This week, a BBC radio interview with Professor Andrew Weeks shook the birth world. Mothers, midwives, antenatal teachers, and doulas listened in disbelief as Weeks shared views that can only be described as deeply sexist and dismissive. It’s shocking to hear such comments in 2024, especially from someone with such influence in maternity care.
For context, Professor Andrew Weeks is a Consultant Obstetrician at Liverpool Women’s Hospital and a Professor of International Maternal Health Care at the University of Liverpool. He’s known for his work in maternal health research, including efforts to improve care in low-resource settings. Despite his impressive resume, Weeks’ remarks in the interview revealed a perspective that blames women for the challenges faced by modern maternity services.
Weeks claimed that today’s mothers are too old, too fat, and too educated to know what’s good for them. In his eyes, the rising intervention rates, staff shortages, and distrust in maternity services are largely due to women’s behaviour and choices. This narrative ignores the complexities of birth and reduces women’s autonomy to a problem that needs fixing. It also disregards the systemic issues plaguing maternity care today.
His comments suggest that women should stop questioning their care, trust the system, and avoid making selfish choices, such as hiring a doula or insisting on a particular birth plan. The implication was clear: if women just behaved, the system wouldn’t be so overwhelmed. This kind of thinking is not only outdated but dangerous, as it shifts the blame onto individuals rather than addressing the structural failings in maternity care.
Can Women Have Both Safe and Enjoyable Births?
Perhaps one of the most troubling claims made by Weeks was that women cannot expect both a safe birth and an enjoyable one. According to him, believing otherwise is naïve and selfish. This black-and-white thinking ignores the reality that many women want—and deserve—both. Safety and enjoyment are not mutually exclusive; in fact, they often go hand in hand.
When women feel respected, supported, and heard during birth, their experience is not only more positive but often safer. Emotional well-being has a direct impact on physical outcomes. For instance, when a woman feels relaxed and cared for, her body is more likely to labour efficiently. Stress and fear, on the other hand, can stall labour, increase complications, and lead to unnecessary interventions. To dismiss the importance of enjoyment, empowerment, and connection in birth is to dismiss the very essence of what it means to support women.
Weeks’ view reduces birth to a medical event—a series of boxes to tick to achieve a live baby at the end. While safety is, of course, the priority, birth is also a profoundly emotional and transformative experience. How a woman feels during birth can shape her relationship with her baby, her sense of self as a mother, and even her mental health for years to come.
The Plane Analogy That Failed
During the interview, Weeks used a metaphor that has sparked widespread criticism. He likened pregnant women to silly girls on planes, bothering the cabin crew with unnecessary questions about seatbelts. In his view, women should simply trust the pilots (the doctors and midwives) and stop interfering. The underlying message was clear: women should be passive passengers, trusting the professionals to know what’s best.
This analogy fails on multiple levels. First, not every woman is on the same “plane.” Birth is not a one-size-fits-all experience. Some women choose to take the train, opting for home births or other non-traditional routes. Others have had traumatic experiences—a crash landing, so to speak—and are too scared to fly again. Many just want reassurance and a collaborative approach to their care, not blind obedience.
Weeks’ analogy also ignores the reality that not all pilots (or maternity professionals) are equally skilled or trustworthy. Women have every right to ask questions, seek clarity, and make informed decisions about their care. Blind trust is not the answer, especially in a system where women’s voices are often dismissed, and mistakes can have devastating consequences.
Blaming Women Ignores the Real Issues
Weeks’ comments reflect a wider problem in maternity care: the tendency to blame women for systemic failings. Many women feel unsupported, dismissed, or even traumatised by their maternity experiences. This is not because they are demanding or difficult but because the system often fails to meet their needs. Understaffing, poor continuity of care, and rigid protocols are just a few of the systemic issues that contribute to negative outcomes. Shifting the blame onto women not only ignores these problems but perpetuates a culture of silence and dismissal.
When women feel unable to ask questions or advocate for themselves, they are more likely to experience trauma. Birth trauma is not just about physical complications; it’s often rooted in a lack of respect, autonomy, and communication. Women who feel silenced or belittled during birth are more likely to carry those scars for years, affecting their mental health and future experiences.
It’s also worth noting that many of the issues Weeks blames on women—such as rising intervention rates—are often the result of systemic practices. For example, routine interventions, such as inductions and continuous monitoring, are often driven by hospital policies rather than individual needs. These practices can lead to a cascade of interventions, increasing the likelihood of complications. Blaming women for these outcomes ignores the role of the system in creating them.
Why Women’s Choices Matter
Far from being the problem, women’s choices are part of the solution. When women feel empowered to make informed decisions about their care, they are more likely to have positive outcomes. Research shows that when women have continuous support during labour—such as from a doula—they are less likely to need interventions and more likely to have a positive birth experience.
Choice is not about being difficult or demanding; it’s about recognising that every woman’s journey is unique. For some, a planned caesarean feels safest. For others, a home birth is the right choice. What matters is that women feel respected and supported in their decisions. When women are given the space to make choices that align with their needs and values, the entire system benefits.
What Needs to Change?
If we want to improve maternity care, we need to stop pointing fingers at women and start addressing the real issues. Staffing shortages, burnout among midwives, and a lack of continuity of care are major barriers to providing high-quality, personalised support. Investment in these areas is essential to create a system that works for everyone.
Cultural attitudes also need to change. The paternalistic mindset that views women as passive patients to manage, rather than active participants in their care, has no place in modern maternity services. Respecting women’s autonomy, listening to their concerns, and valuing their input are not optional—they are essential to providing safe and effective care.
The Bottom Line
Birth is not a one-size-fits-all process. Every woman’s journey is shaped by her experiences, values, and circumstances. What feels safe and empowering for one woman may not be the same for another. That’s why choice and individualised care are so crucial. Women deserve the right to explore their options, ask questions, and make decisions that feel right for them.
Professor Andrew Weeks’ comments have highlighted just how far we still have to go in challenging outdated attitudes in maternity care. Women are not the problem. The system needs to do better. Until it does, women will continue to demand respect, autonomy, and a seat at the table. It’s not about being difficult; it’s about being heard. Because at the end of the day, birth isn’t about the professionals. It’s about the women and families they serve.
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