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The NHS cult of natural birth Women are being denied crucial medical intervention

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December 5, 2023   7 mins

One of the riskiest things you can do in an NHS hospital is have a baby. Two thirds of NHS maternity units are not “safe enough” for women giving birth, according to the Care Quality Commission, while a quarter deliver “a high risk of avoidable harm to mother or baby”. But poor maternity care is nothing new: the past decades are littered with examples of scandals and promises of “never again”.

I was three months pregnant, in March 2022, when midwife Donna Ockenden’s government-commissioned report was published, detailing the extreme failings in maternity care in Shrewsbury and Telford. Thinking about giving birth in these circumstances was more than a little nerve-wracking. 

For many women, pregnancy and childbirth is a means to an end — something you have to do to get the baby you and your family so desire. And yet, a picture is being painted in the NHS of a custom-made journey of self-discovery that allows women to realise their true biological and spiritual potential. I remember an appointment, late in pregnancy — when I was trying to keep the weight off my swollen ankles — during which I was asked by my midwife whether I had filled out the playlist requirements in my NHS-issued birth plan (the “blue book”). It is only now, a year later, that the contrast between this moment and the reality of the neglect I suffered during my son’s actual birth can raise a hollow laugh.

Few investigations into the UK’s dire maternity care seem to want to explore the emergence of a natural or holistic ideal. Most focus on funding and staffing — which almost everyone agrees the NHS is lacking. But in every scandal, the same problems arise: delayed interventions for babies with low oxygen or slow heart rates, caesarean sections being refused and women’s concerns being ignored.

For many of those women whose children have died, poor funding or staff morale were not the cause. “Beatrice died with three midwives and two doctors in the room,” the interminably brave Emily Barley tells me. “There was not a lack of staffing, that was not the problem. The cultural issues, the attitude issues, the lack of leadership — these are way more important.” Beatrice died in May 2022 due to medical negligence after staff at Barnsley Hospital failed to monitor her heart rate and missed signs that she was in danger. Like many of the mothers and babies who have lost their lives to poor maternity care, Beatrice’s death was wholly avoidable — proper and timely medical intervention would have delivered her safely into Emily’s arms.

These appalling fatalities only tell part of the maternity care horror story. There are all those children born with serious brain injuries due to complications in long labour, or the women left with severe injuries which are rarely reported. I had the good fortune to leave with a healthy baby after an unjustifiably terrible ordeal and women like me often clam up — partly not wanting to relive the trauma, partly from guilt at not feeling joyful during those first few days of a child’s life. Perhaps worse than being denied pain relief, left in soiled sheets and ignored by midwives was the shame I felt for having not enjoyed the experience. Photos of his arrival show me pushing him away. For months, midwives had lectured about how beautiful, wonderful and natural this moment would be; how I would bond with him during skin-to-skin contact and breast-feed him immediately. Those words rang in my ears as I realised my first meeting with him — after surgery and a haemorrhage — would be one of nausea and pain.

But unlike our mothers and grandmothers, those of us giving birth today have Twitter, where an informal group of women digging into the background of NHS policy and practices have become something of a lighthouse in the storm of maternity scandals. “I have the receipts,” maternity safety campaigner Catherine Roy tells me, describing how care has been shaped and influenced by a push towards “natural” childbirth. Her feed is full of the “complimentary therapies” offered during childbirth in NHS trusts: things such as “sterile water injections” for pain relief or “mindful relaxation techniques” such as hypnobirthing for £30 a pop. She points out that such practices are no longer kept to the fringes. Staff working at Nottingham’s Queen’s Medical Centre and City Hospital’s maternity departments, both mired in scandal, were found to have “been using aromatherapy to treat infections, ‘hysteria’ and help prevent labour complications”.

How did we get here? How has it become acceptable for women to be neglected during labour, refused pain relief, and to be encouraged to delay — or even be denied — medical intervention? Throughout the mid to late-20th century, feminist movements interested in reclaiming women’s bodies began to have influence on midwifery. Books such as Our Bodies, Ourselves (1970) sought to challenge a sexist culture by encouraging women to take ownership of their bodies’ functions. This was an era when unnecessary interventions — from shaving to enemas — were common in maternity care, making many women feel like livestock instead of mothers. But the new emphasis on women’s bodily autonomy also began to view childbirth as a part of women’s identity — and, as such, something that should be entirely dictated by a woman’s natural processes. 

