Of Birth and Health White Papers: where the political meets the personal

This is an odd day.  My eldest child is 16 today, and it is therefore, the sixteenth anniversary of becoming a mother to a term baby: bittersweet memories vie with the present day realities leaving me feeling somewhat disorientated and bewildered.

 

At 8.20am, 16 years ago, after 24 hours labour: being transferred into hospital, having labour augmented, suffering agonies without anaesthesia with those synthetic contractions, giving birthing yelling in animal agony as I birthed my baby in fear and pain, facing a blank hospital wall and a drip machine because I was not important enough to be talked to face to face by the staff.  That memory haunted me for many years and my body remembers, even if the joys of subsequent births have healed the wounds.

 

And yet despite this my baby was born miraculously calm and cheerful, she fed right away and easily and we both took to breastfeeding as ducks to water.  This was the joy of motherhood for me, and it continues to be.

 

And then the weeks of challenge, nursing a baby learning the art of motherhood alone with a husband working away, building a new life outside of employment which had been the centre of my life up until then.

 

And as winter turned to spring and then to summer, I would sit in our tiny garden overlooking the park, with my tiny daughter playing at my feet, and as she grew older how I loved to sing and to read to her.

 

These memories partially suppressed bubbled to the surface through this day 16 years on.  Sixteen years old, my child was woken by her four siblings, being sixteen years old she curled her lip at our practical present, being sixteen she had already got her birthday money out of us some days earlier, being sixteen she wanted to spend her birthday not with us but with her friends at a sleepover.  And I realised I was clinging to a daughter I no longer had.

 

“How do you mother a teenager?” I ask the memory of a mother struggling to come to terms with her new role 16 years earlier.

 

And today I went to a meeting where CS rates were discussed and professionals talked of women as ‘them’ as opposed to ‘us’ the professionals.  I thought this does not feel right – ‘should it not just be ‘us’?’  Was this the attitude underyling my experience of becoming an object in the hospital system 16 years ago?

 

And this afternoon, in another meeting I learnt that the Government has changed its mind and Maternity Services will be commissioned by GP’s.  And I wanted to cry with frustration and fear.  16 years ago I had to change GPs twice to find a GP who would cover my homebirth (despite the evidence even then that supported my choice). Dr Eisner (now retired) and her practice were the only ones to really specialise in maternity care in the area.  Certainly Dr Eisner was the only GP who ever turned up to one of my births – and 16 years ago she turned out at 4am and stayed with me until her surgery began – so just missing the triumph over adversity which was my first birth.

 

I so fear  GP’s who have no interest and no committment for good birth, whose knowledge is limited and partial, taking control of the budgets and purse strings, using their power to stop the progressive investment in normality, not understanding the importance of ensuring a good start to motherhood and a good start to those little lives.  GPs who care but don’t understand because in the last 20 years they have progressively handed over all the work and knowledge and experience to midwives and centralised maternity services based in hospitals.

 

I was so looking forward to midwives as independent professionals in partnership with their medical colleagues and service users having the chance to be part of the commissioning of the care they see as necessary for the wellbeing of women, and now we have GPs – General Practitioners being given the role – who asked for that?

 

I feel tonight that if we all pull together, work hard and campaign well, we might just stave off the worst – but that is no where near good enough!  I want the best, the best for my daughter  – my daughter who is sixteen today – not the make-do, not the maybe if we have enough staff, but the world class services that have been abolished in the new terminology of the new Government.  I want my daughter to have world class midwifery and maternity care – because she deserves it and so do I!

 

And so today past and present collide. The personal is so painfully the political.  And with bitter sweet memories, and anger borne of experience and determination borne of love, I pull on my boots, roll up my sleeves, paint my placard and light my candle in the dark.

 

Sisters I hope you may join me, I cannot do this alone. And tonight I feel as alone as I did all those years ago staring into the abyss of a blank hospital wall.

 

 

 

Write that letter!

Here I go again.  Cracked record time.  This is a summary of the key points I wanted to make at my recent meeting with local MP.  And yes they all look familiar, and yes it has probably all been said before.  But I am about changing the way the wind blows so I will say the same thing over and over again to anyone and everyone until that wind is blowing in the right direction.  I invite you all to do the same – copy my bullet points into your own letter, or make up your own and send it back to me. Please feel free to add them as comments on the blog here.

Those politicians in Whitehall, Town Hall, Foundation Trust and Maternity Unit need to be awash with the letters and emails of women and their families demanding the care we all deserve.  Yes write that letter . . . because we are worth it . . . and so are our daughters . . . .

