Women's Views on News |
- Maternal mental health care needs to improve
- The Nigella furore and women in the media
- Remembering Doris Lessing
- Excluded and silenced
| Maternal mental health care needs to improve Posted: 11 Dec 2013 08:09 AM PST
A recent Guardian roundtable discussed the glaring gap between physical and mental health care provision for pregnant women. The focus was on maternal mental health and on what needs to be done to help prevent, diagnose and treat any problems experienced by women during pregnancy and in the first year of their baby’s life. And to encourage a free and frank discussion, the event was conducted under the Chatham House Rules, so comments are not attributed. The current disparity in mental health provision is an example of the – until very recently – relatively typical approach to mental health care as an afterthought to physical health. In maternal care, however, this is particularly dangerous and further amplified because mothers so rarely acknowledge mental illness, either in part or fully. Many women cover up their real feelings – often because they fear that their child will be taken away. More than half of all pregnant women experiencing some sort of depression or other mental illness do not discuss their feelings even with their partners. And the feeling of being unable to discuss their situation with anyone is further exacerbated by the lack of continuity of care within the NHS. Participants at the roundtable included specialist midwife Katrina Ashton (Medway Maritime Hospital); Steven Dalton, chief executive officer (Mental Health Network); Belinda Phipps, chief executive officer (NCT); Dr Tara Lawn, consultant in perinatal psychiatry (City and Hackney Centre for Mental Health); Sally Russell, managing director (Netmums); and Cathy Warwick MBE, chief executive offer (Royal College of Midwives). Several of the participants mentioned continuity of care as an important aspect when it comes to improving maternal mental health care provision, particularly as it has become increasingly rare for a pregnant woman to see the same midwife, or midwives, throughout her pregnancy. Other pressures that appear to play a large part in suppressing the reporting or discussion of maternal mental health appear to stem from the societal archetype of pregnancy and motherhood as an idyllic achievement and point of extreme happiness. That this is not always the case, is something that inspirational speaker Elaine Hanzak knows well -the pressure a woman feels to enjoy pregnancy and a new baby. "I felt I wasnʼt 'the type' to get depression. "Normally, Iʼm an outgoing, optimistic, positive and strong person who thought that as a new mum I 'had it all.' "I wanted the baby, I had a lovely home, supportive husband and family and a teaching job that I loved. "And to add to my own reluctance to admit that I was ill, one colleague said that I should 'count my blessings and pull myself together,' while another said that she knew I was putting on this problem because I wanted a longer maternity leave." After a difficult pregnancy and birth, Hanzak was eventually admitted to a hospital for two months to help her recover from puerperal psychosis, the most severe form of postnatal depression. But because there is currently a lack of facilities, many women may find it difficult to get the specialist treatment they need. One roundtable participant pointed out that 'there are only 19 mother-and-baby units in England, none in Northern Ireland, two in Scotland and one in Wales.' Such small numbers mean there is a high probability that a mother needing specialist hospital care could, if she were moved to a such a unit, be separated from her family at a time when she is most in need of extra support. Even worse is the potential for a new mother to be separated from her baby, which, for a woman already suffering from mental ill-health, may be one of the most difficult things for her to recover from. With the rising birthrate and understaffing putting midwives under increasing pressure, it is understandable why only 29 per cent have specialist training in mental illness. Information and campaigning organisations such as the Child and Maternal Health Intelligence Network, the Maternal Mental Health Alliance and the Joe Bingley Memorial Foundation are increasingly drawing attention to the multi-generational impact of maternal mental health. The Maternal Mental Health Alliance is a coalition of UK organisations committed to improving the mental health and wellbeing of women and their children in pregnancy and the first postnatal year. 'This acknowledges the extensive evidence that investing in mental health at this early stage can have a dramatic impact on long-term outcomes for mothers, fathers, children, families and society.' Roundtable participants felt that one relatively simple change could produce rapid and dramatic improvements in maternal mental healthcare – to shift the emphasis of care in the perinatal period (three months before to one month after the birth) from only physical to an equal combination of physical and mental. While birth is of course a physical event, it is also a dramatic and emotional life change. The outlook is not bright in terms of additional funding and investment in maternity care, particularly as the government continues to ask the NHS to make savings. As consultant obstetrician Dr Joanne Topping said, 'A unit this size [Liverpool Women's Hospital] should have a consultant present 24/7. ‘At the moment we usually have that for 14 or 15 hours a day. ‘Our aim is 24/7, but that would need us to have four more consultants, which would cost £400,000. Given our £4 million cost-saving target, realistically we aren’t going to get those consultants.' Much remains to be done in order to provide the level of maternal mental health care that women should have in the UK, making the work of campaigners and health organisations increasingly important. We need to keep talking about it to make sure it happens.  |
