22 August, 2017
The review made by the midwifery standard body will seek to replace the word 'normal birth' with 'physiological birth'. The connotations of 'normal birth' have long been associated with birth without medical interventions such as caesareans, epidurals and instrumental delivery. Delivery by these means can lead to guilt and a feeling of failure for many women. There has been acknowledgement from Cathy Warwick, Chief Executive of the Royal College of Midwives that "what we do not want to do is in anyway contribute to any sense that a woman has failed because she has not had a normal birth. Unfortunately that seems to be how some women feel".
Statistically, 4 in 10 women give birth naturally, without caesarean section, induction, instruments or epidural, down from 6 in 10, 30 years ago. This partly accounts for the rise in older, heavier mothers leading to more complications.
No one will forget the inquiry into the death of 11 babies and one mother at Morecambe Bay Trust between 2004 and 2013 when normal births were championed 'at any cost'. Midwives closed ranks and relationships with doctors were frayed. They sought to uphold normality, sadly with tragic consequences.
What will replace this is a broader 'better birth initiative'. Professor Warwick has said "we would make absolutely sure under the better birth initiative that we did use language and terminology that prevented people from thinking that we are going out there saying to midwives 'You need to get a normal birth at all costs'. We've never said [that] but we can see how the terminology did let people think that was the case".
Despite the change in wording the belief of the college remains the same, that avoiding intervention would be best for many women. Professor Warwick goes on to say "If you have a caesarean section it does not mean that you're a failure. Something has happened in your birth that means you need some help and support and it can still be a very positive experience".
Doctors have welcomed the change in language and Lesley Regan, president of the Royal College of Obstetricians and Gynaecologists said; "While we support the promotion of a vaginal delivery, it is also important to stress that no woman should be made to feel their birth experience is 'abnormal' because they needed to have an intervention".
The trigger for the campaign for a normal birth would appear to have been originally the rise in caesarean section rate.
Knowledge is very often power, but it can also increase anxiety for women and medicalise the experience. The internet and greater publicity and awareness of clinical negligence and the catastrophic consequences in birth injury cases, a growing population and medical progress certainly keeps the debate alive.
For further information please contact solicitor Leonie Millard in our Clinical Negligence department via email or phone on 01254 770517. Alternatively send any question through to Forbes Solicitors via our online Contact Form.