This Is Going to Hurt – and it certainly does

by | 13 Feb, 2022 | Blog | 5 comments

Photograph: Anika Molnar/BBC/Sister/AMC

Guest Post by Paula Cleary

Adam Kay is honest about hurting women – but has he caused harm in ways even he had not imagined?

I decided to watch ‘This is Going to Hurt’ on BBC iPlayer to try and see if there was anything I could find sympathetic about the protagonist. Unless you’ve witnessed birth from various angles you might be forgiven for thinking “This is going to hurt” is an accurate representation of normality. And that’s because it IS. One kind of reality, anyway.

When you’ve seen another way of doing things, the reality depicted by Adam Kay can be viewed with a different lens: the normalisation of casual violence against women that only looks like violence when you’ve seen the alternative. The story we see on the screen is one told from the perspective of a busy registrar, permanently fighting exhaustion, like a heroic firefighter going from one blaze to another, seemingly trying to put out the never ending fires. The women in his world range from women he doesn’t seem to believe because they look too young to be as clever as him, to women who may as well just be cadavers for all the respect and gentleness and sensitivity he shows them.

I get it. He’s pushed for time. He is exhausted and suffering from PTSD. Poor Adam. This isn’t how it should be.

But while we are all very busy feeling for the poor protagonist who has a messed up social and love life because of his heroic dedication to his work…. what we are not seeing is any humanity whatsoever in telling the stories of women he is serving. Their human story seems extremely two-dimensional. Irrelevant almost. Or laughable.

The reason for the department to even exist at all, the women themselves, are mere bit parts in the obviously much bigger story of how poor young Adam’s life and career progress is going. Inconveniently labouring at silly places like carparks and stairwells that he needs to rescue them from by shoving them around like inanimate puppets on the end of his heroic hands. Laughing at them for eating what they thought was a bit of their placenta. The dialogue in these instances is utterly dehumanized and patronizing, and he is so wrapped up in his own hero identity he forgets that the women going through labour are the real heroes of their own story. The pain and suffering he is in takes centre stage in a story about women at the most painful and vulnerable moments of their lives.

Was Adam unaware of the numbers of women who have suffered from sexual abuse in their lifetime before setting foot into his do-whatever-you-need-to-do-and-eyeroll-at-anyone-who-thinks-otherwise workplace? Did he consider some may be rape victims? The statistics might make him rethink his cavalier attitude to breaking and entering women at will, without much pause for such things as consent?

There will no doubt be many viewers who watch Adam Kay’s This is Going to Hurt and find comfort in it’s “honesty” and “brats and twats” humour. In the dystopian and dark corridors of modern NHS hospitals which function in a dysfunctional and permanently understaffed and underfunded way that is reminiscent of a war zone, and where PTSD is the norm, I guess you get your laughs where you can.

Oh stop being so snowflakey and over sensitive, you may say. It’s reality. Get over it.

I invite you to step into a world where a different reality IS possible. Where women are not simply glove puppets for men with a hero complex. If you look around enough there are hundreds and thousands of women giving birth around the world every day being cared for by sensitive midwives. Sensitive obstetricians. Emotionally intelligent, woman-centred practitioners. Do those women have any fewer obstetric emergencies? Perhaps not. But they are not treated like someone on a butcher’s block. They are spoken to as if their feelings and thoughts and input matter. They overcome traumas more easily because they were respected.

Their PTSD matters. Their stories matter. Their heroism matters.

Renowned former obstetrician and WHO director of Women’s services Marsden Wagner spoke of the embedded misogyny and casual traumas inflicted by his profession using the expression “Fish don’t see water”. Decades later, it seems the tank is still dirty – no one seems to be able to see clearly at all.

But then again…. if you’ve never seen the clean sparkling waters of an unpolluted waterfall, river or ocean, I guess a dirty fish tank looks completely normal – reality at its worst.

Paula Cleary

Paula Cleary

Paula Cleary is an experienced birth activist and the founder of Birthplace Matters. She lives in Cambridgeshire with her husband and five children and works as a doula and antenatal teacher. She was recently involved in the March with Midwives movement and is passionate about woman-centred compassionate care.


  1. Carolyn Ruth Hastie

    Brilliantly said Paula.

    “I invite you to step into a world where a different reality IS possible. Where women are not simply glove puppets for men with a hero complex.”

  2. Lucinda Phillps

    Absolutely brilliantly written and sums up my feelings perfectly. Thank you Paula ?

  3. Lyn Stark

    This is the holistic, woman centered response required. Thank you Paula.

  4. A

    I left Obs as a female doctor because of the PTSD. Because no matter how woman-centered and empathic I was it was never enough.

    When my husband told me that I was talking about my patients as if I no longer understood how they felt, as if I’d lost my empathy – I left the profession.

    Rather than blaming the clinicians – both midwife and medical – who are trying their best yet losing their humanity through receiving no support, perhaps you should be working to improve the situation rather than lambasting someone so obviously damaged by this inherently misogynistic speciality.

    I lost babies. I lost Mums. I gave everything I had and it wasn’t enough. It would never have been enough. I have and will never get over that. I didn’t get time to debrief. The midwives did. I didn’t get sent home after a poor outcome. The midwives did.

    Look after your medics and maybe they will be able to look after your women.

  5. Jilly

    A, Thank you for sharing your memories of that harsh reality. We can all look after each other better. All of the team. Women – all staff. This is happening in units where Professional Midwifery Advocates are supported to take that whole team view (that support is rare but happening in pockets)


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