Catherine tells me that, in the Nineties, the views of non-medical organisations such as the National Childbirth Trust (NCT) were given almost as much weight as the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists. The idea that “pregnancy was not an illness” and therefore didn’t necessarily require medical intervention, became prevalent. Targets for vaginal (or “natural”) childbirth rates were introduced. Much like the recent furore over NHS guidelines being tweaked by external organisations such as Stonewall, part of the ethos of maternity care has been shaped by external organisations with their own agendas and views of how women should be treated. As such, the idea of having a baby as a means to an end diminished, and the view of childbirth as an authentic experience for women at home, free from interfering doctors, proliferated.

Worse still, this move towards a hands-off approach was at least partly the result of a cold, cost-benefit analysis by the National Institute of Health and Care Excellence (NICE) in the early 2000s. A remarkable document from the Parliamentary Office of Science and Technology in 2002 discusses the problem of high caesarean rates, stating that women requesting c-sections are “unlikely to be determined simply on the basis of ethics and evidence, but is also a question of resources and cost effectiveness”. The same document notes how some hospitals have a “culture that takes pride in low CS rates”. It seems that a cash-strapped NHS had allowed a “nature-knows-best” approach to flourish in order to conceal their inability to meet the needs of women’s medical care. 

What has not changed is the fact that childbirth is often unpredictable and complicated. Women who sail through pregnancy with no problems can swiftly find themselves in life-or-death situations. Mary (not her real name) had expected a normal birth after a healthy pregnancy, but developed sepsis and complications as her daughter’s heart rate dipped. Eventually, after being unable to provide an epidural because of the sepsis and unable to monitor the baby’s heart rate properly, staff approached Mary with a choice. “They told me we can give you the option of having an emergency section, or wait an hour just to see how it goes,” she tells me. “But why give me the option to go for an emergency section? Why would I risk waiting? It confused me, I was worried — is it an emergency, or isn’t it?” Hopped up on gas and air, after hours of painful labour, Mary was asked to make a decision that could mean life or death for her baby — a decision that staff should have had the authority to make.

The NHS “fell in love with a certain idea, that birth could be this beautiful, peaceful experience”, Ruth Ann Harper from the Infant Feeding Alliance tells me. “If you breathe your baby into the world, there will be oxytocin and perfect bonding, you’ll breastfeed with ease, create a perfect microbiome, tackle poverty and be an activist against unethical practices by the formula industry in developing countries,” she says. “All of that is a very enticing fantasy — but it’s nothing more than a fantasy.” 

Harper, along with Sue Haddon, set up the feeding organisation to challenge thinking around a breast-is-best mentality. They believe that overcomplicated, overbearing medical advice — such as how to “bond” with your child after birth — has been forced on women when it is unnecessary. In contrast, what should be the realm of medical expertise (such as delivering a baby safely) seems to be focused on natural processes. “I respect women who want lavender oil and home births and want to breastfeed well into childhood — do whatever you like,” says Harper. “But that does not mean the NHS needs to produce a leaflet about it and change what it knows to be true — that quite a lot of us have complications and need help.” 

In some ways, not much has changed for women giving birth. My mother tells a story of midwives in the hospital laughing at her for asking for the TENS machine — an instrument which did little more than tickle her back. But from hypnobirthing to antenatal classes and breathing techniques, Catherine argues that a focus on “natural childbirth” has become the norm, while “giving pharmaceutical pain relief to women” is seen as a failure — what she describes as “a denial that childbirth is painful”. 

For Professor Ellie Lee, director of the Centre for Parenting Culture Studies at the University of Kent, part of the problem is that women have been told birth has to be “meaningful, that it has to say something about who you are as a woman”. This pressure on women, to brave it out on their own, reflects a wider change in relations between patients and the NHS, she tells me. “There has also been a shift towards embracing alternative medicines, and a belief that if we do the right things for our bodies, our bodies should be able to do the right thing for us.”

As a result, we have ended up with a maternity system that seems to think doing very little for women and their babies is the preferable form of treatment. And while there is nothing wrong with wanting a natural childbirth, this is difficult territory. For not only are we risking women and babies’ lives by pretending that childbirth is not dangerous, but we are also failing women in the most basic aspects of care and common sense. For Sue, whose daughter was hospitalised with serious problems, including dehydration, after she was told not to supplement her milk supply for fear of affecting her ability to breastfeed, the needless harm of poor care cannot continue. “I know that I’m one of the lucky ones. I know that there can be more devastating harms than this. And I know that if that had happened, I wouldn’t be here talking about it.”

The baby groups and stay-and-plays I have attended are full of women whispering similar stories of mistreatment to one another, vowing not to return to that hospital again. But for maternity staff to rediscover their medical authority, and do what they were trained to do — deliver healthy babies and keep mother’s safe — more of us have to speak up and prove that this fetishisation of a “natural” fantasy was not done with our consent. 


