Covid-19 restrictions are stripping away birth rights

Image of a distressed womanMidwife Claire Harbottle shares her worries about how Covid-19 restrictions are affecting hard fought for birth rights.

“In the 60s and 70s pregnant women went into hospital alone to give birth. They were subjected to routine enemas and pubic hair shaving (both unnecessary and potentially harmful), routine episiotomy if it was a first baby (unnecessary, painful and harmful), separation from their babies and regimented feeding schedules (positively harmful).

Their partners viewed their new babies from behind a viewing screen, making bonding harder (harmful). By the eighties and nineties all women were routinely given a period of time on a continuous monitor upon admission to hospital (pointless and harmful), but at least their partners were allowed to be with them during the birth.

Since then, campaigning has meant that partners can be more involved in birth and in most hospitals they have had open visiting including overnight. Enemas are a thing of the past, as is shaving, routine episiotomy and separation.

Covid restrictions did away with 40 years of campaigning for the rights of parents and birthing people to be supported by their partners at this crucial and vulnerable time. All of the interventions listed above have been entirely discredited – yet we still have interventions now which are considered ‘routine’ but which will be discredited in their turn. Birthing women and people often benefit from support to make their own decisions. Their partners need to be able to access them for this.

People outside the birth world are entirely unaware that partners are being refused access during antenatal care, during inductions (which can take days) and during postnatal stays. Some hospitals even stopped them being at the birth of their own child. The government lifted the ban on hospital visiting on 5th June but across the country partners are still being refused access.

It’s causing huge distress. It’s leaving birthing women and people vulnerable in a system that has form for getting it very wrong. You can go to the pub for a pint, but not to the ultrasound scan where problems with your baby may be spotted. You are banned from the decision-making consultation afterwards. You can fly to Spain for a holiday but not help your partner reach her new baby to feed after a caesarean section, nor care for your newborn. This is wrong and it’s in great danger of becoming normal. We cannot let this happen.”

MBRRACE: Why More BME women and babies die. A BME woman responds.

Access Denied image

Guest Blog by Beth (an AIMS member)

I remember questioning a few midwife friends about how Black and Minority Ethnic (BME) women are treated in the maternity system. The consensus is we are treated differently but not in a good way. I wish I had known earlier. Outcomes and experiences are worse even when you take away the obvious social economic factors.

BME women like me are more subjected to interventions because of arbitrary criteria such as BMI, our baby’s growth is measured against a population which is not similar to ours, and I noticed that the gestational diabetes criteria negatively affects a lot of Asian women. Our options of where and and how to birth are therefore significantly, and I’d say unfairly, limited. The constant narrative that we’re not optimal for birth because of our body size, this and that. All of my friends who are of oriental descend have been treated horribly when giving birth. None of us fall into the stereotypical vulnerable groups (non English speaking, low income, uneducated, domestic violence, substance abuse etc). None of us are over 40 years old, either.

The truth remains that the NHS maternity risk assessment is racist, non evidence based and arbitrary. The midwives and obstetric staff feel that they have a right to carry out protocols against us because they’re written in hospital guidelines. We’re considered not just as a sub class of people but our bodies are less superior and non optimal for birth because we’re not white, not a certain body size and not significant enough in number. It’s the high intervention rates, abusive practices and attitudes that make accessing maternity services more dangerous for BME women. I say the lack of acknowledgement of the issue means it’s not addressed.

When someone doesn’t think BME women deserve human rights (life) and doesn’t really care about them, they are less likely to take their concerns seriously, less likely to take care with their bodies, nor, I suppose, do they want to save them in an emergency. The NHS is unlikely to acknowledge that or the fact that higher intervention rates can cause higher mortality rates because they can cause complications and complexities.

If more interventions really mean better safety, over 40 years olds and BMEs are subjected to more interventions so you’d expect mortality to come down and not go up significantly. Something’s not adding up. I don’t think the real issue is age nor race nor ethnicity. We’re very much designed to survive whatever the colour of our skin.

I think the problem is the poor attitude towards women – the power imbalance in the care model exacerbated by institutional racism. I don’t think it’s just the obvious issue with differences in colours of skin. There’s tribalism between different groups of similar skin colour. Having institutional protocols mean that poor treatments of particular groups go undetected. All these factors are what makes pregnancies and births more dangerous for many BME women, all else being equal.

Britain, our home, is multicultural. Now is the time for our healthcare system to move on with the times and provide a maternity care model that understands and responds to women’s needs with fair and evidence based assessments. Treat every woman with respect and care. Give us all continuity of carer (in pregnancy, birth and postnatal recovery), a relationship-based model, which has been proven to improve outcome, experience and importantly reduce errors (i.e. reduce mortality). The disproportionately high maternal mortality rates for BME women have been highlighted in the latest MBRRACE report. The structural inequality and poor attitudes in the healthcare system needs to be addressed urgently. (https://www.npeu.ox.ac.uk/mbrrace-uk/reports).

The quality of healthcare we get and our chance at survival shouldn’t be determined by the colour of our skin. We are the same with the same human needs underneath it all. It’s time for us to all stand together to demand the NHS to prioritise maternity services and stop denying us care, damaging our health (harming women and babies) when we need care the most. We have worked hard to pay for our health system. It is not right for our needs to go unmet. The NHS must respond to women’s healthcare needs for our country to thrive.

Note from admin: If you would like to support or join in campaigns for quality and equality in maternity services, please contact AIMS at www.aims.org.uk.