Some of the midwives and patients from the fifth series of One Born Every Minute. Photo: Phil Fisk
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One Born Every Minute is the opium of the masses

Like millions of others, I love Channel 4’s maternity documentary. But it is feeding us an overly rosy view of an NHS suffering from staff shortages and cutbacks.

OK, OK, so we all know that Made in Chelsea and The Only Way is Essex aren’t actually depicting the reality of life in Chelsea or Essex, but there’s something about medical reality TV programmes that somehow makes you think what you’re seeing is real. Channel 4’s Bafta-winning documentary series One Born Every Minute (OBEM) has recently returned to our screens for a fifth series. While its popularity is partly rooted in a certain voyeurism, many women (myself included), have watched it in the run up to childbirth in the hope of learning something of what was to come. After all, it’s a documentary, and though edited, isn’t scripted or staged. The care is real. The cleanliness, the calm, the almost ideological commitment to the profession, are all a true reflection of what our maternity units are like. . . right?

Like millions of you, I’ve tuned in to watch the messy business of childbirth. I’ve watched aghast as devoted midwives stay on past their shift to see through the labour of a woman whom they were so attentive to, you’d be forgiven for thinking they were long-lost friends. In one episode, they actually were! In more precarious situations, hoards of impeccably timed, rigorously diligent and profoundly empathetic midwives work in perfect harmony to support women, as if they were mythical angels of midwifery. The rose-tinted atmosphere is heightened by personal narratives from the midwives, who often talk about their profession as a dream vocation. While I don’t doubt many midwives do enter the profession thanks to vocational aspirations, statistics also tell us that midwives are leaving the profession in droves, suggesting that “tea and cake interspaced by miraculous experiences” might not be an entirely accurate portrayal of what their working lives are like.

For me, OBEM was a window – or so I thought – into the type of care I could expect to receive on the NHS. I wish I could confirm that the series offers an accurate depiction of the type of care you can expect to receive as an expectant mother, because frankly, it is exactly the level of care women should be receiving. And for many health professionals, it is precisely the type of care they wish they could deliver. But both my personal experience and crucially a range of figures, suggest otherwise.

One can safely assume that the maternity wards that agree to be filmed are not those struggling with staff shortages or overcrowding problems, as many of our maternity wards currently are. But I’ve come to wonder whether OBEM doesn’t actually act as a sort of pacifying decoy where there might otherwise be mass indignation as to what is truly happening in our hospitals.

The programme has aired over a period during which NHS restructuring means many maternity units are being downgraded or even shut down because of staff shortages and overcrowding. According to a recent survey, new mothers describe maternity units as “severely understaffed “with “overworked staff” on postnatal wards in particular. More than half of birthing units are not meeting the staffing guidelines set out by the Royal College of Obstetricians and Gynaecologists and a third of mums in labour are now being turned away from wards, a scene we have so far seen only once on the last season of OBEM! The Royal College of Midwives is campaigning for 5,000 more midwives to be recruited to meet growing demand and speaking last year its chief executive Cathy Warwick warned: “We are many thousands of midwives short of the number needed to deliver safe, high-quality care.”

In the series, we watch as consistently composed midwives with all the time in the world tend compassionately to labouring women in state-of-the-art facilities. And yet meanwhile, many of us experience a system in which overworked and over-stretched midwives struggle to meet requests beyond the barest essentials. And who can blame them when, unlike the midwives on OBEM who seem to enjoy endless tea breaks, the midwives who don’t make it onto our screens report that missing meal breaks and finishing shifts late is a daily occurrence. As one midwife confessed to me: “One Born Every Minute is about as similar to my experience of being a birth centre midwife as Green Wing is to working in a hospital.”

We have our own perceptions of the NHS, shaped by the images we see on our screens. In the case of OBEM, these images are embellished with stories of women’s struggles within a pristine and perfectly-oiled system. If our own experiences differ from the narrative, we assume it’s an anomaly, an exception – that we were simply “unlucky”.

The reality is that the NHS chief executive Sir David Nicholson says £20bn must be shaved from the budget by March 2015, much of which involves hospital closures or downgrading. This is something which many campaigners see as cost-cutting not, as is claimed, an attempt to provide a more efficient service. While we happily watch an army of midwives fawning over newborns in immaculate hospitals, the government is undertaking the biggest NHS restructuring in history, which massively impacts the levels of care women can expect to receive.

The Maternity Services Survey 2013, which examines the experiences of women in 137 NHS Trusts in England, found that “more women felt that they were treated with kindness and understanding and had confidence and trust in the staff caring for them during labour and birth” than during the last survey in 2010. But it also revealed some worrying findings.

Among them was the fact that almost one in five women feel their concerns during labour were not taken seriously. Of the 230 women who provided comments about their experiences of accessing care, only one comment was positive. Of the remaining comments, over 87 per cent referred to women’s negative view of their care.

The UK may well be one of the safest places in the world to give birth, but all is not well. It has one of the worst rates of stillbirth in the developed world, and according to a globally-renowned professor of maternal care, government restructuring is to blame. What’s more, despite the majority of maternal deaths happening post-birth, budget pressures mean that almost half of new mothers are not immediately made aware of how to spot life-threatening conditions. And although the government has pledged that women can expect consistent care from a single midwife during labour, 46 per cent say they do not receive this.

OBEM has shone much-needed light on the experiences of women in labour, but the programme’s rosy depiction of our maternity wards shields us from the gruesome reality of what’s actually happening to them. If we were privy to the strains being placed on our wards, we might just be spurred into action. While the NHS is in need of profound change to render it more sustainable, care for women and babies at the very start of life should be shielded from cuts. Let’s not confuse the care we wish we had with the care we actually have and in so doing, end up lulled into a false sense of security. In the age of progress, we often assume things can only get better. The truth is, programmes like OBEM depict how it should be. Sadly, for many of us, that won’t be the reality.

