On 11 August 2017, the Royal College of Midwives (RCM) in the United Kingdom, dropped its 12-year long ‘normal birth’ campaign. Officials say the campaign is to blame for unnecessary deaths and sent the wrong message to future mothers – that they were failures for accepting medical intervention during childbirth.

The RCM began an initiative promoting ‘normal birth’ in 2005 that encouraged mothers to deliver vaginally without medical interventions. These interventions encompassed induction of labour, caesarean sections, forceps or medical pain management such as epidurals.

The campaign came under fire after a series of tragic infant deaths at the University Hospitals of Morecambe Bay between 2004 and 2013.

Government investigations further revealed that the deaths of 16 babies and three mothers could be attributed to a ‘lethal mix’ of major failures of care at the hospital. A glaring line in the investigation report also read, “There was a growing move amongst midwives to pursue normal childbirth ‘at any cost’”.

‘Musketeer midwives’ determined for women to give birth ‘normally’ despite risks

The report continued to describe that midwives – self-proclaimed “the musketeers” – pursued natural childbirth overzealously. Women were incorrectly classified as low risk, with midwives frequently discouraging obstetricians from intervening – despite women clearly requiring obstetric care. The relationship between doctors and midwives was described as “seriously dysfunctional”.

Many other factors were also reported to have contributed to this unfortunate scenario such as a culture of denial, collusion and incompetence.

“Our findings are stark and catalogue a series of failures at almost every level – from the maternity unit to those responsible for regulating and monitoring the trust. The nature of these problems is serious and shocking,” expressed Dr Bill Kirkup, lead inquirer in the investigation.

At least seven midwives were investigated during the scandal, resulting in two being struck off and another suspended. The midwife ‘normal birth’ campaign was highlighted as a possible instigator of the dangerous midwife mentality that was evident in the hospital.

James Titcombe, whose son Joshua was one of the babies who died during the Morecambe Bay incident, welcomed the end of the campaign.

“The decision by the RCM to withdraw its campaign for ‘normal birth’ has come much too late for my own son, Joshua… But, is a welcome step. The approach for too long influenced a style of care in maternity wards that put lives at risk,” he lamented.

Chief executive of RCM: Campaign may have “created the wrong idea”

Professor Cathy Warwick, chief executive of the RCM has stated that the organisation is reviewing the campaign – a process which is expected to take six months.

“There was a danger that if you just talk about normal births – and particularly if you call it a campaign – it kind of sounds as if you're only interested in women who have a vaginal birth without intervention,” she said. However, she denied that the campaign resulted in any harm.

The midwifery trade union said that it will instead start to use the term “physiological births” to replace the term “normal births” as part of a “better births initiative”. It also stated that it will not change its stand that “childbirth without medical intervention is best for most women.”

“We would make absolutely sure under the better births initiative that we did use language and terminology that prevented people from thinking that we’re going out there saying to midwives, ‘You need to get a normal birth at all costs’. We’ve never said [that]; but we can see how the terminology did let people think that was the case,” she expressed.

“If you have a caesarean section, it doesn’t mean that you’re a failure. Something has happened in your birth that means you need some help and support – and it can still be a very positive experience,” iterated Warwick. MIMS

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Sources:
http://www.telegraph.co.uk/news/2017/08/12/midwives-agree-drop-normal-births-campaign-makes-women-feel/
https://www.theguardian.com/society/2017/aug/12/midwives-to-stop-using-term-normal-birth
https://www.thetimes.co.uk/edition/news/midwives-back-down-on-natural-childbirth-2f78d65ng
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/408480/47487_MBI_Accessible_v0.1.pdf
https://www.theguardian.com/commentisfree/2017/aug/14/royal-college-midwives-normal-birth-joshua-titcombe