Today, I’ve read and reread everything I can find on the Morecambe Bay Report.
It’s cold and cloudy outside, but that's no bad thing. I'll be in my writing spot all day (I can’t write at a desk, I don't know why. Student essays, my blog, and my book were all written on the sofa, or if it was especially cold, in bed).
So now you know my exact location, let’s get down to the point of this post.
I’m writing about one of THE most overwhelming situations you’ll ever run into as a midwife…
When death or harm happens because of something health professionals have done.
Now, this case is so huge that I can only give you an account as I understand it. Plus, it's ongoing. I believe history is being made.
I also believe there are two major changes coming to UK midwifery, which I'll tell you about.
What happened at Morecambe, nutshell version:
- Morecambe Bay hospitals were in trouble for having the highest mortality rate in the UK back in 2011. Alarms also rang from public complaints from events starting in 2004
- In particular, James Titcombe, father of a baby who died from an infection aged 9 days, felt the death was preventable. He also felt that his son's chart had gone missing, possibly destroyed before it could be used as evidence
- So the police and the government and the NMC got involved
This is where the governmental side of things starts to get a bit weird.
- The Care Quality Commission -- the government organisation that's supposed to make healthcare better -- was internally accused of a cover-up of the way Morecambe Bay was governed
- This accusation was looked into really roughly. One government staff member was dragged in off maternity leave with her 3-month-old, and:
'the interviews were very aggressive and bullying in tone.... some staff were driven to tears...'
- It ended with the government being sued, successfully, for libel in 2013. This was by staff who were supposed to have been involved in the cover-up
So what the heck was going on?
The truth is, we have no idea what's going on in government.
But whether there was some kind of cover-up or someone was just looking for a scapegoat... it looks like Morecambe wasn’t getting the support it needed. For years.
What's going on now:
- The Morecambe Bay Report came out on the 3rd March
- It looked into Morecambe hospitals and the Care Quality Comission
- It was put together by Dr Bill Kirkup (the same person who looked into the Jimmy Saville case)
- It describes really awful mistakes and practices...
- ... ranging from poor relationships between midwives and obstetricians to major organisational failures, and substandard care
- Also, it looks at more deaths of mothers and babies that appear to be preventable
- Worryingly, a small group of midwives calling themselves ‘the musketeers’ are accused of ‘pursuing normal birth at all costs’, causing death and harm
What this means:
There are big, positive changes afoot from the Morecambe Bay Report. This includes 50 new midwives and doctors starting work in the hospitals, which is great, though the effort needed to change things is immense.
Two big changes coming to UK midwifery:
1. Getting Rid Of Supervisors Of Midwives
Supervisors of Midwives support practice and protect the public. They're usually hugely experienced.
So why is the government looking to get rid of supervision, a form of support for midwives and women that's been around for 100 years? Sounds like the last thing we need.
There are clear reasons why it's being considered.
Two midwifery supervisors in Morecambe looked into a case of a baby death and decided the care was good -- but later, it was found the care was substandard in places.
The Morecambe Bay report says that one supervisor in particular was also staff rep -- causing a conflict of interest for her between supporting colleagues and investigating them.
So the government think supervisors are not a healthy, modern way of regulating midwives.
This is making many sad and worried about the future of midwifery.
Supervision means 'self-governance' to a lot of midwives.
They argue, if midwives can't self-regulate, how the heck can they have the power to fight for and support women's birth rights?
Others feel a newer method of regulation may be a positive change and an opportunity for midwifery to get safer.
2. Normal Birth In The Media
There are suddenly lots of 'The cult of natural childbirth has gone too far' type articles around.
This is understandable right now, but not great.
I think there's going to be an issue with the credibility of midwives and normal birth.
We know, empirically, that when midwives are the lead practitioner for healthy women and babies, mortality and morbidity go down.
Promoting normal pregnancy and birth is one of the things that makes midwifery so important and unlike any other kind of care.
Navigating between supporting normal birth, reducing unnecessary intervention, and ensuring women and babies get the medical attention they need is the epic task of midwives.
I think that it's not surprising that a trust failing in many areas had this core part of midwifery fall apart. But just because one (undersupported) trust got so many things wrong, doesn't mean that midwifery's function of supporting normality is wrong.
All this sounds very dark and serious -- and it is. Mothers and babies have died.
BUT I absolutely believe we shouldn't judge the midwives involved. There's so much more to this.
Because this is such an immense topic, I've split my thoughts.
I'll be putting out 'part two' soon, which is on why it's REALLY IMPORTANT for every midwife to get educated on how powerful they are.
If you haven't already, why not consider subscribing so you don't miss it.
In the meantime, I'd love to hear from you. 1) Is there anything in this post that you didn't know already? Or 2) Do you have a perspective or information to share, so we can learn and grow from the Morecambe Bay Report?