‘From birth until they die’. Wasn’t that what Winston Churchill said in 1943, when he delivered a speech to the nation in response to the Beveridge Report, recognizing the need for “compulsory national insurance for all classes and for all purposes” and paving the way for post -NHS war establishment?
He never meant it literally (straight to the grave), and yet, eight decades later, that’s what he’s come to.
A baby born today in the UK is more likely to die before their first birthday than a baby in most other first world countries.
Having babies in the UK is far from a joyful or safe experience, writes Sarah Vine
Meanwhile, new mothers are dying in greater numbers than at any time in the past 20 years. In total, an embarrassing 20,000 women each year suffer from post-traumatic stress disorder due to their experiences in the delivery room.
Such is the devastatingly inadequate state of maternity care in Britain today, as highlighted by a new parliamentary inquiry into birth trauma, published on Monday.
Good care for pregnant women and new mothers is “the exception and not the rule.” The attitude of clinical staff towards them is described in the report as being of “surprisingly poor quality”, supported by testimonies of vulnerable women being belittled, patronized, neglected and ignored by midwives.
Simply put, having babies in the UK is far from a joyful or safe experience.
No wonder the birth rate has fallen off a cliff. Unless you can afford to go private, the chances of things going wrong are worryingly high. And women are not stupid. They know. The findings of this report have simply confirmed what, anecdotally, we have all feared (and experienced, either firsthand or through friends and family) for years.
When I had my daughter, 21 years ago this month, it was no different. At the time I was lucky enough to live just a short bus ride from one of the country’s leading maternity hospitals, Queen Charlotte’s in west London.
Despite its inauspicious location overlooking HMP Wormwood Scrubs (prisoners could sometimes be heard exercising in the yard), Charlotte’s had a reputation for providing care second to none. Professor Robert Winston, also known as “the baby doctor” and a very prominent figure at the time, had made a name for himself there, leading his team in cutting-edge neonatal research.
I attended prenatal classes, obediently biting my tongue as midwives lectured us on the evils of pain relief, showing us slides of Native American women giving birth squatting in forest glades (wokeness in the NHS is by no means a concept new).
I was by far the oldest there (I was 34), and most of my classmates were no older than my own daughter is now. This seemed to be a source of great irritation to the staff, who muttered darkly about “geriatric mothers” and incessantly berated me about my weight. When I tentatively expressed my concerns about the birth, explaining that my own mother, who was 20 when she had me, had almost died and had been in intensive care for weeks afterwards, they told me not to be so silly.
But nothing could have prepared me for the level of disdain I experienced once I arrived in the delivery room. My contractions were close, and yet when they checked me, unceremoniously and with as much respect as someone stuffing a turkey, I was only 4cm dilated. It was made clear to me in no uncertain terms that they thought I was wasting their time. They put me in a room and basically let me get on with it.
The night passed and my contractions continued, but I still wasn’t progressing. After much cajoling, I managed to persuade them to give me an epidural, which they did very reluctantly. I felt dirty, guilty and like a total failure. It worked for a while, but then once the local anesthetic wore off, I felt excruciating pain on one side of my body. Your answer? ‘I told you’.
They left me again for a few hours and then, since I was still not progressing, they decided to give me oxytocin, to speed up labor. It worked. Before long, the contractions were so close together that I could barely breathe and I was vomiting from the pain.
Around breakfast time, after hours and hours of this, my daughter began to show signs of distress. I don’t really remember much about this phase, but I do remember that around 10 in the morning the obstetrician came on duty. He – or maybe it was her, I don’t remember – examined me and found that she was still only 5cm dilated, my daughter had a posterior presentation and had passed meconium, which usually happens after she is born. Some very harsh words were exchanged and I was prepared for the theater.
Posterior presentation is when the baby’s head is facing the wrong direction in the birth canal. It can result in a long, slow labor (because the position of the head makes it difficult for the cervix to dilate) and extremely painful back pain, like what I had experienced. It can also prevent the epidural from working, which was the case for me. It often results in the need for a forceps delivery, unless the midwife can turn the baby. But since successive midwives had not detected any of this, it was too late for that. My daughter was in trouble and they needed to get her out immediately.
The difference between professionalism in the operating room and in the delivery room was striking. They treated me with kindness, gentleness and the utmost respect. There were two surgeons working together, quickly and efficiently. One of them took the time to give me continuous feedback, reassuring me with every step. I remember thinking at the time, why didn’t I do this in the first place?
Since then, I have come to seriously question the sacred status midwives have in this country. Romanticized by shows like Call The Midwife, they are revered as givers of life and sources of all maternal wisdom. But my experience, at least, shows that this is far from the truth.
Of course, there are some brilliant midwives; But many are politicized and prejudiced, entrenched in their beliefs and practices, and, most worrying of all, not very good at their jobs.
When they should show empathy, patience and care, they instead seem to betray impatience and irritation. One of the recurring themes in this report is the “dismissive” attitude of clinical staff, and that rings very true to me.
In fact, it was a midwife who almost cost the life of my second child, my son. She was born by elective caesarean section 16 months after his sister, at another Surrey hospital. Once again, I was made to feel like a cop out for not wanting to try another “natural” birth, but I was really terrified of repeating the act. So I swallowed my shame and insisted on it.
His birth was a completely different experience. Calm, professional, happy. Unlike his sister, who came out bruised and battered and fighting for her life, he entered the world peacefully and safely. Which might explain why he’s so catatonically laid-back, while his sister is one of life’s pugilists. But that is another story.
When he was about three months old, he developed an ear infection. I mentioned it to the midwife at the children’s clinic and she told me not to worry. But I did it. I have serious ear infections and there is a history of it in my family. I kept bringing it up and she kept dismissing me. I asked for antibiotics and was told that “we don’t prescribe antibiotics for small babies.”
The only thing he seemed to care about was whether I was breastfeeding or not. It was, but he was a gannet, so she was topping him off with formula. This was met with grave disapproval. I was told that was probably the reason he had an ear infection – didn’t he know that breastfeeding was a vital source of antibodies for babies?
There is a lack of compassion in the care of mothers and babies in this country that has nothing to do with resources or funding.
Bottom line: I woke up one morning and realized something was very wrong with my little one. I took him to see the midwife, again, and she basically told me that she was crazy. But this time it was decided. I waited until the end of the children’s clinic and demanded to see the GP. He looked at my son and called an ambulance.
She had something called mastoiditis, now a rare condition but once a common cause of childhood death. The Surrey hospital prescribed huge doses of intravenous antibiotics, but it was too late. He was taken to St George’s in Tooting for an urgent operation to remove a large cyst on his brain. The team was amazing, but we were in the hospital for weeks.
Then I was diagnosed with severe postpartum depression and all my hair fell out. My son has residual health problems. And all because that stupid woman didn’t want to listen.
I’m lucky. My children are lucky. But many are not, and that is unacceptable. I know too many women (friends, colleagues, family) with horror stories to tell, and not all of them can make them up.
The truth is that there is a lack of compassion in the care of mothers and babies in this country, which has nothing to do with resources or funding, but with ingrained attitudes, entitlement and, frankly, the arrogance of a profession who doesn’t know how to do his job well.
Let this report be the wake-up call you need.