Newsletter number 18
September/October 2024
Last week the Care Quality Commission published a report into UK Maternity Care in 2023 and 2024.
131 maternity services were examined and only 4% were deemed “outstanding” with pockets of excellent practice. 65% were rated “inadequate” or “requiring improvement”. The Authors of the Report were concerned that Midwives and indeed student midwives were learning to accept sub standard care as normal because they never see anything else.
The thing I find frustrating about such reports (and haven’t we had so many just recently?) is that they blether on about “safety” whilst not having a clue about what makes women safer.
Safety does not depend on yet more machines that go ‘ping’ as has been shown in the copious research which has been done into midwifery and childbirth, the fundamental safety factor is the relationship between the mother and the midwife. When a woman has her own midwife that she has been able to get to know, when she has a midwife at her back who she has formed a relationship with the woman and her baby are safe, when she is just a cog on a conveyor belt with no specific person taking responsibility for her, she is not safe.
This news is not earth shattering – it has been shown that the same happens with your relationship with your GP, or dentist, or hairdresser – human beings need relationships with the people who care for them and the people who care for them need relationships with the people they are caring for. These relationships bring joy and interest into our lives but trying to set up these schemes in maternity care has brought robust sabotage and opposition – the whole profession was busy trying to bring in such schemes until Donna Ockenden sadly put a stop to them by saying that they should all be stopped until we had enough staff. Dream on is my response!
Donna has brought great comfort to many parents traumatised and bereaved by the system, she is a brilliant listener and exhibits great empathy but sadly she is no visionary and just suggests more of the same (which has already got us into this mess) – more monitoring, more checks, more interrupting of labour, more controlling of labour, more doctors, more alienation etc etc.
Childbirth is a time of health – it is not an illness. Don’t be deflected by the siren call of “more complex” pregnancies. You may look after a woman who has had a heart transplant once in your career, but it is unlikely that you will look after two. Women in 2024/2025/2026 are healthier than they have ever been. Just look at them.
Open your eyes.
Women shine with health – polio is almost non-existent, tuberculosis unheard of, rickets unknown. Infections are dealt with in minutes with antibiotics. Labours are more complex because they have been interfered with by doctors who by starting them off too early, then have made them more painful, longer and more hazardous for both mother and baby. The same with acceleration of labour – more painful, longer and more hazardous. A nearly 50% caesarean section rate has to be a nonsense – if it was really necessary the human race would have died out by now. And what’s this with all this bleeding? Women lose so much blood at the moment that it leaves them exsanguinated for weeks, having difficulties producing enough milk for their babies and taking forever to get into the role of mothering.
Yes, some women are fat but Sara Wickham has shown in her excellent books and newsletters that this is no handicap, especially if you get her into a deep pool of water. Much safer for a baby to have an obese mother than an anorexic mother.
Childbirth and pregnancy should be taken out of the hospital – a wholly inappropriate place for such an intimate process. The venue also affects the behaviour of the professionals, they become less bossy and overbearing in someone’s home, here the mother is in charge – as she should be. The power dynamics change in women’s homes, the woman who is becoming a mother - the most important job in the world is in charge, so much better than the professionals being in charge, what preparation for responsibility is it to make a woman feel powerless? Ridiculous.
Having taken maternity care out of hospital midwives should be forming themselves into small Albany type groups. 4, 5 or 6 midwives working together. No off-duty rota, just a holiday plan and each midwife taking on about 27 women a year. Honing down the vast factory like atmosphere into manageable small units where people can thrive, work professionally and enjoy their lives.
Am I just shouting into the ether? Cannot someone else see what has happened to birth?
If the CQC Report is affecting your pregnancy I have some suggestions for you on my TikTok feed.
Did you love “Sensitive Midwifery” written in 1986?
Well, it has had a complete makeover, chunks removed, different references, several additions addressing the problems of today, more pictures and hopefully – big solutions!!
Kindle edition is £6.50
Paperback is £15.