Ella Whelan is a freelance journalist, commentator and author of What Women Want: Fun, Freedom and an End to Feminism.

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Nell Clover
Nell Clover
9 months ago

The article unfortunately confuses several issues, which shouldn’t be allowed to detract from the general argument made.

It needs correcting that there is hardly any research into the “natural ideal”. There is lots of scientific research into natural maternity care. Indeed, it was prompted by real world data showing it is generally far safer. All medical intervention carries risk. It turns out less is more for most child births. This is most simply evidenced by the safest performing maternity systems in the world having far lower rates of medical intervention and fewer c-sections. Of the Western healthcare systems, (after adjusting for obesity related complications and immigration) the USA and UK have significantly lower rates of natural birthing and very poor newborn mortality rates.

That said, natural childbirth is not to be confused with complimentary therapy or doing nothing. The article reveals an NHS maternity system with midwives that have confused complimentary holistic guff with scientifically proven techniques for managing natural birth. Natural childbirth isn’t hands off either: natural child birth requires robust medical risk screening at all stages of pregnancy including through every moment of delivery.

These maternity issues aren’t restricted to the NHS. The entirely different healthcare system in the USA is suffering the same problems. Clearly, this is a cultural problem. This cultural problem afflicts both patient groups and midwifery: the loudest voices in both groups silencing moderate voices and dictating how midwife services work for everyone. The “Guardian reader” effect.

The underlying issue is rejection of the scientific method. Instead, UK midwifery is now guided by bodies like the NCT which prioritise anecdotal experience above statistical significance. This is a part of a much broader societal malaise in the UK, and rapidly growing elsewhere in the West. It is no coincidence that the more scientifically literate societies of Japan, Finland, Estonia, and Singapore manage to combine natural childbirth with the very best, very safest maternity care in the world.

Last edited 9 months ago by Nell Clover
Jeremy Bray
Jeremy Bray
9 months ago
Reply to  Nell Clover

Ideology is the enemy. There is also a reluctance to give pain relief when desired. My own birth in 1946 I am told involved a battle between nurses who were reluctant to give pain relief and my father a pathologist and my mother who desired such help. So such issues are not new.

The birthing classes delivered at the hospital to my wife and me and other couples who were encouraged to make birthing plans were entirely unrealistic in the face of real needs during the actual process.

Sarah Finney
Sarah Finney
9 months ago
Reply to  Nell Clover

I agree it’s now culturally ingrained amongst parents and is going to take a lot of work and re-education for things to change.

I attended positive birthing group sessions, it was the only option open to me in the very rural area I live.

The attitudes I heard shocked me, women considering home births after CS, a women with a newly diagnosed heart problem determined to persevere with her home birthing plan against consultant advice.

I’m a paramedic and therefore have, limited, obstetrics training and experience, I’ve seen shoulder dystocia, and I’ve listened to traumatised colleagues recounting blow by blow accounts of transverse lies out of hospital, and catastrophic haemorrhages. But still I began to absorb the pervading ethos of hands off at all cost.

Then I went to visit a close friend, we got talking about birthing. My friend is a obstetric disaster story. Of her 4 babies one was an extreme premi due to complications of, an ultimately unnecessary, amniocentesis, one required episiotomy and forceps, the next was tragically stillborn at term due to an abruption, nobody’s fault just horrendous bad luck, the fourth was the most heavily monitored pregnancy you could imagine with a planned C section delivery.

My friends advice to me was, so long as you walk out of the hospital with a healthy baby in your arms within a reasonable time frame after the birth, how you get to that point really doesn’t matter. If it’s natural birth – fine, if baby needs a bit of assistance – fine, if you need a C section – fine.

After that I ripped up my birthing plans I’d already started and rewrote them, much simpler, and I lot more “if the midwife or doctor feels they need to intervene then they have my consent to go ahead without further discussion”.

As it was I had a natural delivery, monitored via scalp attached monitor throughout, and home next day.

Catherine Farrar
Catherine Farrar
9 months ago
Reply to  Sarah Finney

I’m sure you’re not suggesting that if a woman is treated without respect and dignity that’s okay as long as the baby is healthy?

