We cannot lose our precious progress to normality!

I am really concerned about what is going to happen next. We have just had the budget and all the rhetoric is about cuts, cuts, cuts. It is the rhetoric that worries me in some ways because it is about pushing the boundaries of what cuts are acceptable. We have no choice they say but to tighten our belts – but they do not specifiy what they mean. And in the post budget rhetoric it is to slam the poor and the sick rather than taxing the rich and the bankers, to cut spending rather than raise taxes to protect services. To be a fair budget and to be fair rhetoric we need to hear both.

Of course cuts are not just about benefits it is about our public services. Services are used disproportionately by the poor and disadvantaged. This is where my greatest concerns lie and this is not being highlighted in the media or in political speeches. I know that Bradford Maternity Services have been asked to cut about a million and half pounds from its budget. With a rising birth rate, investing in midwives and normality – I wonder where the cuts are going to be made? The Birth centre is not happening because, I am told, maternity services have made only half the cuts that they need to make – and the ‘stick’ for compliance is the money not being released for the birth centre.

And reader, you must understand that these cuts are made from UN-RINGFENCED budgets, that is from budgets that can be reduced by the acute Trust anyway because it gets a lump sum of money for all the hospital (and community) services in its care and then it divides it out between the departments. The PCT may give the Hospital say £100 for maternity services but the Trust is not obliged to give that money to maternity services – it can give £70 to maternity services and spend £30 elsewhere. And then ask the Maternity Services to cut their budget from £70 to £50. I don’t know yet whether this is what is happening in Bradford – but it could be.

What worries me most in this situation is that what will be cut, what will be lost, is our precious progress to normality, increasing and welcoming homebirth, supporting breastfeeding in communities, reducing CS rates and other interventions, increasing the numbers of midwives to meet national recommendations on woman to midwife ratios. Readers, it is my fear that progress here will be lost when we are only just beginning to feel the benefits. I fear a return to the bad old days of me knowing personally anyone who has a home waterbirth in Bradford, of CS rates of 30%, of decreasing breastfeeding rates, of midwives burning out or battening down the hatches because of the immense pressure they are under.

The thing is, that cutting investment in normality, quality midwifery led care, breastfeeding will actually increase costs in the short medium and long term: Lower breastfeeding rates raises re-admission rates for babies and young children (Eg. gastro problems, excema) and has an impact on health and wellbeing stretching for decades afterwards; CS costs about 4 times as much as a home birth (tariff), research shows that more doctors mean higher intervention rates ( which costs more money, source Denis Walsh’s excellent presentation at ARM conference Oct 2009), quality midwifery reduces the need for analgesia, raises breastfeeding rates and lowers postnatal depression rates to name but a few. Midwives save money whilst saving lives

So this is a call to arms. Albany for All! We want good quality maternity care, which means continuity of care from midwives. But folks, if we have any chance of getting this or even retaining the progress we have now made, we need to get out there NOW and start making a noise, waving the shroud, reminding Governments, MPs, PCTs and Hospital Trusts what cutting investment in quality care and progressive normality for birth will cost in terms of money and unnecessary suffering.

It is time to organise, strategise and get those dandelions growing!


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