March 30, 2003

Reflections on this UK workshop tour

Today I am packing up in the UK ahead of returning to Sydney tomorrow. As I look back on this trip, it’s useful to reflect on what I have learnt from this trip:

The Birth Centre concept is finally being developed in the UK. However, disturbing trends are emerging - for example, I have just spent four days at Birmingham Women’s Hospital, where a new Birth Centre is under construction. It has been commissioned by the obstetricians, who have the majority on the decision making committees that are overseeing the staffing, design, construction and management of the new unit. The unit will be located in the obstetric unit and will have a double door access to the regular labour wards. Staff will rotate throughout all areas. In other words, this is a sham and a complete nonsense that appears to have an expansion of this highly medicalised unit as its primary purpose. I pity the poor midwives who will be trying to make it work for women. This is not an isolated event either, I heard of other examples of this kind of duplicity going on in the UK.

The Occupational Health and Safety people are developing into a police force that is hampering improvements and systematically undermining common sense. I have heard a long litany of ridiculous decisions they have made: women in supposedly home-like facilities not being allowed onto sofa beds (or similar comfy chairs) in labour because they cannot be easily cleaned; fathers not be allowed to make a cup of tea because they may burn themselves on the kettle; all birth balls removed from a unit afer a small mishap with one ball brought in from home by a labouring woman; towels for use with hot water being kept under lock and key; toast not able to be made in labour ward kitchens because it may set off the smoke alarms if someone is distracted and forgets to take it out of the toaster; etc etc. I should have made a list as I went along, but I was so gobsmacked (to use a local expression) that I didn’t write them down. Next time I will compile a dossier - it will make a great basis for an article in one of the midwifery journals!

On the other hand, I heard about dirty units, filthy floors, run down equipment and a general lack of facilities. It seems that the Infection Control Officers are not nearly as diligent as their OH & S colleagues!

The over riding impression that I have, however, is that this is a very “sick” culture, where women expect to be given drugs in labour and midwives offer them routinely because there is no real belief that women have the stamina or will power to labour without props of some kind. When I show birth videos I now make it clear that al the births midwives will see are ones where no drugs are being used of any kind. This is a rarity in the UK, even for home births. I think that this lack of trust in birth is contributing to the poor self esteem and low levels of confidence that are very evident amongst British women, which is hampering political action, personal improvement and change within the maternity services.

So, with a heavy heart at the lack of progress in British maternity circles, I head back home. Sometimes I wonder why I bother putting myself through considerable inconvenience to keep plugging away in the UK with the message about normal and natural births. There are midwives and women here that appreciate what I am saying and who have personal experience that backs my message. I just wish there were a whole lot more of them.....

Posted by andrea at March 30, 2003 06:42 PM

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Andrea, I am very grateful that you come to the UK to impart your expertise and passion for midwifery and normal birth. Midwives are very slowly breaking free from medicalisation and Obstetricians, although it is slow. After attending the workshop in Bham, I went back to work and was informed by the receptionist at the surgery, that the GP's are no longer doing any Pre-natal clinics, yippee. Thats only taken us 5 years!!!!!!!! A small breakthrough but fantastic.

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Posted by: fp292003 on January 21, 2004 03:02 PM

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hi, i have recently been working on the birth centre attached to birmingham womens hospital and i have loved every moment. the midwives working here are all very much enthusiastic and have a true belief in women giving birth naturally and seeing what the female body can do- without a doctor or drugs. i have witnessed the most beautiful births and have seen women feel truly happy and proud of what they have achieved. i do not feel it is a sham and feel that it is a great opportunity for women and midwives to go through labour and birth the way it is meant to be. it is still in the beginning stages of development but i feel it is working ok and women have really enjoyed birthing here. i agree that obstetricians must start believing that women can give birth without a ventouse, episiotomy and epidural, when midwives know that support, a bath and a massage works just as well!!!

Posted by: student midwife on April 25, 2004 02:51 AM