Former NHS Senior Midwife Speaks
This was written as a response to criticism of a post by Emma Ashworth based on her new book, available from AIMS, AIMS Guide TO Your Rights in Pregnancy. A book I am eagerly awaiting delivery of.
“As a former NHS senior midwife who left practice to become my medically disabled child’s full time carer, who has let her registration intentionally lapse, it affords me the ability to speak freely without concern over any professional reprisal.
There is a vast difference between an obstetrician or a midwife permitting time to sensitively discuss care plans and options with a woman, giving her an unbiased true reflection, giving her information and allowing her time to come to her own decisions and supporting those decisions she makes. What are the risks of intervention and possible outcomes, what are the risks of not intervening and possible outcomes is very different to the outright coercion women are routinely subjected to.
Versus, what is the norm across every obstetric maternity unit in the UK of “I am just going to pop you on the CTG, let’s have a listen in and see how baby is coping, can you get on the bed…” or “I have booked your induction in for xxx date as you are going to be term plus 12 and our policy here is to induce at term plus 12” or “Oh no, we always advise our twins are ELCS too much can go wrong and it can go wrong very quickly” and “a home birth? why on earth would you want to risk your health and your baby’s health by wanting a home birth?” and “I am just going to check your cervix and see how you are doing, okay so I can break your waters (while they pick up the amnihook)” or even a Consultant laughing at a lady who wanted a VBAC with twins saying “Don’t be so silly, I will see you on the table at 38 weeks” (Me being that lady who was very informed)
We know coercion goes on, we see it happening all the time, we see antenatal wards fill up with routine IOL’s, women coming in at term plus 11 in the evenings to begin induction not having a clue what that entails. Absolutely no idea. Terrified that by tomorrow if they don’t have a baby in their arms their placenta will fail. Fully believing that they will go into labour that night and have a baby in the morning.
Those same women utterly exhausted on day 3 throwing in the towel and agreeing to a suggested LSCS (caesarean section/birth) (conveniently being added onto the days ELCS list (elective caesarean/birth)) as they cannot bare go through another cycle of prostin and have lost all hope that their cervix will ever dilate. Believing their bodies have failed them and they just cannot get into labour.
“Your placenta will start to fail at term plus 12”, is not giving a woman unbiased, factual, evidence based information, it is inflammatory, it terrifies women and it has the desired effect. Compliance.
Particularly when they hear it over and over again.
Midwives blithely following care plans without open discussion, feeling unable to challenge or discuss with obstetricians, those midwives who are practicing within an atmosphere of institutionalised bullying.
Midwives who are too afraid to stick their heads above the parapet and truly advocate for women in their care.
To get through the system to the point where you do have a voice that counts, takes years of doing admission CTG’s, administering Prostin on women who have no concept on any risks of hyperstimulation, standing in clinic hearing an obstetrician suggest an IOL for mild carpal tunnel for him to then say “my women love me, I give them what they want” (wretch)
Any midwife who says they haven’t is bare faced lying.
You have to get your feet under the table before you can start blocking the Consultant on today accompanied by his Reg, his SHO and his lackies who wants to do a labour ward round and enter the room of the woman in your care who does not need an obstetric review let alone an audience of 5.
Women are routinely subjected to misinformation, inflammatory one liners, very heavy bias and downright coercion and abuse.
Well done Emma Stromberg Ashworth Doula…this book is invaluable and I champion you from the rooftops for not only the wondrous benefit it will bring to all women, but for raising awareness on this topic so as all practitioners within maternity services actually sit up and listen and reflect on and appraise their own practice.
There is nothing divisive about this book and the topic in general.
Maternity practice is litigious practice and that really does need to stop for the benefit of all maternity service users.
Sadly every student midwife, every practising midwife within the NHS, knows it, experiences it. But, they are often unable to raise concerns.
They certainly cannot raise concerns whilst they are registered and bound my NMC codes or if they ever want to pursue a career within not only Midwifery but within any NHS profession.
Speak up and you are ostracised and if you get ostracised you cannot advocate for any single woman.
It’s a fine line you have to traverse. Make yourself a scapegoat and you will be one. I have seen so many excellent midwives go down, be lost, leave and suffer mental and emotional poor health.
For example, NHS Midwives practice on their PIN, obstetricians on their GMC number, they both know that regardless of which Union they join, the buck stops with them.
They practice knowing that they are always going to be held accountable within the court of law and can face civil and criminal charges …manslaughter being what is drummed in the most. It is all very litigious.
I was feisty, I fought tooth and nail, I ran up against the establishment, I had obstetricians gunning for me and I brought change to one obstetric unit, small changes, but change.
But I had to go through my time of frankly doing unspeakable things to women or keeping my mouth shut, to get there.
I had to change units, I had to drive a 3hr round trip each 12.5hr shift (if I was lucky) to find a unit that I felt comfortable practising in.
The final straw in one unit, I had to sit and listen in to women and their families being gaslighted on serious case reviews, knowing that 3 of the people at the table are in the Trust legal teams and the entire purpose of that review is to quash these women and her families.
To watch a Head of Midwifery sell her soul to quash and stamp on women. Tell women that they are essentially imagining things. Even when I practiced and was supported and promoted within a unit that I feel is one of the most progressive units in the UK with an excellent HOM, you ruffle the feathers of the establishment.
You rattle the patriarchal and misogynistic system.
You have to battle obstetricians and even when you have earned their respect, you have to hear “look, I don’t get sued because I did one (a LSCS) I would get sued if I didn’t” and “DO YOU KNOW WHO I AM?”
It takes huge strength and a a bloody good HOM to stand tall.
Very few midwives get the opportunity.
It is easy to become burnt out, disillusioned, to become the midwives who are resentful and are essentially obstetric nurses.
The ones who sit in handover and ridicule the women in their care, who laugh at birth plans and “well this one is heading for a section” etc.
Not because they don’t care, but because that is what the system and the establishment is.”
As someone who has spent the whole of covid, unpicking harm caused by coercive healthcare professionals, I am tired of reading about how harmful this is to relationships between women and HCPs – those are being damaged daily by misinformation and coercion dished out by maternity services, bringing this to people’s attention is not the issue – the issue is that it happens at all.
I fully endorse that no-one needs to listen until that information is being passed on in a fully evidence based manner, giving the pros and cons of all suggested pathways as required by moral, ethical and legal standpoints.
If birth rights were being upheld we wouldn’t have the situation we are in now, with AIMS and Birthrights swamped and the They Said To Me Page getting many messages daily.