A five year forward view for maternity care was recently released by the government.
“It is a time when the experience we have can shape our lives and those of our babies and families forever.”
The report began with:
“The birth of a child should be a wonderful, life-changing time for a mother and her whole family. It is a time of new beginnings, of fresh hopes and new dreams, of change and opportunity. It is a time when the experiences we have can shape our lives and those of our babies and families forever. These moments are so precious, and so important. It is the privilege of the NHS and healthcare professionals to care for women, babies and their families at these formative times”.
Good start. As a bump, birth and baby professional who sees over 60 pregnant and 80 new mums every single week – and a mum myself who has been through the ‘process’ a couple of times – I whole heartedly agree!
Birthing is unbelievably special, probably one of the most incredible moments of our lives, but so manywomen feel at the best ‘removed’ from it (like birth was ‘done’ to them) and at worst properly ‘traumatised’ by it.
At last someone seems to be asking the questions for womenhood!
The report goes on to state:
“We heard that many women are not being offered real choice in the services they can access, and are too often being told what to do, rather than being given information to make their own decisions”.
Most weeks an expectant mum in our YogaBump classes talks about an experience she has been through that caused unnecessary stress. Usually because they are not properly informed on why a decision has been made. Often information is confused as the mum never sees the same midwife, or consultant. Just this week we heard a story where one midwife reported a baby as too small, and just two weeks later, another reported the same baby too big!
The report agrees:
“Women told us how important it was for them to know and form a relationship with the professionals caring for them. They preferred to be cared for by one midwife or a small team of midwives throughout the maternity journey. Many women expressed frustration over receiving conflicting advice from different healthcare professionals throughout their care.”
Now, I am not saying I don’t appreciate the medics, the midwives and the amazing level of care in this country that keeps us all safe and healthy. I am also aware that no parent ever wants to go through the unbelievably tragic pain of still-birth. However, it seems that the balance is really skewed, and normal (i.e. with no complications) women who should be enjoying normal pregnancies and births are often having their excitement and enjoyment replaced by anxiety and fear. Mostly because they feel ill-informed and excluded in their own births.
“Our vision… become safer, more personalised, kinder, professional, and more family friendly.”
So what to do? The author of the report, Baroness Julia Cumberlege states:
“Our vision for maternity services across England is for them to become safer, more personalised, kinder, professional and more family friendly; where every woman has access to information to enable her to make decisions about her care; and where she and her baby can access support that is centred around their individual needs and circumstances.”
How this actually translates within a struggling NHS we are yet to see, but at least someone has at last ‘stated the obvious’, and this report will have to be acknowledged by healthcare professionals.
A headline guide to what the new National Maternity Review Report means for you
- Every woman should develop a personalised care plan, with her midwife and other health professionals, which sets out her decisions about her care, reflects her wider health needs and is kept up to date as her pregnancy progresses… They should be able to choose the provider of their antenatal, intrapartum and postnatal care and be in control of exercising those choices through their own NHS Personal Maternity Care Budget, making decisions about the support they need during birth and where they would prefer to give birth, whether this is at home, in a midwifery unit or in an obstetric unit, after full discussion of the benefits and risks associated with each option.
Women have their own birth budget! Wowsers.
There is also talk about women getting their own online ‘pregnancy and birthing shopping list’ which they are talked through carefully and without bias.
- Evidence-based, unbiased information should be made available to all women to help them make their decisions and develop their care, enabling them to access their own health records and information that is appropriate to them, including the latest evidence and what services are available locally.
A cohesive online portal of balanced, factual, information which has been accredited and has a range of ideas for pregnancy and birth would certainly be a huge step in the right direction. Being able to see their own medical notes here, will also enable mums-to-be to ask appropriate questions, helping to create cohesion throughout antenatal, intrapartum and postnatal care.
- Every woman should have a midwife, who is part of a small team of 4 to 6 midwives, based in the community who knows the women and family, and can provide continuity throughout the pregnancy, birth and postnatally.
Great, a small team with consistent care, a midwife you can build a relationship with.
- Those who work together should train together. The Nursing and Midwifery Council and the Royal College of Obstetricians and Gynaecologists should review education to ensure that it promotes multi-professionalism and that there are shared elements where practical and sensible.
Many midwives I know personally feel that midwives and obstetricians should work much more closely, with a greater respect and understanding. The proposal is, to help relationships and a consistent voice, there should be an assigned obstetrician to each midwife.
- Development of The Community Hub. Community hubs should enable women to access care in the community from their midwife and from a range of others services, particularly for antenatal and postnatal care.
Let’s hope the ‘other services’ provide holistic care that women both want and need HypnoBirthing, Pregnancy Yoga, Breathing and Birthing Tool Workshops, Massage in Labour, Acupuncture …. Ah the birthing dream…
“A positive experience of childbirth.”
The report concludes:
“We know that women are more likely to report a positive experience of childbirth, regardless of the outcome, if their care is personalised, if they are treated with respect and if they are involved in decision making.”
Well said. It is yet to be seen how all the incentives and ideas will materialise in a struggling NHS, but let’s stop putting birthing women last on the list of priorities. A safe, happy and healthy birth is the start to a safe, happy and healthy life for a brand new person. It makes sense emotionally, and economically, that it should be a priority in life, not an afterthought.
Jackie Heffer-Cooke is renowned as one of the region’s leading pregnancy and birthing experts and is Co-Director of the Orange Grove Clinic.