Catherine Farrar
Catherine Farrar
9 months ago
Reply to  Sarah Finney

The problem isn’t just silly women and midwives who are against intervention. So often in cases where thing go wrong the problem is “experts” not listening to womens’ concerns – this doesn’t t just apply to maternity care. Women need to have a voice to Improve outcomes. If you adopt a “you’re the expert Dr, you know best” attitude, what happens when you know you need intervention and the Dr doesn’t listen?

elaine chambers
elaine chambers
9 months ago

The NCT was new and therefore private in the UK when I gave birth and what I’d learned from them decidedly annoyed the NHS so I ended up being shaved, given an enema(SP?) and treated much like a farmer treats his herd so that nothing would get in the way of the obstetriction’s clean hygenic experience. Harsh lighting, noise, constant internal interference actually slows down the birth. Episiotomies were routine regardless, therefore stitches followed. Kindness was not on the agenda, a screaming woman in the shared labour ward was actually slapped. This, would you believe it, was at the EGA back in the 1970’s! Just as patriarchal as any male institution.
A thought experiment for the men here to consider. Have you tried pooing in a busy corridor with lots of other men and a doctor popping his finger up your nether regions to see how far your feaces have descened? Not at all condusive to a pleasant evacuation, wouldn’t you say?
My NCT instructor, a white South African, was frank about natural childbirth and gave a list of things that can go wrong. Her instructons were, if this happens abandon natural and go tech she warned. She continued, there are foolish romantic ideas of African women just crouching down and dropping babies without any fuss or pain. It’s not true the death rate in child birth is high, around one in six. The probem is that once the NHS got it hands on natural childbirth it became an ideology ( probably influenceed by economic presures) and so lost its basic commonsense.

June Davis
June Davis
9 months ago

I don’t see this as an either/or decision process. I want to be able to express my desire to manage my health care along with understanding that a doctor has a lot of experience that I don’t have, and is often in a better position to make a decision.

Ardath Blauvelt
Ardath Blauvelt
9 months ago
Reply to  June Davis

To say nothing of having the equipment and ability to intervene.

David Morley
David Morley
9 months ago
Reply to  Nell Clover

Great post. Natural is best is a pretty good heuristic, but it’s far from infallible and needs to be backed up with science. And so called “natural” practices are not always natural at all.

I suspect that part of the cultural history is that in the US and U.K., feminism became entangled with all sorts of new ageism and counter cultural currents. The natural became associated with the good and the female. The unnatural, with the bad and the male. Science was even portrayed as a kind of “rape” of “mother earth”.

This cultural trend was not as strong in other countries.

Dougie Undersub
Dougie Undersub
9 months ago
Reply to  David Morley

The “bad and male” also feeds into the fact that midwives are almost all female and most obstetricians are male.

Stuart Bennett
Stuart Bennett
9 months ago

The NHS is probably trying to save money on consultants and medication so they can afford more diversity champions. Because god forbid any organisation would be be doing what it’s meant to be doing nowadays.

Steve Murray
Steve Murray
9 months ago
Reply to  Stuart Bennett

Vast sums are expended every year on other things which might be avoided – such as ever-rising premiums paid to the Medical Negligence Scheme, the NHS provision for payouts following avoidable errors resulting in injuries and deaths.

These are due to internecine battles between consultant firms, different professions and sheer damn carelessness and perennial failure to “learn lessons”. All the funding in the world won’t change those things. Personal liability would, starting with automatic demotion and retraining where negligence is found.

As we see in today’s news, culprits simply get another job elsewhere.
https://www.bbc.co.uk/news/health-67565498

Last edited 9 months ago by Steve Murray
Ali Maegraith
Ali Maegraith
9 months ago

Childbirth is a minefield. No woman should have a certain philosophy of birth foistered on her unknowingly. Is there a problem with the education programs at the NHS? Do women understand the reasons why birth interventions are avoided as much as possible, in order to minimize further and further interventions? These women clearly felt they were voiceless in the system, vulnerable and some have even lost their babies. Ironically, it’s the natural birth movements that have steered maternity care away from a doctor based model in which the experiences of terrible harm took place and women were required to be completely passive in the process. Mandatory episiotomies anyone? Clearly women are a significant part of the birth process (!!) and the monumental reforms in childbirth practice (kitzinger, odent) placed women rightly in the centre. But women don’t deserve to be lied to. If you are having a baby, get independently educated and prepare yourself well.
Childbirth for the first time is a shock. It’s painful. It’s not at all romantic, It’s hard work. A women’s body goes into an incredible mode that is both awe inspiring and a little scary. No amount of lavender oil will hide that reality.

Stuart Bennett
Stuart Bennett
9 months ago
Reply to  Ali Maegraith

Didn’t some terrifying percentage of women and/or children die in natural childbirth before the advent of maternity care?

