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Posts Tagged ‘maternity’

Back in 2007, the Department of Health published a report entitled “Maternity Matters”. This document included the explicit guarantee that by the end of 2009, all pregnant women (medical needs permitting) would be able choose whether to give birth in either a consultant-led unit, a midwife-led unit or at home. This was welcomed enthusiastically by midwifery and childbirth organisations, but was it realistic or just pie-in-the -sky? Health Secretary Alan Johnson pledged an extra £330 million of funding to achieve the goal, but within a few months maternity units started to complain that the Primary Care Trusts were not passing on the cash. The Royal College of Midwifes (RCM) claimed that units were dangerously short-staffed already, unable to afford to hire the 5000 more midwives needed to even come close to implementing Maternity Matters. They estimated that at least 2 more years would be needed. The National Childbirth Trust (NCT) agreed, stating that “They will struggle enormously to fulfil these pledges.” So, now we’re into 2010. The deadline has passed. Amazingly, the Government is insisting that 95-99% of Primary Care Trusts have achieved their goals, so we must be living in a golden age of maternal choice. How can this be? According to the NCT, only 60% of women actually live near enough to a midwife-led birth centre for it to be a realistic option. And the ongoing massive staff shortages mean that such centres are often closed on a short-term or even a long-term basis. As for home births, well… The overall rate for England is less than 3%. The NCT believes that it would be over 5% if women genuinely could choose. I hear, over and over, stories from women who desperately want a home birth but are denied it, for spurious “medical” reasons, because midwives are not properly trained and therefore not confident, or again, simply not enough staff to go round. Until this Government or the next one puts a substantial amount of money into meeting these wonderful-sounding promises, many many women are going to end up in consultant-led units, when they would have preferred otherwise. Will this be a good experience for them? Will they get the births they hoped for? Watch the new fly-on-the -wall documentary “One Born Every Minute” (Channel 4) and see what you think.

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I felt sickened when I heard about the ordeal experienced by Victoria Anderson at the hands of Susan Rose, an Independent Midwife who cared for her during her pregnancy and home birth. A mismanaged pregnancy and birth led to not only health problems for the mother but a life long physical disability for her child.

Sadly the media and commentators have used this case to vilify the practice of homebirth with glib declarations that homebirth is unsafe. Jeremy Vine on his radio show posed the question whether homebirths should be banned and concluded that they were indeed unsafe. That it was the individual midwife who was dangerous, not the practice of homebirth itself, seems to be a concept too tricky to understand. An anecdote has led to sweeping generalisations. The fact is that studies have shown that homebirth is as safe, or safer than hospital birth for low risk women. When a hospital delivery goes wrong due to negligence, incompetence or staff shortages, no-one decrees hospitals to be an unsafe place to birth a child. Yet when a home birth goes wrong there is much wringing of hands and mutterings that a home is not a suitable place for a child to be born. If a hospital birth goes wrong there is sympathy for the mother, if the same happens at home she is often blamed for being selfish or misguided.

I write this not as an ardent pro-homebirther. In fact my children were all born in hospital, in a variety of modes. I have welcomed the numbing bliss of the epidural in equal measure to the euphoria of a drug free birth. Whilst I know homebirth is safe it just wasn’t a personal option for me. I write this weary of the incorrect, alarmist tone the media seems to take today whether it be because they are too lazy to research an informed opinions or in their strive for sensationalist headlines and snappy soundbites. Contrary to what the media would have you believe, this story isn’t about the unsafe practice of homebirth but the unsafe practises of this particular midwife. In fact if you read the story carefully the error was in her antenatal care where gestational diabetes was undetected and this triggered the cascade of events leading to this tragedy.

For many women homebirth is a reasonable option; scaremongering and incorrect reporting and distorted emphasis should not set the tone. If I was a mother trying to decide where to give birth to my child reading some of the commentary of this case would scare me witless. The tragedy of this case is not just the physical and emotional damage inflicted upon this mother and her baby but that scaremongering and sloppy journalism may also damage the concept of homebirth per se, a choice which for the majority of women is a safe and valid option.

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