Some of the midwives and patients from the fifth series of One Born Every Minute. Photo: Phil Fisk
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One Born Every Minute is the opium of the masses

Like millions of others, I love Channel 4’s maternity documentary. But it is feeding us an overly rosy view of an NHS suffering from staff shortages and cutbacks.

OK, OK, so we all know that Made in Chelsea and The Only Way is Essex aren’t actually depicting the reality of life in Chelsea or Essex, but there’s something about medical reality TV programmes that somehow makes you think what you’re seeing is real. Channel 4’s Bafta-winning documentary series One Born Every Minute (OBEM) has recently returned to our screens for a fifth series. While its popularity is partly rooted in a certain voyeurism, many women (myself included), have watched it in the run up to childbirth in the hope of learning something of what was to come. After all, it’s a documentary, and though edited, isn’t scripted or staged. The care is real. The cleanliness, the calm, the almost ideological commitment to the profession, are all a true reflection of what our maternity units are like. . . right?

Like millions of you, I’ve tuned in to watch the messy business of childbirth. I’ve watched aghast as devoted midwives stay on past their shift to see through the labour of a woman whom they were so attentive to, you’d be forgiven for thinking they were long-lost friends. In one episode, they actually were! In more precarious situations, hoards of impeccably timed, rigorously diligent and profoundly empathetic midwives work in perfect harmony to support women, as if they were mythical angels of midwifery. The rose-tinted atmosphere is heightened by personal narratives from the midwives, who often talk about their profession as a dream vocation. While I don’t doubt many midwives do enter the profession thanks to vocational aspirations, statistics also tell us that midwives are leaving the profession in droves, suggesting that “tea and cake interspaced by miraculous experiences” might not be an entirely accurate portrayal of what their working lives are like.

For me, OBEM was a window – or so I thought – into the type of care I could expect to receive on the NHS. I wish I could confirm that the series offers an accurate depiction of the type of care you can expect to receive as an expectant mother, because frankly, it is exactly the level of care women should be receiving. And for many health professionals, it is precisely the type of care they wish they could deliver. But both my personal experience and crucially a range of figures, suggest otherwise.

One can safely assume that the maternity wards that agree to be filmed are not those struggling with staff shortages or overcrowding problems, as many of our maternity wards currently are. But I’ve come to wonder whether OBEM doesn’t actually act as a sort of pacifying decoy where there might otherwise be mass indignation as to what is truly happening in our hospitals.

The programme has aired over a period during which NHS restructuring means many maternity units are being downgraded or even shut down because of staff shortages and overcrowding. According to a recent survey, new mothers describe maternity units as “severely understaffed “with “overworked staff” on postnatal wards in particular. More than half of birthing units are not meeting the staffing guidelines set out by the Royal College of Obstetricians and Gynaecologists and a third of mums in labour are now being turned away from wards, a scene we have so far seen only once on the last season of OBEM! The Royal College of Midwives is campaigning for 5,000 more midwives to be recruited to meet growing demand and speaking last year its chief executive Cathy Warwick warned: “We are many thousands of midwives short of the number needed to deliver safe, high-quality care.”

In the series, we watch as consistently composed midwives with all the time in the world tend compassionately to labouring women in state-of-the-art facilities. And yet meanwhile, many of us experience a system in which overworked and over-stretched midwives struggle to meet requests beyond the barest essentials. And who can blame them when, unlike the midwives on OBEM who seem to enjoy endless tea breaks, the midwives who don’t make it onto our screens report that missing meal breaks and finishing shifts late is a daily occurrence. As one midwife confessed to me: “One Born Every Minute is about as similar to my experience of being a birth centre midwife as Green Wing is to working in a hospital.”

We have our own perceptions of the NHS, shaped by the images we see on our screens. In the case of OBEM, these images are embellished with stories of women’s struggles within a pristine and perfectly-oiled system. If our own experiences differ from the narrative, we assume it’s an anomaly, an exception – that we were simply “unlucky”.

The reality is that the NHS chief executive Sir David Nicholson says £20bn must be shaved from the budget by March 2015, much of which involves hospital closures or downgrading. This is something which many campaigners see as cost-cutting not, as is claimed, an attempt to provide a more efficient service. While we happily watch an army of midwives fawning over newborns in immaculate hospitals, the government is undertaking the biggest NHS restructuring in history, which massively impacts the levels of care women can expect to receive.

The Maternity Services Survey 2013, which examines the experiences of women in 137 NHS Trusts in England, found that “more women felt that they were treated with kindness and understanding and had confidence and trust in the staff caring for them during labour and birth” than during the last survey in 2010. But it also revealed some worrying findings.

