Ockenden report

My daughter was conceived in the most medical way imaginable, through IVF. Therefore, it made sense to me to choose a highly medicalised birth – an induction on her due date. The very act of making the request felt a little subversive: during my research in books and online, the pervading view seemed to be that interventions such as inductions or C-sections should be a last resort. “Women have been doing this for millions of years,” I was reassured. “Your body knows what to do.” My body, I reasoned, didn’t know anything: it didn’t know how to conceive and it barely knew how to sustain a pregnancy. Therefore, the chances of it knowing how to show the baby the correct exit were, to my mind, vanishingly slim. The midwife I made the request to didn’t agree. “Your body will know when it’s time for the baby to come,” she trilled. Luckily, I was subsequently referred to a supportive doctor. “It’s what I’d do,” she confided, before pointing out that the chances of a stillbirth begin to rise steadily after the 40th week of pregnancy. Thank god for that doctor. The risks of our obsession with “natural” childbirth were laid bare in a 27 March Sunday Times report on the Ockenden review, due to be published this week, which revealed that 300 babies were lost and at least 12 mothers died at the Shrewsbury and Telford Hospital Trust between 2000 and 2019 because it denied mothers caesarean sections. The trust had previously boasted in a parliamentary select committee of its “low intervention rate”. One mother, whose baby died, was told: “we’ve got the lowest caesarean rates in the country and we are proud of it and we plan to keep it that way.” Outside of the worst cases, it isn’t hard to find stories of the harm this attitude causes. A friend, Nicole, delivered her first child via C-section, but when she requested a C-section for her second child, was told she must attend a vaginal birth after caesarean (VBAC) class before she could book it. “I had to take that class and learn my vagina CAN push a baby out,” she said. She was also handed a pamphlet about the harms that C-sections can do to children, including causing a higher body mass index and increasing the chances of asthma. “It hurt to hear medical professionals tell me I was somehow making my child worse off,” she said. When you are pregnant, there is often a sense that the more medicalised the birth, the more you have failed. At my birthing class, one of my group, a doctor, was visibly shaken when the instructor said that even if your waters have broken, you should go home to be away from a medicalised environment. “But a membrane has broken,” he said, aghast. “It puts you at risk of infection. You need to be monitored.” Why are we so obsessed with “natural” delivery? My guess is that it is partly to do with the idea of the feminine mystique – that women’s bodies contain an unknowable, magical force that must not be interfered with – and also that it is simply another way to shame women. But giving birth – however it’s done – is still a life-threatening situation, killing more than 300,000 women around the world each year. Simply coming out of it alive, and with a healthy baby, should be the only goal.