Being a UK midwife means you never have to say you’re sorry

Better birth initiative

In the wake of the Morecambe Bay Report, which investigated the deaths of 11 babies and a mother and placed blame squarely on a midwifery culture that valued “normal birth” above all else, you might think that UK midwives would be in a mood of somber reflection about their deadly philosophy.

You would be wrong.

Yesterday I entered the weekly Twitter chat at the hashtag #WeMidwives hosted by the Royal College of Midwives (RCM). If I hadn’t been there myself, I would not have believed the smugness, meanness, utter lack of reflection and inability to tolerate criticism that characterized the Royal College of Midwives and its members.

Apparently, no matter how many dead babies, no matter how many dead mothers, being a UK midwife means you never have to say you’re sorry.

The topic of the chat was the latest in deadly midwifery philosophy, the RCM Better Births Initiative.

The Better Births initiative started in May 2014 with the aim of developing service-led and evidence-informed resources for maternity care in the UK covering the antenatal, intrapartum and the postnatal periods.

The three themes that we are focussing [sic] on are:

1 The promotion of normal births for majority of the women and normalisation for all women, achieving normality…

In other words, it is the new iteration of the Campaign for Normal Birth, yet another example of MIDWIFE-centered care.

What about MOTHER-centered care? Don’t be naive. UK midwives apparently believe that if it is good for them, it must follow that it is good for mothers. They seem intellectually incapable of differentiating their interests from their ethical obligations to women and babies.

What is normal birth? It is never explicitly defined, but the fundamental RCM belief appears to be that if a midwife can do it, it’s normal and if only a doctor (obstetrician, pediatrician, anesthesiologist) can do it, it’s abnormal and to be abhorred and eliminated.

You can follow nearly the entire chat on Twitter at #WeMidwives. The topic was “What does better births look like for you and why?” The narcissism of a group of health professionals placing their vision of birth above the mother’s needs and desires is truly mind boggling, not to mention thoroughly unethical.

Below are a few exchanges that will give the flavor of the discussion:

Me: @MidwivesRCM Shouldn’t focus be on what better birth looks like to MOTHERS, not midwives? #WeMidwives

RCM: (No response.)

Me: When will RCM acknowledge that Campaign for Normal Birth led to the Morecambe Bay horror? #WeMidwives

Everyone else: (No response.)

James Titcombe (father of a baby who died at Morecambe Bay): How will better births ensure this type of culture doesn’t develop again? #WeMidwives

Newberry Doula: Inappropriate care fm all levels of staff is more likely in overstretched systems IMO. OBs failed too #WeMidwives

Only one midwife had the integrity to state the obvious:

Geraldine Butcher: @MidwivesRCM @WeMidwives hi need to listen to what we don’t want to hear as well as what we do #wemidwives

The rest of the conversations were meaningless platitudes …

wemidwives tweet 1

wemidwives tweet 2

Or worse:

wemidwives tweet 5

And, of course, the inevitable:

wemidwives tweet 3

And the chilling:

wemidwives tweet 4

Why won’t the Royal College of Midwives or its members apologize for the deaths that occurred at their hands?

Cognitive dissonance:

…[H]ow do we square two dissonant cognitions when one of them is the belief that we are decent people and the other is the knowledge that we have inflicted pain on an innocent victim?

Ask any kid who wallops a younger brother. “I’m decent, but I hit him,” the argument runs, “therefore he must have deserved it.” It’s the most vicious of circles. Aggression begets self-justification, which begets more aggression, and thus do the authors lead us, one small step at a time, down the road to Abu Ghraib and to all those deeds throughout the ages whose doers were never the monsters we’d prefer them to be but just decent people like us.

And at the end of the day, when the time comes for decent people to tell their story, self-justification is left holding the pen.

According to The Advantages of Not Saying You Are Sorry in Scientific American:

Given that apologies offer a relatively simple way to mend relations and heal wounds for victims and offenders, why do people refuse to apologize? Beyond escaping punishment, there may be some psychological benefits to standing one’s ground. For example, adopting a self-righteous stance may feed one’s need for power. If the act of apologizing restores power to the victim, it may also simultaneously diminish the power of the transgressor. Thus actively denying any wrongdoing may allow the offender to retain the upper hand…

A second possible benefit of standing one’s ground in the face of an accusation is saving face. No one wants to admit to being a hypocrite. Inherent in an apology is the admission that one’s behavior failed to align with personal values and morals, as people generally don’t apologize for actions they believe are right and just. Thus when we admit that we are wrong, we expose the fact that we may talk the talk, but we do not walk the walk…

So rather than apologizing for a deadly philosophy and catastrophic failures that resulted in multiple deaths, the RCM and UK midwives have doubled down by refusing to reflect, refusing to take responsibility, refusing to express remorse. Instead they figuratively put their fingers in their ears, blocking those who ask uncomfortable questions in an effort to pretend that criticism doesn’t exist and there is no need to think about past errors. Hence the Twitter chat ended with the RCM praising its members and “celebrating your efforts :)”.

What the RCM fails to recognize is that babies and mothers will continue to die at the hands of their members as long as they continue to evade responsibility for the fatalities that have already occurred as a result of a midwife-centered philosophy that values process over outcome and gives pride of place to midwives’ needs and desires while ignoring those of mothers and babies.

Commentor Cordy, a midwifery student, advised, “don’t be worried she is 1 we are many.”

Here’s my advice:

Be worried!

I may be one, but my voice is transmitted around the globe thousands of times each day. And I’m not the only one. Brave parents, like James Titcombe, battling heartache but faithful to the memory of their precious loved ones will not stop until midwives accept responsibility for their actions and their philosophy.

Be worried!

Your behavior is unethical, immoral, self-serving and harms innocents. I don’t know how many babies and mothers will have to die before midwives will be held to account, but I do know that the day of reckoning is coming.