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Just days before its official release, a government-commissioned review on maternity safety in England was reportedly altered to remove criticism of the “normal birth drive,” according to Dr. Bill Kirkup, a former member of the inquiry team. This campaign, widely supported by midwives, promotes vaginal births without medical intervention. However, past investigations have linked it to preventable deaths and harm within maternity care. Dr. Kirkup revealed to the BBC that similar concerns were excised from the latest review, prompting his resignation in protest. He emphasized that the issue represents a significant patient safety risk that deserves full transparency.
The National Maternity and Neonatal Investigation report, published recently, highlighted systemic problems including repeated instances where women’s concerns were ignored by maternity services in England. Among its main recommendations was the call for the government to appoint a maternity commissioner aimed at driving improvements—a proposal that ministers have accepted. Nevertheless, the report drew surprise from many advocacy groups due to its conclusion that the “normal birth” agenda had not played a role in poor maternity outcomes. This stance contrasts with previous findings and ongoing debates shaped by organizations like the Royal College of Midwives (RCM), which encouraged vaginal deliveries without interventions between 2007 and 2017.
The RCM promoted the idea that unmediated vaginal births were preferable for both mothers and infants, sometimes advocating for women to stay at home even when medical attention was warranted or for restrictions on caesarean sections. Such policies have been criticized in prior reviews for contributing to avoidable harm and fatalities. Notably, former Health Secretary Sir Jeremy Hunt remarked last year that “the language, and the thinking behind it, is still alive.” Dr. Kirkup, who previously led maternity inquiries in Morecambe Bay and East Kent, observed that midwives’ pursuit of normal birth often came “at any cost,” causing serious harm. Investigators involved in the Amos review, he stated, found evidence indicating that this approach persists in some areas.
Dr. Kirkup disclosed that while the earlier draft of the maternity review included explicit criticism of the normal birth agenda and had been approved by numerous individuals, those sections were removed just eight days before publication. Faced with this decision, he felt compelled to resign, stressing the importance of openly addressing the issue to protect mothers and babies. He refrained from detailing how the changes were made but suggested that Baroness Amos might have been influenced by “the wrong voices” concerning this matter. Amos declined to comment when asked about these allegations.
Maternity safety advocate James Titcombe, who lost his son Joshua due to inadequate care at Morecambe Bay NHS Trust, expressed deep shock at Dr. Kirkup’s revelations. A longtime critic of the normal birth emphasis within the health service, Titcombe questioned the review’s independence and integrity, stating that bereaved families deserve full transparency and that he felt “profoundly betrayed” by the findings of the Amos review. Meanwhile, NHS England previously discouraged hospitals from exceeding a caesarean rate of around 20%, though this policy was abandoned in 2022.
In contrast, midwife and author Leah Hazard welcomed the review’s conclusions. Sharing her response on social media, she asserted, “The Amos review is out and it could not be clearer. There is no evidence that ‘normal birth ideology’ exists in any definable way or that it dominates maternity care in England.” Hazard called for an end to the debate, urging everyone to focus instead on providing “world class, safe equitable midwifery care.”
Read the full article from The BBC here: Read More
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