Women's Rights?

Have recently been reading an interesting article in the guardian about women’s rights not to be questioned about their childcare arrangements or plans for future pregnancies when applying for a job (It has been illegal since 1975 to ask this question of women).
Whilst I wholeheartedly support this, I do think that the whole question of ‘Family Friendly Hours’ and the rights of pregnant women have totally made the world of midwifery and maternity a crazy place to work in. A busy maternity unit has to supply safe, effective midwifery care 24 hours a day, 7 days a week, every week of the year without break in any shape or form. The work force is traditionally predominately female and the age of the work force is mainly of child-bearing age.

Where I work at the moment there is always at least 10 midwives pregnant or on maternity leave at any given period in time. These midwives always return from maternity leave on very reduced hours and usually demand to work set hours. There is never any cover available for them whilst they are on maternity leave so you can imagine this leaves a very depleted work force.

This impacts very heavily on the work-force left to keep the place going and it usually falls very heavily on the shoulders of the older, senior full time midwives who have their own set of problems at home i.e. looking after elderly parents/husbands/partners etc. These midwives never ask for leave or time off to fulfil these demands and often leave at the end of a busy shift to start another shift at home.

Is this equitable? If women really want to have equal rights then surely the men should be involved more in the care of the babies and have time off from work as well to enable the woman to come back to work earlier than a year. And, are the women who are having a year off from a ‘with woman environment’ really being supportive of the profession that they profess to belong to and what about their colleagues? Are they being fair and equitable to them by insisting on having as much time off as possible and then coming back on reduced hours? I don’t think so and trying to manage a service that provides care for a 24 hour period is a total nightmare with continually reduced dwindling resources.

I never thought I would find myself thinking this but I wish sometimes that we could just employ midwives that had completed their families or had no intention of having one in the interest of providing a truly first class maternity service for women.

Hungry mother and baby

Independant Midwives

Independent Midwives


Well, the Government has done it again. Alan Johnson has made a futile and quite frankly condescending and insulting attempt in order to tempt midwives back into the profession by offering them £1500, plus the same amount in childcare, training days and travel.

What a joke and how sad that women feel that they have to resort to the care from Independent Midwives in order to receive the kind of that they want and are entitled to (Pelling, Daily Telegraph). But the sad reality is that the system is NOT providing the high level of skilled midwifery care that women have a right to.

They have this right because, pregnancy and child birth are fundamentally, normal, life changing events and if managed correctly, sensitively and safely, then women and babies should emerge from this journey relatively unscathed and hopefully as healthy as they were before the pregnancy (unless, of course there is any underlying previous medical or obstetric problem).

Pregnancy and childbirth is the pivot on which the future health of the nation and future generations hang. Surely, it would be better house-keeping for want of a better word, for the government to spend extra money on resources now and prevent billions in litigation costs and costs related to morbidity acquired during the pregnancy process?

The irony of all this is, is the fact that Independent midwives as ‘lovely’ and caring as they may be, will soon be in the same position as NHS midwives – overstretched and unsupported and thus begins the vicious circle all over again.

Happy New Year

Well it is a New Year and it has been an extremely busy Christmas and New Year in the maternity unit where I work with the birth of many babies. Fortunately, for all these women, there was a happy outcome with the safe arrival of lovely healthy babies and without adverse complications for the women. So what,? I can hear some of you say or perhaps, ooh how lovely and so on and so forth.

My point is that I have recently been reading graphic accounts of child birth and pregnancy outcomes in the third world and developing countries and have been trying to make sense of the great inequity there is between our world and theirs. Of course, we all know that pregnancy and childbirth is just the tip of the ice berg of the problems and it would be naïve to suggest anything other than this.

I have had a lot of response to my posts that I wrote before Christmas about choice and pain relief and I have had an excellent response to these from all kinds of people with all kinds of experience and I thank you all for taking the time and trouble to write a response. It has been extremely interesting to read them all and I am sorry but I cannot possibly reply to you individually.


Choice and control for women are the basis of the central themes which are the main drivers for developing maternity services in the western, developed world. It is interesting to compare this with the drivers in the third world or developing countries where their main objectives are to reduce maternal and neo-natal mortality and morbidity

Sometimes. I feel we have maybe lost sight of just what providing a safe maternity service involves and just how much we take for granted. Do Women in the Gambia or Sierra Leone or any of the other African countries have a choice about where they have their babies or what kind of pain relief they are going to have? If they are lucky, they will have their babies without too much fuss with other women attending them using their remedies and ways of delivering a baby or they may find themselves, in labour, with terrible complications having to walk anything from 50 to 100 miles to access the nearest hospital. By then, sadly, it may be too late for either woman or baby or both.

Yes, we can moan and complain about our NHS system but against all odds, it provides a gold standard of care to the majority of women and the best thing of all is that not only can women choose where they have their baby and what pain relief they want but the outcome is 99.9% positive, with a live mother and a live healthy baby – which of course – is the aim.

Happy New Year!!

Choice and Childbirth

It saddened me recently to read an article in a professional midwifery journal which was written by a woman who had recently given birth in a private hospital in London. In this article the woman described her journey of care in the private sector. The article is centred solely on the wondrous care that the ‘doctor’ (obstetrician) gave this woman and her partner and I quote:
“Choosing the right consultant was critical to a happy and calm pregnancy”!

