Every mother with their own named midwife? Sounds like an empty promise
In theory, it would be wonderful if every pregnant woman in the UK could be assigned a named midwife, one who could guide them through pregnancy, labour and beyond. In practice, however, it just won’t work. I am constantly reading about the shortage of midwives in this country, and wonder whether Andrew Lansley, after setting out his somewhat blurry proposals, has any idea about how he is going to fulfill his promises for the future. Whilst his decisions for these plans seem admirable (he wishes to support vulnerable women such as those who suffer from post-natal depression or trauma, due to a miscarriage or stillbirth) I would be interested to hear how he intends to provide this one-to-one care, in a service that is already straining at the seams.
The first major flaw in his plan seems to be the mothers he aims to help: those who have suffered miscarriage, had a stillbirth or suffer from post-natal depression are all obviously seen as more ‘vulnerable’ cases than women who don’t present with obvious difficulties during their pregnancies. The vulnerable obviously need to feel fully supported, but how can Lansley ensure that all the women who need this extra care will receive it under his new scheme? For example, my friend was diagnosed as having bi-polar disorder in her early twenties, and yet did not develop post-natal depression after any of her labours.
There are, on the other hand, women who do not have a history of depression before they give birth, and yet suffer from post-natal depression later on. There are not always definite ways of predicting which women will need greater support before, during and after labour, and if Lansley’s plans to provide one to one care for those who are classed as being ‘at risk’ then surely many will fall through the net and not be offered the care they need, at the critical time in which it is needed.
Obviously the ‘one size fits all’ approach does not work in any healthcare situation, especially something as complex as maternal care. But far more realistic ways of tackling the issue of sufficient support for all women, rather than a proposal for all who need it to have a named midwife, would be to help develop areas in the service that are already working well in practice. The one-to-one care that Lansley proposes will never be practical on maternity wards where midwives work shifts, and have to expertly spread their care and duties when times are busy. If he invested some time walking around maternity wards, (although his more than frosty reception from certain hospital staff on a recent visit has probably put him off) then he would see how midwives work, and hopefully wish to support them by funding expansion in certain areas, needed for the growing caseload of expectant mothers.
My friend, a midwife, is involved in a pilot scheme in a South London hospital that encourages women to learn about their pregnancies, and explore some of the things that may arise before, during and after labour. They are taught to take their own blood pressure, test their urine and listen to the baby’s heartbeat. These expectant mothers are being encouraged to take responsibility – in a caring environment – for their own changing bodies. The women are overseen as a group, and their support from the team provides them with skills – both practical and emotional – that will no doubt encourage a greater understanding of the whole process of pregnancy and labour.
With care like this being put to the test, it is admirable to see that midwives are thinking about how they can help women, and themselves, to work efficiently together in a manner that will be conducive to supporting both parties, and add to the service that the NHS can provide. Plans such as these, if they are rolled out over time, seem to me to be far more realistic way of providing good care for all women who feel they will benefit. Surely these should be the things that Lansley should be supporting, rather than pie-in-the sky plans that will only disappoint.
Excellent birthing units exist all over the country, but some have had to close due to lack of funding; teams of community midwives, often those who care for women who wish to give birth at home, are providing a formidable service, and yet they are constantly finding that they are stretched with the amount of women they take on. If they were given extra provisions, or more midwives to work within their teams, then they would be able to expand their caseload of expecting mothers. I had two of my three children at home under the expert care of a brilliant team of Community Midwives based in South London. I will always be a huge promoter of women being given choice about where they give birth, and how, but surely they need to feel supported by a functioning and established team.
If Lansley’s proposals fail before even leaving the ground (which, unfortunately, I feel they will) then the very women who he is trying to support will feel even more disappointed by the care that is being provided for them under the NHS. And through no fault of the teams of hard-working midwives, but because of a health minister partial to handing out empty promises.Tagged in: Andrew Lansley, childbirth, health, health minister, hospital, labour, midwife, miscarriage, Mother, nhs, post-natal depression, pregnancy, stillbirth
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