Three weeks ago I visited a friend who was giving birth to her first baby. Charlotte was excited but scared. I mumbled all the usual reassuring things, but then stopped. Why was she telling him that everything would be alright? He knew perfectly well that the Select Committee on Health had found that two out of five maternity units provide care that is unsafe until a certain point. Childbirth in the UK is all too often a secret game of Russian roulette.
Hadn’t he spent the last few months scrutinizing the neonatal death rate in MLU (Midwife Led Units) where women with “uncomplicated” pregnancies are expected to have a “normal delivery”, many with no operating room at hand if things suddenly go wrong? What about that devastating email I received from a reader who had been told to “keep pushing” long after a c-section was necessary?
“My dear son is now nine years old, which is the amount of time it has taken to get the NHS to admit there was negligence,” Sarah wrote. “My husband and I had no idea that the doctor who could have saved Jamie from serious brain damage was 27 minutes away and still in his pajamas when the midwives finally called him.”
In 2019/20, maternity injury claims it cost the NHS a staggering £2.3bn, 40 per cent of all NHS claims payments. So she wasn’t exactly doing my dear friend a favor by telling her not to worry, was she?
To the amazement of Charlotte and her husband, I received a scathing list of instructions: “Don’t trust what the midwives tell you, trust your instincts. Do not give birth in a place that does not have surgical facilities; you never know what could go wrong. If you think labor has gone on too long, insist that the midwives call an obstetrician to check on the baby. Don’t be intimidated by a harassing midwife with a natural birth agenda. Ask for a caesarean section. If necessary, SHOUT! Keep yelling until they do something. Do not passively accept whatever treatment you are given; Your baby’s life could depend on it.”
Report of Dr. Bill Kirkup this week in “a toxic culture” of “deplorable” maternity care at East Kent Hospitals University NHS Foundation Trust only confirms that my advice, which sounded a bit unhinged, was spot on. Their research identified 97 cases in which poor care led to the death or disability of mothers and newborns. In fact, midwives were faced with the challenge of achieving a delivery without intervention. Some 45 babies who should have survived died at two of the trust’s hospitals and 12 suffered brain damage.
There is little here that Donna Ockenden hasn’t found at the Shrewsbury and Telford Hospital NHS Trust (where more than 200 babies died). Or, indeed, Dr Kirkup, whose 2015 investigation into Morecambe Bay maternity services identified a “culture of denial, incompetence and collusion”.
Basically the deal is that we pay the NHS £134bn a year and they blatantly lie to grieving parents whose children their neglect has killed. They are so desperate to cover up medical errors that trusts actually blame women for the deaths of their babies. What The daily telegraph reported earlier this weekcertain hospitals will even record live infant deaths as stillbirths to avoid scrutiny.
What can be done with such institutional evil? Besides waiting helplessly for upcoming damning investigation (Ockenden will report shortly on Nottingham University Hospitals NHS Trust)? Well, for starters, they could train the extra 5,000 midwives that David Cameron promised (but never delivered) in the 2010 Conservative election ticket. Dr. Kirkup didn’t think staffing was the problem in East Kent, but midwives are under great pressure. They are unable to provide individual mothers with the care they need.
Uproot the “normal delivery is best” philosophy promoted by midwives who see caesarean sections as a failure when, so often, they are a lifesaver.
Abolish MLUs that are not attached to hospitals. You cannot guarantee that an “uncomplicated” pregnancy will end in an easy delivery.
Force NHS trusts to stop their despicable lies. Dr. Kirkup has called for a “public service liability law” so that hospitals can be prosecuted if they stage cover-ups in future tragedies. “It would impose a legal duty on public bodies to be truthful and not hide problems,” he said.
Yesterday I held Charlotte’s daughter in my arms. So beautiful, so miraculous, so new. Come safely into this world, unlike the 1,000 British babies who would survive each year if our maternity services were as safe as Sweden’s.
Can we really live with that? Let’s get serious about breaking this cycle of child cruelty and death.
Listen to the mother. Mothers know what’s best.
