You know those times when you're beyond exhausted?
You thought you'd stop a few hours ago but then another job appears, and another, and now you're still standing but not sure you can feel your legs anymore?
This is how I and many other people in the midwifery world feel about the press coverage on 'the cult of normal birth' right now. It's like whack-a-mole, misinformation keeps popping up.
There are many midwives and Mums writing about all this and they're doing an amazing job. They're trying to get the facts out.
I wanted to add to the pile because when something like this happens we should all speak our minds. As women. And advocates for women. Again.
(The good that comes out of all this is, I suppose, that we realise how many excellent advocates there are, it's great to see).
The basic message in the press and other media channels is that the 'cult of normal birth' has 'gone too far'.
This has stemmed from the Royal College of Midwives changing their 'Campaign for Normal Birth' into 'The Better Births Initiative'. The idea behind this was simply to ensure antenatal and postnatal care was involved in the initiative.
The press seems to have taken this, erroneously, to mean that the Royal College of Midwives is not advocating for normal birth anymore.
The main source the press is using is the Kirkup Report. This report found that in Morecambe Bay Hospitals, among many other factors leading to failures in care, there were a small group of midwives 'pursuing normal birth at all costs'.
However, this was one of 5 areas of failure in that trust and the press are not reporting on any other.
No-one wants to talk about the chronic warning signs, the underfunding, understaffing, pressure and major organisational failures that trust suffered...
At one point during the Morecambe Bay investigation, the Care Quality Commission was actually internally accused of a cover up. The government was successfully sued for libel over the case in 2013.
But we've forgotten this. Here we are talking about how midwives are 'dangerously obsessed' and Jeremy Hunt is tweeting about how ending normal birth promotion will help halve infant loss.
It's enough to make you weep.
This is a really complicated situation and everyone is trying to do the best they can. Midwives hold a weighty role and one of their biggest responsibilities is deciding what's abnormal and what's normal and when to get the medical team involved. Can we be surprised that in a trust failing in so many ways, this particular issue came up?
If it was as simple as 'let's be on the safe side', midwifery would be pretty simple. But we also have iatrogenic harm, which is the harm caused by medical intervention, a caesarean rate rising well beyond what the WHO suggests is safe and women's choices to think about.
My suggestion is that midwives are overworked, vulnerable and not paid anywhere near enough (remember the pay gap means compared to men, women work 57 days of the year for free).
They're an easy target for blame.
Midwives are tired and I don't think many of them care about the reputation of the profession for its own sake. Criticism is never nice, but the important thing is that midwives being vilified is very bad for women and families.
If you paint the advocates for women as dangerous and unbalanced, women's choices become limited.
This fight against what the media are saying is not about the midwives, it's about the women.
There is a petition on all this here: https://you.38degrees.org.uk/petitions/evidence-not-prejudice-deliver-better-births
(Further reading: the Midwife Diaries Morecambe Bay Report Summary; CEO Royal College of Midwives Cathy Warwick’s Words Matter and so does evidence based thoughtful care; Soo Downe's Normal Birth – evidence and facts; and Nikki Williams’ RCM campaign for normal birth and the media misrepresentation)
This is not the fun filled post I had planned for when I got back from holiday but I'm seething. If you are too, please consider sharing this post. And leave me a comment letting me know your thoughts!
Much love for everyone involved in this situation,
P.S. Cheerful news: I've had some conversations with midwives, students and others in the birth world who want to get small business ideas off the ground. The insight and inspiration they have is amazing and they're changing the rules for care as they can achieve things on their own terms. I really think we need to help ourselves until the government can help us again. If you'd like a one to one 15 minute chat with me about your midwifery business idea, email me on firstname.lastname@example.org. I only have a few spots left this week but I'd be thrilled to hear what your plans are.