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At the heart of general practice since 1960

The commercialisation of birth

Instead of trying to encourage pregnant women to buy things they don’t need, why can’t we just give good pregnancy advice? Margaret asks

It's pink, it's glossy, and it's probably somewhere in your practice. It may even be on your shelves, in your cupboards, or – heaven forbid – on your desk. It's Emma's Diary – ‘your week-by-week guide to your pregnancy'.

It is designed for women who attend to tell their doctor that they are newly pregnant. Into this happy scene, ‘presented with the compliments of your GP' and stamped with the logo of the RCGP, Emma's Diary is where the commercialisation of pregnancy and childbirth begins.

You only have to read the cover – free gift packs from Argos and Boots; the leaflets that fall out are for Sanatogen vitamins (and this is not just plain old folic acid, but supplements for the ‘father-to-be' too), complete with a money-off voucher to sweeten the deal.

There are adverts for breast pads, expressing machines, stretch mark cream, special extra-safe-for-baby cars, baby bank accounts, car seats, nappy creams, disposable nappies, ‘the essential baby checklist' (from Argos), stain removers, life insurance, baby swimming classes, organic pureed food, baby monitors and a pram, which is pictured with a roughly size-eight woman beaming while wearing pale clothes and 10cm heels. In what life do we need all this stuff? What right do GPs have to hand women an implied aspirational shopping list? It makes me furious.

Oh yes, there is the science bit. It's at the back, and it's a sliver of the magazine's total content – 25 pages out of 144. This is the RCGP-approved information and in fairness, there are three lines somewhere at the start saying ‘no endorsements of the products, services or websites advertised in Emma's Diary is implied or intended by the RCGP'.

That's three lines, though, in a big book.

The problem for pregnant women in the consulting room is that they are a captive audience. GPs are trusted, and we hand over what is effectively a book of adverts just as the thin blue line of maternity has declared itself. This stuff costs so much money and most of it is unnecessary. I worry that the invitation we give women when we hand over Emma's Diary is that of unattainment. What better way to sow seeds of self-doubt and guilt? 

I am not going to mention the content of the Emma's Diarywebsite – complete with its ‘celebrity pregnancy news' – except to say that it is not the strongest feminist statement you will read this year. Why are we involved in this?

Even some maternity hospitals – rather than protecting women from unneeded interruptions and allowing them time to recover from labour and birth – have large sample packs from commercial companies, made up like a ‘gift', delivered to new mothers at the bedside.

The current leadership in the RCGP makes me proud to be a GP. Emma's Diary makes me cringe. We should ditch the adverts and give good information via an evidence-based app or a website, and we could work with not-for-profit agencies to achieve it.

We could support women and their families by being clear that, for example, ‘during pregnancy, all kinds of organisations will want to sell you things. The good news is that you or your baby don't need most of them'. Wouldn't that be better for all of us?

Dr Margaret McCartney is a GP in Glasgow

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