| The Nigella furore and women in the media Posted: 11 Dec 2013 06:34 AM PST
While the jury is still deliberating on the trial of the two women accused of stealing nearly £700,000 from Nigella Lawson and her ex-husband Charles Saatchi, it's easy to reach a guilty verdict with regards to the national media's treatment of Nigella. In just the first line of a report on 'the voluptuous TV chef['s]' arrival at court, the Daily Mail made sure to mention Lawson's 'undulating curves' and 'ample bosom'. On the next page, under the title 'The exquisitely crafted image of a Domestic Goddess', the paper scrutinises Lawson's hair, face, fashion and weight. Meanwhile, text boxes around a large photo of her face inform us that her 'caramel highlights' cost £250, that she is likely to have had 'a few subtle fillers', wears false lashes and has had eyebrows threaded, and has recently 'shed pounds'. The miracles of trial by appearance! The Daily Mail was not the only guilty party; in a helpful guide to 'the art of court chic' the Telegraph pointed out Lawson's 'flattering' Julien Macdonald coat, before comparing her court outfit to those of Heather Mills and Naomi Campbell. The media's obsession with the appearance of female celebrities has been shown to have an effect on the self-esteem of young women. A recent survey conducted by Girl Guiding UK found that it contributed to more than seven in 10 of those aged 11 to 21 feeling anxious about the way they look. Just as disturbing as the media’s focus on Lawson's witness-stand wardrobe, is its penchant for victim blaming. Not content with giving ex-husband Saatchi an apologist platform following him being pictured with his hands on Lawson's neck in June, the Daily Mail, as if to link the two events, made sure to include a photo of the incident in its report about Lawson's cocaine use. As noted by the Everyday Victim Blaming campaign: 'The media reports cases of violence against women and children with an almost willful avoidance of the actual reasons for these acts.' Quite.  |
| Posted: 11 Dec 2013 03:06 AM PST
I have read and re-read 'The Golden Notebook' by Doris Lessing and still find it as intriguing and fascinating as I did upon a first thumb through. It is challenging, layered and expansive. Focusing on the life of Anna Wulf, a single mother, the novel is composed primarily of the four separate notebooks Anna uses in order to better understand her life. One notebook each for her writing life, her political views, her emotions and for everyday events. It is bold, honest and on occasion uncomfortable. It is also deeply engrossing. Parts of the novel may reflect or make reference to themes or occurrences in Doris Lessing's own life. She was born Doris May Tayler in 1919 in Persia [now Iran] to British parents suffering from profound traumas caused by experiences they had had in the First World War. The family moved to a maize farming settlement in troubled Southern Rhodesia [now Zimbabwe] when Doris was six years old. Doris left 'formal' education at the age of 13, and left home when she was fifteen – but like other South African writers who did not graduate from high school – such as Olive Schreiner and Nadine Gordimer – she ‘made herself into a self-educated intellectual’. Much has been written about her subsequent marriages and her children – she had two by her first husband, Frank Wisdom, who she married when she was 19, and one by her second, German communist Gottfried Lessing – so it would be pointless to write more, but there are interesting articles on the subject here and here. For a time she was a committed communist – she left the party in 1954; an exile – she was not allowed back in to Rhodesia after 1957 until 1980 nor to South Africa after 1956 for speaking out about racism and white colonialism; and by the time she and her son Peter moved to London in 1949 she was a single mother. An outspoken advocate for social change, she had many stories to tell – and she wrote over 60 novels, plays and factual pieces. Her first novel 'The Grass is Singing' was published in 1950, her poignant last, 'Alfred and Emily', in which she imagined what life would have been like for her parents if World War I had not happened, in 2008. She received numerous awards for her writing, both for individual pieces and for her body of work as a whole; the James Tait Black prize for volume 1 of her autobiography 'Under My Skin' in 1995 and the Nobel prize for literature in 2007. She was awarded the Nobel prize for literature because with ‘scepticism, fire and visionary power’ she ‘subjected a divided civilisation to scrutiny’. For further information on Lessing's remarkable life, you can read the acclaimed autobiographies she published: ‘Under My Skin‘ and ‘Walking in the Shade‘ or have a look at this comprehensive website. Doris Lessing died in London on 17 November 2013. She is already sorely missed.  |
