‘Giving birth shouldn’t be a game of chance’
In the wake of a devasting report into maternity services, Rebecca Holman calls for urgent change
WHEN MY SON was born, in a hurry, with the cord around his neck, I just felt relief and awe about the efficiency and kindness of the midwives who looked after us so brilliantly.
Now I feel a shiver of dread when I consider how lucky we were. What if we hadn’t had the senior midwife looking after us? What if she hadn’t been watching his heart rate like a hawk? The more I thought about it, the more our healthy child felt like a prize we’d won in a game of chance. I felt the same shiver of dread when I read the findings of the Ockenden report, the result of a five-year investigation into maternity services at Shrewsbury and Telford NHS Trust.
The investigation, headed by senior midwife Donna Ockenden, considered 498 cases of stillbirth and found one in four had significant or major concerns in maternity care that, if managed appropriately, could or would have resulted in a different outcome. In 12 cases of maternal death, none of the mothers received care in line with best practice at the time. The report also highlighted the trust’s obsession with keeping Caesarean section figures low, to hit targets, as an issue. Poor training and staff shortages were flagged, as well as the trust’s refusal to properly investigate patient concerns.
But while I don’t know anyone who faced the unimaginable tragedy of the families in the report, certain elements of it sound eerily familiar.
I went into hospital to have my son hoping to have as little intervention as possible, but I understood that childbirth was unpredictable. I had visions of begging for pain relief, of my husband searching for help. This wasn’t my imagination running wild, but based on stories friends had shared after their own traumatic births.
Earlier this year, NHS England abandoned the use of Caesarean targets as a performance measure, while the head of the Royal College of Midwives (RCM) apologised for its part in promoting ‘normal’ births that have contributed to the deaths of mothers and babies. I am among those who feel these targets were dangerous and applied a ‘gold standard’ to childbirth that simply isn’t realistic.
The Ockenden report also highlights 15 immediate and essential actions for all maternity services in England. Firstly, funding. As the report was released, the RCM warned that a shortage of 2,000 midwives means women and babies remain at risk. Chief executive Gill Watton said, ‘I am deeply worried when senior staff are saying they cannot meet the recommendations in the Ockenden review, which are vital to ensuring women and babies get the safest possible maternity care.’
As I prepare to give birth again in a few weeks, that feeling of dread is back. The care I received before was second to none, but what if I just got lucky? Individualistic, patient-led care should be the gold standard for childbirth, and until our overstretched maternity system can offer this, giving birth will always feel like a terrifying game of chance.