#BirthTrauma: The Vultures Are Circling

Trigger Warning: This week's blog mentions birth trauma and baby death.

When I read the birth trauma report last week I felt compelled to write about how I felt it missed the mark completely. You can read my response to it in last week’s blog here.

Since then a friend of mine sent me a screenshot of a Facebook ad that appeared on her feed. She said that this type of ad has been all over her feed since the publication of the report.

I had a look and found more of the kind of ads she was talking about.

The ads were sponsored ads for birth injury claims coming from various different law companies. The ad copy was crafted to target your pain points (and in this case the advertising term ‘pain point' really is hitting the nail on the head).

Were you traumatised by your experience of birth?

Did you or your baby get hurt in the process of birth?

Did you both sustain an injury?

Has your quality of life suffered?

Don’t you want answers?

Did you know that you could be owed £1000s?

At the click of a button you can fill in an enquiry form and a team of medical negligence specialists will be able to help you ‘get what you deserve’.

The question of how many thousands of pounds could possibly compensate you for a stoma bag or for leaving hospital without your baby formed in the back of my mind.

And what do we and don't we deserve? 

Who decides what weight of a claim can right a wrong or undo the harsh words and uncaring hands those women encountered?

As I scrolled through the various ads a penny dropped; For the first time I saw clearly how the relationship between birth and the judicial system extends beyond the coroner’s court.

Industrial birth produces business for the legal sector and I think this is part of a vicious circle that has us spinning on a self perpetuating downward spiral towards more and more medicalisation and ultimately towards more trauma.

It became blatantly obvious to me that this is no coincidence. 

It all serves a purpose.

More medicalisation, more injury, more pain, more pharmaceuticals, more litigation, more medicalisation; more money! 

You might think that this doesn't really apply to us here in the UK where 'health care is free'. To this I say that this is about the direction that money flows in, not about who pays. You could argue that 'free healthcare' puts us at a disadvantage: No privatisation also means that services aren't competing against each other. In a publicly funded service there really isn't any incentive to do better other than taking pride in your vocation.

Whether you deliver a mediocre service or a stellar one, you get paid the same. At this moment in time the NMC holds the monopoly on birth, and pregnancy and birth are almost exclusively contained within NHS services. Apart from a few independent midwives in the UK (none in Northern Ireland) women have nowhere else to go and so a growing number of them choose to do their own thing.

Within the NHS trying to move policy away from medicalisation or even to support women unconditionally out of guideline isn't easy. It takes a lion's heart and as it stands there aren't enough lions.

And so it's business as usual and before you know it, there'll be another report.

I don't doubt that some law firms are about to make some fine commissions out of the aftermath of this one.

The press, too, have been having a field day. I have seen plenty of evidence of poor journalism not just in the last two weeks but over the years. The bias towards a narrative that birth is intrinsically dangerous and that women and babies need to be saved from it is blatant in most of everything I have ever read in mainstream reporting over the years.

The truth is that for most women medicalisation is not necessary and just like it is true for any other aspect of life, adding unnecessary medical procedures also ads risk. It wouldn't take much research for a journalist to dig up the mountain of evidence for the protective nature of birth physiology that exists today.

Whilst I fully back the idea that women who want to choose to medicalise aspects of their pregnancies and births must be supported in doing so, I can see how for many women it is their fear of birth that drives them look to medical solutions. Women are influenced by media and the perception that we have created around birth drives fear. The media coverage right now and the reporting that will ensue once the various law suits are going to be brought forward will serve to keep us on this merry-go-round.

The proposed solution from some of the traumatised mothers themselves, from the policy makers and from the lazy journalists are elective caesarean sections and just yesterday I saw a quote on social media that struck a chord with me. The quote is from midwife Dr Sara Wickham who is one of the most accomplished writers and analyst of current evidence in the realm of pregnancy, birth, postpartum and early infancy.

Here's what she said:

'When a baby is born in less-than-optimal condition by caesarean, people say, "Wow, it was a good job we did a caesarean ... that baby really needed us to get it out."

And when a baby is born looking really healthy, happy and alert by caesarean, people say, "Wow, it was a good job we did a caesarean ... we managed to get that baby out while it was still in good condition."

In what state does a baby need to be born by caesarean in order for people to say, "Oh, maybe we shouldn't have done that caesarean. Perhaps that baby should have been born physiologically?"'

I wonder exactly the same thing and as I see the vultures circle over the carcass of mainstream maternity care I wonder where it'll all go. Where will the pendulum swing? 

I see more and more women who opt out of mainstream maternity care altogether. Some of them needed to experience the clinical and fractured approach of mainstream pregnancy and birth surveillance to want better next time and others are there right from the first time they conceive. Women curate their pregnancies and births according to what they need with as little or as much involvement from institutionalised practitioners as they like and while this will not be the solution for everyone, it is a delight to see.

What we need is a balanced approach to achieve a healthy big picture. That's true for individuals (and I see it with my pregnancy massage clients all the time) as well as institutions. Once you introduce balance, the structure supports itself.

So what would balance mean for maternity care institutions? How could it be so healthy that the vultures would take their leave?

My pipe dream for the future of maternity care is that pregnancy and birth are recognised as the rites of passage that they are. I would love to see a world where women and babies can benefit from maternity care that understands female physiology. What if we encouraged women to indulge their senses in pregnancy and birth regardless of how little or how much medical technology they want.

Last weekend I was invited to co-host a workshop called ‘Making Sense Of Birth’ with my friend and colleague at her beautiful venue in Dungannon, Northern Ireland.

I took her up on the offer without hesitation.

Our workshop explored the process of birth through the five main senses.

Naturally, given my love for pregnancy aromatherapy massage and body work, I got to take a deep dive into the sense of touch and the sense of smell.

Exploring the process of labour through the lens of our five senses revealed the tools that are at each of our disposal to tap into the wisdom of our bodies to help us through the process of giving birth.

What do you want to see?

What do you want to smell?

What do you want to feel on your skin?

What do you want to hear?

What do you want to taste?

And how do you want to initiate your baby’s first experiences of embodiment?

Have your midwives or doctors told you that by considering this will reduce your need for pain relief for instance? And if you consider it ahead of entering into a medical scenario for labour and birth, your and your baby's experience is likely to be more positive than if you have never thought about any of this. 

How can we help women and their babies be able to have access to the merits of medical advances if they need them without having their pregnancies and births medicalised unnecessarily. 

This takes a degree of honesty and humility that I haven't seen present in any of the various reports, guidelines or media coverage.

My wildest dream by far is that we talk openly about the relationship between birth and death.

If it is at all possible to back maternity services out of the corner we must accept that the work of observing the very inception of life will inevitably involve the witnessing of bereavement and grief. 

Remembering that not having been able to prevent the death of a baby is very different to causing a death of a baby is the first step off the merry-go-round. Blurring the lines between those two different narratives whilst pretending that every baby death is potentially avoidable is at the root of over-medicalisation. It sells papers, it lines pockets and it hurts people. Medical malpractice does exist but the 'medical malpractice experts' generally seem to be looking in the wrong place. I suggest taking a good look at the national, regional and individual hospital guidance that you base your rulings on before you take them as the baseline for judging individual clinicians. 

But wait, that might serve to draw the attention to the conversations we need to actually be having.

Are you pregnant and interested in talking real about your pregnancy and birth or maybe you just fancy a pregnancy massage? 

Send me an email to [email protected] to enquire about my services.