I can’t write this New Year blog without mentioning the intense media coverage over Christmas and New Year, not just on the state of maternity care in the UK but also the reporting on homebirth options. I love that fact that the canny press team at The Royal College of Midwives use this typically quiet news time to raise the profile of the plight of maternity services in the UK.
It started with Cathy Warwick the giving this interview on the BBC and followed with headline coverage in the papers.
Cathy Warwick quite rightly advocates the importance of women being able to make choices about where and how they wish to birth based on unbiased information.However, according to Cathy this isn’t happening and women are being frightened into having hospital births without fully understanding their options.
She says that increasing numbers of midwives are being drawn into the hospital system, not into the communities where they are needed and where they can support normal homebirths. So by default midwives are being herded into the medicalisation of their profession not just the the medicalisation of the women they care for.
Midwives are being trained, but are not finding jobs easily, so although the Government appears to be honoring its pledge to train more midwives there seems to be a discrepancy between the number of midwives being trained and the number of jobs available.I personally know of very good midwives struggling to find work.
This was followed up by an article in the BBC and in the Guardian that examined, in more depth, the reality of the state of maternity services in the UK which reiterates the point I often try to make – that women are unaware of just how safe it is to homebirth if they are low risk.Do women properly weigh up the risks of a homebirth, if they are low risk, with the risks associated with intervention if they go into a hospital?
We know statistically that if you stay at home, you are at a lower risk of intervention.One thing we always say to women in classes is, even if you are going into hospital, stay at home until the last minute.Do not be tempted to go in to early.Trust your instincts.
Homebirth is not the right option for everyone, but when you look psychologically at the impact of the environment on a birthing mother it is without doubt the most appropriate place to birth for the majority of women. Thankfully money is being invested in some hospitals to create a more homely environment and I was recently told excitedly of the new birth rooms, complete with mood lighting, at Epsom and St Helier Hospital in Surrey. However, compare that to the new plans for a “planned caesarean theatre” at another large county hospital, not so far from where I live, and you have to question the consistency of policy supporting investments in maternity services.
In classes I ask mums to become more aware of things in their environment that pose a threat and which can have a negative physical impact on a mother during her birth.Simple things can be unconsciously processed as a threat by a birthing mother, who is more acutely aware and alert to her surroundings.Her threat system is very easily aroused and labour can stall or slow down with the slightest ‘threat’- just seeing the incubator in the room triggers an unconscious train of thought that is related to the baby not being healthy.If you are pregnant just close your eyes for a moment, be aware of walking into a labour room and seeing the incubator in the room.Be very aware of what happens in your body as you see the incubator.In classes women describe feeling a flicker of tension, a physical tightening, which is triggered by that stimulus.
This is one of the reasons why a homebirth is so much more conducive to birth, hospital doesn’t just increase the possibility of a physical intervention it is a psychological intervention.
The debates about maternity care in the media were then usefully followed by a fantastic special on the Today Programme by the artist Sam Taylor-Wood who had two complicated hospital births and then a homebirth. She interviews Sheila Kitzinger amongst others and looks at the history of birth and shift towards more medical birth – nudged into medicalisation by the Peel Report published in 1970 which, although not evidence based, called for women to birth in hospitals.
Sam also looked at a project in Bridgend in Wales where the homebirth rate has risen to 4%.But they had to retrain midwives to support homebirth!It reminded me once of a midwife who said she thought hypnobirthing deskilled her and another community midwife that only had one birth a month but was desperate for more – is there a very real possibility that midwives are actually in danger of being deskilled not by hypnobirthing, doulas, or normal birth advocates, but by the fact that hospital births and intervention are increasing?
Sam talks about her decision with James Naughtie to make it here.
There is no doubt that birth is becoming more medicalised, at detriment to mothers and their babies.If you are low risk, examine the evidence, to your research (do you book a holiday without researching destinations and hotels in detail?) read other women’s stories, become aware of what birth really is and what it can be.Become aware of what you want for your baby, how you want your baby to enter the world.
Do not offer up your maternal intuition or your instincts in exchange for what someone else thinks.The first rule of motherhood is not to abdicate that responsibility.
I hope that this year, collectively women in communities everywhere begin to regroup, to begin, as mothers did in Bridgend, to talk about the experience of birth, the magic of birth, how manageable birth actually is and how capable we are of birthing our babies.Perhaps if women started speaking up more, encouraging and supporting other women the tide may begin to turn.