Ali Maegraith
Ali Maegraith
9 months ago
Reply to  Stuart Bennett

You mean to say ‘modern maternity care’. There have been midwives caring for women for 1000s of years. Of course medical intervention is life saving in childbirth (and is sadly lacking in many parts of the world) but for the majority of women, it is not needed. The problem is when women with healthy normal pregnancies are channelled into a system that anticipates the worst, when well prepared, these women are likely to have a straightforward birth.
Women died in childbirth in the past for many reasons. Poverty, poor hygiene, higher risk of infection, lack of access to midwives.
Many many more women will end up dying in childbirth when we’ve forgotten how normal birth takes place and become completely dependent on a surgeon and an operating table!

Jane Anderson
Jane Anderson
9 months ago
Reply to  Ali Maegraith

Quite! One thing which is now a rare creature is a fully confident, capable midwife. So many now seem to spend most of their time watching machines, rather than recognising signs.
I’ve certainly seen how one intervention leads to another, until you have a full blown emergency on your hands, with neither the woman nor the staff feeling in control.

Vesper Stamper
Vesper Stamper
9 months ago
Reply to  Ali Maegraith

Indeed, outcomes improved markedly with the understanding of hygiene and infection care. That alone counts for more than we know.

Peter B
Peter B
9 months ago

“Most focus on funding and staffing — which almost everyone agrees the NHS is lacking.”
Always claimed. Never proven.
I for one disagree. The first order problems with the NHS are not to do with funding, but management, organisation, culture and priorities. Until we get to grips with those, throwing more money at it will only make it worse. Similar to Brooks’ First Law of software project management: “adding manpower to a late software project only makes it later” – a critical observation of the communications and organisational overhead of large and poorly managed organisations.

Matt M
Matt M
9 months ago
Reply to  Peter B

I disagree too, Peter.
The NHS gets 9% of UK GDP in taxpayer funding, 11% of GDP in total funding when private funds are included. Same as the health systems in New Zealand, the Netherlands, Sweden and Japan. Only France, Germany and the USA spend a higher % of GDP in taxpayer funding.
As for staffing, the Conservative manifesto in 2019 was aiming for 50k extra nurses over the course of the parliament. That target was hit in Sept 2023 with 51,234 extra nurses having been recruited. The total nurses in the NHS went from 300,904 to 352,000.
In my firm we run “lean” which means that extra resources and money are almost never available and managers need to hit their targets using their existing people. This requires a laser-like focus on the teams critical objectives, jettisoning any distractions or “nice-to-have” objectives, accurate monitoring of success and failure and only recruiting and retaining managers who can do the job – and sacking those that cannot.
That is what the NHS requires.

Vesper Stamper
Vesper Stamper
9 months ago

I don’t have time to go into how confused this article is, as Nell Clover says below. As a former midwifery apprentice, childbirth educator and doula who had two home births in which complications were competently managed, it seems that normal birth—which most women can and do have—is treated as a tool of abuse.
The author states: “It seems that a cash-strapped NHS had allowed a “nature-knows-best” approach to flourish in order to conceal their inability to meet the needs of women’s medical care.”
This is a good premise, and I’ll grant that in a mandatory system like NHS one can anticipate that cost-cutting bureaucracy would, of course, want to don the mask of “natural childbirth” to justify neglect. But that’s not what I read here.
In midwifery we talk about the “cascade of interventions”, in which emergencies often begin several steps back in the childbirth process, even before labor begins at all. We don’t know why a baby ended up in distress or why a mother ended up in emergency surgery, but the message persists that childbirth is inherently dangerous, which is not true.
The nineties and early 2000’s produced reams of scientific literature about the inherent safety of the birth process and how easily interventions can cascade into a mess. But somewhere in the 2010s, it seems, we abandoned that notion in women’s health and swung back to a belief that a woman’s body—and her baby’s—is her enemy. I’m sure we can think of examples of that belief on multiple levels. But this gnostic holdover swings back into fashion every now and then and freaks us out, and we must refuse.
Emergencies and tragedies do happen. Life is disappointing and terrible and I wish we could make it perfect. But the more important thing is to examine what led early on to the emergency so that care providers can do better. Obviously not monitoring heartbeats and offering essential oils for infection is no standard of care at all—to call it neglect is to say almost nothing. But very often, these are iatrogenic issues and not the fault of the birth process itself, or else we wouldn’t be here with 9 billion people on the planet—and don’t tell me that’s because of the miracle of the epidural.

David Morley
David Morley
9 months ago
Reply to  Vesper Stamper

But somewhere in the 2010s, it seems, we abandoned that notion in women’s health and swung back to a belief that a woman’s body—and her baby’s—is her enemy.

