What would you change about the maternity services? Orange Grove’s Preparation for Birth expert Jackie Heffer-Cooke asks the big birthing questions and asks you to get involved with answering them…
Over two years ago a five year forward view for national maternity care was released. It seemed to be innovative and really listening to the voice of it’s service users, the birthing women.
It promised to give women their own birth budget and excellent consistent advice as to how to use it. It suggested there would be the creation of a cohesive portal of information, online, which has a range of ideas for pregnancy and birth, with balanced, factual information. It said there should be a community hub, enabling women to access care in the community from their midwife and from a range of other services for antenatal and postnatal care, and that there should be a more joined up approach to care, with midwives and obstetricians singing from the same song sheet.
Sounds amazing, like a dream…
At around the same time, we had another paper appear – The Safer Maternity Action Plan – whose national ambition is to half the rate of stillbirth, neonatal deaths, maternal deaths, and brain injuries that occur during or shortly after birth, by 2030.
At the time of release in 2015 the chief executive of RCM Cathy Warwick added “it is deeply frustrating for midwives that they cannot provide the quality of maternity care that they want to deliver because they are so short-staffed, so we were very pleased when Jeremy Hunt admitted that the Maternity Services needs more midwives.”
After 3 years, at last, this week, the government announced a 25% boost in maternity training places. Mr Hunt also promised that by 2021 women would be seen by the same midwife throughout labour, pregnancy, and birth.
Present Chief executive of the RCM Gill Walton called the latest move “a very long overdue acknowledgement” of the need for more midwives. However, she did add “simply training more midwifes is only half of the problem”.
One of the issues that birthing women face is the perhaps contradictory subtext of the two papers written in parallel within the last three years. One seems to be birth centred, women centred, a cohesive hub, informed choice; the other is a safety paper, which means that birth is going to become ever increasingly medicalised to absolutely minimise risk, meaning that unimaginable numbers of women will have more medicalised births, possibly unnecessarily. What a conundrum. To make clear, I am NOT belittling the second paper, the most important thing IS safety, safe mums, safe babies, but what does that mean for the ‘normality’ of birth? If birth is simply seen as a risky business, there will be more and more interventions and procedures such as inductions and caesareans. But at what cost? And I don’t just mean economically.
There has been a significant increase in inductions in the last two years, has it saved lives? Where are the statistics? And if it has, then it will be worth it, but then we must look at how women, and their partners, are supported throughout intervention, and throughout their time on the birthing units and delivery suites. We must talk to women, and their partners, about how the experience can be made easier, more comfortable, ‘nicer’ for them. All too often birth educators like me hear stories of women being left for hours, on noisy hot wards, with no opportunity to rest, and that’s before they start established labour, which as we know is a challenge you need to feel particularly well rested for!
It is absolutely brilliant that birthing seems to be moving in the right direction, that new systems are shaping up, that more midwives will be around to help, but there is so much more to be done. Out-of-box thinking needs to take place to really get birthing couples to an experience they may even, well, enjoy!
Did you know that you can have your say?
I am the chair of what’s called the MVP – Maternity Voice Partnership. The MVP is a team of service users (birthing parents) service user representatives (health and birthing providers and experts outside the NHS, family nurses, social workers etc), commissioners, and service providers (midwives, obstetrician’s, sonographers) working together to review and contribute to the development of local maternity care. The MVP believes that every woman on the maternity pathway has a chance to have her voice heard about the service she is receiving.
If you are pregnant or have been through birthing in the last two years, we need to hear from you, good or bad, your thoughts and opinions. You will be listened to without judgement, and every voice from every corner of Norfolk society will be heard. Plus, we need to hear from service user representatives, if you provide a service to pregnant or birthing women that’s you! There has never been a more important time to speak out, get involved and make a difference. This is a pivotal point, and if we get this right future generations of our daughters will own their birth-right. This birth-right is a birthing service which is not only safe, but which is empowering, comfortable and provides confidence to the birthing parents who walk through its door. That in turn means each new baby, each new life, gets what they deserve too, the best beginning possible to their life within their new family.