I've been thinking deeply about this issue for a long time.
Can I first say that it's appalling and a tragedy and a disgrace that it took mothers, not the inspection bodies to pick this up and my heart goes out to all those mothers, partners and families affected by this.
Clearly, the issue isn't one type of birth prioritised over another per sae. We are mammals. We birth well when we feel safe. So many interventions and practices around birth are to ensure that the health care professionals feel safe in their practice, not that the mother and partner feel safe and listened to. Birth is not safe for some women, however, that's a fact.
We have a sense called Interoception, it is a lesser-known sense that helps you understand and feel what's going on inside your body. Mothers when birthing often know when things are going wrong- because of this.
What it actually boils down to is a refusal to listen to women and practice woman-centred-care. Woman centred care is staff intensive but it does lead to better outcomes for birthing women. There are studies that clearly show this but it is expensive. There was a midwife home birth team in London called the Albany Practice who were experienced practitioners in woman centred care and they smashed the intervention rates and they had better outcomes for their women who were generally from lower socioeconomic backgrounds, so a double whammy in results. They were closed down because it was felt that the women in their care got a better service (and we must ensure a shit service for every woman, we can't have some getting a gold standard of care and showing up the hospital practices) and that the cost of providing this care where the women (98% of them) were delivered by their named midwife (it was a case-loading style of service provision) was felt to be too much.
Instead we load on the cost of poor care off into the future. I have a child with a SpLD which may or may not have been caused by hypoxic-ischaemic encephalopathy (HIE) at birth - we will never know. Add in the repercussions of my trauma and the cost of treating my poor mental health and there you are - actual avoidable cost.
I put that in not to bang on about my own trauma - which incidentally pales into insignificance compared to what some of these families have suffered but just to say I do have/had skin in the game.
I sat on a maternity services liaison committee (as it was known back in the day) because I was passionate about woman centred care. I found to my horror that the NHS is as institutionalised as any other large public body. It has been designed to work for the staff and not for the patients. There is bullying and intimidation at all levels. It really is like turning a large ship to get things changed I found. This was 18 years ago, but I see that not much has changed in the interim.
It's about time we demanded one midwife for one woman. And the same team throughout. Anyone remember domino care? That was where your community midwifery team / hopefully your named midwife came out to you in early labour, assessed you and went with you to hospital to deliver your baby. All gone. There's a national shortage or midwives, and those that enter burn out pretty quickly due to the unsafe working conditions, there literally aren't enough midwives on the wards.
We must make noise and demand change. This second rate and under-staffed and under-funded model cannot continue. We owe it to these women and babies to demand better. Birth is a risky business but research shows what makes it safer and that IS woman centred, compassionate care. That means listening to women, and acting on their concerns.