Myriam Francois is a writer, broadcaster and academic with a focus on current affairs, the Middle East, Islam and France. She currently works as a broadcast journalist for TRT world, a global news network, and was the presenter of documentaries including BBC One's “A Deadly Warning: Srebrenica Revisited”.

She is a Research Associate at the Centre of Islamic Studies (CIS) at SOAS University, where her research focuses on British Muslim integration issues. She also undertakes the centre’s media outreach and research dissemination in relation to its work on British Muslim communities.
Myriam is currently a PhD (DPhil) researcher at Oxford University, focusing on Islamic movements in Morocco. 

She tweets @MFrancoisCerrah

Photo: ASA
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Harmful gender stereotypes in ads have real impact – so we're challenging them

The ASA must make sure future generations don't recoil at our commercials.

July’s been quite the month for gender in the news. From Jodie Whittaker’s casting in Doctor Who, to trains “so simple even women can drive them”, to how much the Beeb pays its female talent, gender issues have dominated. 

You might think it was an appropriate time for the Advertising Standards Authority (ASA) to launch our own contribution to the debate, Depictions, Perceptions and Harm: a report on gender stereotypes in advertising, the result of more than a year’s careful scrutiny of the evidence base.

Our report makes the case that, while most ads (and the businesses behind them) are getting it right when it comes to avoiding damaging gender stereotypes, the evidence suggests that some could do with reigning it in a little. Specifically, it argues that some ads can contribute to real world harms in the way they portray gender roles and characteristics.

We’re not talking here about ads that show a woman doing the cleaning or a man the DIY. It would be most odd if advertisers couldn’t depict a woman doing the family shop or a man mowing the lawn. Ads cannot be divorced from reality.

What we’re talking about is ads that go significantly further by, for example, suggesting through their content and context that it’s a mum’s sole duty to tidy up after her family, who’ve just trashed the house. Or that an activity or career is inappropriate for a girl because it’s the preserve of men. Or that boys are not “proper” boys if they’re not strong and stoical. Or that men are hopeless at simple parental or household tasks because they’re, well...men.

Advertising is only a small contributor to gender stereotyping, but a contributor it is. And there’s ever greater recognition of the harms that can result from gender stereotyping. Put simply, gender stereotypes can lead us to have a narrower sense of ourselves – how we can behave, who we can be, the opportunities we can take, the decisions we can make. And they can lead other people to have a narrower sense of us too. 

That can affect individuals, whatever their gender. It can affect the economy: we have a shortage of engineers in this country, in part, says the UK’s National Academy of Engineering, because many women don’t see it as a career for them. And it can affect our society as a whole.

Many businesses get this already. A few weeks ago, UN Women and Unilever announced the global launch of Unstereotype Alliance, with some of the world’s biggest companies, including Proctor & Gamble, Mars, Diageo, Facebook and Google signing up. Advertising agencies like JWT and UM have very recently published their own research, further shining the spotlight on gender stereotyping in advertising. 

At the ASA, we see our UK work as a complement to an increasingly global response to the issue. And we’re doing it with broad support from the UK advertising industry: the Committees of Advertising Practice (CAP) – the industry bodies which author the UK Advertising Codes that we administer – have been very closely involved in our work and will now flesh out the standards we need to help advertisers stay on the right side of the line.

Needless to say, our report has attracted a fair amount of comment. And commentators have made some interesting and important arguments. Take my “ads cannot be divorced from reality” point above. Clearly we – the UK advertising regulator - must take into account the way things are, but what should we do if, for example, an ad is reflecting a part of society as it is now, but that part is not fair and equal? 

The ad might simply be mirroring the way things are, but at a time when many people in our society, including through public policy and equality laws, are trying to mould it into something different. If we reign in the more extreme examples, are we being social engineers? Or are we simply taking a small step in redressing the imbalance in a society where the drip, drip, drip of gender stereotyping over many years has, itself, been social engineering. And social engineering which, ironically, has left us with too few engineers.

Read more: Why new rules on gender stereotyping in ads benefit men, too

The report gave news outlets a chance to run plenty of well-known ads from yesteryear. Fairy Liquid, Shake 'n' Vac and some real “even a woman can open it”-type horrors from decades ago. For some, that was an opportunity to make the point that ads really were sexist back then, but everything’s fine on the gender stereotyping front today. That argument shows a real lack of imagination. 

History has not stopped. If we’re looking back at ads of 50 years ago and marvelling at how we thought they were OK back then, despite knowing they were products of their time, won’t our children and grandchildren be doing exactly the same thing in 50 years’ time? What “norms” now will seem antiquated and unpleasant in the future? We think the evidence points to some portrayals of gender roles and characteristics being precisely such norms, excused by some today on the basis that that’s just the way it is.

Our report signals that change is coming. CAP will now work on the standards so we can pin down the rules and official guidance. We don’t want to catch advertisers out, so we and CAP will work hard to provide as much advice and training as we can, so they can get their ads right in the first place. And from next year, we at the ASA will make sure those standards are followed, taking care that our regulation is balanced and wholly respectful of the public’s desire to continue to see creative ads that are relevant, entertaining and informative. 

You won’t see a sea-change in the ads that appear, but we hope to smooth some of the rougher edges. This is a small but important step in making sure modern society is better represented in ads.

Guy Parker is CEO of the ASA