Since the publication of the Kirkup Report and more recently the Interim Ockenden Report there has been a concerted attempt to undermine and smear midwives, the midwifery profession, and to deny the legitimate experiences and wishes of childbearing women who wish to retain autonomy over their own bodies and births. These attempts have been led by powerful actors in government and media. They have been biased and misogynistic in tone, given the reality of female physiology, and the sex of the vast majority of midwives and birth workers. Nevertheless there exists the irony that intervention levels in pregnancy and labour have never been higher in the UK, some hospital trusts have induction rates of nearly 50% and Caesarean Section rates of near 40%. The cases which are attributed to “normal birth ideology” are failures to escalate or refer appropriately, and do not offer proof that there is fundamental, wholesale failure in the physiology of birth.
Despite the overwhelming evidence, demonstrated most recently by the Lancet series of reports, that optimal outcomes of physical, psychological and emotional health are consequent on physiological labour and birth with minimal intervention, recent published comment, interviews and blogs from the RCM suggest this evidence has been ignored. The majority of professional midwifery associations in the world continue to see their role as promoting and supporting the physiology of birth as reflected in our NMC Standards of Proficiency for Midwives. This view is supported by the World Health Organisation, FIGO, and the International Confederation of Midwives, and is associated with a promotion and strengthening of professional midwifery in countries where it is not present or robust.
The UK was among the first countries in the world to develop a strong midwifery profession and was historically regarded as having a maternity service to aspire to. The RCM has undermined and misrepresented the evidence regarding physiological birth and has allowed itself to indulge in the demonisation of the profession it was formerly presumed to represent. The failures noted by the recent reports in maternity services are complex, institutional and systemic and should not be laid upon individuals and professional groups. There is no evidence that wholesale increases in levels of medical intervention in labour and birth will reduce rates of stillbirth and intrauterine death, since countries which have better outcomes than the UK, also have lower intervention rates. In the UK, NHS trusts have varying rates of stillbirth and intrauterine death, higher medical intervention rates in labour do not correlate with improved outcomes in these trusts.
All midwives are aware of the desperate shortages of staff in many places of work, and poor staff retention rates, as many find the reality of their work prevents them from offering the standard care they aspire to. We are convinced that the recent messages received loud and clear from our professional body, suggest that our primary role in supporting physiological childbearing is a mistake which should be rectified, and that our attempts to give compassionate continuity of care are not appreciated. This radically undermines morale for many midwives who hear these reports. They negatively impact the confidence of the population in physiological processes and the midwifery profession. We may take from these messages the assumption that autonomous professional midwifery is no longer required in the UK, even by our own professional body, the RCM. We repeat our request that the board of the RCM resign and a new board be elected and that the CEO is reappointed to reinstate the RCM as a professional body which supports its members.
Initial signatories:
Margaret Jowitt
Katherine Hales
Catherine Cooper
Dr Irene Walton
Tracey Osben
Kerrianne Gifford
Becky Millar
Hilary Rosser
Pam Dorling
Signatures
Roseann Pailor, Midwifery sister, GWHNHSFT
Maddie McMahon, Doula trainer, Developing Doulas
Anika Riesen, Midwife, UHD
Aida Kaman
Vanessa Beecham, Antenatal teacher, NCT
Clare Williams, Midwife, Swbh
Margaret Jowitt
Maria Bosco, Midwife, UH sussex
Victoria Aldwincklr, Midwife
Claire Essery, Midwife, Wexham Park Hospital
Rachel Oliver, Midwife, WVT
Trudy Brock, Midwife, Birthjourneys Midwifery