The key issues that concern MSLC and its service user chair in Bradford And Airedale is the following:

  1. Lack of midwives – one to one midwifery care or at least continuity of midwifery care is shown by all the research to be key to maintaining normality through pregnancy and birth (which reduces obstetric costs), increasing breastfeeding, reducing postnatal depression, increased customer satisfaction with their care and experience generally
  2. Midwives are the key professional contact for pregnant women and their families, it is they who have the expertise and knowledge to help women make informed choices for their care etc – it is not GPS – as the Kings Fund report acknowledges.  The Government policy for restructuring of the health service should develop and enhance this role.
  3. In this context we are concerned about reports that Maternity Services will go into the GP commissioning structure.  Our evidence shows that certainly in this district the interest and expertise of the GP’s do not lie in Maternity Services.  Midwives are the key professionals here.  We think it would be a retrograde step (so much so that a visit to an MP was necessary)
  4. We are very concerned at the briefings we have received about the GP consortia being formed to take over the PCT function in the next 18 months in this district.  Particularly that there is no director being proposed for Women’s and Children’s Services.  This is an indicator perhaps of the GPs’ current focus and expertise in this area.
  5. We want to be assured of the national commissioning body for  Maternity Services and would like to know as soon as possible the proposals for taking this forward and how it will work.
  6. As the service specification for the area is being finalised, recognising the standard of care should be at one to one midwifery care, and that Maternity Matters implementation requires a choice of birth places and care patterns eg homebirth, birth centre, community midwifery model, and recognising that this standard is currently not being met within the NHS at all, we would like to see service provision opened up  as per the white paper to enable all willing providers to bid for service provision.  We note that there are providers waiting in the wings to fill the gaps in service provision here and we are eager to take things forward but need Government policy and structuring to support that – eg through the national commissioning body, and through an enabling insurance regime for midwives not employed directly by NHS

Hope these points help.

Every good wish

Ruth Weston

www.aquabirthsathome.co.uk

Too busy to change the world? Together we can do it anyway!

“Feel the fear but do it anyway” is a maxim in the business world.  In the world of change making I would say: “We are too busy to save the world, but we come together and do it anyway!”

This week I have been on the outskirts of planning a birth pool sit in (Aquabirths supply the pool!) supporting Agnes Gereb the Hungarian midwife imprisoned for supporting women to have a homebirth.  I have also been involved in and attended a women’s empowerment event set up by Bradford District Women’s Forum (this blog is a reflection taken from the short speech I made there).

Who are we when we as women, come together to do these things?  We are networks of overcommitted women who are too busy to change the world but come together because we are going to do it anyway.  We are Mums with small babies, women with full time jobs and businesses, women with family issues, health issues, relationship issues but we come together because we don’t want that to be the end of what we do, we want to make the world better.

With Bradford District Women’s Forum we come together as a network of networks – as women from contrasting sectors of the community – the council, local Radio, the police, the health service, the voluntary sector, business, asylum seekers, community centres and more.  We come together because on our own we cannot make the changes we want to see.  For instance I want to see every woman have a good birth and get the care and support she needs and deserves around the birthing time.  But I know I cannot do it alone, and that  I need to work within the context of the wider needs and demands of women in Bradford.  So we gather together as a group of women with different backgrounds and agendas but with a passion for making Bradford a better place for women to live.

So then, women of the world unite: on our own we can change little and we are too busy to do anything else, but coming together we can make change happen.

I am really touched that a group of mothers are going to so much effort to support a midwfe in Hungary who is supporting women who like them chose to have a homebirth.  Here we see an international dimension to women coming together across cultures and other divides.

This is big and inspiring stuff, and hold on to it because it is not always like that! At this moment I always think of Jeremy Hardy who said the rallying cry of the left wing activist was: “ ‘I thought you were bringing the leaflets!’ ‘No, I thought you were bringing the leaflets’ ”  We are busy and overcommitted and despite that we manage to pull of some really good things. For instance, the women of Bradford came together as the racist EDL march came upon us – to form Women for Peace.  It brought women together across cultures and faiths, age and class, it was dynamic, visible creative and colourful.  My bright green ribbon still flutters on our front gate as it does all over Bradford even now.  We are proud of what we pulled off, making it clear that Bradford was a city of peace, diversity and tolerance.

On the other hand we are overcommitted and busy women so at other times it really is a case of Everybody thought that Somebody would do it because Anybody could, but Nobody did.  And I cringe at the number of times this has been the case – the Bradford District Women’s Forum’s AGM, being just one example!  Even the most successful actions tend to have a bit of this to them – because we are all doing it in our spare time – and we don’t have any! So carry on Airedale Mums you are doing a fantastic job!

 

Finally, earlier this year my sons who were both learning to write, and gaining enthusiasm and confidence in the skill, hit on the phrase “Mum is Mad” as it needs the minimum of letters for the maximum impact! It was everywhere, on every piece of paper (Mum is mad), doors, walls, wipeboards in the office, the fly leaves of books etc etc. Mum is Mad.  I said “Fabulous! :Love it! Mum is M.A.D. “Marvellous and Dynamic!”

Marvellous and Dynamic!  Turning an insult into an accolade, turning a barrier into a stepping stone, we are determined, passionate, overcommitted, dynamic, creative, tired, busy, enthusiastic.  We are Marvellous and Dynamic and although we are too busy to change the world, we come together and do it any way.