Is the NHS's obsession with doctor-free births putting babies at risk
08:55 GMT, 22 November 2012
Can there really be greater grief, for any mother, than the death of her child If there can, it’s probably that of Rhiannon Davies, condemned to live for ever knowing that her baby’s death was entirely preventable — if only she had done things differently.
Rhiannon gave birth to her daughter, Kate, at one of those achingly trendy ‘birth centres’, staffed by midwives alone and unsullied by a whiff of an obstetrician.
So when complications set in, and
suddenly the presence of a doctor didn’t seem like such a bad idea,
there were 40 miles between Kate and the help she needed.
Birthing centres: More and more women are opting to give birth in centres staffed by midwives
An air ambulance was eventually called, but way too late. Even then, there was only room for the baby.
That was the last Rhiannon saw of her. /11/21/article-0-1617EBD4000005DC-507_634x975.jpg” width=”634″ height=”975″ alt=”Bereaved: Rhiannon Davies and her husband Richard Stanton who lost their daughter Kate” class=”blkBorder” />
Bereaved: Rhiannon Davies and her husband Richard Stanton who lost their daughter Kate
But you know the really scary thing I doubt that Kate’s story — just one among altogether too many — will change anything at all.
There is a virulent, creeping orthodoxy, backed by powerful and media-savvy voices, which is drowning out common sense in favour of dragging pregnant women back to the Dark Ages.
This orthodoxy embraces a single, pernicious belief: that modern obstetric practice amounts to no more than unwanted, male-dominated intrusion; it is to be avoided at all costs and women who seek any part of it are ‘giving in’.
And so home birth with a midwife is — according to this belief — gold standard; midwife-led units (MLUs) come a close second and a hospital obstetric unit is bottom of the list.
Successive governments have offered vote-winning pledges to the endless calls for ‘more midwives!’ This government was petitioned for 5,000 more of them as recently as August.
A third of all pregnant women never see the same midwife twice
But when have you ever heard a call for ‘more super-qualified obstetricians’ No, nor me. Yet in spite of the fact that obstetricians know everything that midwives know — plus the extra that often means the difference between life and death — the Royal College of Midwives and the NHS back midwife-led units.
It’s hardly surprising. For the RCM, it ups their status and pay claims if they are the ones in charge; for the NHS, it’s cheaper, on its current costings: a home birth averages 1,066, an midwife-led unit birth 1,450 and a hospital birth 1,631. So, seemingly for the sake of a measly few hundred quid, misinformation is routinely delivered and anti-obstetric philosophy deliberately spread.
The Childbirth Trust urges mothers to use midwife-led-units (file photo)
Leading the pack is the National Childbirth Trust, which just loves midwifery over medicine. Urging mothers to use midwife-led-units, it states in its policy documents on midwife-led births: ‘There is a focus on keeping birth normal and using encouragement with non-pharmalogical [sic] approaches for soothing pain,’ they say.
And: ‘Clinical equipment is kept to a minimum’. And: ‘Women are less likely to have epidural anaesthesia, episiotomy (an incision made in deliveries) and Caesareans.’
Note how the avoidance of these things is presumed to be ‘good’ — the corollary of which, obviously, is that their use is ‘bad’. Yah-boo, then, to the dedicated researchers whose discoveries have saved pain and lives; hurrah for the primitive view that Nature knows best.
And let’s just forget that, back in those revered Dark Ages, women and babies, in their droves, died torturous deaths in childbirth.
'Only in small print do you find this: a full 40 per cent of them (midwife births), if they are first births, end up being transferred to a hospital midway through labour'
I’ll say this for these evangelical anti-obstetric lobbyists: their use of figures is cunningly clever. They will point, for example, to the ‘success rate’ of midwife births, at home or in an midwife-led unit.
Only in small print do you find this: a full 40 per cent of them, if they are first births, end up being transferred to a hospital midway through labour — half as emergencies, half because the women are scared, in agony and deciding a natural birth doesn’t feel as appealing as it did.
It would be a heck of a way to enjoy a contraction, I’d have thought: terrified, stuck in a traffic jam, blue light flashing and a whoo-whoo screaming from a siren over your head.
Which leads to another devilish statistic: if, once you get to the hospital, your poor baby should die, that then counts as a hospital death, not a midwife death.
This is why the safety of home births is overplayed; research shows that although women do recover more quickly from home births than hospital births, their babies are twice as likely to die.
And one more blatant misrepresentation: should you dare ask for the full obstetric works, aka a carefully planned Caesarean, you’ll be furiously quoted the World Health Organisation’s opinion that Caesareans are far more dangerous for the child.
More and more women are opting for 'trendy' birthing centres
Again, not true: the clue is in the word ‘world’, which includes mud huts and unsterilised knives. In Britain, in 2012, a Caesarean birth is now as safe as any other.
The big question, therefore, must be: why are women falling for it
Why are grown-up, educated, intelligent, able women — who grasp the finest technological advances of our times — buying into unenlightened nonsense when it comes to the most important thing they will ever do as a woman
In short, why do more than 30,000 British women every year actively plan a birth without an obstetrician on hand should things go wrong
To be fair, the propaganda is relentless: words like freedom, autonomy, powerful, fulfilling — and even, believe it if you will, ‘orgasmic birth’ — clutter the literature foisted upon a newly-pregnant woman.
But the one word that is most used, and scandalously abused, is ‘choice’. Advocates of midwifery over obstetrics use ‘choice’ as the most persuasive tool in their box.
The wickedness of this is that what they are dressing up as choice is the very opposite. The moment you sign up for a midwife-led birth, at home or in a unit, you have effectively removed all the choices that would have remained yours had you simply found the best hospital around and hopped on its list.
More than 30,000 British women every year plan a birth without an obstetriician
Long before you know how difficult your labour will be, you will have signed away most forms of pain relief and any chance of a Caesarean; a back-rub and a pep talk might not be quite what you need at that point.
Change your mind half way through — or have it changed by unpredictable crisis — and it’s back to the flashing blue light and the whoo-whoo.
In a good hospital, by contrast, you unpack your choices with your nightgown. Need more pain relief Ask for it. You find, perhaps to your own surprise, that you’re coping Tell them thanks, but you won’t have the epidural after all.
You feel something is wrong Demand to see a doctor, NOW! Or you feel your midwife is providing all you need Wave the doctor bye-bye.
It is those options that give women the power and control we fought for so long to get; to have signed them away, months earlier, is to leave yourself without the care that could have saved Rhiannon Davies’s baby Kate.
Rhiannon, poor woman, meant only the best, and deserves nothing but our utmost sympathy. Kate, like all the other babies in this country, deserved a lot more than that.