Excuse me, but I was led to believe that choosing the right ‘midwife’ was critical to a happy and calm pregnancy? Midwife meaning being with woman – obstetrician – this word is derived from the Latin word obsterix meaning ‘standing before’.

Yes, that is surely what private obstetricians do with great ease and charm – stand before and hold their hands out for a very fat, lucrative pay cheque which they spend laughing their heads off at the silliness of these women who fall prey to their seductive charms of claiming to ‘always being there’ and ‘yes of course I will cancel my holiday to make sure I am there for the delivery of your baby!’

There is something slightly obscene about the private male obstetrician who seduces these vulnerable women by promising to ‘always be there’ whatever the time of day or night, always at their beck and call – almost like a marriage or a relationship. Are these women really choosing private care for the right reasons? Does this love and care that is lavished on them by a male at a vulnerable time in their lives make up for a big gap in their own relationship? Do the women think that the male obstetrician is superior to the female midwife? Does this smack of patriarchal forces still at work in a society when we are supposed to have moved on from this?

Back to the article in question - the midwives were only mentioned briefly right at the end of the article and their care was only in the post-natal period. I know that the NHS struggles to provide maternity care given it provides a ‘gold standard’ of care on peanuts but at least it is still true to the midwifery profession and against all odds tries to support it and enable its growth.

Yes, women have a right to a choice where they have their babies and how they receive their ante-natal care but the question is are the women who pay privately for it ‘being short changed’ in that the only care they receive from a midwife is at the end when they have had their babies?

Immigration - the true cost

There is a plethora of discussion about the financial impact that the high level of immigrants to this country from Eastern European Countries has on this country. We all know the arguments well – yes some of them contribute more in tax, earn more are more highly skilled but balanced against this is the fact that there has been no financial allowance made for the extra demands on the all the public services including the NHS. Because the migrant population is mainly young, they are deemed to be fit and healthy but this has had a huge impact on the already overstretched maternity services in this country. For example, an interpreter is needed for every woman accessing maternity care – this does not come cheap and is around £80 -£100 per hour. This is for all the care from the ante-natal, period, intra-natal and post-natal period. It does not take a mathematician to work out that this is a huge amount of money. However, this is not the issue – these women are entitled to and should receive the high level of excellent midwifery/maternity care that all women in this country receive.

The issue is that recently, there has been nothing but complaints from these Eastern European Women about the care that they received in England. I cannot cite them all but one woman in particular thought her care in labor was appalling because she did not have a doctor deliver her baby and she did not have an episiotomy to deliver the baby – she sustained a very small laceration that needed no suturing what-so-ever and had healed by day 7!! The actual care that this woman received in labor was very low tech, with no intervention, no continual monitoring and resulted in a water birth (which is what the woman had requested on her birth plan)! The question I have is – what is the problem? Why are these women complaining? All the ones that have complained have absolutely no justification whatsoever. All complaints have been thoroughly investigated and the women have had exemplary ante-natal care with an interpreter present, the same in labour and the same post-natally with much more support at home that they would have in their own countries. Britain is the only country that still does post-natal visiting at home!
Another point worth flagging up – is as one woman told me – in labour, in Poland, no pain relief is offered or allowed in labor at all!!

So, what is going on? Will this level of complaints increase? Are they really at the receiving end of terrible care or are they just jumping on to the band wagon of the ‘claim culture’ that we have bred in Britain?

What ever the issue is, midwives need to be alerted to it and quickly put a halt to it. What concerns me is that the fact the women from other countries don’t seem to understand that midwives are professionals in their own right and are on an equal standing with obstetricians and doctors – perhaps it is just a misunderstanding and this can be easily remedied in the parent craft education. If it is not, then immigration might have a big part to play on the midwives role and change it and if we are not careful, midwives might find themselves working as obstetric nurses.

More thoughts on labour

Thank you all for your interesting thoughts about pain relief in labour. It is a vast subject and one that generates much thought and discussion. I can vividly remember my own experiences of labour (three times) although I cannot begin to describe the pain, I can remember the moment of giving birth and the feelings that evoked. I actually did have Pethidine and entonox for all 3 labours and thank goodness for that! There is no way I could have gone through labour without anything as I had long labours with all my children and in those days (20 odd years ago and counting) there was not much choice. In fact, the whole attitude, and this was from the midwives as well, was that you ‘put up’ and ‘shut up’. You were very much left to just get on with it. Labour and birth was a process and a ‘job of work’ to be got on with and there was no room for discussion and debate.

How very different to now when women are given all the information they need and their progress in labour is discussed all the way through both with the woman and her partner. This, of course, is how it should be. Giving birth used to be a very lonely process not so long ago. Even your partner could not be there let alone a friend or birth companion.

Interestingly, there has been quite a debate recently about the presence of male partners in the delivery room suggesting that the outcome of labour does not always result in a vaginal delivery when a male partner is around and some birth gurus have even gone on to suggest that there may be a link between the soaring caesarean section rate and the presence of a male partner. This is because, the male partner tries to rationalise the birth process and keeps trying to talk to his partner which interrupts the natural flow of the birth hormones. This is just one theory, there are many more.

It would be interesting to hear your views, thoughts and experiences.