what would we do differently.
- Build birth centres from the ground up and make them the default. We know what women need to birth safely, and the list isn’t long. I suggested finding a philanthropist with fifty mil.
- Teach birth at school. Mars says young people are learning next to nothing about it. She’d teach birth and death.
- Give every obstetrician a year in a physiological birth setting, learning “how to keep their hands still, their mouths still, their minds still.”
If I had to add a fifth, it would be Mars’s line from the end: “It’s not a shortage of midwives, it’s a shortage of money to pay midwives.” The email template further down has that one, plus proper emotional and mental health support in pregnancy and after birth, because we’re Fear Free Childbirth and that one had to be in there.
The school one stayed with me because of her grandson. Mars is now nonna to three, and her eldest grandson was at the births of both babies after him. He thinks babies can only be born if he cuts the cord. The first time, the speed of it frightened him and he ran out. Mars followed him, explained what had happened, and he went straight back in. “Birth doesn’t scare him,” she said, “because he wasn’t hidden from birth.”
As she put it, “what people don’t know they fear, and what they fear they fight against.”
Email your MP
I asked Mars what she’d say to anyone who wants to do something with all this. First, thank you, because “this is a pretty thankless task and very few people thank you.”
Then email your MP. Ask what they plan to do about maternity care and tell them what you want: fund it properly, fund birth at home and in birth centres, fund antenatal education. Be “an absolute broken record.” Mars suggests sending it every year on your child’s birthday, so your MP thinks, “Why is Mars emailing me that again?”
I said we’d write you an email you can copy. Here it is:
How to send it
- Find your MP. Put your postcode into WriteToThem.com and it fills in your MP’s details for you, or use Find your MP on the Parliament website.
- Copy the email below, add your own line about why this matters to you, and send it.
- Mars’s tip: send it again every year on your child’s birthday. Be a broken record.
Subject: Maternity care: what are you planning to do?
Dear [MP’s name],
I’m one of your constituents and I’m writing about the state of maternity care.
[Add a line or two of your own here, if you’d like. You might have had a baby, be pregnant now, be thinking about it, work in maternity, or be watching someone you love go through it.]
We’ve had report after report telling us what’s going wrong in maternity services, and from what I can see, too little has changed. So I’d like to know what you’re planning to do about it.
Here’s what I’d like to see:
- More midwives, properly paid and properly supported. Midwives shouldn’t be stretched, understaffed and sent into the fray. Fund the maternity system properly.
- Proper emotional and mental health support, in pregnancy and after birth. Every woman should be asked how she’s feeling about the birth and about becoming a mother, and anyone who is frightened, anxious, struggling or traumatised should be able to get specialist support quickly, without a long wait.
- Birth centres and home birth funded as a real option. For straightforward pregnancies, care should be built around the person giving birth, with the hospital there for when it’s needed.
- Birth education for everyone, starting in schools. Young people should learn what birth is and how it works, and every family should have access to good antenatal education.
- Obstetric training that includes physiological birth. Doctors who specialise in obstetrics should spend time learning in a physiological birth setting, so they understand what birth looks like when it’s left to unfold.
Please could you tell me what you’ll do on each of these, both in Parliament and locally.
Yours sincerely,
[Your name]
[Your address, including postcode]
Short on time? Send this instead: Dear [MP’s name], I’m one of your constituents. I’m worried about the state of maternity care. Please fund it properly: more midwives, properly paid, proper emotional and mental health support in pregnancy and after birth, plus birth centres, home birth and antenatal education. What are you planning to do? [Your name, address and postcode]
Mars didn’t want anyone leaving our conversation frightened of the system. “There are people within the system, doctors and midwives, who really do just want for you to have a peaceful birth where you’re informed,” she said. Get yourself a doula. And even if you’re years away from deciding about a baby, “start your education now.” Going in informed puts you in the driving seat, and you can only be there if you know what the hell’s going on.
Questions I get asked about this
What is the difference between a natural birth and a physiological birth?
The terms get used loosely. As Mars describes it, in a hospital setting a “natural birth” often just means a vaginal birth, which can still include induction, forceps or other instruments. A physiological birth is one where labour and birth are left to unfold without medical intervention unless it’s needed. If you’re planning your birth, it’s worth asking your midwife which one they mean when they use the word.
Is birth a medical event?
Both Mars and I think it usually doesn’t start as one. It can become one, and when it does, doctors, midwives and hospitals are exactly what you want. The doctor at the Portland put it well: if you need his hands, he’s in.
How do I email my MP about maternity care?
You can find your MP and their contact details through the UK Parliament website, and there are services that let you type your message and send it to your MP directly. WriteToThem.com finds your MP from your postcode and sends your message for you. There’s a template you can copy further up this page.
How do I find a doula?
Mars’s organisation, Abuela Doulas, trains doulas and has a directory where you can look for one near you. A doula sits outside the maternity system and is there for you and your baby, which, with fewer birth partners allowed in some places, is one reason Mars thinks they’re needed more than ever.
Where to go from here
If this episode has stirred something up, there are a few places to start.
To add your voice, copy the email your MP template and send it. To find a doula, Mars’s directory is at Abuela Doulas.
If what came up for you was fear rather than fury, the free Tokophobia Test takes about five minutes and tells you what you’re facing. No pressure, no scare tactics.
When you’re ready to stop carrying it on your own, the Tokophobia Support Circle is a small monthly membership where women who understand make sense of it together, with a live group call each month. For focused one-to-one help, there’s the Tokophobia Support Programme.
Both are run by our partner site Fearless Birthing – founded, like Fear Free Childbirth, by Alexia Leachman. You can also read Alexia’s books, Betrayed By Your Biology and Fearless Birthing.
About Mars Lord: Mars Lord trained as a doula in 2004, specialising in twins, and now trains doulas through Abuela Doulas, which also runs a directory for finding one. She is a life coach to Black-bodied women on misogynoir and its effect on their lives and work, and a birth activist. She has been part of the National Maternity and Neonatal Collective, a group of grassroots birth organisations feeding solutions into Parliament and the national maternity inquiry. Abuela Doulas ›
About the author: Alexia Leachman overcame her own tokophobia – and in the process developed the Head Trash Clearance Method, the approach she now uses to help women clear their fear of pregnancy and birth. For over a decade she has worked with women around the world and trained perinatal professionals to do the same. She is the author of Betrayed By Your Biology, a book on tokophobia and reproductive anxiety, host of the Fear Free Childbirth podcast, and is often described – by the women she works with and by the podcasts that invite her on – as a world expert on tokophobia. More about Alexia ›
Fear Free Childbirth is a publication and is not a substitute for medical or mental-health care. If you’re struggling to cope or in crisis, please contact your GP, midwife, or a qualified professional.
Read next:
- 3 lies about childbirth we’ve all been told
- Hospital or home birth? Interview with Sonia Killik
- Save the midwife
Alexia supports families planning pregnancy and birth. She helps them to overcome their fears and feel calm and confident about birth and pregnancy.
Alexia also trains birth professionals in the Fearless Birthing, a unique approach to birth preparation that is ideal for those who have fears around birth.
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