September 8th, 2009 15:16 EST
Deliverance Now for Britain's Mums
London (Women`s Feature Service) - For a significant number of women, one of the challenges of motherhood is dissociating their children from the extreme pain of bringing them into the world - and the problem in Britain is growing. Babies are born heavier, career women put off motherhood until later in life, In-Vitro Fertilisation (IVF) increases the rate of multiple births and the country has failed to recruit enough midwives.
The British charity, Birth Trauma Association, set up to help those traumatised by their experience of giving birth, documents harrowing accounts.
For instance, its website carries an extract from the diary of a mother named only as Louise. When her son William was born, she suffered massive blood loss, a torn cervix, a ruptured uterus and was catheterised for weeks. "My mum asked me on Christmas Eve if I was excited for Christmas," she wrote. "I didn`t lie, I said `No`. She asked, `Why not?` and I said, `Because I don`t get excited about anything any more. I am so frightened that one day I will get my feelings back, but it will be too late, William will have grown up, and I`ll have missed it.`"
The British government says it has responded to complaints that there is a shortage of midwives and women are not getting adequate care. It has pledged to invest millions in addition to the Â£1.78 billion (US$1= Â£0.60) spent on maternity services in 2007-2008. In total, it has said it is spending a further Â£330 million in the three years from January 2008.
"Delivering the Maternity Matters commitments is a priority," a spokesman for the Department of Health said, but also admitted care was not consistently good. "We are aware that different parts of the country face different challenges, and that some areas have further to go than others, but we expect to see real improvements in maternity services across the country over the next year," he stated.
The swine flu epidemic could add to the difficulties, as pregnant women and their unborn babies have been identified as especially vulnerable. Nearly all agree improvement is imperative, but a brave few have argued the dangers have been overstated, childbirth has never been safer and a certain amount of pain is an essential part of motherhood.
A senior midwife and associate professor of midwifery at the University of Nottingham in eastern England whipped up a storm of controversy with comments published in the journal of Evidence Based Midwifery and then echoed in the mainstream press in July. "A large number of women want to avoid pain. Some just don`t fancy the pain (of childbirth). More women should be prepared to withstand pain," Denis Walsh was quoted as saying by the `Observer` newspaper. "Pain in labour is a purposeful, useful thing, which has quite a number of benefits, such as preparing a mother for the responsibility of nurturing a newborn baby."
Walsh was, of course, only referring to the pain of labour, not to anything worse.
In 2000, the world set itself a Millennium Development Goal of reducing maternal mortality by three quarters by 2015 and infant mortality by two thirds. The WHO has singled out Britain for inconsistent care (in a statement released around 2007). Although overall maternal mortality levels were extremely low, as throughout the developed world, rates were higher in poorer areas of Britain and among newly-arrived immigrants.
For example, it said, in 2002-2004, the overall infant mortality rate was 4.9 per 1,000 live births in England and Wales, but the rate for those in the routine and manual occupation group was 5.9 and if the mothers were of Pakistani origin, the infant mortality rate was 10.2. The reasons are manifold, but include poverty and delays in seeking care.
Campaigners say it is in everyone`s interest to improve standards for everyone, as the millions the government is investing should be compared with the millions paid out in litigation settlements.
Obstetrics and gynaecology payouts are higher than for any other National Health Service (NHS) specialisation and totalled 2.48 million pounds in the 12 years to March 2007, according to figures from the NHS Litigation Authority. "One of our key arguments is that we are spending enormous amounts of money on litigation - most of which arises when units are short staffed. It is simply not cost effective for maternity services to be the Cinderella service," said Maureen Treadwell of the Birth Trauma Association.
The staffing situation is a vicious circle. For midwives, working long night shifts and facing a very real risk of being sued, it can be hard to recommend to others a career that had once seemed a joyful vocation. As they struggle to cope with two or three women at once, the ideal of one-to-one care for those in labour seems a distant dream and the government`s argument that it is delivering on its promises has a hollow ring.
"It`s the stress of the job," observed one harassed midwife, explaining why it has become so difficult to recruit midwives, "There is no normality."
(Â© Women`s Feature Service)
By Barbara Lewis