Donna Ockenden 

 Donna has just finished her damning report from Telford and Shrewsbury and is now starting on Nottinghamshire. I wrote her the following email - she didn't respond and I have emailed her before when she has answered so I presume she just wasn't impressed.

Dear Donna

What a magnificent job you have done. Because of your warmth and empathy people feel healed from terrible trauma. Your kindness and sympathy and good listening skills have helped so many people and will help so many people in Nottinghamshire too, so well done and thank you.

You should be proud of your Report but I’m sorry to say. I think your recommendations have taken the profession back about 30 years. You seem to think that all births take place in high tech industrialised Obstetric Units, you don’t question that. Have you read the research into Place of Birth?      https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30063-8/fulltext

Surely there is a place for women to be guided towards choosing a home birth? We have known for about 10 years that if women book for a home birth they are safer irrelevant of actual place of birth.

Your misguided faith in CTGs is sad – there has been more research into Continuous Foetal Heart Monitoring than into almost any other area of childbirth and it does not work, however hard we try and justify its use. However hard we bash it and try and get a different result. Every research report shows that it increases intervention without improving mortality and morbidity. However well we learn to “interpret” its message, it doesn’t have a message, it is the Emperor’s New Clothes. I know millions have been invested in it, that it gives employment to thousands but IT DOESN’T WORK. Repeat,  It Doesn’t Work. It is time to read the research and find out what improves mortality and morbidity. It is a relationship with the Care Giver that improves mortality and morbidity.

The Emperor’s New Clothes again is Ultrasound scanning. Again where is the evidence to show its clinical validity? I know we love scanning, I know that a whole industry has been built around it, I know that fortunes have and are being made around it. I know that people’s jobs – lots and lots of people’s jobs, depend upon it, but where is the evidence to suggest that we should be using it in such a cavalier way?

Using it to pretend that we can assess the weight or size of a baby in late pregnancy – this has been shown to be patent nonsense.

At the moment our Maternity System is shored up on ignoring research and vested interests being put before the wishes of women. Women not being told the truth and being coerced into doing things that they don’t want to do, and we wonder why midwives are leaving! They came into the profession because they wanted to be autonomous midwives, but todays midwives are being forced into being Obstetric Technicians and handmaids to their Obstetric Colleagues and they can’t bear being part of the coercion of women and the bullying culture this spawns.

All over the country midwives have been working really hard to improve the service – setting up what we know gives women great satisfaction and much safer outcomes  – continuity of midwifery carer. Very hard trying to change a whole culture and what have you suggested? That all attempts to improve the maternity services should be put on hold until we have enough staff to implement it !! What planet is this coming from? We are haemorrhaging midwives. As a nation we have more qualified midwives per head of population than any other European country but they are not practising as midwives – in fact out of every cohort of newly qualified midwives 95% leave in the first year after qualifying . We cannot continue with such waste and the distress that it represents.

Women should be told the truth, midwives should be enabled to care for small groups of women that they are able to form a relationship with. Instead of concentrating all resources on the insatiable high tech Obstetric Unit women should be encouraged to think about a home birth on the understanding that the birth may take place at home or in the hospital, depending on what transpires. The decision on where to give birth should only take place once the woman knows what this labour is like and being assessed at home by a midwife she knows and trusts will help the labour to progress smoothly and the right decisions to be made.

I have written to you because I can see how much you care about what happens to women

I hope you will listen

Caroline Flint RN RM ADM