- guardian.co.uk, Sunday December 28 2003 09.43 GMT
Giving birth is one of the most emotional and life-changing experiences that a woman can undergo; there is always some pain, but with the right care and support it should also be an intensely rewarding one.
The vital ingredient for a good birth is the quality of the care during labour and delivery, and for the majority of women this means a midwife. Yet, as we report today, these professionals are becoming a rare commodity, as they abandon their jobs, disheartened by low pay and increasing pressures. At the root of their dissatisfaction lies the transformation of childbirth from natural process into a hi-tech, medicalised procedure devoid of personal touch. The midwifery crisis in Britain means that community birth centres are having to close their doors, when common sense and cost-effectiveness tell us that the policy should be moving in exactly the opposite direction.
From several points of view, smaller centres, run entirely by midwives, make sense. They are more women-friendly because the staff get to know the mothers better, tending to see a woman throughout her pregnancy. When midwives rush from patient to patient, mothers are put under stress, which in turn can provoke distress in the unborn child. As the National Childbirth Trust has pointed out, staff come under less pressure because they will not be dealing with the hi-risk cases where anaesthetic or intervention is necessary.
Nor need small units cost more. Though there may be more staff per mother, births are easier and hospital stays shorter. Because the staff know her, a woman can wait till later into labour to come into the centre.
The closing of smaller units is creating a dangerous shortage. As midwives are moved to larger hospitals, more leave the profession. Alarmingly, many quitting are under 40 and it is unclear how they will be replaced. Midwives matter as much as doctors, and Ministers must recognise this. Small maternity centres are as important as flagship hospitals and need their own action plan. The survival of these women-centred facilities is a telling test of the Government's avowed intention of increasing patient choice.
Hi-tech units and specialist support have saved many thousands of lives and will always be needed, but we should not lose the wider picture. Childbirth is not an illness. It is the most natural event of all.
