Radical maternity shake-up to widen childbirth choice

A RADICAL shake-up in maternity services was signalled by the Government yesterday after accusations from MPs that childbirth is too often an 'over- medicalised' and degrading experience.

Home births should become routinely available to pregnant women with minimal risks of complications, and medical interventions should not be carried out without good clinical reasons, the Government said. About 96 per cent of babies are delivered in district general hospitals.

An expert committee will be appointed shortly by the Department of Health to review policy on care during childbirth, particularly to reassess the relative contributions made by the GPs, midwives and obstetricians. Health ministers are also to establish a task force to examine management of maternity care.

The Government's determination to guarantee choice for women over where and how to give birth was spelt out in its response to the critical Commons health select committee report on maternity services earlier this year. MPs accused health care professionals of providing 'over- medicalised' services that degraded the experience of pregnancy and childbirth, treating them in some areas like 'illnesses' rather than part of normal, healthy life.

Brian Mawhinney, Minister of State for Health, yesterday appeared to acknowledge that many of the criticisms were justified, and spoke of the need to empower women to take more decisions about the care they received.

'Pregnancy, childbirth and the early years of life are no longer the hazardous experiences they were in times past. The rate of perinatal and infant mortality is at the lowest level ever. Doctors, nurses and midwives can be justifiably proud of the services they provide,' he said.

The expert committee is to be chaired by a woman independent of the professions involved, and will include several representatives of the users of maternity services. The all-party select committee's complaints about 'demarcation disputes' between professionals attending women in labour will be examined by the new group.

Mr Mawhinney said the expert committee would be asked to take 'full account of the shift in attitudes of many women in favour of a more homely and less technological setting for care, while not compromising the safety of mothers and babies.'

The Department of Health yesterday accepted that all pregnant women should be given birth plans tailored to their own views on acceptable interventions such as epidurals. There should be continuity of care, with one person responsible for a patient's care throughout.

The Royal College of Midwives welcomed the response as an endorsement of its views that women should have as much choice as possible over the manner and place of delivery.

The Royal College of Obstetricians and Gynaecologists described the Government's response to the report as 'very responsible'.

Maternity Services, a Government response to the second report from the health committee; HMSO; pounds 6.25

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