This week there has some been some very random, and very mysterious news headlines in the media. Without warning, the media began reporting that the Royal College of Midwives was no longer going to be promoting ‘normal birth’. None of the offending journalists seemed bothered by the fact that this ‘news’ was;
A. Old News (The Normal Birth Campaign, which sought to support midwives to minimise unnecessary, dangerous over-intervention, changed its name to the Better Births campaign way back in 2014),
B. Fake News (Midwives are committed, by their code of conduct, to following women’s wishes, facilitating informed decisions about mode and manner of birth and educating themselves to become and remain, the experts in birth the way humans evolved to do it. When pregnancy or birth veers away from this default physiology, their duty is to involve doctors in a woman’s care.)
So where did this ‘news’ come from? I’m not sure, but I wonder what my poor, late father would be thinking. He was a journalist and he always taught me that any journo should pride themselves on verifying their sources and checking their facts. It appears modern journalism isn’t so rigorous or quality controlled.
Neither, it seems are modern politicians holding themselves to the highest levels of behaviour. In response to the articles in the press, our Secretary of State for Health, Jeremy Hunt, tweeted this:
@MidwivesRCM ending campaign for ‘normal’ births will help govt plan to halve neonatal deaths & injuries
Now I don’t know about you, but his tweet seems to suggest that the Royal College of Midwives and the thousands of committed, hard working, compassionate midwives working their arses off every day are somehow solely responsible for all the damage to babies that happens during birth. It sounds like he thinks midwives need to shut up so the Government can sort it all out. It sounds like he can’t be bothered to listen to the people who matter most in all this heated debate: the people pushing babies out of their bodies and the staff who catch them.
How about we address the enormous amount of pressure the service is under; the understaffing, the cuts, the lack of bursary making it impossible for many people to train as midwives, the avalanche of midwives leaving in despair and the whole generation of experienced midwives reaching retirement, with no one to replace them? What are we going to do to address the harm, to both midwives and mothers by the toxic working environment described recently, by a midwife on this very blog?
How about we pay some attention to the iotrogenic harm and the enormous financial and emotional cost of too much unnecessary intervention? What about the work we need to do to ensure families have access to their birthrights and are not coerced into decisions or manipulated into following ‘guidelines’ rather than being put firmly at the centre of their care? How about we work out how to share best practice and reward evidence based care? Oh, I know…how about we actually implement the Better Births Maternity Review that this very government requested and which Baroness Julia Cumberlege spent months compiling after travelling around the country talking to staff and parents?
I know this word ‘normal’ causes consternation. I can understand why. After all, in our polarised world that so often lacks subtlety, if someone doesn’t fit the definition of normal, it is assumed they are therefore abnormal and abnormal is something no one wants to be. From abnormal it is only a short mental hop to ‘failure’ and from failure to grief, anger and defensiveness. But birth isn’t about normal or abnormal. And it certainly isn’t about failure.
As the great Mary Cronk says: sometimes, some mothers and babies just need some help. There is no shame in that.
Look, birth is complicated. It’s one of those things that humans think they know about because they did it once, or they know someone who did it. But birth is very, very far away from being knowable. One person’s perception of what maternity services may, or may not, need to do to improve is a value judgement only, not necessarily a truth.
Whether you call it normal, or natural, physiological or purple with pink spots, birth without unnecessary intervention, with a calm, competent, kind, compassionate midwife in the corner, is an experience that millions of women yearn for. I know, because I talk to them every damn day. Nothing you think or say will change that, Jeremy Hunt. You might not understand why they might want to do that. You might think they are mad, or the midwives who support them are mad. You might not believe that birth can be BOTH safe and satisfying, you may even subscribe to the daft notion that some woman hold the experience of birth above the outcome. But blaming midwives and heralding the end of the word normal as the beginning of a new era of increased safety is, quite frankly sickening when YOUR cuts and lack of investment make birth more dangerous every day.
There is more than a hint of sexism in all this: midwives should stop trying to protect normal birth and step aside. Women should stop thinking they have choice in childbirth and just do as we are told, taking our medicine like good little girls.
I’ve met a few midwives that I think would be happier in a different job. But MOSTLY I meet midwives who lie somewhere on the sliding scale of awesome – every shift skidding between ‘doing pretty bloody well given the utterly ridiculous under-staffing, pressure on the service and lack of resources’ to ‘heroic, sensitive, wise facilitation of a woman’s deepest desires against all the odds’.
There is a reason midwives have been burned at the stake, literally and metaphorically, since the dawn of time: They can perform magic.
If you’re coming for them Jeremy Hunt, you’ll have to get through me first.
Great blog but skirts around the issue of ‘motive’ for the fake news and fails to mention the main character in Mr Hunt’s tweet. I understand why you would do so as, like many others, I have seen what happens when anyone goes up against James Titcombe and is subject to abuse/intimidation from his followers. Questions do need to be asked however as we cannot allow policies to be dictated and midwifes wrongly vilified simply because we are too scared to challenge the bereaved. So in that vein….
1) Why would Jeremy Hunt place any success on the possible number of deaths declining onto a man who has no clinical qualifications rather than the ‘Each Baby Counts’ campaign, consisting of some of the UK’s most qualified professionals in maternity, obstetrics and gynaecology, whose remit is to reduce loss of life by 50% over the next 3 years?
2) Why take an old story regarding dropping the work ‘normal’ and apply it to neonatal deaths when there is no evidence that the two are linked?
3) Why is Mr Titcombe so determined to campaign on the subject of ‘normal’ birth when it has no relevance to his son’s case?
4) Why did Mr Titcombe go to great lengths to respond only to those people who left comments in his article “Its too late for my son, but the end of the campaign for normal birth is welcome”, who asked the question “what is this really all about”? once they recognised that there was no link to his son’s tragic death and ‘normal’ birth. The material Mr Titcombe offered these commentators was ambiguous and still showed no connection between the two.
5) Is it just a coincidence that Mr Titcombe has just announced he is to set up a new organisation called “patient safety learning’, supported by the commercial software company he works for?
It will be interesting to see who will be in this new organisation and how it will be funded.
“Hunting for the truth” – it will all come out in the wash – eventually
Hi – thanks for your comment. Yes, I openly admit to choosing not to mention that aspect of the story, for all the reasons you allude to! I am not courageous enough to become a target but I agree that there is more to this than meets the eye. I am sure the media was seeded with a ‘story’ and was used to further a particular agenda. I think many of us are wearing our tin foil hats at the moment!
My main beef is with Mr Hunt, who should know better than to have his views impacted by one person, particularly, as you say, by a person who has no wide experience of birth or training in the maternity arena. User views are crucial, of course, and Mr Titcombe’s views are valid as part of a wide consultation of user views. But allowing one person to dictate policy is shortsighted, unethical and ultimately dangerous.
Thanks for the reply, unfortunately these matters go unchallenged because people are scared of the backlash. Although I have suggested a motive I have to agree that now is the time to get those hats as Mr Hunt is no fool and feel there is more to this that just helping out a mate. Or perhaps I give him too much credit!
I’m inclined to agree with you. I am just a humble doula and I will do my best to stand strong for midwives.
It certainly looks like Mr Hunt is determined to dismantle the NHS!