| Posted: 11 Dec 2013 01:09 AM PST
By Margaret Ward, director of the Women’s Resource and Development Agency, Northern Ireland. Northern Ireland is not yet a society at peace as the legacy of the past continues to overshadow our present. Contention over the flying of flags and the holding of parades in disputed areas has made for increased instability over the past year – and has led to the N.I. Executive inviting Richard Haass and Megan O'Sullivan from the United States to facilitate talks as part of a process to find a solution to these issues. At the same time, there is a backlash against women's agency in a number of different ways, all of which impact on the ability of women to participate fully in initiatives intended to support the transition out of conflict. This brief article considers some of the key issues affecting women's lives and their ability to contribute fully to the work of peace building and conflict transformation. Some of the views contained within the article were gathered during workshops organized by the Women's Resource and Development Agency (WRDA), the Community Foundation for Northern Ireland and the National Women's Council of Ireland, who are partners in a significant project entitled ‘Women and Peacebuilding: Sharing the Learning‘ (2012-2014) which aims to capture the experiences of women living through the conflict and through the subsequent period of conflict resolution and peace building in Northern Ireland. Reproductive Rights: While political parties are divided on constitutional issues, they share many characteristics when it comes to women – they are very conservative. Abortion remains a criminal offence. The British 1967 Abortion Act does not apply. When the issue was debated in the Assembly 2000 and 2007 there was overwhelming opposition to any progressive reform of the abortion law, although women members of the Legislative Assembly (MLAs) were largely either supportive or remained quiet, despite the fact that the N I Assembly has no power to reform this law as it remains a ‘reserved matter’ under the control of Westminster. The peace process also impacts on issues like abortion. When an amendment to a Westminster Bill on Human Fertilisation and Embryology was to be put by a British Labour MP in July 2008, she was told by then Prime Minister Gordon Brown that if she did so she would be jeopardising the peace process because the Democratic Unionist Party (DUP) (which has 9 seats in the House of Commons and is opposed to abortion) would object. The British government wanted DUP votes to support 42 day detention for terrorist suspects. New guidelines issued in 2013 to the medical profession by the DUP Minister for Health, aimed at restricting the extremely limited circumstances in which terminations of pregnancies have taken place, has led to situations where women with non viable foetuses have been refused medical help and forced to travel to England for terminations, without medical support or NHS assistance. This has led to public outcry and calls for the reform of abortion legislation in Northern Ireland. Ironically, it has also led to the Marie Stopes Clinic in Belfast, established one short year ago (November 2012) amidst great controversy, having the BBC, on its first anniversary, broadcast its morning news programme, Good Morning Ulster, from the Clinic, providing very positive news coverage. When public opinion enters the mix, it is clear that political parties are not reflecting a more liberal and tolerant attitude that is beginning to emerge. Dealing with the past: The omission of women from consideration of the past was starkly evident in the 2010 consultation on a ‘Community, Sharing and Integration strategy. This was concerned with how divisions in Northern Irish society could be tackled and society developed along shared lines. The contribution of women to the maintenance of society during the conflict was ignored. So also was any indication that women had a role in the future development of a more peaceful society. In response, women's groups came together and with financial support from the Community Relations Council organised events for women around the region. As a consequence, a strong and united response was put forward stating that the strategy had to be redrafted in order to acknowledge: - that a long and violent conflict took place and is still in some aspects ongoing; - the need to address the differential impact of the conflict on women - that those effects are ongoing – for example in respect of dependency upon alcohol, prescription drugs, mental health problems etc; - those involved in making and drafting policy must undergo gender awareness training – including MLAs and civil servants at all levels. - a new Cohesion, Sharing and Integration or Shared Future strategy needs to acknowledge the role of women in conflict resolution and peace-building. It must look specifically at examples of good practice within the women's sector: - the definition of cohesion must be all encompassing and specifically name women and women's groups as having contributed to the development of peace, having a place in building the peace and the need for women's sector to be positively encouraged into public life in a post conflict situation. There has been little meaningful response to this. While a new strategy, ‘Together Building a United Community’ has been released, which mentions the existence of the Gender Equality