When it comes to knowing your choices during pregnancy, birth and afterwards, if you’re in the UK, you need AIMS, the Association for Improvements in the Maternity Services.
For over 60 years, they’ve pioneered a woman-centred approach to maternity care.
AIMS has always recognised this work as political. Of course it is – if you challenge embedded practice, and especially if you want to make an impact on the assumption women should do as they’re told. We know formalised maternity care has a deeply patriarchal approach to managing pregnant and birthing women, while a feminist understanding values instinct, experience, insight and relationships alongside scientific knowledge.
‘Equality, inclusivity and diversity’
More recently, a fresh challenge arose, to communicate AIMS’ newly-minted policy on equality, inclusivity and diversity.
In 2021, this means saying it’s possible for someone who is not a woman to give birth (and it’s not only women who menstruate, conceive and go through pregnancy). This is a result of defining ‘women’ not as a sex, but as a gender identity.
AIMS’ statement starts off with an unambiguous commitment to acknowledge the different experiences and needs of minorities and to work for equal access. Of course.
Then we see the sex denial.
Their list of ‘differences’ they say any diversity policy should cover includes ‘gender and gender identity’, but not ‘sex’. Under the UK Equality Act of 2010, ‘sex’ is a ‘protected characteristic’, and its omission here is notable.
Then, they go on:
‘We recognise that some people who are pregnant are not women. They may be men, non-binary or something else.’
That ‘something else’ is, of course, one of the cornucopia of exotic gender labels, that even their champions can’t explain ( listen to Stephen Nolan’s Stonewall podcast for a taste of their confusion.
Whatever. AIMS are referencing gender identity, putting those particular ‘people who are pregnant’ into a different category from women, divorcing them from the sex class they belong to.
Not just AIMS
It’s not just AIMS who are doing this, but other well-known, mother-focussed organisations like La Leche League, Doula UK, Birthrights and others outside the UK. But here, AIMS were pioneers for female-focussed campaigning.
Not any more.
AIMS is aware (surely) our sex unifies us.
Dividing us like this dilutes any struggle against sexism in maternity care, and leads to a confusion of meaning.
Say AIMS: ‘We believe the empowerment of pregnant women can co-exist with supportive care for trans people.’
So, on the one hand we have ’empowerment’ for pregnant women and on the other hand, co-existing alongside, we have ‘supportive care’ for the other lot.
What? No empowerment for them? Just ‘supportive care’? Of course, AIMS’ mask has slipped. The ‘other lot’ are, in fact, hiding there still, in the ‘pregnant women’ category…but that’s not what they say because they’re not in the ‘woman’ category. No. They’re in the second group, known here as ‘men, non-binary, or something else’.
Who benefits?
Who benefits from this confusion and even apparent contradiction? Some trans people might feel gratified to be listed in this way, but not all. In the longer term, and looking at the bigger picture where men can identity as women (and non-binary and not forgetting the ‘something else’, too), this conflation of sexed and gendered language and denial of biological reality works against us.
It’s part of the wider culture where language and purpose has been changed by stealth, including by legislation in some countries, without consultation or consent.
It works against us by being part of an entire ideology that undermines women and privileges men.
It becomes part of the discourse in which sex simply disappears into ‘gender identity’, where women can ‘identify’ out of their sex class. They can’t however leave the material reality of it – not the sexism, the oppression, pay gap and the risks to safety faced by all women in our world, or the socialised stereotypes and expectations that disadvantage us from birth.
It’s a discourse in which women may try to match their gender identity to their body via surgical removal of their breasts (along with any chance of uncomplicated breastfeeding), and a distortion of their biochemistry by testosterone.
Sadly, there’s no body of research showing this relieves unhappiness any better than therapy, though we should accept some individuals may feel life has improved (but those women are still ‘women’ after it, what can I tell ya?).
Language matters
Some organisations, legislators, academics and researchers substitute the word ‘mother’ with ‘gestational parent’. This changes the language without thinking about consequences for comprehension, or the views of women who value this word as part of their own life experience and relationships.
So-called ‘additive language’ (‘mothers and gestational parents’, ‘women and birthing people’ and so on) is no better, as it incorporates the falsehood that ‘gestational parents’ are not mothers. That, to us, creates an inevitable credibility problem.
We resist the idea that a gender identity – any one of the 100s – should ever obscure the reality of sex.
Our concerns about men who have a trans identity (as women, non-binary or indeed, something else) – including that our sex-segregated spaces and rights will be colonised – are of course different.
But our sisters who are trans are still our sisters, even when they deny it, and they’re welcome everywhere women are.
They should have that ‘supportive care’ AIMS campaigns for, individualised according to need.
They should have as much choice, agency and support as anyone else. This includes use of the pronouns they ask for, and a right to respectful acceptance during care.
But that ‘supportive care’ should happen without throwing a blanket of pretence over everything else, reducing the physiological reality of ‘woman’ to yet another ‘gender identity’.
The answer?
AIMS doesn’t need to tell the wider world that some people who are pregnant are no longer women.
Happily, there’s an easy solution.
NICE – the National Institute for Health and Care Excellence – have a new caesarean birth document.
It explains, as a preamble, ‘this guideline uses the terms ‘woman’ and ‘mother’ throughout. These should be taken to include people who do not identity as women but who are pregnant or have given birth.’
The British Pregnancy Advisory Service talks in similar terms. So does the Association for Breastfeeding Medicine’s journal. It’s a simple act of explanation and inclusion, with no denial of reality, biology or logic.
How about it, AIMS?
Heather Welford
October 2021
With Woman 
Yes! SO grateful for the work you are doing. I have stopped telling women about AIMS and Birthrights as a result of their misogynistic stance on this, which is short sighted and offensive to so many. Thank you 🙏
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Has AIMS commented on Heather’s critique?
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Heather has said it all and so cogently. I am beyond furious that all the work that feminists have done over the years is undermined by a minority of misogynists and blinkered women who ought to know better. Only women give birth and only women breast feed.
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