What were the midwives supposed to do? Turn birth into a pitched battle with the mother? Walk out on her? The first would have been assault, the second negligence.
It is a midwife's legal responsibility to attend a woman in childbirth, and to give the help she can, whoever the person is and wherever she is. The Cumberlege Report, commissioned by your government, stressed that women should be able to choose where and how they have their babies. Midwives are there to give emotional support and to use their skills to make birth as safe and satisfying as possible. They are not there to indoctrinate or impose their will on their clients.
I'd like to tell you about my daughter, Tess, and the birth of her second baby. The first had been born at home - a 101/2lb boy - in a water pool with two midwives who were dear friends. It was an exultant and satisfying experience. This time it proved harder to get the birth she wanted because tests in late pregnancy revealed high levels of sugar in her blood. It is a possible sign of gestational diabetes, which has been called 'a diagnosis looking for a disease'. She became 'high risk'. Obstetrician, GP and community midwife wanted her in hospital, warning her of the possibility of a baby with its head born, but stuck by the shoulders.
She researched the issues carefully and concluded that home was safe, that being immersed in water would be the best pain relief - safer than an epidural, and that she could move freely to help the birth. Her decision was informed, realistic, and arrived at bearing in mind the pressures midwives are under to conform. Obstetricians can often be dogmatic and arrogant - out of touch with the ways women feel and think about birth.
The birth was straightforward. At the end of January, a perfect 9lb 10oz baby slipped out like an eel - and Tess had her home waterbirth. But the last months of pregnancy were clouded by anxiety. She struggled against a technocratic system which treats women's bodies as machines at risk of breakdown.
In many countries today there is a rebirth of midwifery. Midwives are not content to be assistants to obstetricians: to keep the patient quiet, to prepare her for examinations and manoeuvres, and to clear up afterwards. They have rediscovered their ancient calling of being 'with' women and sharing in the joy of birth. To deny midwives this is to deny them professional status, and the responsibility, for which their training prepares them, to be a skilled companion in an important life transition.
I don't think you should opt out of this one, Virginia. I suggest you ask the NHS Management Executive, which monitors implementation of the Cumberlege proposals, to intervene immediately. Please stand up for women.
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