To read the full review, please click here: https://www.england.nhs.uk/wp-content/uploads/2016/02/national-maternity-review-report.pdf
The Positive Birth Movement welcomes this Review with open arms. It is clear that a real intention to listen to women's voices ran through the process of gathering information for the Review, and this intention sings out loud and clear from every page of the document.
Baroness Cumberlege, who led the review, clearly has a deep understanding of women's issues, in particular the vital time of pregnancy, birth, and post-partum, and of the need for this time to be treated with the reverence, respect and sensitivity it deserves.
Much is being made in the press of the Review's proposal to give every woman her own £3k 'maternity budget', allowing her to 'hold the purse strings' and thus drive the decisions for her care.
Like any decision that places control and autonomy into the hands of women, this proposal is likely to be met with some derision. There will undoubtedly be suggestions that women might make unsafe or misguided choices.
There is a great deal of press confusion about childbirth safety, and this is a reflection of a wider cultural misconception that 'low budget / low tech' childbirth is inherently dangerous. In fact, what we are learning from the evidence tells us the opposite: women's bodies work better and birth better in low tech environments, and often the very best birth for all concerned - home or home from home environment, minimal medical interventions - is one which could be obtained on the lowest budget.
At the Positive Birth Movement we frequently try to make this point: that the choice for women does not and should not have to be between 'safety' and 'experience', and that often those choices which improve the woman's experience, also simultaneously improve her and her baby's safety.
That aside, it is often the case that opportunities for women to 'be in the driving seat' for their childbirth choices, raise concern. Often women, it seems, are not trusted to make the right decisions for their care and in the past this has resulted in their being encouraged to 'lie back and think of England' in the birth room, and 'leave it to the experts'. Many women still talk about their childbirth experience in terms of what they were 'allowed' or 'not allowed' to do.
The Maternity Review upends all of that, and challenges a birth culture in which women are, quite literally, on their backs, which has pervaded for the past 40 or 50 years. It puts power firmly back in the hands of women, and holds up the birth experience to be a vital and important part of women's lives, not just a means to an end.
The Review makes direct reference to what makes birth 'positive':
We know that women are more likely to report a positive experience of childbirth, regardless of the outcome, if their care is personalised, if they are treated with respect and if they are involved in decision making. However personalised care and choice are not just about a woman’s experience. It is increasingly evident that personalised care means safer care and better outcomes. We also know that when staff work in well led, positive environments and are supported to take pride in their work and to deliver high quality care, outcomes for women and their babies improve.
(National Maternity Review, p.43)
The Review calls for a 'grassroots movement to improve maternity care', and adds that, 'women and their families can be powerful agents for change' (p.85)
At the Positive Birth Movement - which has been established for over 3 years and has over 400 groups worldwide - we fully support these notions, and will continue to encourage women to learn as much as they can about their birth options and choices, ask questions, request evidence, and demand better care. Pregnant women are not 'patients', they are 'consumers', but for too long they have been trapped in a 'doctor knows best' dynamic where they have been expected to do as they were told or advised.
The Maternity Review proposes many creative and well thought through ideas to place birth choices firmly back in the hands of women. At the Positive Birth Movement we believe that women can and will make the best possible decisions for their own care the care of their babies, whose safety they hold as paramount. They deserve to be given the power in the birth room, they deserve better safety, and they deserve better birth experiences.
For these reasons, we welcome the Maternity Review, and look forward to further news as to how the UK government intends to put such excellent recommendations into practice.