Thank you for an interesting post. I don’t know enough to verify the above, but am not surprised by it. So many of these things seem to swing back and forth based on ideology and fashion rather than science. Indeed, they seem to track social trends in wider society far better than they track scientific evidence. Worse yet, sometimes the scientific evidence seems to track social trends too.

Helen Hughes
Helen Hughes
9 months ago
Reply to  David Morley

And what is science apart from our attempts to understand nature, usually through reduction, often missing the whole picture? As a mother of four I feel very uncomfortable with the idea of my body, pregnancy and birth being reliant on scientific evidence. I trusted myself and my body’s innate knowledge, and the more I did this the easier the births were. Including twins. All natural births, all over aged 34.

Helen Hughes
Helen Hughes
9 months ago
Reply to  Vesper Stamper

Thank you so much for this comment. And for your work.

David Morley
David Morley
9 months ago

set up the feeding organisation to challenge thinking around a breast-is-best mentality

We need to recognise that both sides in this debate are ideological, and originate in different takes on feminism. The pro bottle side is about freeing women from the limitations of child rearing. Whether breast is best should be determined scientifically, not by an ideology. If it is best, then women should be told that plain and simple. Their choice is then an informed one.

Vesper Stamper
Vesper Stamper
9 months ago
Reply to  David Morley

Yes, this was one of the more head-smacking moments in the article for me. Breast is best, and yet we recognize not every woman can (for myself it took a team of caregivers to rescue my supply), and not every woman chooses to for whatever reason, and yet babies needn’t starve to death as a result. We can recognize that breastmilk is best for babies and not let it become ideology.

Last edited 9 months ago by Vesper Stamper
Helen Hughes
Helen Hughes
9 months ago
Reply to  David Morley

It should be determined neither by science nor by ideology (isn’t science in the end also an ideology?), but women being empowered to trust their bodies. As Vesper has said, things can go wrong and this is a part of life. The adoption of the upright stance in humankind has meant that women must give birth through a narrow pelvis and it is simply harder for us than for many other mammals. But things are much more likely to go wrong if we are made to be afraid, to be stressed, to think we have a kind of right to do it all pain-free.

David Morley
David Morley
9 months ago
Reply to  Helen Hughes

but women being empowered to trust their bodies

You’re promoting your preferred ideology here, I’m afraid. If you empower women you give them information, choice and agency. You don’t set out for them the direction that should take them. That is disempowering.

And as some of the women commenters have pointed out, simply trusting their bodies would have been misplaced in their case.

madeleine muir-wyett
madeleine muir-wyett
9 months ago

I was at my fittest when I got pregnant at 29 with my daughter. In a dance studio all day. Doing yoga and swimming and cycling. Always been slim- 8 stone and 5’5 1/2 – absolutely normal healthy physique. My labour ended up an emergency C section as my baby was big. We both would have died in days gone by as would my mother if not for medical interventions. It is nonsense that child birth is usually safe and when it is natural. Never has been. Many young women in past knew that it might be a death sentence.

Last edited 9 months ago by madeleine muir-wyett
David Morley
David Morley
9 months ago

Yes. But you are up against an ideological history which sees the “medicalisation” of childbirth as an invasion of female spaces by men. In the past midwives were women, doctors were men.

Even in the comments to this piece you will see people trying to deny that the involvement of the medical profession in childbirth was a good thing – putting the massive improvements in child and mother survival down to non medical issues like hygiene alone.

Stephen Bryan
Stephen Bryan
9 months ago

Reading between the lines of those heart rending investigations into infant death or disability the commonest feature is failure of midwives to act on foetal distress or to not even properly monitor, and calling in obstetrician or neonatal paediatrician too late, but this is rarely made explicit in the summary. My wife and I both doctors and intended to go NHS, but lost confidence during antenatal process and went private. A middle class option not available to most. Sadly midwive training is now light on medical facts, and the trainers tend to be natural birth zealots. Obstetrics once attracted good doctors but not now, many units are made toxic by midwife vs doctor politics so not considered good career option and units struggle to fill consultant posts.

cjboyle
cjboyle
8 months ago
Reply to  Stephen Bryan

Thank you for sharing. Your post perfectly encapsulates what we experienced 16 mos ago.

Midwife in hospital failed to monitor dropping infant heart rate. Support called in very late. Emergency c-section by good docs (we were lucky there) saved the day.

Throughout labour, midwife offered opinion & conjecture, few facts … even literally arguing at bedside with anesthesiologist during labour … before angrily continuing complaining to us privately after the doc had left the room.

My parents are a surgeon & a nurse, and I grew up with a certain expectation of quality explanation and care.
The NHS antenatal process startled & alarmed me, but as my wife wanted to continue, we didn’t turn to private.
It’s an error we’ll certainly correct if she one day regains the courage to go through the process again following the trauma of this bad first one.

