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Green Birth: How Modern Birth is Killing the Planet and Killing Us

By Maddie McMahon, Doula and Doula Trainer

As the state of the planet earth has been discussed again with the celebration of the Earthshot prizes this week, our thoughts are drawn once more to how we should be addressing sustainability and reducing waste in the maternity and health services. In this article doula and doula trainer Maddie McMahon shares her views of the detrimental impact of the current birth practices.



Green Birth: How Modern Birth is Killing the Planet and Killing Us

Nero didn’t actually fiddle while Rome burned, but it’s a useful trope. Our leaders are having parties and averting their gaze from the destruction they are causing.

Greta has not minced her words: our house is on fire. The countdown to global destruction has well and truly started and the human race must act, now, to avert the extinction of our species. We know it’s too late to avoid the crisis: it’s coming, and we will need to learn to live in a new, hotter, more dramatic environment.

To change this trajectory, we will need to look at every single aspect of our lives. From birth to death, every action has a reaction, every part of our modern, capitalist system has an impact on the environment and will need to be stopped, changed, or adapted to be greener and more sustainable.

I think the way most of our babies are being born and raised right now is a great example of our thoughtless attitude towards sustainability, the environment, and our physical and mental health. As my doula friend Siobhan Ridley told me:

Around the world today it is likely that pregnant women and people will be breathing in a whole raft of toxic chemicals, from exhaust fumes to formaldehyde in household paints. We eat meat and fish full of micro-plastics that find their way to the placenta, lodging themselves in the very organ that sustains our growing child.’

And all this is, unsurprisingly, proven to increase the chances of stillbirth. The pollution we swim around in is literally killing our kids.

And if the baby makes it, modern birth practices impact the environment and affect the health and wellbeing of both the mother and child. Modern, industrialised, factory-farming birth is causing us harm. Birth trauma, PTSD, perineal trauma, operative birth, a sub-optimal microbiome, poor breastfeeding rates, depression and suicide are just some of the outcomes of the conveyor belt along which we are forcing parents to travel.

At every birth I see enormous bin bags of waste; single use equipment and packaging, incontinence pads, innumerable plastic gloves, PPE, plastic cups from the drinks machine…the list goes on. Even at a homebirth I witness the midwives making, then carrying away, enormous bags of rubbish. As one midwife I know says:

“I’ve seen a change over the years from reusable to disposable. Even things like speculums and cord scissors which are metal. Even drapes and curtains are disposable these days.Vicki Matthhews

Clinical waste ends up in the incinerator – that tall chimney you can see at your local hospital is pumping all manner of stuff into the air. The rest of the waste ends up in landfill. So, if we are being pressurised to think more carefully about what we throw away, why isn’t the NHS getting on board? As well as becoming more patient-centred, informed-choice focused, evidence-based and compassionate, our healthcare system also needs to work on getting greener.

Apparently, they agree with me. At least they did pre-pandemic. In January 2020 NHS Chief Sir Simon Stevens announced immediate action to work the NHS towards zero net carbon emissions.

“The NHS will be taking immediate action in 2020, with a proposed new NHS Standard Contract calling on hospitals to reduce carbon from buildings and estates, whilst switching to less polluting anaesthetic gases, better asthma inhalers, and encouraging more active travel for staff.“

Then, of course, the Covid-19 pandemic caused a veritable tsunami of single use PPE and the government compounded the issue by buying millions of quid’s worth of unusable stuff. The impact is obvious everywhere I go – there is even a seagull with a paper mask in its nest outside my bathroom window.

The waste at births can be appalling. Birth packs opened but not used. Plastic aprons and gloves ripped off and discarded countless times, plastic-backed inco-pad after inco-pad, after inco-pad used, screwed and binned.

After a birth with a multitude of interventions and consequential waste, the assault on the environment can continue. Putting aside conversations about individual choice and physical ability, the impact of formula feeding is rarely mentioned. An article in the British Medical Journal stated:

The production of unnecessary infant and toddler formulas exacerbates environmental damage and should be a matter of increasing global concern,” argue experts in The BMJ today.

Furthermore, Dr Natalie Shenker, UKRI Future Leaders Fellow at Imperial College London, and colleagues, highlight research showing breastfeeding for six months saves an estimated 95-153 kg CO2 equivalent per baby compared with formula feeding.

For the UK alone, carbon emission savings gained by supporting mothers to breastfeed would equate to taking between 50,000 and 77,500 cars off the road each year, they write.

There is a ton of research to suggest that highly medicated births are more likely to lead to lower breastfeeding rates, and so the landfills are filled ever fuller with the detritus of formula feeding.

Then we have disposable nappies and wipes. Not disposable at all. In fact your average paper nappy, filled with chlorine and super absorbable sodium polyacrylatem, takes around 400 years to biodegrade. If Shakespeare’s baby bum had been clad in these chemical laden monstrosities, his poo would still be mouldering away somewhere, together with the wipes his mother used, contributing to the next enormous fatberg in our sewers.

Hospitals contribute to the almost universal use of disposable nappies and wipes by making it difficult to use washable nappies on the wards and providing such miniscule cotton wool balls to wipe sticky meconium off tender bottoms that parents can’t wait to use something more effective.

During the worst staffing crisis in NHS history, the potential for improvement is looking pretty grim. After all, on an average understaffed, busy shift, who’s got time to ensure that stocks of equipment are used in date order to avoid things going out of date and having to be binned? And when staff are just trying to survive, no one has the time or energy to think about novel ways to save time and money and mitigate environmental impact.

So, what is the NHS doing to ensure their environmental footprint reduces? During the pandemic, highly medicalised birth practices have spiralled out of control. If this is the kind of birth you need, or want, you’ll get no judgement from me. But if you’re planning a natural birth, you can feel proud that your plans not only maximise the chances of a happy and healthy birth experience for you and your baby but have less of an impact on the environment.

What I’d like to see is the multi-national conglomerates having less of a strangle hold on birth and babies. From Big Pharma to Big Formula and Big Food, there are people making enormous profits off parents and pumping out greenhouse gases like there’s no tomorrow.

And there’s the rub. If we want a tomorrow for these babies, maybe we need to start thinking about the environmental impact and calling on government to limit the marketing of environmentally unfriendly, unhealthy, unethical products to the health service and directly to parents. Consumer pressure is powerful; together we can call for more action, demand better from our health service and stop lining the pockets of fat cats by boycotting environmentally unethical, totally unnecessary products.

Because no one seems to be joining the dots here. Our environment, our physical health and our mental health are all connected, in simple and more complex ways. And right now, we’re running around like headless chickens, disagreeing over the problem, its causes and its solutions. I can’t believe some people are still fighting over how we give birth or feed our kids like they have the moral high ground. If we don’t start seeing birth holistically, caring for the whole family’s health and mental wellbeing, whilst also caring for the environment, we are merely fiddling while Rome burns.

December 2022

Maddie McMahon, doula and doula trainer

This week the Midwifery Hour was focussed on Sustainability

Further discussions on Sustainability may be found at:

Last chance saloon or a ray of hope? COP26 climate change and midwifery practice – Maternity & Midwifery Forum % (

Scotland Maternity & Midwifery Festival 2020 – Dr Lorna Davies – Reducing Our Carbon Footprint in Maternity Care on Vimeo (

Dr Jenny Hall – Sustainability and the NMC Education Standards on Vimeo