Birth Trauma
The APPG Birth Trauma report arose out of MP Theo Clarke’s concern that she was not alone in her experience of traumatic childbirth. It is based primarily on women’s voices and is all the richer for it. 1311 women responded, 100 maternity professionals and 92 organisations including charities. 694 women had experienced caesarean section, mostly emergency, 378 had instrumental deliveries and 147 3rd or 4th degree tears. Some of these categories may overlap. Yes, most of the women had experienced physical trauma but these ‘misfortunes’ were made all the worse by unthinking, uncaring, inhumane treatment. Failures to even acknowledge a woman as a fellow human.
The report reveals a fundamental disregard for the needs of women in hospital during and following childbirth, their need for pain relief, their need for clean sheets and help with personal care on arrival at the postnatal ward, let alone help in caring for their newborn. Of course it is no wonder that postnatal staff are rushed off their feet, now that most of the women on the ward have actual bodily trauma, and the mother baby dyad are regarded as occupying one ‘bed’. Postnatal has always been the Cinderella part of the service, once the baby is born the mother is left to fend for both herself and her baby. Just remind me, how many weeks is it before a woman is even allowed to drive following surgical delivery? How many years must people study before qualifying as a neonatal nurse? Are women expecting too much of hospital services or are hospital services expecting too much of women, I wonder?
Forgive me, I write as a mother who always felt safer and better cared for at home and this report reminds me why. It reminds me why I am such a passionate defender of continuity of care by a known midwife and why I am still angry at the demise of the Albany, Neighbourhood midwives, One to One and all those NHS schemes set up over the years from Changing Childbirth to Better Birth. Because this type of care works, indeed it is the only type of care that has consistently better results than hospital based care – and vastly better, vastly less traumatic – indeed not just less traumatic but positively life enhancing for mother, baby and family.
It is no wonder that so many women are following the freebirth route and so many midwives reinventing themselves into birthworkers. Good for them, but what about the vast majority who trust the NHS only to risk being let down so badly?
Most women expect little more than to be treated with respect and kindness. Not care that leads to some of them being able to say, “animals are treated better than the way we were treated in hospital” (though, sadly, this sentiment will not be new to any of us). These stories reveal scant kindness, they reflect a flagrant disregard for women’s very humanity. Some of these women felt that they had been treated as a mere birthing vessel, a slab of meat.
There is a chapter devoted to anal injury and once again I despair of a system which appears to expect women to birth upon their backs, putting the strain in the very place least able to resist it, the perineum. Anatomy and physiology are ignored. So also are some of the women who suffer so horribly and for years. Shame on the system.
As a psychologist, I know that stress results from feeling helpless, hopeless and having lost control of what happens to you. It results in PTSD when a person fears for the very survival of themself, their baby or their partner. Five percent of mothers experience PTSD following childbirth, 20% postnatal depression. There is hardly a more toxic place than a maternity hospital under pressure of sheer numbers. But even when ‘quiet’, the more controls that are put in place to reassure the managers and obstetricians, the less control a mother can have over her treatment, the more she will be bullied and coerced into complying with obstetric protocols and guidelines. Her voice is unheard.
What are we as a society doing to women, to their babies, to the family? And what have we done to the noble profession of midwifery that such a report can be written? Has the system rendered midwives blind to their cruel practices, deaf to the voices of women and indeed even to the cries of hungry babies? I believe it has.
What is to be done? I think we need far more community midwifery, a birth centre in every town, why not combine it with a Sure Start centre? It will need a dedicated ambulance to transport the women who need extra help (as Mary Cronk would have said). Midwives need to learn again how to love the women they care for, they need to get to know them personally because then they will really care about them they will really listen to them. We need to remind ourselves that the role of the midwife is to be ‘with woman’.
The APPG Birth Trauma report arose out of MP Theo Clarke’s concern that she was not alone in her experience of traumatic childbirth. It is based primarily on women’s voices and is all the richer for it. 1311 women responded, 100 maternity professionals and 92 organisations including charities. 694 women had experienced caesarean section, mostly emergency, 378 had instrumental deliveries and 147 3rd or 4th degree tears. Some of these categories may overlap. Yes, most of the women had experienced physical trauma but these ‘misfortunes’ were made all the worse by unthinking, uncaring, inhumane treatment. Failures to even acknowledge a woman as a fellow human.
The report reveals a fundamental disregard for the needs of women in hospital during and following childbirth, their need for pain relief, their need for clean sheets and help with personal care on arrival at the postnatal ward, let alone help in caring for their newborn. Of course it is no wonder that postnatal staff are rushed off their feet, now that most of the women on the ward have actual bodily trauma, and the mother baby dyad are regarded as occupying one ‘bed’. Postnatal has always been the Cinderella part of the service, once the baby is born the mother is left to fend for both herself and her baby. Just remind me, how many weeks is it before a woman is even allowed to drive following surgical delivery? How many years must people study before qualifying as a neonatal nurse? Are women expecting too much of hospital services or are hospital services expecting too much of women, I wonder?
Forgive me, I write as a mother who always felt safer and better cared for at home and this report reminds me why. It reminds me why I am such a passionate defender of continuity of care by a known midwife and why I am still angry at the demise of the Albany, Neighbourhood midwives, One to One and all those NHS schemes set up over the years from Changing Childbirth to Better Birth. Because this type of care works, indeed it is the only type of care that has consistently better results than hospital based care – and vastly better, vastly less traumatic – indeed not just less traumatic but positively life enhancing for mother, baby and family.
It is no wonder that so many women are following the freebirth route and so many midwives reinventing themselves into birthworkers. Good for them, but what about the vast majority who trust the NHS only to risk being let down so badly?
Most women expect little more than to be treated with respect and kindness. Not care that leads to some of them being able to say, “animals are treated better than the way we were treated in hospital” (though, sadly, this sentiment will not be new to any of us). These stories reveal scant kindness, they reflect a flagrant disregard for women’s very humanity. Some of these women felt that they had been treated as a mere birthing vessel, a slab of meat.
There is a chapter devoted to anal injury and once again I despair of a system which appears to expect women to birth upon their backs, putting the strain in the very place least able to resist it, the perineum. Anatomy and physiology are ignored. So also are some of the women who suffer so horribly and for years. Shame on the system.
As a psychologist, I know that stress results from feeling helpless, hopeless and having lost control of what happens to you. It results in PTSD when a person fears for the very survival of themself, their baby or their partner. Five percent of mothers experience PTSD following childbirth, 20% postnatal depression. There is hardly a more toxic place than a maternity hospital under pressure of sheer numbers. But even when ‘quiet’, the more controls that are put in place to reassure the managers and obstetricians, the less control a mother can have over her treatment, the more she will be bullied and coerced into complying with obstetric protocols and guidelines. Her voice is unheard.
What are we as a society doing to women, to their babies, to the family? And what have we done to the noble profession of midwifery that such a report can be written? Has the system rendered midwives blind to their cruel practices, deaf to the voices of women and indeed even to the cries of hungry babies? I believe it has.
What is to be done? I think we need far more community midwifery, a birth centre in every town, why not combine it with a Sure Start centre? It will need a dedicated ambulance to transport the women who need extra help (as Mary Cronk would have said). Midwives need to learn again how to love the women they care for, they need to get to know them personally because then they will really care about them they will really listen to them. We need to remind ourselves that the role of the midwife is to be ‘with woman’.