Homebirth advocate: "I am not a nutter."Methinks she doth protest too much.
Homebirth advocate Emma Mahoney feels compelled to tell us at the outset of her article in support of independent midwifery in the UK Times Online: "I am not a nutter."
Mahoney starts her piece the way homebirth advocates always start, with self congratulation about how "educated" she is, how hard she worked to get the experience that she wanted, and, of course, about how wonderful her personal birth experience was. Then she turns to the issue of independent midwifery. First she states what everyone knows to be true; the British government talks about homebirth without having any intention of doing what it has promised.
The latest 2005 White Paper says even more of the right things, namely that all women will be looked after by "a midwife they know before and after the birth"...So far, so good. Then Mahoney continues with the nutty claims, based on her conversations with "dozens" of women:
Now for the brutal, bloody truth. This one-to-one care is to be achieved by 2009, says the Department of Health, by recruiting 1,000 midwives. But that's not enough, say the Royal Colleges of Midwives and Obstetricians in their report, Safer Childbirth.
We need a further 5,000 midwives just to offer one-to-one care in established labour - that's just the pushing stage, let alone the pregnancy and post-birth period. So while the numbers don't add up, paying for these midwives is even more disastrous.
According to Louise Silverton from the Royal College of Midwives, the extra £330 million funding announced with a fanfare in January has not been ringfenced, so as the money has started to trickle through last month, reports are already coming back that it's being spent on other wards by the local hospitals.
Post-natal depression, sometimes triggered by a bad birth experience, is rife. Ruth Weston ... a student of liberation theology, ... believes that the only way forward is for midwives and mothers to join forces ...Mahoney includes the usual "threats":
[Westong says that] ... a small number of women will go ahead and have their babies their way if independent midwives are lost. And that small number of women is already increasing as they opt out of the NHS altogether in favour of "freebirthing". [According to] Veronica Robinson, editor of The Mother magazine, "These women have educated themselves and are not irresponsible as people suggest," says Veronica... (Evidently they are holding their own babies hostage. They will expose their babies to the increased risk of unassisted homebirth if we do not give in to their demands.)Absent from Ms. Mahoney's piece is any mention of the real issues of independent midwifery: Is homebirth with a midwife as safe as hospital birth? Do independent midwives have acceptable safety statistics? Who provides oversight for midwives who are independent of any regulatory body? Is it ethical to practice midwifery without insurance? Should the government pay a much higher premium to purchase malpractice insurance for independent midwives? Should the government, which already pays for all maternity care, pay more for a luxury option desired by a small group of women?
I'm not sure why Ms. Mahoney felt it necessary to declare at the outset of her article that she is not a "nutter". The problem with the article is not that it makes her sound crazy. The problem is that it advances spurious claims, based on no evidence, addresses only emotional issues, and never even mentions the most critical issues, the safety of babies and mothers. Perhaps Mahoney should have attempted to reassure us that she is not a gullible fool, but than again why bother. Simply saying it does not make it so.