Midwives support women however they give birth

by | 12 Aug, 2017 | Campaign, Maternity Care | 20 comments

By Katherine Hales, ARM National Coordinator

We regret the reporting in the Times and the Guardian yesterday morning (12/08/2017) of the decision by the RCM to integrate their ‘Campaign for Normal Birth’ into the new RCM ‘Better Births’ initiative.The report suggests that in the past women have been “told that they should have babies without medical intervention” and that as a result midwives have failed to refer women to medical practitioners when required to do so. It also suggests that the use of the word “normal” has instilled a feeling of failure in women who have had interventions in childbirth.

As is often the case in media discussion and reporting on childbirth the discourse becomes polarised with commentators lining up with opposing views and any more subtle points of view entirely lost. Few people and no midwives would, I suggest, promote normal birth “at all costs” but it has to be remembered that midwives are required to be protectors of normality. We facilitate the optimum conditions in which a woman can give birth safely and without the unnecessary interventions which can mitigate against physiological birth. Midwives are required to stand with women offering emotional and physical support but remaining observant and alert for any sign of problems developing for a women or her baby. This is an internationally recognised part of the midwives role supported by both RCM and RCOG.

Unfortunately these  reports suggest that midwives are to abandon the aim of protecting  normal birth and that women who hope to fulfil a plan to birth vaginally are unrealistic. We suggest that this reporting is patronising and dangerous, women and midwives know that sometimes interventions in labour and birth are necessary. The failings found in institutions and individual practitioners have not occurred because the RCM highlighted the requirement for midwives to facilitate normal birth. This obligation has always existed; but most midwives are also well aware of their duty to have open, informative conversations with women in their care to enable them to make decisions for their care which best fit their wishes and circumstances. It is also important to remember that the Royal College of Midwives are not a regulatory body and do not set standards for midwifery education or practice. The reports in the Times and the Guardian make it sound as if the RCM has this power.

There are many complex reasons why medical interventions in childbirth have increased in recent decades but midwives will continue to stand with women in protecting safe physiological birth as long women wish us to do so.

Please let us know your views in the comments.

 

Katherine Hales.

National Coordinator.

ARM.

12/08/2017.

20 Comments

  1. Phillipa Gentleman

    Thank you for this article. When I read the article which was tweeted yesterday about ‘normal birth’ I became really upset. For me midwifery has always been about supporting my clients and doing what is in their best interests. I have always maintained that at the end of the day all we want is a happy, healthy mom, baby and family. If intervention is needed for that then so be it but I do not believe that midwives make woman feel like failures if intervention is needed or that we discourage it when needed. If anything we try and assist our clients to see the reasons behind these interventions and understand why they are necessary. I maintain that woman have been giving birth since the beginning of time and we are there to assist especially when things aren’t going as planned. We are the ones who understand what it means to go through labor both physically and emotionally. I believe that at the end of the day only a midwife or/and a doula are what helps the client transition into becoming a mom. I am proud to call myself a midwife (even though the U.K. NMC refuses to acknowledge my qualifications, skills and expertise) and will always promote safe physiological birth where possible. The last thing we need is higher intervention rates just because the RCM has decided to instill even more fear in the normal birthing process in my opinion by their decision. Do they not realise that this decision only brings about more distrust of midwives from the public?

    Reply
    • Nicky Grace

      You’ve articulated that really well Philipa. It’s almost worse than this – it’s fake news as it seems the RCM hasn’t withdrawn the campaign for normal birth – they’ve integrated it into a different programme called ‘Better Births’. It seems Cathy Warwick’s remarks have been taken out of context. It’s very worrying as the article smacks of a deliberate attack on the RCM and midwives. We must stand together – you’re very welcome to join ARM (if you’re not already a member) – at least you can be with like-minded people then!

      Reply
  2. Chris Argent

    I have been a midwife and member of the RCM now for 37 years. I read the article in the Telegraph yesterday and am very annoyed , deeply offended and let down . As a midwife we are the expert in normal (physiological) pregnancy and delivery. I would never ensure a woman has a vaginal delivery at any cost else I would surely have lost my qualification by now. Being a midwife is being with woman providing individual care as the labour permits.

    Reply
    • Nicky Grace

      Agreed Chris. It’s so annoying and frustrating. The Telegraph article appears to be fake news – the RCM never made any such announcement, they integrated their campaign for normal birth into their ‘Better Births’ programme. Please write to your MP!

      Reply
  3. usha ukande

    Yes, the midwives support normality in child birth, yet they are genuinely concerned about the welfare of both mother and the baby. They spend more time with the child bearing women , and are educated to observe any thing going wrong with the mother and the fetus, well in time to refer her to an obstetrician. No midwife would ever put the women and her baby at risk knowingly. We run a midwife-led natural birthing center along-side a maternity unit run by the obstetricians and nearly half the women admitted with us are usually transferred to the maternity unit who require medical intervention, and there is no conflict no-where.

