Making a difference with birth room photos...

I once posted a link on social media to a study about images of birth rooms by Bowden et al (2016), which led to an overwhelming response from midwives, birth folk and women. The researchers collected images from a variety of online sources and then analysed them to see what they contained.

No prizes for guessing: the dominant images were of ‘bed centric’ technologically-focused birth rooms, and the visual messages reinforced the idea that beds are the most appropriate places on which to give birth. (More on the study below).

The level of passion that people have for this topic didn’t surprise me, because this is something that comes up a lot in my workshops, but it did get me thinking about whether there was something that we could do about it.

If you’re new to this area and wondering why I’m saying all of this, then you may like to know that beds are not actually great places on which to spend your labour and birth. Many women find that their labours are more comfortable and that they give birth sooner if they are active, upright and moving around freely. If they’re able to adopt the position that suits them best in the moment. Most of the above things are not as easy if you’re three feet off the ground on a surface which doesn’t have much room to move around on.

Plus, in the same way that the question of whether Jack could have fitted on the door with Rose is apparently moot because it was more about buoyancy than space, most people who are on delivery beds are nine or ten months pregnant and generally not at their most agile…

Why do photos matter?

Why do pictures of birth rooms matter? Well, because images of birthing environments are going to affect all of us, but especially those of us who are pregnant. They will influence our attitudes, our choices and maybe even our behaviours upon entering a birthing room or space. Imagine if you went to visit a planet where all the images of birth were of candlelit water pools, or of women entering small, cosy, cushion-filled tents when they went into labour. Do you think that’s what you would expect to find? Would your ideas about birth be different if you grew up in that culture?

What can we do about it?

I want to propose a solution; a really simple and easy thing that almost anybody who is interested in making a difference here could do.

Part of the reason that bed-focused images predominate is because those are the images that people are posting to image websites, which include both the paid ones and those which kindly give creative commons licences to their photos for bloggers and website owners to use.

A potential solution then, is for us to upload more images of bedless birth environments (with or without women or families in – please respect privacy, copyright and all that stuff, of course) onto sites which make images available. It’s also important to tag or name them well so that they will come up when people search for images of labour or birth rooms.

You don’t even have to give them away. If you’ve got a bit of time, or perhaps you’re a birth photographer who needs to make a living from your work, then set up an account with the paid-for photo sites and upload photos which newspapers and news websites can buy. I can tell you that I often have a really hard time finding non-bed-focused labour and birth pictures for my website, so I’m sure others find the same. What I’m also sure of is that most other people probably don’t care about finding positively-focused images as much as I (and perhaps you) do, so they may not look beyond the first one.

I realise that most people will read this, decide it’s too much like hard work and click onto something else. That’s fine. But don’t let me then hear you saying that there’s not much we can do to make a difference. Because, actually, there are loads of tiny things that we can do, and this is just one of them.

Bowden C, Sheehan and Foureur M (2016). A Birth Room Images: What they tell us about childbirth A discourse analysis of birth rooms in developed countries. Midwifery. DOI: http://dx.doi.org/10.1016/j.midw.2016.02.003

The Research

Objective: This study examined images of birth rooms in developed countries to analyse the messages and visual discourse being communicated through images.

Design: A small qualitative study using Kress and van Leeuwen’s (2006) social semiotic theoretical framework for image analysis, a form of discourse analysis.

Setting/Participants: Forty images of birth rooms were collected in 2013 from Google Images, Flickr, Wikimedia Commons and midwifery colleagues. The images were from obstetric units, alongside and freestanding midwifery units located in developed countries (Australia, Canada, Europe, New Zealand, United Kingdom and the United States of America).

Main findings: Findings demonstrated three kinds of birth room images; the technological, the ‘homelike’, and the hybrid domesticated birth room. The most dominant was the technological birth room, with a focus on the labour bed and medical equipment. The visual messages from images of the technological birth room reinforce the notion that the bed is the most appropriate place to give birth and the use of medical equipment is intrinsically involved in the birth process. Childbirth is thus construed as risky/dangerous.

Key conclusions and implications for practice: As images on the Internet inform and persuade society about stereotypical behaviours, the trends of our time and sociocultural norms, it is important to recognize images of the technological birth room on the Internet may be influential in dictating women’s attitudes, choices and behaviour, before they enter the birth room.