Madeline Jordan, Midwife, UHD
Amy Batstone, Midwife, NHS
Sarah Davies, Former Senior Lecturer Midwifery
Lucy Hale Evans, Environmental professional, National Park
Amalia Alonso Guerrero, Midwife, NHS
Frances Barnsley, Retired Midwife voluntary Midwife Mongolia and Myanmar
Becky Reed, Midwife (retired), Albany Midwifery Practice
Antonia Gorman, Doula, Melliapis
Leah de Quattro, PhD Researcher, University of Manchester
Grace
Karen Henry, Midwife, ESNEFT
Laurie, Student Midwife
Lucia rocca-ihenacho, Lecturer and CEO, Midwifery Unit Network & City, University of London
Emily Arnold, Midwife, MSI Reproductive Choices
Laura, Midwife
Sallyann Beresford, Doula
Kirsty Mason
Lottie Blunden, Midwife
Nadine Edwards
Rebecca Crewdson, Community Midwife, NHS
Amanda Wyatt, Midwife
Deepa Santhosh, Student Midwife
Luisa Jbira, Midwife, NHS
Paula Cleary, Campaigner, Doula and Writer, Birthplace Matters and March with Midwives
Amanda Williams, Midwife, Wrightington, Wigan & Leigh nhs trust
Rachel Whittalwilliams, Swansea bay university hb
Mary Yff, Midwife (not currently registered), Amani Birth, Childbirth Educator
Rebecca Master, Ex-midwife
Olga Tonkin, Midwife, RCHT, Cornwall
Mavis Kirkham, Midwifery Professor Emerita
Katrina Fraser, Midwife, NHS Fife
Mieke Brakeboer, Community midwife, NHS Scotland
Claire lewis, Soon to be student midwife
Heidi, Hypnobirthing practitioner
Wendy Few, Midwife, Sheffield Teaching Hospital Trust
Christina Simpson, Midwife, Australia
Maria Teresa Conti, ostetrica, Roma
Yasmin Raeis, Midwife, Rsuh
Sheryl Wynne, Birth Doula
Tamsin Bailey, Midwife
Elke Heckel, Midwife retired, Independent
Lisa Mansour, IBCLC, Independent
Cathy Walton, Midwife (retired), Albany Midwifery Group Practice and King’s College Hospital
Catrin Elis, Midwife, NHS
Karine reynaud, Midwife, Imperial nhs trust
Vicky Barbour-Andrews, Birth Trauma Coach, Self employed
Sarah Ardizzone, Midwife, NHS
Caroline Spear, Doula, Homeopath SDSHom, Nutritonist
Emma Broyd, Ex-Midwife, Current Health Visitor
Lucinda Holman, IBCLC, Doula, Private Practice
Eleanor Cook, Doula and NLP Trainer
Angela Howard, Mother
Molly O’Brien, Midwife, midwife educator, associate lecturer, Optimal Birth
Jessica Earnshaw, Midwife
Shonagh, Student Midwife
Daphne Glenn, Health Visitor (previously midwife), SE Health and Social Care Trust
Ian Kemp, Midwife, CQC
Amanda Garside RM, Independent Midwife, IMUK
Sophie, Student Midwife
Lynne, Midwife, NHS
Dawn Jacobs, LMC Midwife, NZCOM
Jenny Jackman, Registered Midwife, Barwon Health
Sara Merritt, Midwife, Ex-121 midwives
Sandra Bush, NCT antenatal teacher, NCT
Rosie Soul, Doula
Santina zaccarini, Midwifery Team Leader, NHS Forth Valley
Effrosyni Georgiou, Midwife, Chelsea and Westminster hospital
Borbala Polya, Doula, Antenatal educator, NCT
Amanda Burleigh, Midwife RM, RGN, Independent
Debbie Nuttall, Midwife, ELHT
Gill Marchant, Doula
Carole Goddard, Midwife, Independent
Nadia McEwen-Prior, Midwife, ESTH
Sorcha Hamill, Midwife, currently studying for SCPHN
George, Midwife
Michaela Lavelle, Antenatal Teacher, NCT
Manuela, Homebirth midwife, London hospital
Shaunee Jamieson, Midwife, NHS
Katie, Antenatal Educator
Chloe, Student midwife
Jacqui Tomkins, Midwife, Chair of IMUK, Independent, London Birth Practice
Thea Riley, Midwife, UHMBT
Rebecca Cotton, Midwife, NHS
Georgia Macad, CPM, Birthing Home Director, MSc student, Certified Professional Midwife, North American Registry of Midwives
Cate Langley, Retired consultant midwife
Sonia richardson, Midwife, University of the west of England
Lauda McLaren, Midwife, UHS
Michelle, safehands doula, Doula, hypnobirthing teacher
Tara Luke, Doula
Sónia Barbosa da Rocha, Razao dSer Lda, Portugal
Gifty Ahmed, Midwife, NHS
Charlotte Keyworth, Midwife, lecturer in midwifery
Nicola Attridge, Student Midwife
Karen Lawrence, Former midwife and childbirth educator
Wendy Proctor, Midwife, NBT
Jennifer Tribe, Midwife retired, Transformation and wellbeing coach
Sabrina
Deborah Hughes, Retired midwife, ARM
Mary Sidebotham, Midwifery consultant, Australia
Dee, Midwife, NHS
Suzanne Smith, Doula
Nicola Norris, Speck
Jacqui jarrett, Midwife, NHS
Fiona Willis, Doula and women’s health therapistFiona Willis, BirthDance
How have we arrived at this point..? Where the RCM head midwife is apologising for midwives promoting normal birth.