    Reply
    • Nicky Grace

      Well said Usha – if you’re in the UK please do write to your MP to say this and complain about the attacks on Jeremy Hunt.

      Reply
  4. Erica Steinhauer

    Thank you for this clear succinct over-view/critique.
    Off to share it far and wide….
    Blessings on your Work,
    Erica Steinhauer

    Reply
    • Nicky Grace

      Thank you very much for sharing Erica. We all need to spread the word about these attacks and the importance of unity for midwives and women.

      Reply
  5. Janet

    Hear, hear! Every woman giving birth has a midwife with her no matter how the birth unfolds. A midwife accompanies the mother to the operating theatre to support her during a caesarean and will stay and give support during other operative births that don’t involve surgery such as forceps and ventouse
    (suction cup) births. The midwife works with her obstetric colleagues to provide this as well as being the main carer during a non assisted birth. Therefore all midwives needs skills across this spectrum but are the experts in non assisted births

    Reply
    • Nicky Grace

      Thanks Janet! Couldn’t agree more!

      Reply
  6. Kay Hardie

    Well said Katherine.
    I cannot begin to describe the outrage I am feeling on reading and re-reading these newspaper articles.
    But my deeper concerns are the possible hidden agendas surrounding all this bad press – the erosion of the role of the midwife and the rise of the obstetric ‘nurse/advanced practitioner’ and handmaiden to obstetrics.

    Reply
    • Kay Hardie

      oops posted too soon….. At the end of all this rhetoric is WOMEN.

      Where will women go for the continuous, safe, wise, holistic and family centred maternity care they want?

      Reply
      • Nicky Grace

        That’s a very good question Kay. It certainly feels like a sustained attack on midwifery and women’s rights in childbirth. We must not give up, if anything is worth it, honoring our commitment to women is worth all this struggle. Women and midwives must stand together!

        Reply
        • Jessie

          I find it really disheartening to read this. Women all over the internet – especially Mumsnet – continually share their feelings of disempowerment – many do feel that midwives pushed them towards “natural” births they didn’t want, denying them epidurals and putting pressure on them to refuse interventions.

          If midwives’ answer to all this is to simply bury their heads in the sand and insist their profession is perfect & woman-centred, the demise of the midwife will be very fast indeed.

          Perhaps if you actually listened to the women who are telling you they want a real choice – an epidural when they want, an elective caesarean without scaremongering, a real breakdown of the statistics on incontinence (especially faecal incontinence) post vaginal birth, then you would find them rushing to support your campaign to “save the midwife”.

          Reply
          • Nicky Grace

            Hi Jessie, I’m sorry you feel disheartened by our response. Being a with-woman midwife means advocating for women’s choice whatever it is, not for the agenda of any particular health professional whether midwife or obstetrician. Our helpline receives many calls from women who have had choices denied in that they feel intervention is pushed onto them and research evidence suggests that most women prefer not to have intervention unless it’s clinically necessary – but we totally agree with you that it has to be the woman’s choice and no one else’s! We don’t think our profession is perfect, and we genuinely welcome your view. I think we all want the same thing – safe, respectful childbirth where the woman is the one calling the shots. If that means an elective caesarean then she should have that option!

  7. Edel Dobbin

    I think we also need to consider why the RCM started this campaign in the first place. If all of the interventions routinely offered to women were harm free and of no consequence, then why would we campaign to minimise them?

    I think a real danger that we must bear in mind (and is in danger of getting lost in this misrepresentation) is the very real harms that are done to women and babies in the routine application of interventions, which is very different to a necessary intervention.

    Women need to be aware of and supported to create an environment, attitude and language that is conducive for physiological/normal birth as well as the limitation and harms associated with unnecessary medicalisation of a healthy woman/baby.

    If we made that distinction then I daressy it would be much easier to identify when interventions were absolutely the most appropriate course of action.

    Reply
    • Nicky Grace

      You make an excellent point. In fact, I was only reading today the current education standards for midwifery education – it says quite clearly that women should be informed in a compassionate way of all their options including risks and benefits. Research shows shows that many harms come from unnecessary interventions.

      Reply
  8. JACQUELINE RICHARDS RM

    Its not about conflict but smarter working in teams to benefit the patient and contribute to what remains a privelege – to be present at birth, witness parenthood and contribute to new life coming into the world – with dignity and respect for fellow professionals and the contribution each has to make to ensuring child bearing and childbirth is not only a positive and fulfilling experience but safe.

    Reply
    • Nicky Grace

      Hear hear! I don’t think anyone would disagree with this – midwives are being portrayed as committed to ‘normal’ birth at all costs when this is simply untrue.

      Reply
      • Irene Walton

        I do so agree with all that has been said. What I think we must do is to high light to the people that have such undeserved power that they must start to be aware of the evidence and heed it, in that all interventions must be warranted and be as risk free as possible

        Reply

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