The cult of physiological birth – Part 1

The ideology of normal birth has been implicated in the avoidable deaths of mothers & babies again.

It was upsetting to watch the Panorama documentary last week ‘Midwives Under Pressure’. My heart goes out to the parents whose babies tragically died at Gloucester birthing unit.

However, apart from exposing their raw grief, I am not sure what else the ‘investigative programme’ revealed or achieved.

Yes, there was some acknowledgment that staffing levels were critically low at this maternity unit but they are at many hospitals across the UK.

There were some heart wrenching accounts from midwives who were scared that they were one fatality away because of lack of staff available for women.

But this is where the short half an hour documentary stopped short.

It was just long enough to scare the living jesus out of any pregnant parents but too short on time to discuss the very real issues behind staff shortages.

Which do not begin and end with lack of funding as the programme suggested.

The next day Twitter was ablaze with the usual suspects blaming the ‘cult of physiological birth’ and the ‘ideology of normal birth’ for the deaths of these babies.

Currently the NHS are 2000 midwives short according to the RCM.

In 2023 53% of student midwives considered leaving their course.

Statistics from the same year showed that 15% of student midwives dropped out before finishing their course.

The Maternity & Midwifery Forum refers to the low attrition rate of student midwives as ‘running up a down escalator’.

It makes me think of filling a leaking bucket.

The RCM says low pay, student debt and concerns about staff shortages are all reasons given.

On closer inspection of the numbers a different picture emerges.

We do in fact have more midwives now in 2023 (32,375) than we had in 2013 (31,003).

And the birth rate has dropped from 698,000 births in 2013 to just 605,000 in 2023.

So, do we actually have more midwives now in 2023 and less births than 10 years ago in 2013?...

Hmmmm……

If that is so, what is causing the dangerously low levels of staff then???

Oh, I see a 30% induction rate of all births in 2023 might account for the additional workload (just 12% in 2013).

And a 40% c section rate in 2023 versus a 24% c section rate in 2024.

Inductions and c sections mean lengthier stays in hospital, more care needed, more manpower needed.

But why have we made birth so complicated, interventionalist and medicalised?

According to the Twitter trolls we are living through age of ‘the cult of natural birth’!

Because c sections and inductions save lives I hear the paternalist maternity system cry!

Hmmmm…..

But maternal mortality is higher now (13.4 deaths per 100 in 20/21) than 10 years ago in 2013/15 (8.8 deaths per 100)

Ohhhhhh….

Yes, and infant mortality is higher now too (4 in every 1000 in 2021) compared to 3.8 in every 1000 in 2013.

Perhaps another reason for the high attrition of student midwives is that a younger generation of women are unwilling to be a part of this medicalised birth culture that so often is robbing women of their bodily autonomy and the cause of much birth trauma.

But more about that next week.....