Criticism of ‘normal birth drive’ removed from birth report, says expert

A review of maternity safety in England was changed days before it was published, a former member of the inquiry team has said, to avoid criticism of a “routine maternity drive”.

The campaign, which promotes vaginal delivery without medical intervention and is supported by many midwives, has been found by other reviews to contribute to avoidable deaths and injuries.

But Dr Bill Kirkup told the BBC that similar criticisms were dismissed in a government review that forced him to resign.

“I don’t think it’s appropriate to push this under the covers,” he said. “This is a patient safety risk and I think it should be called as such.”

Asked for comment, Baroness Amos declined to comment.

The National Maternal and Newborn Screening Report was published on Tuesday.

Investigating care across England, he found that Women were often not heard in maternity services.

One of the main recommendations – the government will appoint a maternity commissioner to carry out reforms – has been accepted by the ministers.

But many campaigners were surprised by the review’s conclusion that the “normal” birth agenda did not contribute to poor birth outcomes.

In the year Between 2007 and 2017, the Royal College of Midwives told its members to encourage women to give birth vaginally without any medical intervention, such as pharmaceutical painkillers or forceps.

It is argued that such a birth is better for women and children. But the practice – which sometimes encourages women to stay at home when they seek medical attention or is denied caesarean sections – has been criticized in many reviews as contributing to avoidable deaths and injuries.

Writing last year, former health secretary Sir Jeremy Hunt said: “The language and the thinking behind it is still alive.”

Dr Kirkup led maternity reviews in Morecambe Bay and East Kent and found the practice had caused harm in both areas. An inquiry in Morecambe Bay, for example, found that midwives were pursuing normal births “at all costs”.

He said investigators working on Amos’s review found evidence that “it’s still the case, at least in some areas.”

He told the BBC that a “significant number of people” had signed a copy of the report, which included criticism of normal births, but eight days before it was published it “disappeared”.

Based on the evidence, Kirkup felt he had to resign. “We need to acknowledge that this is a problem and that it has implications for patient safety for mothers and babies,” he said.

“I think the light of day needs to shine on it and then we can have a real conversation about why this happens sometimes and how we can make sure it doesn’t continue.”

Kirkup said he would not discuss how the changes came about, but I think she (Baroness Amos) has heard the wrong voices on this issue.