" 'over-zealous' pursuit of natural childbirth ‘at any cost’ led at times to unsafe care " and deaths in Morecambe Bay maternity unit

[inamaymaybewrong]

Thoughts on this, which is getting a lot of coverage today?

www.gov.uk/government/news/morecambe-bay-investigation-report-published

Official investigation into the uncessary deaths of babies and a mother at a hospital in Morecambe Bay cites 5 ways in which the maternity unit there was dynfunctional. including:Midwifery care became strongly influenced by a small number of dominant midwives whose ‘over-zealous’ pursuit of natural childbirth ‘at any cost’ led at times to unsafe care.

I've seen some commentators point fingers at the Royal College of Midwives campaign eg www.morecambebayinquiry.co.uk/index.php/blog

What's been your experience of the extent to which these things are issues elsewhere in the country, whether you're a patient or a professional? Maybe the tide against the medicalisation of birth and intervention has started to turn too far? Or maybe (hopefully) this is an isolated incident?

FWIW, I'm part of a few online groups geared towards attachement parenting though I'm firmly on a different end of the spectrum to others involved in them who are fervently pro-home birth and anti-intervention and active in groups on those issues too. I can't imagine getting much balanced discussion of this there so posting here instead! I've name-changed too as I may post my own (patient) experience later depending how the thread goes and don't want to out myself!

I'm not sure that the 90s were better than now. I suspect that the fashions of each decade suited some women and not others e.g:

1950s - home birth no questions asked, fine if that is what you wanted, not fine if you didn't.

1970s/early 80s - the induction craze - induction/acceleration - epidural - forceps as the basic package. Well some women did ask for induction, and some tried to avoid it like the plague.

1980s/90s - lots of MLUs shut down. Not good if that was your choice. Now MLUs back in fashion (on paper at least).

Ahh, thanks Chunderella.

I practice with the woman that I'm caring for that shift being the focus of my practice. If that means that the thought of statistics and the General birth trend goes out the window then so be it.

Inbetween shifts I lobby both locally and nationally for better resources, better staffing, better antenatal education for women all of which should help improve outcomes of "normal" birth. But my main focus has to be what the woman wants when I'm caring for her while obviously trying to make sure that a plan of care is safe and gives her the best chance of a vaginal birth if that's her wish.

And you don't need to actually tell women that they've not had a "normal" birth. They'll be quite capable of picking that up for themselves if it's part of the terminology.

I've seen threads on MN on this very subject before. Someone asks another poster quite innocently "did you have a normal birth last time" (meaning vaginal). Someone else jumps in and says that they had a lscs but that doesn't mean they had an abnormal birth.

It's like the women who are told they had a lscs for failure to progress.

Language is powerful.

Who do you think developed the high/low risk guidelines to sort women into?

The obstetricians, midwives and anyone else who has a lot of inpit into maternity care.