Bread for all and Roses too
American suffragist Helen Todd addressed a group of working women in the United States in 1910, arguing that voting rights would provide a way to improve women’s working conditions and wages, saying:
Not at once; but woman is the mothering element in the world and her vote will go toward helping forward the time when life’s Bread, which is home, shelter and security, and the Roses of life, music, education, nature and books, shall be the heritage of every child born in the country, in the government of which she has a voice.
The phrase “Bread for all, and Roses too” became an important slogan for the woman’s suffrage movement in the US. The phrase captures the sense that it is not enough to have only the basic physical needs of life – food and water, shelter, clothing. A life of purpose, dignity, and meaning also needs beauty, comfort, and joy. Feminist efforts since the early 20th century have seen significant gains for women and girls, so that both the Bread and the Roses of life are more attainable for most women (while acknowledging that social privileges still make this more accessible for some than others).
Why maternity systems need a Bread and Roses movement
Maternity services around the world have primarily focussed on meeting basic physical health needs. Avoiding death and injury. Governments and large health organisations count mortality and morbidity rates and rates of interventions – so a lot is known about the physical outcomes of pregnancy and birth. This is the Bread.
Maternity systems (particularly in high-income countries) have been pretty good at providing Bread. Maternal morbidity and mortality rates have fallen over the past 100 years, as have the rates of poor outcomes for the fetus / baby. The fall was biggest prior to the 1950s with the pace of change slowing over the past few decades. (Though in some places it looks like the rate of maternal poor health might now be going backwards.)
What maternity systems have not been good at, and in many cases have actively resisted, is providing Roses. The idea that women should be profoundly grateful if they and their baby survive birth alive and with only minor physical consequences is common. It is only in recent years that researchers have begun systematically collecting data about women’s experiences of birth. The focus to date has been on women’s experiences of birth as psychologically traumatic. The rate is high – and it is difficult to know whether it had increased or remained stable over time in the absence of historical interest in the phenomenon.
Asking to avoid psychological trauma is barely close to asking for a full rose – a mere petal. What about births that are full of joy, beauty, connection, and meaning? It is possible to experience birth this way and it doesn’t happen by accident.
Asking for more is seen as too much. Through my professional life time I have seen women belittled for asking for things like access to midwifery care, continuity of carer, home-like surroundings to give birth in, access to showers and baths during labour, and pleasant surroundings with privacy and some control over things like lighting, sound levels, and temperature. The common retort, particularly from obstetric circles, is that women should not focus on the experience of birth because physical safety is jeopardised by trying to achieve this. This is, of course, complete nonsense.
Asking for Roses doesn’t imply or require the refusal of Bread. Receiving Roses is only possible when Bread is consistently available. Roses don’t grow by accident. Like wheat for bread, Roses must be planned for, cultivated, and harvested. I am ready for a new era in maternity care where women’s birth experiences matter, and matter deeply to all maternity professionals.
Bread for all. And Roses too.
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Categories: Feminism, History, Philosophy, Reflections
Tags: Bread and roses, Helen Todd, Suffrage
Birth Small Talk 
If you don’t get thousands of responses saying that you’ve left the reader in floods this morning, the world is broken.
This is utterly, utterly beautiful and the perfect explanation.
Sadly of course, many maternity services aren’t even providing the bread right now.
Huge love and thanks, Emma Ashworth
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That’s beautiful Emma. Thanks for taking the time to comment.
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I literally could not love this post and your ongoing contribution to Maternity education any more….
Thank God for you Dr Small.
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Thanks Jade – your comment fills my cup xxx
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I think that for their bodies to work as nature intended, women need the roses. All they get are crumbs of midwife time, and the bitter pill, tethered to beds with no control over theri movement. In my own study of 63 wmen interviewed perception of control correlated in the p< 0.001s with absolutely all clinical variables, length of labour, pain relief given, Apgar score, time taken for involution, and psychological ones, time taken to establish a routine, enjoyabiity, feeling of stress. etc etc etc
Thank you Kirsten
xxx
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Yes – the two are more linked than people realise. The point remains however that women should get nice things because they want nice things – not simply because it makes the sorts of outcomes healthcare systems care about better.
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Wonderful description, Kirsten. Two things come to mind:
As you rightly state, the ‘nice things’ shouldn’t be predicated on healthcare measurables. Isn’t it ironic that ‘self-care’ is so in vogue, but wonderful birth experiences are not.
Going back to my analogy, we don’t want starvation rations, we want decent food, to suit everyone’s needs, and accessible by everyone. If women are full members of society, that shouldn’t be too much to ask.
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It shouldn’t be too much to ask for – but there’s very little investment in (metaphorical) rose gardens in maternity care at present.
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