‘From the cradle to the grave’. Wasn’t that what Winston Churchill said in 1943, when he broadcast an address to the nation in response to the Beveridge Report, in which he recognized the need for ‘national compulsory insurance for all classes and for all purposes’, paving the way for the post-war establishment of the NHS?
He never meant it literally – as in, straight to the grave – and yet, eight decades later, it has come to this.
A baby born in Britain today is more likely to die before its first birthday than a baby in most other First World countries.
Having babies in Britain 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 two decades. In total, an embarrassing 20,000 women suffer from postnatal post-traumatic stress disorder every year due to their experiences in the labor and delivery unit.
Such is the devastatingly inadequate state of maternity care in Britain today, as exposed by a new parliamentary inquiry into birth trauma, published on Monday.
Good care for pregnant women and new mothers is ‘the exception rather than the rule’. The attitude of clinical staff towards them is described in the report as ‘shockingly poor quality’, supported by testimonies from vulnerable women who are belittled, patronised, neglected and ignored by midwives.
In short, having babies in Britain 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 something going wrong are worryingly high. And women are not stupid. They know this. The findings of this report have simply confirmed what, anecdotally, we have all feared – and experienced, for years, either firsthand or through friends and family.
When I had my daughter 21 years ago this month, it was no different. I was fortunate at the time to live a short bus ride from one of the country’s leading maternity hospitals, Queen Charlotte’s in West London.
Despite its less favorable location overlooking HMP Wormwood Scrubs (you could sometimes hear the prisoners exercising in the garden), Charlotte’s had a reputation for second-to-none care. Professor Robert Winston, also known as ‘the baby doctor’ and a hugely prominent figure at the time, had made a name for himself there and led his team in groundbreaking neonatal research.
I attended antenatal classes, dutifully biting my tongue as the midwives lectured us on the evils of pain relief, and showed us slides of Native American women giving birth crouched in forest clearings (being awake in the NHS is by no means a new concept).
I was by far the oldest there (34 years old), most of my classmates were no older than my own daughter is now. This seemed to be a source of great irritation among the staff, who muttered darkly about “elderly mothers” and berated me endlessly for my weight. When I gently expressed my concerns about the birth and explained that my own mother, who had twenty when she had me, had almost died and I had been in intensive care for weeks afterwards, they told me not to be silly.
But nothing could have prepared me for the level of contempt I experienced when I arrived at the labor ward. My contractions were close, and yet when they checked me – unceremoniously and with about 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. I was put in a room and was actually able to move on.
The night passed and my contractions continued, and yet I made no progress. After much persuasion I managed to persuade them to give me an epidural, which they did very reluctantly. I felt dirty and guilty and like a total failure. It worked for a while, but once the local anesthetic wore off, I had excruciating pain down one side of my body. Their response? “I told you so.”
They let me lie down again for a few hours and when I still wasn’t making any progress, they decided to give me oxytocin to speed up the delivery. It worked. It wasn’t long before the contractions were so close together that I could barely breathe and I was throwing up from the pain.
By breakfast time, after hours and hours of this, my daughter started showing signs of anxiety. I don’t really remember much about this phase, but I do remember that the midwife came on duty around 10 a.m. He – or maybe it was a she, I don’t remember – examined me and discovered that I was still barely 5cm dilated, that my daughter was presented posteriorly and that she had passed meconium, which usually happens after birth. A few sharp words were exchanged and I was ready for the theater.
Posterior presentation is when the baby’s head faces the wrong way into the birth canal. It can result in a long, slow labor (because the position of the head makes it harder for the cervix to dilate) and extremely painful back pain, like the one I experienced. It can also happen that an epidural works, as was the case with me. It often results in the need for a forceps delivery unless the midwife can turn the baby over. But because successive midwives had not noticed any of this, it was too late. My daughter was in trouble, and they had to get her out right away.
The difference between the professionalism in the operating room and in the delivery department was striking. I was treated kindly, gently and with the utmost respect. There were two surgeons who worked together quickly and efficiently. One of them took the time to give me a running commentary and reassured me every step of the way. I remember thinking at the time: why didn’t I just do this?
Since then, I have seriously begun to question the sacred status that midwives have in this country. Romanticized by shows like Call The Midwife, they are revered as givers of life and sources of all motherly wisdom. But in any case, my experience shows that this is far from the truth.
Of course there are some brilliant midwives; but far too many people are politicized and biased, entrenched in their beliefs and practices and, most disturbing of all, not very good at their jobs.
Where they should show empathy, patience and caring, 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 seems so true to me.
In fact, it was a midwife who almost took the life of my second child, my son. He was delivered by elective caesarean section 16 months after his sister, at another hospital in Surrey. Once again I was made to feel like a refugee for not wanting to attempt another ‘natural’ birth, but I was honestly terrified of a recurrence. So I swallowed the shame and insisted.
His birth was a completely different experience. Calm, professional, cheerful. Unlike his sister, who came out bruised and battered and fighting for her life, he entered the world peacefully and safely. That might explain why he’s so catatonic relaxed, while his sister is one of life’s boxers. But that’s a completely different story.
When he was about three months old, he got an ear infection. I told this to the midwife at the baby clinic and she said not to worry. But I did. I get serious ear infections, and there is a history of this in my family. I kept bringing it up, and she kept turning me down. I asked for antibiotics and was told that ‘we don’t prescribe antibiotics for small babies’.
All she seemed to care about was whether I was breastfeeding or not. I was too, but he was a gannet, so I was refilling formula. This was met with serious disapproval. I was told this was probably the reason he had an ear infection: didn’t I know breastfeeding was an essential source of antibodies for babies?
There is a lack of compassion in maternal and infant care in this country, which has nothing to do with resources or funding
Long story short, one morning I woke up and realized something was very wrong with my little boy. I took him to the midwife – again – and again, she basically told me I was angry. But this time I was determined. I waited until the end of the baby clinic and demanded to go to the doctor. He took one look at my son and called an ambulance.
He had something called mastoiditis, now a rare condition but once a common cause of infant mortality. The hospital in Surrey gave him massive doses of intravenous antibiotics, but it was too late. He was transferred to St George’s in Tooting for emergency surgery to remove a large cyst on his brain. The team was great, 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 issues. And all because that stupid woman wouldn’t listen.
I’m happy. My children are lucky. But far too many people are not, and that is unacceptable. I know far too many women – friends, colleagues, family members – who have horror stories to tell, and they can’t make it all 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 and everything to do with deeply ingrained attitudes, entitlements and, frankly, the arrogance of a profession that knows not how to do his job properly.
Let this report be the wake-up call they need.