Service users have been forced into submission out of fear that their own bodies might not perform how they are meant to. Reclaiming childbirth as a sacred rite of passage (Reed, 2021) is vital. The birth journey, has been forgotten and replaced with a rushed end-point. To wait, comes from a root word meaning to watch attentively and was once a highly regarded experience. These days, the idea of waiting conjures up the idea of being tuned out and of idling (Monk-Kidd, 2006). We, as Midwives have also been forced into submission through fear. We are greatly affected by cognitive dissonance, which is causing more burnout and deteriorating mental health, resulting in many having no choice but to leave the profession.
Our profession needs leaders who understand and believe in women, birthing people and birth as the individual and unique life event that it is.
Signed
My main concern is the militancy against the profession and its work to support physiology. Undoubtedly this driven by anger amongst some of the campaigners, anger that is completely justified.
However their methods must be questioned particularly when they make claims for using interventionist approaches that is unsupported by evidence; and seek to influence midwifery education and practice both online and in the NHS.
The RCM has given this group carte blanche to shape midwifery work in the way they see fit as opposed to evidence that informs it. How can this be allowed?
Never have I been so
Dishareartened in this profession looking for a
Way out before something forces me out ?
Please add my signature.
And I would like to add that I began my training in 2001 and as a Student midwife was lucky to be assigned to a passionate Community Team providing Antenatal & postnatal care, Antenatal & postnatal education, Team intrapartum care for low risk multips & homebirths – they were the old G grade – band 7 equivalent – with a few F grade (band 6).
If it wasn’t for this team I wouldn’t have seen normal births.
Our student midwives & NQms need to see normal physiological birth and be supported by senior team members.
Senior team members should be enabled to provide a gentle quiet presence in the background/room. A steadying presence to facilitate confidence in the NQms learning journey.
We need supervisors of midwives back and we need more midiwfery voices on the NMC board – if not then bring back our own regulation. Our once proud and long-standing tradition of self-regulation has been eroded away. We are not nurses we are autonomous practitioners and it’s disgusting that this is no longer recognised. Some of us have been top Band 6 Community & Homebirth Midwives since 2 years after qualifying.
The RCM has completely lost its way. Mortality rates in the US are absolutely shocking, for a developed nation. Why? Because of a highly obstetric model which is extremely patriarchal and driven by economics. It would seem the RCM will happily sell us down the river in the same manner.
Add my name
Student Midwife
My husband and I will be grateful forever to the wonderful independent midwives who supported our pregnancy pathway leading to the welcome of two wonderful children, now in their 30s, into our family.
We have been astonished and angered by recent suggestions that, if we have understood correctly, a reluctance to refer mothers for Caesarean sections and other interventions may have resulted in poorer than expected outcomes. This flies in the face of all we know about experienced midwives practising their craft with concern and love for all that birth represents to expectant parents. Those helping, nurturing hands are treasured beyond words and the current criticism and muddle-headed representations to Parliament by those who should be honoured to represent the proud profession of midwifery via its professional body must stop.
We have no axe to grind, only a desire that the very best midwifery practice and practitioners should be available to all mothers-to-be throughout the UK, whatever their circumstances. Please do not let all that has been achieved over the past few decades in caring for women and babies here in the UK be compromised.
Thank you. So needed this. Just wish our professional body spoke up for midwives as you have. Can I tweet your comment.
It’s easy to see why so many midwives have left the profession. There is no support and we are fed up with being slated. What about all the good things we do!
My heart breaks for anyone affected negatively in this report. It also aches for all the Midwives who strive every moment of their working lives to support and facilitate physiological birth for the women that hold that dear to them.
Midwives are trying very hard to stay true to the art of midwifery; nobody makes mistakes deliberately and we all want to do the very best for those we care for. Morale is at it’s absolute lowest at present and more will leave in the very near future.
I only received the email yesterday evening (30th) and have only just read about adding my name to the list. I have done but think I’m too late to be counted?
So sad to see the rapid disintegration of support for birthing mothers and the midwives who support them