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I’ve spent the past 24 hours chatting when I can on the The Gram about This is Going to Hurt, by Adam Kay. I thought carefully about sharing my opinion and to my relief, it seems I’m not alone in not loving it.

So let’s start with the positives. A few pages in and I was chuckling out loud. Adam Kay is funny and there’s no doubt that he is (was) a very dedicated and hard-working Doctor. I’m so happy he’s now a TV Comedy writer, he’s definitely got a talent for it. This leads me to praising Junior Doctors everywhere for the undeniable sacrifices they make for their jobs and their patients. The NHS is a beautiful institution and we need to look after it. It makes me so proud of the UK and (*for now) couples should thank their lucky stars that they don’t get lumbered with a huge bill for having a baby in hospital, like people in many other parts of the world.

Throughout the book Adam references his suffering partner, who he calls H to preserve her privacy, the dozens of times he’s missed weddings, parties and other special occasions because there’s just nobody else who can work the shift and even, the number of times he’s slept in his car because the drive home to bed before the next shift isn’t worth it. Clearly, nobody becomes a doctor for the money, even if he does mention money, going private and his future ferrari-driving house in France aspirations on a few occasions.

Now for the not-so positives. Ready?

I don’t know about you, but as a woman reading this book, about a man working with the female body, I felt pretty sick for three quarters of it. And it seems I’m not alone. After sharing some stories with exerts from the book, I’ve had about a hundred DMs from women saying #metoo.

So Adam Kay is a Junior Doctor (unless you hadn’t gathered) who specialises in Obstetrics and Gynaecology, or ‘brats and twats’ as he says his medical school refers to it. Charming. His reasons for doing so aren’t for the admiration of women’s incredible life-giving bodies, nor for the privilege of witnessing new life being born multiple times a day. Instead he says: ‘I liked that in Obstetrics you end up with twice the number of patients you started with, which is an unusually good batting average compared to other specialities (I’m looking at you, geriatrics.)’ Fine. But then he says: “I also remembered being told by one of the registrars during my student placement that he’d chosen obs and gynae because it was easy. ‘Labour ward is literally four things: caesareans, forceps, ventouse and sewing up the mess you’ve made.”

So you see how I’m not convinced his heart was truly in this from the start. At least not for the reasons I’d hope for as a woman.

Mr Kay goes on to ridicule the birth wishes (I’m careful not to say ‘plans’ - we all know birth can go its own way, despite being depicted as very dumb in this particular part of the book) of his patients and completely undermines them in a way no woman would consider funny. He mocks hypnobirthing and women who practice it, calling us a ‘certain denomination of floaty-dressed mother’ and thinks it’s hilarious for women to outline which aromatherapy oils she might like to use during her labour. He even chooses to mention this mother’s ‘whale music’ and that the ‘whole thing was doomed from the start.’ This was where I got to when my mouth dropped to the floor. There’s a sort of ‘god-like’ status that society puts on doctors. They’re medical, experts, they have the facts, they know best and they ought to be obeyed. Except, this man seems to have swallowed only what he’s been told and closed his mind off to any school of thought that existed before his textbooks, and disregarded absolutely any alternative thinking whatsoever, even if backed up by evidence.

There is evidence that Hypnobirthing works - it’s not rocket science. Surely he sees the fear in women on that labour ward every day? Surely he must know about the delicate balance of birth hormones required for the whole thing to work smoothly, i.e less fear = less adrenaline? Surely he might be able to agree, if trying really really hard to put himself in the shoes of just one of the women in one of the beds on that ward, that by relaxing their minds, their bodies will be able to work more efficiently? All of the midwives I have worked with in hospitals across South London have supported a woman’s right to choose aromatherapy, homeopathy or Hypnobirthing in her birth room as tools to help her cope. In fact, three midwives in one particular hospital are trained Hypnobirthing Teachers and run aromatherapy in pregnancy and childbirth workshops.

Sadly, Mr Kay has seen too many medicalised hospital births to see birth as in any way glorious and beautiful - to him it seems to be something women need him to manage for them. The facts are, when a woman steps into a labour ward her chances of medical intervention goes up there and then by 50% - the cascade of intervention is hard to stem. Especially when faced with doctors like Adam Kay who will roll his eyes if a mother asks questions or exercises her human rights.

There’s just so much about the language in the book that I can’t stomach either, nor can I accept as accurate information - yet I know from my experience as a Doula that this is the ‘line’ OBs often take. For example, the footnote next to Syntocinon, reads: ‘You’re meant to progress by a centimetre of dilation every hour or two, and if that’s not happening despite Syntocinon then it’s caeserean time.” LIke there’s absolutely, categorically no other avenues to try from here then? None at all? What do we know about a dilating cervix and baby positioning? Nothing else we can consider here…off to surgery then, why not.

We know women dilate in childbirth at different speeds with or without Synto. The word ‘progress’ and the phrase ‘failure to progress’ makes me cringe every single time I read it, like a timeframe on birth is realistic and using the word failure anywhere near a woman in labour is kind.

Anyhoo, I’m getting drawn into the nitty gritty now. And I’ve not even touched upon the delightful anecdote where he was bleeped mid-wank to assist a woman (or in his terms, deliver her baby) and he smugly closed one entry with: “Mother and baby both fine, good old me. I can now write my own bucket list and tick off ‘Delivered a baby while still erect.’ Speaking of buckets, anyone else want to take a moment here to calm yourself, take a deep breath and/or vomit into one?

What I would like to end on is, the book makes me really sad that it’s received so much praise and nobody (that I’ve heard of) has highlighted that this isn’t an ok attitude to have about birthing women. This Doctor is highlighting the systemic patriarchy in medicine and it needs to be changed.

Human Rights in childbirth matter. Being listened to and respected matters. Having options matters.

And finally, it’s never entertaining to me to hear about someone else’s trauma. I don’t care how many hours unpaid work you’ve done that week, or how you dress it up as a comedy sketch. It’s not funny.

If you’ve suffered trauma or are experiencing PTSD from childbirth, here are some places you can go for the right connections and support.

Birth Trauma Support Family

Dr Rebecca Moore and Birth Better

Birth Talk

How to Heal a Bad Birth

Tranquil Birth

Also - never not going to signpost to these:

Positive Birth Movement

Birth Rights

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