Xinyu Addae-Lee | You want babies? Give women a better birthing experience

Mother’s Day was last month. A day of celebrating women who have carried, birthed, and/or cared for the next generation. However, women don’t seem to be itching to become mothers anymore. Across the globe, birth rates are plummeting. In countries as diverse as Japan, Italy, South Korea, and even Jamaica, fertility rates are well below the replacement level.

Quite recently, there was an article titled ‘Baby Shortage’, speaking about the reduction in births at the Victoria Jubilee hospital ‘tumbling’ from 500 to 300. Many have speculated about the various reasons for the decline. Offering explanations such as the increasing cost of living, job insecurity, delayed marriages and parenthood due to academic and career goals, the shift in gender role perspectives, insufficient parental support and so on.

As a result, governments are offering cash incentives, tax breaks, and even housing perks to entice families to have more children. But amid this scramble to boost numbers, a fundamental question remains ignored, one which has long been on my conscience: Are we truly celebrating mothers if we are not respecting and supporting the process of childbirth?

One of the most overlooked aspects of this crisis is not just economic insecurity or lifestyle preferences – it’s the birthing experience itself. For many women, the decision to have children is shaped not just by affordability or career aspirations, but by the fear, trauma, and lack of dignity surrounding childbirth. And in some countries, this is exacerbated by an inhumane and outdated policy: denying women the right to have a birthing companion.

SILENT PAIN OF LABOURING ALONE

In many public hospitals across Jamaica and in other parts of the world, women are forced to labour alone, stripped of the emotional and physical support that a trusted companion could offer. Partners, mothers, sisters, and doulas are barred from entering the delivery room, and the woman is expected to go through the unfamiliar, exacerbating, excruciating and sometimes terrifying experience of childbirth on her own. Let’s be clear, there is a very real risk of the woman facing her own mortality. This is not something that should be faced alone, by choice.

ABSENCE IS NOT BENIGN, IT’S HARMFUL

According to the World Health Organization, the presence of a labour companion is a critical component of respectful, high quality maternity care. Women who labour without support are at increased risk of: Longer labours, Higher rates of medical intervention, including caesarean sections, a greater need for pain relief, higher levels of birth trauma and postpartum depression.

Studies have also shown that a woman is at a greater risk to suffer verbal and physical abuse.

In contrast, women who have a continuous support person during their childbirth experience: shorter labours, a lower likelihood of complications, improved Apgar scores in newborns, increased satisfaction and emotional well-being.

This is not anecdotal. It is backed by decades of global research. A 2017 Cochrane review, which examined over 15,000 women across 17 countries, found that those with a birth companion were 25 per cent less likely to have a caesarean section, and 38 per cent less likely to have babies with low Apgar scores.

Do you need to ask which set of women are most likely to recommend their experience to friends and family?

So why are we still denying this basic, low-cost, high-impact intervention?

DEEPER CRISIS: DISRESPECT AND DISEMPOWERMENT

The issue is not just about statistics. It’s about dignity. When a woman is left to suffer alone during one of the most vulnerable moments of her life, she is not just physically unsupported – she is emotionally abandoned. Her needs, wants and basic humanity are dismissed, for expediency, efficiency and convenience.

In too many hospitals, childbirth has become a clinical transaction – focused on output, not experience, on policies, not people. And this indifference has consequences. Women who endure disrespectful or traumatic births are less likely to return for subsequent pregnancies. Some even develop a fear of childbirth so intense that they avoid having more children altogether.

We cannot claim to care about falling birth rates while failing to care for the birthing process itself.

RECLAIMING BIRTH AS A HUMAN EXPERIENCE

If we are serious about addressing the demographic crisis, then we must start where life begins: in the delivery room. That means: Mandating the right of every woman to have a labour companion of her choice, training staff in respectful maternity care, designing hospital spaces that are family- and woman-friendly, and centring the mother’s emotional and psychological well-being in every step of the process.

Birth is not just a medical event – it’s a profoundly life altering one. And in that moment, no woman should be left to navigate pain, fear, and vulnerability on her own.

WAY FORWARD

As we confront the consequences of a shrinking population, let’s not forget that how we treat women in childbirth reflects who we are as a society. Women have been dismissed, disenfranchised and diminished, told to accept ill-treatment and injustices in even ‘modern’ societies, but this is changing. The decision to withhold ‘reproductive services,’ is a silent protest for some and for others, it is just a natural consequence of the circumstances and existing conditions they refuse to choose for themselves.

Each woman is complex and the factors that influence her decision to give birth are uniquely hers. But whatever factors each woman takes into consideration, if they lean more toward not reproducing, it is most likely that the woman does not feel safe. As we address these issues, may we not continue to overlook how impactful it can be to ensure that a woman is supported by a person of her choosing during labour and delivery to make her feel safe.

Dr Xinyu Addae-Lee is a medical doctor and attorney-at-law. Send feedback to services@jaxinja.com and columns@gleanerjm.com