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Safety First - why patient safety should be the priority above a 'normal birth'

Medical negligence specialist Nicola Wainwright comments on the recent news that the Royal College of Midwives has dropped its ‘normal birth’ campaign.

Mother with newborn
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Nicola Wainwright is a partner in Leigh Day's clinical negligence team. She deals with a wide range of claims involving different types of negligence and injuries. Follow Nicola on Twitter @NicWwright
On Saturday The Times reported that The Royal College of Midwives (RCM) has dropped its ‘normal birth’ campaign and indicated women will no longer be told that they should have babies without medical intervention.
The RCM said “what we don’t want to do is in any way contribute to any sense that a woman has failed because she hasn’t had (what they called) a ‘normal birth'”.
However, they denied the campaign had affected patient safety.
Yet, I am sorry to say I have met too many parents who did feel that their midwife’s ideology of achieving a ‘natural birth’ without any medical intervention, rather than their wishes or their and their babies’ safety, dictated the way their labour and delivery was managed.
I find it difficult to understand how that can ever have been considered reasonable when what is at stake is the life of a baby, and sometimes the mother.  I do not think anyone if asked where in their list of priorities they would put their baby’s safety would not say first?
I am not intending to scaremonger and of course happily many women can and do give birth without any problems.
However, unfortunately, some labours do not go to plan. For some women medical intervention is a necessity. And for them an ideology that sees intervention as ‘wrong’ can and does have fatal consequences.
Of course, the parents we meet in our work have had this brought home in the most devastating way. They or their babies have been seriously injured or died. They provide tragic first-hand evidence of the devastating consequences of the failure of midwives to seek help and arrange intervention promptly.
Sometimes that delay is not intentional but in a significant number of cases parents have reported to us that their midwife made them feel, or in some cases explicitly said, that a transfer to a medical ward or the need to consult a doctor would be a ‘failure’ and so avoided both until it was too late. There was a definite impact of the push for a ‘natural’ birth on patient safety in those cases.
For example, I acted for bereaved parents whose baby died after they had chosen to give birth in a midwifery-led centre, not knowing that that meant if something went wrong it would take longer to get help and to deliver the baby. When the midwife could not find the baby’s heartbeat she still refused the parents’ first request to transfer to the labour ward and the transfer only finally took place at the parents’ insistence, sadly too late.
Similar issues were, of course, also seen in Morecambe Bay where 11 babies died. Dr Kirkup who led the inquiry into the deaths of those babies and a mother at Furness hospital in Cumbria found amongst other failures an “inappropriate pursuit of normal childbirth”.
This weekend Cathy Warwick of the RCM said she was sceptical that the normal birth campaign had led to any midwife pushing ‘beyond the point of safety', seemingly suggesting that the midwives at Morcambe Bay were ‘one-offs’.
However, the cases I have seen did not occur at Morcambe Bay and to me that suggests that this ideology has been pursued past the point of safety, not just by the odd midwife, but by at least a number of midwives across the country. Clear guidance and re-education which puts both mother and baby safety first is now necessary.

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