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29 March 2022

Why has it taken tragedy to stop the NHS pushing for “natural” births?

During my three days in labour I asked for a c-section countless times. I felt forgotten about, in danger and not listened to.

By Christina Quaine

“It will be alright. Don’t worry. The baby will be OK,” I whisper to my husband. He looks frightened. I’m frightened, too. It’s hard to sound convincing when you’re lying in a hospital bed on a maternity ward. When the midwife has hit the emergency button because your unborn baby’s heart rate has dipped dangerously low.

A number of doctors rush into the room. There is talk of an emergency caesarean. Then the numbers on the heart rate monitor creep back up; the baby’s heart rate is returning to normal. Sighs of relief all round, everyone drifts away from the room apart from my husband and the two midwives currently tasked with my care. Emergency over, we will press on with “natural” labour.

This is my third day in labour on an overstretched maternity ward in an NHS hospital on the south-east London/Kent border. It’s one example of many times during the process in which I felt forgotten about, or not listened to, or in danger. It’s why I find it so hard to read about the Shropshire maternity scandal: because much of it sounds horribly familiar to me. A five-year independent inquiry into Shrewsbury and Telford Hospital NHS Trust will be published tomorrow (30 March), analysing the experiences of 1,500 families between 2000 and 2019. The report is expected to find that at least 12 mothers died while giving birth under the trust’s maternity services, while 300 babies died or were left brain damaged. Much of this because of a need to hit targets for “normal” births.

Throughout my pregnancy in 2019 — and with my previous pregnancy with our eldest son three years earlier — the message from midwives and obstetricians was a resounding “you can’t beat a natural birth”. That is, vaginal delivery without interventions. It was rammed down our throats when my husband and I did National Childbirth Trust (NCT) antenatal classes before the birth of our first son. Thankfully, the charity has since reviewed its framework “to cover all ways of giving birth”.

I was initially keen to try for a vaginal delivery the second time around. I’d had a planned caesarean with our first child (he was lying the wrong way round in the womb) and I knew that recovery from surgery was tough. But by the time of the baby’s heart-rate scare I was on my third day in hospital. I was sleep-deprived and emotional. Still, the midwives remained starry-eyed about the prospect of me having a vaginal delivery. We asked countless times: “Would it be wise to go for a c-section now?” No, no, no. Things will start moving soon.

I was induced into labour. A doctor inserted a balloon into my cervix (the idea is that it inflates, encouraging the cervix to dilate). As the doctor performed the procedure, she told me she didn’t think she had been able to get the balloon in far enough for it to really work. Go back to the labour ward and we’ll remove it within 12 to 24 hours. The ward was so busy that it took 36 hours for a doctor to become available to remove the balloon, which, as suspected, hadn’t done a thing. The next step was to have my waters broken manually. I had been in labour for 48 hours by now. I felt so weary and anxious and the doctor this time did nothing to abate my anxiety.

“I’m afraid this won’t be very pleasant,” he said before embarking on the procedure which, in all honesty, left me feeling like I had been assaulted. How mad it sounds to liken a medical procedure conducted by an NHS doctor in a modern day British hospital to assault. But that’s how I felt then, and it’s how I feel about it today.

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Eventually, after 72 hours in labour and another drop in my baby’s heart rate, he was delivered by emergency caesarean. It was horrendous. By its very nature the surgery was performed in a hurry and I suffered a haematoma — excessive bruising — and lost a lot of blood. I’ve had a “good” caesarean and I’ve had an emergency caesarean and I know which one I would prefer.

It has taken me a long time to come to terms with my son’s birth. Once we were home, I didn’t want to leave the house for weeks afterwards. It was August, the sun was shining, perfect for taking a newborn for a stroll in the park, but I remember an overwhelming feeling of not wanting to be seen by anyone. “You have a beautiful, healthy baby boy,” friends and family would say. The well-meaning message: try to move on, it’s over now.

It’s hard not to look back on my experience and wish that I had been more assertive about what I wanted, but the truth is that for many women childbirth is one of the most vulnerable situations you will be in. It is hard to assert yourself when you’re sleep deprived and disempowered.

It’s a scandal that the NHS has ever had targets for “natural” births. Can you imagine any other branch of medicine — cardiology, oncology, dentistry — maintaining that nature knows best? Of course, a caesarean is not going to be the best option for every pregnant woman, no more than a vaginal delivery will be. Still, I am one of the lucky ones.

“It will be alright. Don’t worry. The baby will be OK,” I said on that summer’s day in 2019. I wonder how many women under the care of Shrewsbury and Telford NHS trust believed the same thing.

[See also: Truth’s out: our “natural” birth obsession kills]

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