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.

Photo: Getty Images
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I'm far from convinced by Cameron's plans for Syria

The Prime Minister has a plan for when the bombs drop. But what about after?

In the House of Commons today, the Prime Minister set out a powerful case for Britain to join air strikes against Isil in Syria.  Isil, he argued, poses a direct threat to Britain and its people, and Britain should not be in the business of “outsourcing our security to our allies”. And while he conceded that further airstrikes alone would not be sufficient to beat Isil, he made the case for an “Isil first” strategy – attacking Isil now, while continuing to do what we can diplomatically to help secure a lasting settlement for Syria in which Assad (eventually) plays no part.

I agreed with much of David Cameron’s analysis. And no-one should doubt either the murderous barbarism of Isil in the region, or the barbarism they foment and inspire in others across the world.  But at the end of his lengthy Q&A session with MPs, I remained unconvinced that UK involvement in airstrikes in Syria was the right option. Because the case for action has to be a case for action that has a chance of succeeding.  And David Cameron’s case contained neither a plan for winning the war, nor a plan for winning the peace.

The Prime Minister, along with military experts and analysts across the world, concedes that air strikes alone will not defeat Isil, and that (as in Iraq) ground forces are essential if we want to rid Syria of Isil. But what is the plan to assemble these ground forces so necessary for a successful mission?  David Cameron’s answer today was more a hope than a plan. He referred to “70,000 Syrian opposition fighters - principally the Free Syrian Army (FSA) – with whom we can co-ordinate attacks on Isil”.

But it is an illusion to think that these fighters can provide the ground forces needed to complement aerial bombardment of Isil.  Many commentators have begun to doubt whether the FSA continues to exist as a coherent operational entity over the past few months. Coralling the myriad rebel groups into a disciplined force capable of fighting and occupying Isil territory is a heroic ambition, not a plan. And previous efforts to mobilize the rebels against Isil have been utter failures. Last month the Americans abandoned a $500m programme to train and turn 5,400 rebel fighters into a disciplined force to fight Isil. They succeeded in training just 60 fighters. And there have been incidents of American-trained fighters giving some of their US-provided equipment to the Nusra Front, an affiliate of Al Qaeda.

Why has it proven so hard to co-opt rebel forces in the fight against Isil? Because most of the various rebel groups are fighting a war against Assad, not against Isil.  Syria’s civil war is gruesome and complex, but it is fundamentally a Civil War between Assad’s forces and a variety of opponents of Assad’s regime. It would be a mistake for Britain to base a case for military action against Isil on the hope that thousands of disparate rebel forces can be persuaded to change their enemy – especially when the evidence so far is that they won’t.

This is a plan for military action that, at present, looks highly unlikely to succeed.  But what of the plan for peace? David Cameron today argued for the separation of the immediate task at hand - to strike against Isil in Syria – from the longer-term ambition of achieving a settlement in Syria and removing Assad.  But for Isil to be beaten, the two cannot be separated. Because it is only by making progress in developing a credible and internationally-backed plan for a post-Assad Syria that we will persuade Syrian Sunnis that fighting Isil will not end up helping Assad win the Civil War.  If we want not only to rely on rebel Sunnis to provide ground troops against Isil, but also provide stable governance in Isil-occupied areas when the bombing stops, progress on a settlement to Syria’s Civil War is more not less urgent.  Without it, the reluctance of Syrian Sunnis to think that our fight is their fight will undermine the chances of military efforts to beat Isil and bring basic order to the regions they control. 

This points us towards doubling down on the progress that has already been made in Vienna: working with the USA, France, Syria’s neighbours and the Gulf states, as well as Russia and Iran. We need not just a combined approach to ending the conflict, but the prospect of a post-war Syria that offers a place for those whose cooperation we seek to defeat Isil. No doubt this will strike some as insufficient in the face of the horrors perpetrated by Isil. But I fear that if we want not just to take action against Isil but to defeat them and prevent their return, it offers a better chance of succeeding than David Cameron’s proposal today. 

Stewart Wood is a former Shadow Cabinet minister and adviser to Ed Miliband. He tweets as @StewartWood.