Among them was the fact that almost one in five women feel their concerns during labour were not taken seriously. Of the 230 women who provided comments about their experiences of accessing care, only one comment was positive. Of the remaining comments, over 87 per cent referred to women’s negative view of their care.

The UK may well be one of the safest places in the world to give birth, but all is not well. It has one of the worst rates of stillbirth in the developed world, and according to a globally-renowned professor of maternal care, government restructuring is to blame. What’s more, despite the majority of maternal deaths happening post-birth, budget pressures mean that almost half of new mothers are not immediately made aware of how to spot life-threatening conditions. And although the government has pledged that women can expect consistent care from a single midwife during labour, 46 per cent say they do not receive this.

OBEM has shone much-needed light on the experiences of women in labour, but the programme’s rosy depiction of our maternity wards shields us from the gruesome reality of what’s actually happening to them. If we were privy to the strains being placed on our wards, we might just be spurred into action. While the NHS is in need of profound change to render it more sustainable, care for women and babies at the very start of life should be shielded from cuts. Let’s not confuse the care we wish we had with the care we actually have and in so doing, end up lulled into a false sense of security. In the age of progress, we often assume things can only get better. The truth is, programmes like OBEM depict how it should be. Sadly, for many of us, that won’t be the reality.

Myriam Francois-Cerrah is a freelance journalist and broadcaster (France, Middle East and North Africa, Islam) and a DPhil candidate in Middle Eastern studies at Oxford University.

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As a Conservative MP, I want Parliament to get a proper debate on Brexit

The government should consider a Green Paper before Article 50. 

I am very pleased that the government has listened to the weight of opinion across the House of Commons – and the country – by agreeing to put its plan for Brexit before Parliament and the country for scrutiny before Article 50 is triggered. Such responsiveness will stand the government in good stead. A confrontation with Parliament, especially given the paeans to parliamentary sovereignty we heard from Leave campaigners during the referendum, would have done neither the Brexit process nor British democracy any good.

I support the government’s amendment to Labour’s motion, which commits the House to respecting the will of the British people expressed in the referendum campaign. I accept that result, and now I and other Conservatives who campaigned to Remain are focused on getting the best deal for Britain; a deal which respects the result of the referendum, while keeping Britain close to Europe and within the single market.

The government needs to bring a substantive plan before Parliament, which allows for a proper public and parliamentary debate. For this to happen, the plan provided must be detailed enough for MPs to have a view on its contents, and it must arrive in the House far enough in advance of Article 50 for us to have a proper debate. As five pro-European groups said yesterday, a Green Paper two months before Article 50 is invoked would be a sensible way of doing it. Or, in the words of David Davis just a few days before he was appointed to the Cabinet, a “pre-negotiation white paper” could be used to similar effect.

Clearly there are divisions, both between parties and between Leavers and Remainers, on what the Brexit deal should look like. But I, like other members of the Open Britain campaign and other pro-European Conservatives, have a number of priorities which I believe the government must prioritise in its negotiations.

On the economy, it is vital that the government strives to keep our country fully participating in the single market. Millions of jobs depend on the unfettered trade, free of both tariff and non-tariff barriers, we enjoy with the world’s biggest market. This is absolutely compatible with the result, as senior Leave campaigners such as Daniel Hannan assured voters before the referendum that Brexit would not threaten Britain’s place in the single market. The government must also undertake serious analysis on the consequences of leaving the customs union, and the worrying possibility that the UK could fall out of our participation in the EU’s Free Trade Agreements (FTAs) with non-EU countries like South Korea.

If agreeing a new trading relationship with Europe in just two years appears unachievable, the government must look closely into the possibility of agreeing a transitional arrangement first. Michel Barnier, the European Commission’s chief negotiator, has said this would be possible and the Prime Minister was positive about this idea at the recent CBI Conference. A suitable transitional arrangement would prevent the biggest threat to British business – that of a "cliff edge" that would slap costly tariffs and customs checks on British exports the day after we leave.

Our future close relationship with the EU of course goes beyond economics. We need unprecedentedly close co-operation between the UK and the EU on security and intelligence sharing; openness to talented people from Europe and the world; and continued cooperation on issues like the environment. This must all go hand-in-hand with delivering reforms to immigration that will make the system fairer, many of which can be seen in European countries as diverse as the Netherlands and Switzerland.

This is what I and others will be arguing for in the House of Commons, from now until the day Britain leaves the European Union. A Brexit deal that delivers the result of the referendum while keeping our country prosperous, secure, open and tolerant. I congratulate the government on their decision to involve the House in their plan for Brexit - and look forward to seeing the details. 

Neil Carmichael is the Conservative MP for Stroud and supporter of the Open Britain campaign.