One of the riskiest things you can do in an NHS hospital is have a baby. Two thirds of NHS maternity units are not “safe enough” for women giving birth, according to the Care Quality Commission, while a quarter deliver “a high risk of avoidable harm to mother or baby”. But poor maternity care is nothing new: the past decades are littered with examples of scandals and promises of “never again”.
I was three months pregnant, in March 2022, when midwife Donna Ockenden’s government-commissioned report was published, detailing the extreme failings in maternity care in Shrewsbury and Telford. Thinking about giving birth in these circumstances was more than a little nerve-wracking.
For many women, pregnancy and childbirth is a means to an end — something you have to do to get the baby you and your family so desire. And yet, a picture is being painted in the NHS of a custom-made journey of self-discovery that allows women to realise their true biological and spiritual potential. I remember an appointment, late in pregnancy — when I was trying to keep the weight off my swollen ankles — during which I was asked by my midwife whether I had filled out the playlist requirements in my NHS-issued birth plan (the “blue book”). It is only now, a year later, that the contrast between this moment and the reality of the neglect I suffered during my son’s actual birth can raise a hollow laugh.
Few investigations into the UK’s dire maternity care seem to want to explore the emergence of a natural or holistic ideal. Most focus on funding and staffing — which almost everyone agrees the NHS is lacking. But in every scandal, the same problems arise: delayed interventions for babies with low oxygen or slow heart rates, caesarean sections being refused and women’s concerns being ignored.
For many of those women whose children have died, poor funding or staff morale were not the cause. “Beatrice died with three midwives and two doctors in the room,” the interminably brave Emily Barley tells me. “There was not a lack of staffing, that was not the problem. The cultural issues, the attitude issues, the lack of leadership — these are way more important.” Beatrice died in May 2022 due to medical negligence after staff at Barnsley Hospital failed to monitor her heart rate and missed signs that she was in danger. Like many of the mothers and babies who have lost their lives to poor maternity care, Beatrice’s death was wholly avoidable — proper and timely medical intervention would have delivered her safely into Emily’s arms.
These appalling fatalities only tell part of the maternity care horror story. There are all those children born with serious brain injuries due to complications in long labour, or the women left with severe injuries which are rarely reported. I had the good fortune to leave with a healthy baby after an unjustifiably terrible ordeal and women like me often clam up — partly not wanting to relive the trauma, partly from guilt at not feeling joyful during those first few days of a child’s life. Perhaps worse than being denied pain relief, left in soiled sheets and ignored by midwives was the shame I felt for having not enjoyed the experience. Photos of his arrival show me pushing him away. For months, midwives had lectured about how beautiful, wonderful and natural this moment would be; how I would bond with him during skin-to-skin contact and breast-feed him immediately. Those words rang in my ears as I realised my first meeting with him — after surgery and a haemorrhage — would be one of nausea and pain.
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