Hospitals are being told to drop their targets which encouraged “normal births” because of fears for the safety of mothers and babies. Maternity units were told to stop using caesarean rates to assess their performance, following scandals in maternity units across the country.
Reported incidents include a mother who lost her son after a trust ignored her pleas for a caesarean section in March 2018 (only for her son to suffer a fractured skull and oxygen starvation when he was delivered with forceps) as well as problems identified in broader hospital wide investigations where there has been an overzealous focus on normal births.
Wider problems are expected to be identified in the awaited report into Shrewsbury and Telford Hospital NHS Trust which is at the center of a current scandal with 1862 cases under investigation. Here, although the full report is awaited, the midwife leading the enquiry has already said that women “felt pressured to have a normal birth” and that there was “a multi-professional, not midwife-led, focus on normal birth pretty much at any cost.”
This follows on from similar findings arising from the investigation at University Hospitals of Morecambe Bay NHS Foundation Trust, where the 2015 report found there was a pursuit of normal childbirth “at any cost”.
It was also reported earlier this month that there is a shortage of midwives across the county which is having an impact on services.
Medical Negligence specialist Simon Mansfield comments:
While I welcome the decision by NHS England to remove targets that penalise maternity services for higher caesarean section rates it is a shame that it has taken this long. The Royal College of Midwives, for context, ended its normal birth campaign back in 2017.
When considering the care provided it is crucial that the focus is on the individual circumstances of each patient and their clinical needs, not on the overall caesarean section rate at an individual NHS trust. This is particularly important as the demographics of pregnant women change and pregnancies become more complex.
As Dr Mountfield of the Royal College of Obstetricians and Gynaecologists, says both vaginal and caesarean births carry certain risks/benefits. These will vary from patient to patient and should be discussed with women as they choose how they wish to give birth. When a decision is made it is also crucial that women feel supported in their decision, that their choices are respected, and that they are not pressured down any particular path.
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