Is there a relationship between birth practice and politics?
We believe that there are some very serious problems facing maternity care. Based on sub-optimal mortality and morbidity statistics and the unhappy experiences of women, families and midwives, it is clear to us that maternity care in the UK and Ireland is in crisis.
Women are not being nurtured and cared for during pregnancy and birth in a way that supports and enhances their well-being or confidence in their abilities to give birth and become competent confident mothers. There is an on-going undermining of women’s rights and agency, and of the understanding that most women can give birth physiologically and without interference.
Midwives and their support for normal birth are being unfairly attacked, if not demonised. This is preventing them from using their midwifery knowledge and skills to give women and families the kind of care they know is best and that has been repeatedly shown to provide excellent physical, emotional and psychological outcomes for mothers and babies.
The concept of risk is wheeled out at every turn. Risk and its avoidance have become so embedded in maternity care that decision-making has been all but removed from the mother and her midwife. Health practitioners' fears of reprisal and fears of the birth process itself can and do lead to women being threatened either that their baby will die or be damaged, or with referral to social services if they do not follow medical advice.
Although the rhetoric in maternity care focuses on safety and safe care, this is still largely restricted to short-term outcomes, often measuring only or mainly the survival of mother and baby. When research examines different models and approaches to maternity and midwifery care, crucial long-term health and well-being of mothers and babies is usually not considered.
Maternity care is increasingly influenced by current ideological and financial considerations rather than rooted in what is best for women, babies and families. UK government reports over the last several decades have provided excellent policies and recommendations for maternity services. These policies have consistently emphasised women’s agency; woman-centred care; continuity of midwifery carer; the benefit to increasing normal birth and decreasing intervention rates but the cultural shifts in maternity ideology and the necessary funding have not happened to ensure their implementation and on-going sustainability.
Policies on the structure of the NHS have changed. The concepts of a unitary NHS, with its central commitment to accessible health care free at the point of need and of health care as a common good for all are being steadily undermined, paving the way for private health care provision. Simultaneously, deliberate and chronic underfunding of the NHS has led to shortages of staff creating damaging stresses on maternity care workers and weakening publicly provided health services.
We are a group of passionate and concerned birth activists who want to use our knowledge and experience to help bring about change. We are concerned about a range of different but related influences on health care that are worsening maternity services for women, babies and families, for midwives and for other birth workers. We will be posting regular blogs pieces on birth, midwifery and maternity services that address some of these issues and support good midwifery and models of maternity care. If you share our concerns, and you think there is a relationship between birth practice and politics please visit our website to see who we are and find out more about our views and aims. While you’re there, we invite you to put your email address into the subscribe bar at the bottom of the page so that we can email you each of our blog posts as they are published.