Stop using the phrase ‘NORMAL birth’, midwives told: Report demands ‘less judgemental’ language in wake of NHS baby death scandal – driven by an obsession to stamp out C-sections
- The Royal College of Midwives want descriptions that are ‘non-judgmental’
- It follows a damning report into failings at the Shrewsbury and Telford Hospital
- Over 200 babies and mothers needlessly died over two decades at the trust
- Obsession with stamping out C-sections, to drive up natural rates, was blamed
Terms like ‘normal’ or ‘natural’ birth should be dropped in favour of factual language, a report has concluded.
The Royal College of Midwives found women feel judged by phrases which suggest their labours have failed or that somehow their birth experience has been abnormal.
Instead they want descriptions that are ‘non-judgmental, non-hierarchical’ and which are not ‘value-laden’, it said.
The report comes after a damning report into failings at the Shrewsbury and Telford Hospital NHS Trust, where over 200 babies and mothers needlessly died.
An obsession with stamping out C-sections, in order to drive up natural birth rates, was partly blamed.
As recently as April, NHS trusts were still posting job ads for midwives committed to ‘normal birth’ and asking for ‘normality-focused midwives’.
A new study has said language used by midwives should be less judgmental (PA)
The RCM report included responses from 8,000 people in the UK, including women, their partners, doctors and midwives.
About 1,500 women who had given birth in the past five years gave their views.
‘Normal labour and birth’ and ‘natural labour and birth’ were the two phrases which prompted the biggest anger.
The study recommended several terms should now be used by health professionals and researchers.
These include ‘spontaneous vaginal birth’ for a birth without intervention or ‘induced and/or augmented labour’ for when labour is induced.
Gill Walton, chief executive of the RCM, said: ‘The relationship between a midwife and the women in her care is an incredibly intimate one.
Rhiannon Davies and Richard Stanton with a copy of the Donna Ockenden Independent Review into Maternity Services at the Shrewsbury and Telford Hospital NHS Trust. Mr Stanton hopes that police now have enough evidence to prosecute those responsible for his daughter’s death
Rhiannon Davies from Ludlow, Shropshire, pictured with her daughter Kate moments after she was born on March 1, 2009 at Shrewsbury and Telford NHS Trust. Kate died just hours later
NHS trusts have come under fire for posting job adverts (pictured) for midwives committed to ‘normal birth’ just a week after Britain’s biggest ever maternity death scandal.
‘The role of the midwife is to advise and support women, to listen to them and to advocate on their behalf.
‘To do that successfully, we have to share a language.’
Historically, the idea of a ‘normal birth’ has been promoted in the UK, with the RCM, the National Childbirth Trust (NCT) and the Royal College of Obstetricians and Gynaecologists (RCOG) signing a ‘normal birth consensus statement’ in 2007.
They said: ‘With appropriate care and support the majority of healthy women can give birth with a minimum of medical procedures…
‘Procedures used during labour which are known to increase the likelihood of medical interventions should be avoided where possible.’
A later 2015 inquiry into failings at Morecambe Bay NHS trust – where 11 babies and one mother suffered avoidable deaths – found a group of midwives’ overzealous pursuit of natural childbirth had ‘led at times to inappropriate and unsafe care’.
Two years later, in 2017, the RCM dropped its ‘normal birth’ campaign and removed similar advice for midwives from its website.
Meanwhile, the RCOG has recently apologised on Twitter for signing up to the ‘normal birth consensus statement’ in 2007.
It said this ‘may have mistakenly given the impression that targets around childbirth could take priority over safety. This is something we acknowledge and sincerely regret’.
The term ‘normal birth’ is still used by other organisations including the International Confederation of Midwives and the World Health Organization.
The report into Shrewsbury and Telford Hospital NHS Trust, released in May, showed mothers were made to have natural births, despite the fact they should have been offered a Caesarean at the hospital.
The review found around 200 babies and nine mothers could have survived if it had provided better care.
The trust’s low Caesarean rate was regarded nationally and locally as a positive.
In the review, midwife Donna Ockenden found the trust presided over catastrophic failings for 20 years — and did not learn from its own inadequate investigations.
It led to babies being stillborn, dying shortly after birth or being left severely brain damaged.
Some babies suffered skull fractures, broken bones or developed cerebral palsy after traumatic forceps deliveries, while others were starved of oxygen and experienced life-changing brain injuries.
Timeline: How the Shrewsbury maternity scandal unfolded
A parliamentary report highlights how Shrewsbury and Telford Hospital Trust (SaTH) has one of the lowest caesarean rates in country, at just 10 per cent of births.
A leading number of maternity organisations sign a ‘normal birth consensus statement’ discouraging medical interventions like caesareans where possible.
At this time then health regulator, the Health Care Commission warns SaTH there were issues in how staff were monitoring foetal heart rates after incidents where babies were injured.
Kate Stanton-Davies dies just hours after being born while under the care of Shrewsbury staff. Her parents begin to campaign for an investigation into what went wrong.
Pictured: A file photo showing the entrance to the Royal Shrewsbury Hospital in Shropshire
Shrewsbury’s maternity services faced an internal investigation in 2013, but it concluded it was ‘safe’ and of ‘good quality’.
An inquiry into failings at Morecambe Bay NHS trust – where 11 babies and one mother suffered avoidable deaths – found a group of midwives’ overzealous pursuit of natural childbirth had ‘led at times to inappropriate and unsafe care’.
It said the entire NHS should learn from the failings observed.
Pippa Griffiths dies shortly after being born while being cared for by Shrewsbury staff.
Her parents join forces with Kate Stanton-Davies’s mother and father in calling for an investigation into maternity services at the trust.
A birdseye view shows the sprawling Royal Shrewsbury Hospital in Shropshire on the outskirts of the town from above
Then health secretary Jeremey Hunt orders an inquiry into the trust which will eventually be headed by midwife Donna Ockenden. The original scope of the inquiry encompasses just 23 cases.
Former health secretary Matt Hancock said the Ockenden review is being expanded to include hundreds of cases.
Also in this year the trust is rated inadequate for safety by health watchdog the Care Quality Commission.
Pictured: A general view of The Princess Royal Hospital in Telford, Shropshire, which is also part of the scandal-hit trust
Ms Ockenden announces the investigation is now looking at cases involving 1,862 families and releases early recommendations ahead of the full report.
The inquiry findings are delayed to 22 March 2022 due to an influx of new information from Shrewsbury and Telford Hospital Trust. The final report was originally due in December 2021.
The report is delayed again this time by a few weeks due to ‘parliamentary processes’.
Today’s final report detailing the harrowing scale of deaths and injuries among babies and women over two decades of the trust’s care is published.
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