“One of the most disappointing and deeply worrying themes that has emerged is the reported lack of kindness and compassion from some members of the maternity team.”
This is perhaps the most disquieting sentence to be found in the first report into failures at the maternity services at the Shrewsbury and Telford NHS Trust between 2000 and 2019, published last week. The report is critical of many of the practitioners involved in delivering maternity care, but it is the Trust’s midwives that are criticised most of all.
This profession, usually associated so strongly with “kindness and compassion”, is here associated instead with cruelty and tragedy: 13 women dead in childbirth, hundreds of babies dead, and many more left disabled after traumatic births. Speaking to MPs on the Commons Health Select Committee, Donna Ockenden, who is leading the independent investigation, described a legacy of “broken families and women who carry guilt on their shoulders for many many years”.
It seems now that many of these tragedies were a consequence of a dogmatic opposition to performing c-sections. While the national c-section rate averages 24% to 29%, at the Shrewsbury and Telford Trust it was between 8% and 12%, apparently due to a widespread belief among midwives that a low rate was a sign of good maternity care.
In fact the opposite proved true, since the report concludes that in many cases earlier recourse to c-section would have avoided death and injury. And some midwives’ single-minded quest for natural (i.e. vaginal) births at “almost any cost” was often achieved through unnatural means, including the injudicious use of forceps and hormonal induction, causing additional harm. Worst of all, when babies died during these protracted and agonising deliveries, patients’ pleas for c-section having been ignored, some of these grief-stricken women were then told that they themselves were to blame for the disaster.
When news of this scandal broke, my Twitter feed was immediately filled with women recounting their own experiences of bad care at other NHS Trusts. Most mothers have some sort of horror story to tell — either their own, or that of a friend or family member — and most of these stories include some kind of error on the part of a medical professional. Usually these involve a lack of intervention, or an intervention of the wrong kind, and women almost always report a feeling of not being listened to or cared for — of being treated like rag dolls, passive and mute.
I’m now 18 weeks pregnant with my first child, and I’m in the unusual position of knowing that I will be having a planned c-section for medical reasons. There’s no debate to be had about how the birth will go — I know exactly what’s in store for me come May. And am unlikely to experience the subtle or not-so-subtle pressure often put on pregnant women to stick as closely as possible to the natural childbirth ideal.
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