Strategy, the reference to women is merely tokenism. The reality is that a recent conference, held in Cardiff in the summer of 2013 in order to consider contentious issues like parading and flags, had police, politicians and community representatives in attendance, and only 3 women out of more than 30 participants. Peace building is still seen as an activity that primarily involves men. Women: Excluded and Silenced: In recent workshops held with women from across Northern Ireland, a clear message is that for some women living in Protestant/Unionist/Loyalist (PUL) areas, paramilitary organisations were viewed as the main problem/threat in their communities. Their existence has resulted in the following: - high levels of control (through fear and intimidation) - local women unable to speak up due to threat to property and personal security - women (and men) and their families living in fear and silence due to the threat of reprisals - high levels of criminality (some of it drug related). Criminality and money emanating from criminal activity has resulted in divided and mistrustful communities. - women do not have 'safe spaces' to discuss issues Essentially paramilitary organisations (men) control significant numbers of communities in disadvantaged areas. Families on low incomes are living 'cheek by jowl' with prosperous neighbours involved in illegal activities. The women did not think of the threats in relation to their own personal security but to that of their sons and grandsons. If the women speak up, their families are in danger. Paramilitary organisations continue to recruit and it is very difficult for women in these communities to keep young men away from paramilitary involvement. In many disadvantaged PUL areas, the absence of jobs and any aspiration for the future for young men adds to the allure of the perceived "glitz" of paramilitary activity – of 'money and women'. The sexual exploitation of young girls is prevalent and often hidden. For women from nationalist/republican areas control is also an issue, particularly in areas where 'dissident' republicans exist. The lives of women and families in some areas are blighted by high levels of anti–social behaviour and low level but persistent criminality. It is suggested that the prevalence of anti-social behaviour has happened due to a vacuum created when paramilitary vigilantism halted and has not been yet been filled by the Police Service. Some women living in these areas say they felt 'safer' during the period of the conflict. Another clear message coming from women participating at these workshops is that there is a generation of people who lived through the trauma of the conflict who have become addicted to alcohol or prescription drugs. Mental ill-health and legal drug misuse manifest themselves ways of many people living and coping from day-to-day and is a huge and often hidden legacy of the conflict. Domestic and Sexual Violence: While domestic and sexual violence persists as a highly gendered problem across the globe, it is a particular and often hidden problem in societies emerging from conflict. Domestic and sexual abuse was prevalent during the conflict and much of this is only now coming to light. For women and girls living in Nationalist/Republican areas, reporting a crime or contacting the police was not an option during the conflict. Therefore many victims of these crimes had no recourse to support and safety. Since the peace process, women from these areas have been encouraged to contact the police to report such crimes. The opposite is true for women living in Protestant/Unionist/Loyalist areas where relationships with and trust in the Police Service have waned significantly. For women who are victims of domestic and sexual violence, avenues to seek support, safety and justice are often closed. In both these contexts women and girls have been and are very vulnerable. Criminality (involving drugs and prostitution) has led to a huge and very worrying increase in the sexual exploitation of girls and young women in some communities. For some men, leaving prison has been difficult in terms of adjusting to 'normal' life and many have turned to drugs and alcohol to deal with the pressure. Women believe this has exacerbated the problem of domestic and sexual violence. There was a high level of consensus on the following: - domestic and sexual violence is increasing - sexual abuse is a major (and often hidden) issue across communities - sexual exploitation of young girls (often in paramilitary settings) is prevalent - as support for the Police Service NI has increased on the Nationalist/Republican side, there is a corresponding decrease in support in some PUL communities. This adds to the vulnerability of women and girls in these areas. While the Haass / O'Sullivan talks are welcomed, there is a perception that women remain excluded as peace building continues to be perceived as male territory. A clear message from women in communities throughout the north is that women have been and continue to be affected by these issues. Furthermore, they want to speak, to have an opportunity to share their views and to have their concerns incorporated into future strategies to deal with the legacy of the past. Margaret Ward is the director of the Women’s Resource and Development Agency, Northern Ireland. A version of this article first appeared in OpenDemocracy.  |
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