Re your letters on how maternity services are failing mothers and babies (17 May), your readers are correct – there is a fundamental problem with our maternity services, which need radical change. As the World Health Organization stated in 1985, “birth is not an illness”; but NHS services treat childbirth as if it is.
In 1992, after years of campaigning, birth activists were delighted when the select committee chaired by Nicholas Winterton made far-reaching recommendations about reorganisation. The government responded by setting up a working party chaired by Julia Cumberlege. They reported in 1993 that women should be at the centre of care, midwives should have a greater and more autonomous role, and that there should be continuity of care.
Various schemes were set up, but without money to change the system. The government changed and, after many years of an obstetric-run system, it was hard to achieve change. However, here is one successful example: the Albany Midwifery Practice in Peckham, south London, in 1997, which was contracted with King’s College hospital. The published results of its first 1,000 births were excellent. Women were enthusiastic about the care they had received. Breastfeeding rates were high, home births over 40% and birth outcomes better than in other midwifery practices. In 2009, King’s terminated the contract, despite a huge outcry from women (see Closure by Becky Reed and Nadine Edwards, published by Pinter & Martin). An independent inquiry by the Centre for Maternal and Child Enquiries did not recommend closure. A retrospective study of all births during the 12 years again had good outcomes.
This unaccountable action is a scandal and should be overturned.
What women and midwives need is this model of care adequately funded and supported. It would solve the shortage of midwives and the poor care reported by successive inquiries. We do not need another inquiry. Women need to reclaim birth.
Wendy Savage
Emeritus professor, Queen Mary University of London
