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Thursday 31 March 2022

The Scandal of NHS Maternity Care

When I talk about "The Failure of Conventional Medicine", as I often do, it is not an academic event, that has no impact on our lives; it is demonstrated by what has happened to our health during the last 70 years, and more. It is about the epidemic levels of chronic disease from which we are now suffering. It is about the spectacular lack of success in how we treat infections. It is about the creation of illness caused by conventional medical treatment, and particularly through adverse drug and vaccine effects.

It is also about a medical system that has failed to keep patients safe from serious harm, and has actually caused direct harm and death on patients.

This harm has been amply demonstrated today, when the Ockenden Report on the maternity practices at the Shrewsbury and Telford NHS Trust over the last 20 years was published. The commercial media has been obliged to report on this awful catalogue of failure. But it has sought to describe this saga of failure as a 'one-off', a situation caused by 'bad practice', the result of professional 'errors' and 'mistakes'.

The Ockenden Report describes the catastrophic failure at an NHS Trust that led to the unnecessary deaths of 200 babies, 9 mothers, and other children who were left with permanent, life-changing injuries.

The situation at Shrewsbury and Telford is certainly not a one-off. It follows the Morecambe Bay Investigation in September 2013 into serious incidents in the maternity department at the Furness General Hospital (FGH) between 2004 and 2013. The report concluded that the maternity unit was 'dysfunctional', that there were "serious failures of clinical care" that "led to unnecessary deaths of mothers and babies". It made 44 recommendations, both for the Trust and the wider NHS, "aimed at ensuring the failings are properly recognised and acted upon". Presumably these recommendations had little impact on Shrewsbury and Telford NHS Trust.

There have been other smaller, but similar investigations. For instance, Basildon University Hospital, part of the Mid and South Essex NHS Foundation Trust, is currently under investigation when a third woman died during childbirth at a hospital's maternity unit in just three years. A BBC article outlines the scale of the problem. In the last 10 years the Trust has paid out over £103m in compensation over 'failings' in its maternity department. It states that this Trust has the highest number of successful clinical negligence claims of any NHS provider, and that "a Trust spokesman said the maternity payments related to cases which could have happened over a 20-year period". The clinical negligence claims related to 36 mother and baby deaths, 31 babies with brain damage, 24 with cerebral palsy and 27 stillbirths.

Predictably, the mainstream media has presented each case in isolation; but they are clearly not 'isolated' cases. So rather than look at the real reasons for these successive failures, they have had to find other 'scapegoats'. It is the shortage of midwives. It involves 'poor staff cultures' at specific maternity units

And, of course, this is about the 'errors' or 'mistakes' of members of the staff; or poor management. Each of these cases will lead, and already have led to the expenditure of yet more resources being poured into the same old medicine.

Never is it asked - is the system of medicine that completely dominates NHS maternity care, at fault?

Are these situations arising because conventional medicine is inherently dangerous? But assumed to be entirely safe?

Maternity care has been increasingly medicalised, from the 1960's onwards, since the days that have been dramatised in the BBC's "Call the Midwife" series. No longer is delivering babies in the NHS the realm of midwives. 

AIMS, the Association for Improvements in the Maternity Services, founded in 1960, "have campaigned tirelessly for improvements to the UK's maternity services, as well as supporting women and families directly through our helpline, and sharing information to pregnant people and health carers ....." This is what AIMS says about 'The Medicalisation of Birth'.

            "Maternity care in the UK, as in much of the Western Hemisphere, is dominated by obstetricians, who have moved from a position where they were called in to assist with a problem labour to the current situation where they control the majority of pregnancies and births. They have done so by persuading the population that childbirth is inherently dangerous, that women's bodies do not function well, by undermining their confidence, by claiming that only obstetric care will guarantee a healthy baby and, worst of all, by carrying out what is now an international witch hunt to remove those midwives who practise real midwifery. As a result of this control, women's voices are often ignored."

Childbirth was not a medical issue before the 1960's. Every pregnant woman was designated a midwife, who befriended, got to know her, and together they worked to deliver the child. This was the norm. It ensured that the mother had someone to speak to, someone who listened to her, someone who knew when to call for medical assistance, if required.

The NHS has, to a significant degree, abandoned this one-to-one relationship between mother and midwife. Is this at the root of the problem? A shortage of midwives? Could this be something to do with the undermining and abandonment of their former role and function?

Now, pregnant women almost exclusively give birth in hospital. AIMS believes that every woman should be able to choose to give birth at home. Even as recently as 2007 the Department of Health said (in Maternity Matters) that "the choice of home birth should be offered to all women". This is not what happens now. The NHS believes that all women need to have access to the latest medical technology, at all times; that unless the natural process of giving birth is supported by doctors, it is dangerous. AIMS has described the process.

        "It was not until the 1970s that (AIMS) realised that, rather than providing quality care for truly high-risk women, the obstetricians had seized the opportunity to gain control of all births. Instead of women being cared for in the community by a skilled midwife, and referred to an obstetrician when the midwife detected a problem, all women were now required to book with a GP who invariably simply referred her to an obstetrician. The community midwives were brought into a centralised hospital service and converted into obstetric nurses. Unfortunately, in the UK the system does not differentiate between an obstetric nurse and a midwife; they are all called midwives."

For instance, ultrasound has to be available, despite evidence that it could be harmful - evidence that has never been properly research, or even acknowledged. And the option of Caesarian birth has to be available, even with concerns that far too many births are using this surgical procedure when it is entirely unnecessary.

I will not even bother to mention he role of pharmaceutical drugs in pregnancy, and their impact on both the mother and the baby. It is a subject in itself, but they are a a known cause of birth defects.

So women no longer had a midwife to take her through the final weeks of pregnancy, someone to talk to, to seek reassurance from, to discuss any social, emotional or medical issues and problems with their pregnancy. Now, she has a bureaucracy of medical experts, who know so much that they do not need to listen to the mother. They know so much, and are so correct, they feel able to 'bully' women, apparently. Yet this is how conventional medicine works, everywhere, in all spheres of medical practise. It is an arrogant medical system. It knows best. 

This arrogance has deeper roots than maternity services. Conventional medicine is in a constant state of denial. The pharmaceutical drugs and vaccines they use cause serious adverse reactions - which are never admitted, until such time they can no longer be denied. To admit the failure , and the inherent dangers of these 'medicines' would be to invite claims for medical negligence - which is already playing a leading role in bankrupting the NHS.

The assumption within the NHS is that they know best, and the best medicine has to have access to the most up-to-date medical drugs and technology. Pregnancy is not a 'normal' process. Women are in mortal danger unless they conform to a medical process over which obstetricians are in control.

Perhaps we all need to ask serious questions of the NHS. And the right question always includes:

"Is the conventional medicine provided by the NHS safe?"