Promoting normal birth is killing babies and mothers

For years, the Royal College of Midwives in the UK has been on a relentless campaign to promote “normal birth.” We are now seeing the results, and they are nothing short of horrific.

Last month the focus was on Furness General Hospital in Cumbria where 6 babies and 2 mothers have died preventable deaths, including:

* Hoa Titcombe, 34, gave birth to Joshua at the end of a normal delivery. But nine days later the baby bled to death after suffering a lung infection which could easily have been treated with antibiotics.

* Thai-born Nittaya Hendrickson and her unborn son Chester both died at the hospital on July 31, 2008 after the midwife in charge of her labour dismissed her fits as ‘fainting’. Mrs Hendrickson later died of a heart attack, while her son died after suffering brain damage.

* In another case Niran Aukhaj, 29, collapsed and died in April that year. Her unborn baby also died. The mother of one, from Ulverston, had experienced a number of problems during her pregnancy, including high blood pressure. Yet midwives failed to take her blood pressure and a urine sample during a routine check-up just a week before she died.

* Liza Brady, whose son Alex was delivered in September 2008 stillborn at Furness General with the umbilical cord wrapped tightly around his neck. At 11lb 13oz, Alex was exceptionally large, yet midwives refused her request for a Caesarean — despite this having been suggested by a consultant obstetrician whom she saw during her pregnancy. During a long and painful labour, the midwives persistently refused her plea to be seen by a doctor and delayed the delivery even though the machine monitoring the baby’s heart showed he was in distress.

‘A doctor offered to help as he came on duty, but he was shooed away by the midwives who said he wasn’t needed,’ recalls Liza.

Lest anyone is tempted to conclude that this is a problem restricted to a single hospital, today’s newspaper reports demolish such wishful thinking (‘If you don’t hurry up, I’ll cut you’: What one mother was told by midwife at NHS Trust where five died during labour).

The [Care Quality Comission] investigated hospitals run by Barking, Havering and Redbridge University Hospitals NHS Trust in Essex.

Four women and seven newborns are believed to have died in the last 12 months on labour wards at the trust’s hospitals.

Sareena Ali, 27, from Ilford, Essex, died in January this year after staff failed to failed to notice she had suffered a ruptured womb that triggered a cardiac arrest and then later tried to revive her using a disconnected oxygen mask. Her daughter Zainab was born lifeless.

Mrs Ali’s husband Usman Javed, 29, who has since moved back to Pakistan, said she was in ‘unbearable pain’ and his pleas for help were ignored by ‘uncaring, incompetent’ midwives…

Then in April, Violet Stephens, 35, from Brentwood, Essex, died after midwives failed to spot she was suffering from pre-eclampsia, which leads to abnormally high blood pressure.

She waited four days to have an emergency caesarean and then died hours later.

Her baby son Christian was delivered healthy and is now being brought up by her sister …

Obstetrician Prabas Misra of Furness General in Cumbria expressed his concern about the rising death toll among midwife attended patients in a letter to his colleagues (Is an obsession with natural birth putting mothers and babies in danger?):

… [Dr.] Misra wrote of ‘the risk of trying to make every labour and delivery normal and natural, and not thinking laterally (about) possible complications. I am all for having a natural childbirth — but not at any cost’.

Although talking about a specific case, Mr Misra has put his finger on an issue at the root of the problems in obstetrics today: the dangerous myth, promulgated by some midwives, that natural childbirth is not only the kindest form of delivery but also invariably the safest.

For years, the prevailing view among some leading figures in midwifery was that obstetricians were little better than trouble-makers. They were seen as over medicalising the natural process of childbirth, slowing down labour with their foetal heart rate monitors, and so increasing the risk of complications.

As a result of these views, UK midwives embarked on a campaign to promote “normal birth.” But what is normal birth? As I wrote in a post last month:

… [N]ormal birth has nothing to do with normal and nothing to do with birth. The definition of normal birth is simple and straightforward: If a midwife can do it, she calls it normal. If she lacks the skill to provide the needed care, she insists that the birth is not normal even if it results in a healthy mother and a healthy baby. “Normal birth” and “midwives” are interchangeable. In other words, “normal birth” is nothing more than a marketing term.

In other words, “normal birth” is about turf, as explained by a British malpractice attorney:

Gill Edwards, a leading clinical negligence solicitor with the firm Pannone, is in no doubt why these fatal mistakes continue.

‘Too often, we see a desire for autonomy, sometimes verging on arrogance, on the part of some midwives,’ she says.

‘It leads them to ignore National Midwifery Council rules that require them to call on the skills of other health professionals whenever something happens which is outside their sphere of practice…’

‘Some of our worst cases occur because the drive to achieve a “normal” delivery clouds the judgment of midwives about when to call in specialist help from an obstetrician, or for a paediatrician to be present at the birth to assist with resuscitation when there are signs of foetal distress during labour,’ says Ms Edwards.

The promotion of normal birth is more than just a disingenuous ploy to promote midwifery, it is wrong on its face.

The mounting death toll of midwife attended preventable neonatal deaths and preventable maternal deaths demonstrates that efforts to promote normal birth kill babies and mothers. That’s not surprising when you consider that promoting normal birth is fundamentally unethical.

An ethical medical professional recommends whatever is safest for the patient, not whatever is most beneficial for the provider.

  • Delete Essex from London

    Barking, Havering, & Redbridge NHS Trust is in London, not Essex.

  • murphette

    That is desinformation, you should learn about eveidence based medicine, start with the birth place study and then go one to the cochrane database and then again to the cemace report…You will then potentialy be able to speak a bout the matter. You are in fact criminal to post such lies….. this is a comment coming from France…

    • Siri

      That explains why it is illiterate. Come back when you’ve learned English a bit better.

      • AlisonCummins

        Siri, what’s that about? Why don’t you just respond to her in french since your language skills are so much better than hers?

        • Siri

          Pas de probleme – avec plaisir! 🙂

    • Box of Salt

      murphette “start with the birth place study and then go one to the cochrane database”
      Dr Amy’s already done that: http://www.skepticalob.com/2012/04/no-birthplace-study-did-not-show-that.html

      http://www.skepticalob.com/2012/09/cochrane-review-on-homebirth-is-a-piece-of-garbage.html

      Could you check your spelling on the “cemace report”? I can’t find that one.

      • DaisyGrrl

        I think she means CEMACH (Confidential Enquiry into Maternal and Child Health) report. At least, that’s what Google gave me.

        Dr. Amy doesn’t address that report specifically, but there is mention of it in this post: http://www.skepticalob.com/2011/04/death-by-confounding.html

        • Box of Salt

          Which is also abbreviated “CMACE” in more recent years – hence murphette’s confusion with the acryonym.

    • Siri

      Murphette, je m’excuse pour ma reponse impolie. Bienvenue a ce blog, et bonne chance!

      Siri 🙂