Isabel Hardman

Excl: NHS tries to ditch the focus on ‘normal births’ after scandal

Excl: NHS tries to ditch the focus on ‘normal births’ after scandal
A Shrewsbury and Telford Hospital NHS Trust hospital (photo: Getty)
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It's only been two weeks since the Ockenden report on the maternity scandal at the Shrewsbury and Telford Hospital NHS Trust came out. That report criticised – among many other things – a focus on ‘normal birth’ and a low Caesarean section rate which had harmed some of the mothers and babies in the cases it had investigated.

Since then, though, there have still been job adverts going out from other NHS trusts for midwives who are interested in ‘normality’ – the common term for a vaginal delivery, preferably without instrumental intervention. These adverts give the impression that some sections of the NHS aren’t prepared to learn the lessons from Ockenden and are still promoting ideology over safe birth.

But there’s a pushback against this. I’ve been passed an email sent from NHS England to medical directors, chief nurses and chief midwives at trusts and local maternity systems warning about ‘language related to birth’. The letter, written by Dr Matthew Jolly, who is the National Clinical Director for Maternity and Women’s Health, and professor Jacqueline Dunkley-Bent, the Chief Midwifery Officer, says: ‘There have been a number of concerns raised about the language used in some NHS trust maternity service job adverts and materials – phrases that suggest bias towards one mode of birth.’

It reminds trusts of ‘the importance of ensuring that language is consistent with women receiving the necessary information and support to make informed decisions about their care’, and asks them to review ‘the language they are using about their services, in job adverts, and any other information designed to support decision-making on pregnancy and birth choices.’ The letter also points to the way the Ockenden final report highlighted ‘the centrality of women’s decision-making.’

Why does this matter? Ockenden and other inquiries have criticised an ideology that ‘normal birth’ is best – something the Royal College of Midwives campaigned for until recently. Even the expression of regret about this campaign by the RCM's chief executive Gill Walton has caused ructions within midwifery, with the former president of the college Caroline Flint and a number of other leading figures signing an open letter calling for Walton and the RCM board to resign. But outside the ‘normal birth’ world, there is a pushback against this ideology from mothers who feel their wishes were ignored and they were pressured into deliveries that left them feeling traumatised or had even worse results for them or their babies.

That the NHS at a national level has recognised this anxiety about ideology is very positive: the most important thing is not a birth that someone can boast about because it involved minimal pain relief or intervention, but a safe one for mother and baby.

Written byIsabel Hardman

Isabel Hardman is assistant editor of The Spectator and author of Why We Get the Wrong Politicians. She also presents Radio 4’s Week in Westminster.

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