Dear Baroness Cumberlege: UK midwifery has become a sisterhood of deadly enablers


Dear Baroness Cumberlege,

Congratulations on your appointment as Chair of the maternity review mandated in the wake of publication of the Morecambe Bay Report. It is a weighty responsibility to have the task of protecting the UK’s mothers and babies from poor clinical care, refusal to address devastatingly poor outcomes, and a tendency for officials at every level to champion each other rather than the babies, mothers and families they are obligated to serve.

I cannot say that I am surprised by the findings of the Morecambe Bay Report. From my blog across the pond I’ve been following midwifery in the US and other countries for nearly a decade. I’ve detailed the progressive radicalization of British midwifery in theory and in practice. The hideous outcomes at Morecambe Bay (where 16 babies and 3 mothers died over a 9 year period) to the newly revealed horror at Royal Oldham/ North Manchester General Hospitals (where an appalling 7 babies and 3 mothers died in just 8 months!) are the inevitable result of a policy where UK midwives consider themselves “guardians of normal birth” instead of guardians of the lives and health of mothers and babies.

I understand how a group of providers can become more concerned about their own self-interest than patient well being as UK midwives have done. What I do not understand is how the NHS has allowed UK midwifery to become a sisterhood of deadly enablers who feel free (on social media no less!) to harass loss parents, make light of their suffering, ignore dead babies and dead mothers, and complain that not enough attention is being paid to their feelings.

I suspect that observing this type of behavior, which will probably not be addressed in the maternity review, might give you some insight into what those who desperate to secure quality midwifery care for their themselves and their loved ones are up against.

I’d like to share with you what happened on just one day, on just one social media platform, as a group of midwives attacked an obstetrician and a loss father.

How did this come to my attention? I was the cause of the attack.

A Professor of Obstetrics alerted a loss father (in his role as patient safety advocate) and myself to a midwifery practice boasting about a successful homebirth after 3 C-sections.

Can you spot the problem? According to the midwives (and journalist/professional natural childbirth advocate Milli Hill) who parachuted in for the attack, the problem was not the terribly risky homebirth. The problem was that a Professor of Obstetrics had dared to correspond with me and they didn’t approve … they didn’t approve at all. You can find the beginning of the Twitter conversation here (UK midwives foolishly continue their bullying on Twitter).

Hill captures their criticism succinctly:

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YOU should explain why you are tweeting with Amy Tutuer [sic]

That’s how I came to be part of the Twitter conversation, and what I observed may interest you in your forthcoming task.

I observed a group of midwives that has become a sisterhood of deadly enablers, ignoring deaths of their patients, incapable of tolerating criticism or even listening to it, patrolling social media to keep obstetricians and loss parents in line, and cheering each other on by encouraging outright dismissal of any criticism.

For example, midwife Sheena Byrom, as is her wont, started tweeting the conversation to NHS accompanied by (yet another!) thinly veiled threat to report the loss father’s failure to toe the midwifery line to your maternity review.

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That’s when I copied you in so you could see the bullying in action.

In the 100+ tweets that passed back and forth over the course of the day yesterday, I did not see even a single one from a midwife acknowledging the appalling litany of maternal and perinatal deaths at the hands of UK midwives. The same dangerous midwifery culture that leads to praise of homebirth after 3 C-section also leads to shirking any responsibility in maternity deaths, and the privileging of process over outcome that the obstetrics professor, the loss father, and I are working hard to confront.

Instead I saw this:

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And this:

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And this:

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I do not understand how midwives can be so brazen as to behave this way in a public forum, and I fear that the same vicious response to criticism is what mothers and fathers face in attempting to hold midwives to account. It is almost as if they believe themselves to be untouchable; they act as if it does not matter what they do, whom they harm, and what tragedies they cause, because as long as they ignore criticism and stick together they can avoid being held to account.

Baroness Cumberlege, in addition to being an obstetrician, I am a mother of four children, now grown. There is nothing more precious to me than these children (and their father) and I cannot imagine the horror of losing a child because of a midwife’s fealty to normal birth above all else, and THEN have to endure contemptuous dismissal of my loss by midwives who promote the philosophy that led to the death of my child.

The task ahead of you is enormous, and I beg your indulgence in intruding on your time, but it is important that you are aware of the vicious behavior of UK midwives on social media, which, I fear, is symptomatic of the behavior that has led to so many preventable deaths.

Amy B. Tuteur, MD