Mothers and midwives gain power under maternity care proposals

PLANS for a radical overhaul of maternity care in Britain, transferring power in the labour room from doctors to midwives and mothers-to-be, will be unveiled by the Government this week.

The proposals, described as a 'manifesto for maternity into the next century', will give women more choice in how and where they give birth, and are expected to lead to a substantial rise in the number of home births. A spokesman for the Department of Health said last night: 'It will aim to give women the opportunity to choose and to put their needs and wishes first.'

The review follows severe criticism of the maternity services by the cross- party Commons Select Committee on Health in its report published in March last year. The report criticised the 'over-medicalisation of birth' which, it said, had made it a degrading experience for most. It said midwives were best placed to care for the women, and that doctors routinely used 'interventions', such as epidural injections, that had not been tested adequately.

The committee's report was warmly welcomed by support groups, including Aims (the Association for Improvements in Maternity Servies), but greeted with some reservations by the Royal College of Obstetricians and Gynaecologists, and the British Medical Association, both of which questioned the safety of home births.

About 94 per cent of births in Britain take place in hospitals, between 1 and 2 per cent at home and the remainder in small maternity or GP units.

The review group, chaired by Baroness Cumberlege, junior minister for health, will publish its report on Thursday. It is expected to recommend that women should:

Have more choice of hospitals;

Be better informed about home births and the 'domino system', where the midwife is at home with the mother, goes with her to the hospital and delivers the baby, and then regularly visits her at home;

Be given their own case notes and have more information about Caesarean sections and epidural injections;

Be cared for by the same person or group of people during pregnancy, childbirth and the first days of the baby's life;

Have the right to choose one professional to take the lead role.

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