Rainer Zuhlke
Rainer Zuhlke
9 months ago

It beggars belief that after a plethora of scandals the NHS still enjoys quasi-religious status among a large majority of the UK population. No, I’m not pushing a US-like health system. Several countries in continental Europa have much better health systems that the entire population enjoys. At the same or often lower cost for the state and the society.

As a side note – my first wife insisted to give birth to our first child at home because that appeared to be the “natural” way. After this experience (no details), she decided to give birth to our second child in hospital (not in the UK).

Margie Murphy
Margie Murphy
9 months ago

It seems women are at the van guard of the natural childbirth ideology. Women’s inhumanity to women can be a terrible thing. Childbirth is nasty, brutish and painful and spouting birthing women as warriors serves only to create a myth and childbirth as a means onto itself in this silly quest for female heroics. A safe delivery with the minimum of pain and trauma should be the “birthplan”. Mine were all caesarions which was totally fine by me. I won the lottery with mine. I would encourage any woman to dispense with the heroics and the theatrics and prioritise safety and comfort with out the risk of PTSD and post natal.depression which seems to be a result of many of these unnecessary childbirth battles.

McExpat M
McExpat M
9 months ago
Reply to  Margie Murphy

I couldn’t agree more with this. There is an unsettling and bizarre masochism that accompanies the natural birth movement. Feminists took over from the misogynist birth experience of the past to box women into a very narrow, and often life threatening worldview of bringing new life to the planet. In the past young men met their death on the battlefield and young women in the process of giving birth. Not everyone met their fate this way but large numbers did. Women are the absolute worst offenders when it comes to pushing a guilt ridden diatribe around birth, nursing and infant care. Two planned sections for me and two very healthy 4000 gram boys. Only my female friends saw my experience as some sort of defeat.

Helen Hughes
Helen Hughes
9 months ago
Reply to  McExpat M

We all have different experiences. I found the interventions in my birthing processes deeply upsetting and disempowering. But maybe the bottom line is whether we have come to expect technological support as a human right, and therefore to demand it and rely on it – which means we lose our autonomy and touch with our natural bodies. It’s the path to transhumanism. I’d quite like to see Mary Harrington respond to this article!

McExpat M
McExpat M
9 months ago
Reply to  Helen Hughes

I can say conclusively that without a c-section I would have had a seriously poor outcome. Do you get your teeth pulled without anesthetic? We never used to. Is it trans human to rely on that technology or common sense? There’s a massive gap between pain reduction and saving a women’s life and having surrogates and external wombs. I believe you misunderstand Mary’s vision of transhumanism and your view further demonstrates this sort of malign derision towards women for needing medical intervention to birth. Not everyone does, but for those who do, we are eternally grateful.

Matt Sylvestre
Matt Sylvestre
9 months ago
Reply to  Helen Hughes

I would not like to try to speak for the great Ms. Harrington and it would be valuable to hear from her directly on the topic but her published writing does speak of the very difficult time she had during the birthing process. It sounds as though her and perhaps her babies health were at great risk during and for a time afterward…. So one should not presume she would have issue with good and necessary medical support…

Charlie Two
Charlie Two
9 months ago

Basically, at every level, the NHS is ideological, marxian to the core, and utterly shite.

Daniel Lee
Daniel Lee
9 months ago

Seriously, folks, the Left is going to kill us all with their civilization-eating nonsense if we don’t stop them. This piece is just today’s example.

David Morley
David Morley
9 months ago
Reply to  Daniel Lee

Totally. Thank god we’ve had a Tory government running things for years and the NHS, and everything else, is going wonderfully. We should all give daily thanks to the intellectual and political colossi this has given us. Boris Johnson, Matt Hancock and Liz Truss, to name but three.

Bret Larson
Bret Larson
9 months ago
Reply to  David Morley

All good leaders. Unfortunately British politics seems to be full of flowers who see themselves as leaders. Not a good situation to be in when everyone has a dagger, for “ceremonial purposes” only.

Dougie Undersub
Dougie Undersub
9 months ago
Reply to  David Morley

The Government doesn’t run the NHS, NHS England runs the NHS. Ministers can do very little to influence how it operates, other than to accede, or not, to demands for more money.
Another disaster courtesy of Blair’s “arm’s length bodies”.

Peter B
Peter B
9 months ago

Thank you. This needs repeating again and again until it finally sinks in with the public at large. The government funds the NHS. The NHS managers manage it (with varying degrees of success). Bad managers need to be fired. But you never see it happening in the public sector.

