Truth no one will admit about why maternity wards are in meltdown
Amid plans to push more women into home births, BEL MOONEY accuses the NHS of a grave deception
EACH week millions of us watch the BBC’s popular, long-running series, Call The Midwife. Invariably, I am in tears at the moving storylines, while my husband’s expression is a rictus of horror at the screams, the agony and danger of childbirth back in the Fifties and early Sixties.
Last Sunday was a particularly harrowing episode. Trying to cover up her unmarried child’s pregnancy, a mother delivered the baby secretly at home — and would probably have killed her own daughter had it not been for midwife Trixie, played by Helen George.
I pointed out to my shocked husband that once home deliveries were the norm. Childbirth was a perilous business and there was precious little choice.
But since the mid-20th century there has been choice. Mothers have had the right to opt for a home birth — as long as their wish does not threaten the safety of their unborn child — but for the majority of women a hospital delivery has been the safer option.
Home births cost the NHS less money than a hospital delivery. But if there are complications, what better place than being on the spot with medical equipment and expertise to hand?
This is why I am horrified to learn the Government intends to encourage more women to have home births, earmarking a budget of £3,000 for each mother-to-be who opts to deliver at home.
Health Secretary Jeremy Hunt has hailed the review as ‘a significant moment for the NHS, giving women more choice, making services safer and helping to shape maternity care for years to come’.
More empty words. For while I’m sure that young mums-to-be will be told they are being ‘empowered’, make no mistake: this exercise is about saving money and covering up the fact that our maternity services are virtually not fit for purpose.
And I believe there is a massive deception at its heart that puts those under threat who are using maternity services stretched to breaking point.
Is this a cynical conclusion to draw from the long-awaited review by NHS England? I don’t think so.
I am desperately anxious that mothers’ and babies’ lives will be put at risk because of another exercise in political spin and cover-up. THE social conditions shown in Call The Midwife may have changed, but childbirth itself is still unpredictable and dangerous. New mothers are often just as frightened and (surprisingly) ill-informed as they were a generation ago.
Have a cosy home birth, dear! But what if something goes wrong? I quail to think of the steady decline in ambulance services reaching their time targets for lifethreatening calls.
The review, led by Tory peer Baroness Julia Cumberlege, proposes giving mums- to- be vouchers of £3,000 that they can choose to spend on private oneto-one midwives delivering care at home or in birthing centres – where there might be ‘ hypnobirthing,’ soothing music and (no doubt) scented candles.
It all sounds appealing. Why, then, do I suspect the enlightened words are a mask for a great con?
If this country can’t afford to deliver a safe, efficient maternity service today, how are all those £3,000 vouchers to be funded?
And since there is a shortage of midwives, how are the extra ones going to be found and trained to deliver this one-to-one service?
Last autumn, it was reported four out of ten maternity units were forced to close because of a staffing crisis among midwives.
Hundreds of blunders occur on maternity wards every day because doctors and midwives are failing to communicate with each other. Staff are chronically over-stretched.
Last year, more than 8,000 safety incidents were reported, in part due to staff shortages.
Cathy Warwick, chief executive of the Royal College of Midwives, has been vociferous about the need for more staff.
Last year, she said: ‘Our maternity services are over-worked, understaffed, underfunded and struggling to meet the demands on them.’ But there is one unequivocal fact in all this that no one mentions: the UK population is the fastest growing in Europe.
More recently, she warned that ‘ the service is teetering; the cracks are beginning to appear; maternity services are under assault’ and blamed the rising birth rate for the pressure.
Obviously a key factor is that foreign-born women tend to have larger families — an average of 2.5 babies compared with 1.84 for UK nationals.
One quarter of Britain’s babies are born to foreign mothers. Overall, in 2011, 56.7 per cent new mums originally came from outside the UK, with the figure rising to 77 per cent in the London borough of Newham.
With immigration at current rates, that figure can only be rising.
For example, the maternity unit at Ealing Hospital is under frightening pressure. There, the vast majority of mothers are from abroad and the unit has had to deal with women of 104 nationalities requiring a team of translators on call 24 hours a day. How wonderful that those women are taken care of. Yet how can we possibly continue to fund such care with dwindling resources?
To make things worse, ‘health tourism’ is thought to cost the taxpayer as much as £200 million a year.
In 2014, one in 14 women giving birth in Britain were temporary migrants or visitors — and cost taxpayers £182 million.
Meanwhile, ‘maternity tourism’ — women from overseas coming to Britain purely to give birth — accounts for 7 per cent of NHS childbirth spending.
It exposes the huge pressure put on already stretched services from those taking up free NHS care at a time when half of NHS trusts had to close their maternity units last year.
But do we acknowledge the roots of this crisis? No.
The general secretary of the Royal College of Midwives says: ‘ The issue here is not about immigration, it is about resourcing our maternity services to meet the needs of the women it serves.’ With respect to Cathy Warwick’s distinguished career, doesn’t this statement take us to the heart of the matter?
Immigration is running at unsustainable levels and mothers born outside the UK are putting unprecedented pressure on our inadequate maternity services.
Health tourism is ‘allowed’ by default, with health trusts finding it almost impossible to recoup the costs. BUT the general secretary of the RCM states that the crisis in her profession has nothing to do with immigration, but is about providing more money to ‘meet the needs’ of more and more women.
In what dreamworld can this be achieved? Oh, perhaps by coming up with a plan to give expectant mums vouchers adding up to £ 3,000 to pay for ‘ choice’ in maternity care.
Vouchers that will make it even more appealing to have a baby in Britain. Vouchers that might also encourage British new mothers to take the decision to have a home birth, because they think it sounds pleasant and don’t understand the consequences.
Encouraging more mothers-tobe to give birth at home is not only a retrograde step, but one that will misdirect much-needed funds away from maternity wards which, if properly invested in, should — and could — be so much safer.
When I had my first child in 1974 (by the way, all three of my births were NHS), the only person I knew who fancied a home birth was an idealistic and ‘alternative’ lady who believed that deep breathing, joss sticks and beautiful music would help ensure the perfect birth on her living room floor.
Unfortunately, the birth did not go according to plan (as births often don’t). After a protracted labour, the poor girl ended up hurtling to hospital in an ambulance for a forceps delivery.
Every pregnant woman deserves the best of professional care. I cannot see how we can achieve this — spending money to attract and train new midwives, addressing our stillbirth statistics and ensuring the next generation is borne into the best possible circumstances — if more and more people are coming into this country to have their babies.
No amount of fine promises can disguise that hard truth.