Last week saw the publication of the results of a survey by NHS regulator the Care Quality Commission (CQC), which found that the number of women nationwide who report a positive pregnancy, labour and birth experience has fallen dramatically.
The poll of 20,900 women found that they had struggled during labour and birth, with only 63 per cent saying they had always been able to get a member of hospital staff’s attention, down from 72 per cent in 2019. Clearly, a person who is in labour should be able to get the attention of a member of staff when needed, so anything less than 100 per cent is a problem, but 63 per cent is horrific.
The survey also showed that aftercare is below the standard that we ought to expect, with only 57 per cent of women saying they were able to access appropriate care and support at home after the birth. This number improved when women were able to see the same midwife throughout - known as 'continuity of care' - and worsened in parts of the country where women are likely to see a different midwife at each appointment, such as in larger hospitals in cities.
Shockingly, two out of five NHS maternity services are now ranked as 'inadequate' or 'requires improvement'. This is the worst level since maternity-specific ratings were introduced in 2018. Just four per cent of NHS maternity units have been ranked 'outstanding' and the number classified as 'good' has fallen from 64 per cent, to just 57 per cent.
The NHS is currently dealing with many complex issues, affecting care in several areas, but one positive to come from this conversation is that we are now talking about the psychological impact that childbirth can have - even during a labour and birth where nothing technically goes 'wrong'.
For so long, there has been an attitude of 'a long as the baby's healthy' then it's a successful birth, no matter what state the mother is left in. It's awful that so many women are having a bad experience, but it's good that we're talking about it.
High-profile women such as Louise Thompson have talked honestly about their experience of birth trauma, encouraging others to do the same.
This isn't about scaremongering; we love to hear positive birth stories from women who had a good experience during labour and childbirth. But it's also important to hear about the trauma, so that lessons can be learned and preventative measures taken, and fewer women will be entering parenthood while struggling with post-traumatic stress disorder (PTSD).
'The women we hear from are distressed and angry that they weren’t listened to, or properly cared for,' says Kim Thomas, chief executive of the Birth Trauma Association. 'A lot have stories about being neglected for hours during labour or really awful tales of bad postpartum care where they were expected to fend for themselves. There’s also definitely still resistance to giving women pain relief, even if they’re begging for it.'
This obsession with a 'natural birth' is a huge issue in maternity units. 'There’s been this focus on having the lowest caesarean rate, when they should have been looking at why some hospitals have higher rates of stillbirth and why others have women coming out with birth injuries,' says Kim. 'There’s sometimes still a commitment to the idea that we’re able to get through it using breathing and the power of positive thought, which is not just ludicrous, but cruel.'
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If you have been affected by any of the issues raised in this piece, you can find support at birthtraumaassociation.org.uk