David Morley
David Morley
9 months ago
Reply to  Peter B

To be fair to the managers, they are in a situation in which the lack the power they need to manage effectively. They are pretty toothless, and the medical profession is very powerful.

I honestly think it’s the wrong model. It makes users the weakest stakeholder in the whole system, by taking their money from them, handing it over to the provider, then leaving them to try and get a service with no bargaining power.

Tobias Mayer
Tobias Mayer
7 months ago
Reply to  David Morley

David, this is sarcasm, right? I certainly hope so!

Catherine Farrar
Catherine Farrar
9 months ago

I accept a lot of maternity care is poor and of course it does happen that staff fail to intervene when they should. I’m sorry to hear the writer had such a bad experience but I can’t accept the argument that there is a cult of natural birth when intervention rates are the highest they have ever been. Less than half of women have a spontaneous labour with more than half either planned C-section or induced and of these spontaneous labours many will then have in labour caesarian or instrumental delivery not to mention other interventions. Very few women have a “natural” birth. I’m speaking as a woman who has had interventions herself so I have no axe to grind here.

Dionne Finch
Dionne Finch
9 months ago

It’s not just a fantasy that natural birth can be beautiful, peaceful, bonding…I had three home births and one hospital birth. The home births were beautiful, the hospital birth full of strange people, noises and smells, my baby whisked off and cleaned up before cuddles.

David Morley
David Morley
9 months ago
Reply to  Dionne Finch

Yes – but we shouldn’t extrapolate from that to everyone’s experience. I was present at all three of mine, and they were all like that. And I do think a positive attitude can help. But it can still be a very tough experience.

David Morley
David Morley
9 months ago

Throughout the mid to late-20th century, feminist movements interested in reclaiming women’s bodies began to have influence on midwifery.

Another good “cultural archaeology” piece, tracing current practices to the ideas, and intellectual turning points of the past. There was a time when medicine generally, and it’s relation to maternity in particular, was seen as patriarchal, oppressive and deliberately robbing women of agency. The “medicalisation” of pregnancy.

As a side note, feminism in France was very different, following both Cartesianism and existentialism in seeing nature itself as oppressive – especially to women. Older French feminists are still very critical of what they call “naturalism”.

Dougie Undersub
Dougie Undersub
9 months ago

Isn’t it complementary therapies? Or was the use of complimentary a little joke about care being “free at the point of delivery”?

Cynthia W.
Cynthia W.
9 months ago

“… a picture is being painted in the NHS of a custom-made journey of self-discovery that allows women to realise their true biological and spiritual potential.”
Oy.

Vesper Stamper
Vesper Stamper
9 months ago
Reply to  Cynthia W.

She sounds…dissatisfied?

UnHerd Reader
UnHerd Reader
9 months ago

When the government holds the purse strings, all sense in budgeting goes out the window. Yet again, women and children are the ones being deemed expendable.

Alan Hawkes
Alan Hawkes
9 months ago

I the worst outcomes, with the worst medical neglect, is there not a case for charging those medical staff responsible with manslaughter through negligence?

Daniel Lee
Daniel Lee
8 months ago

Of a piece with the Left’s ongoing assault on Western standards of civilization. They do not have the right to drag us along in their attempted cultural suicide.

Tobias Mayer
Tobias Mayer
7 months ago

All four of my children were born at home, two in the UK in the 1990s with NHS midwives, and 2 in the USA, with an independent, private midwife. The private experience was slightly better, as it was with just one midwife (with support at birth time) while the UK experience was with a team, some of whom we were compatible with and some not. It was a bit hit-and-miss, but the births both went well enough. My wife was in labour for a full 52 hours with our first son, and yet being at home she was allowed to take her time, and birth naturally. In hospital they’d probably have rushed it or performed a cesarian as they would have needed the bed. My two daughters, born in the USA were both born in birthing tubs, a gentle and calm process. In all four cases we knew that if the birth started to look difficult the hospital was close by. I am a big advocate of natural, home birth. It doesn’t work though if it is a cost-saving tactic by an overworked and underpaid NHS. The problem is not natural childbirth (remember, unnatural, doctor-assisted/drug-assisted birth in the UK is only been around 80 years or so) it is a broad, and ever-dwindling misunderstanding of the natural process of childbirth, and the stress and even guilt the mother is made to feel in hospital (and now NHS home) births. Natural birth isn’t a “cult”. I’d say it is actually hospital birth—where drugs and even stirrups are frequently used, and a mother is little more than a cog or component in the ‘birth machine’—that is the cult. And the sooner we can collectively be de-hypnotised from this cult the better for society—and every mother and child therein.