Last week, we attended Birthrights’ Dignity
Forum, the event which launched their campaign to promote Dignity in
Childbirth.
It is incredibly important that women are
treated with respect and given support, information and choice in childbirth
-we see women whose experience of birth, in particular those who suffer from
birth trauma, impacts on their decision whether or not to continue with a subsequent pregnancy.
The conference explored the varied experience
of women in childbirth, both across UK and globally, set childbirth rights in
the context of human rights law, and pointed to work that needs to be done to
improve the care and support offered to women at this point in their lives.
Why dignity in birth matters
Professor Lesley Page, President of the
Royal College of Midwives, opened the conference
by setting out very clearly that dignity in birth matters because it is bound
up in better outcomes. Respect, kindness and consideration ensure that the care
provided is right for each individual woman, leading to better physical and
emotional outcomes for the woman, baby and family.
Dignity can be provided by simple actions
such as medical staff introducing themselves or knocking before entering a
private room. However, services have been hit by both a birth rate increase
that has far outstripped any rise in midwife numbers, and also an increase in
the number of women presenting with complex healthcare needs, such as those
with high BMIs. This is making it more difficult for midwives to always be able
to deliver the service they want to provide for women.
Professor Page acknowledged that the survey
does indicate there is a distance to go to ensure choice, control and dignity
in childbirth – but she stressed that maternity service workers are passionate
about raising standards, and are already working hard to achieve this.
Dignity in childbirth is a human right
It was incredibly useful to hear childbirth
discussed in the context of human rights.
Helen
Mountfield QC argued that whilst dignity may seem like an elusive concept,
hard to pin down, it is at the heart of human rights with Article 1 of the UN
Universal Declaration of Human Rights states that "all human beings are
born free and equal in dignity and rights." Helen Wildbore of the
British Institute of Human Rights also
outlined the ways provisions in the
Human
Rights Act are applicable to childbirth, from Article 3 which prohibits
inhumane or degrading treatment to
Article 8 which protects the right to respect for private
and family life.Yet despite dignity being
a core right, it can prove difficult to exercise. Helen Mountfield QC argued
that this was particularly true for women, who can unfortunately be used to
being told that what they need or want to actualise their choices just isn't
available. In our experience, this is certainly true with regards to a range of
reproductive healthcare options, from what type of contraception women are able
to access to their choice of where to give birth.
Respectful treatment and maternal
health globally
The White Ribbon Alliance presented their
Respectful Maternity Care
campaign
video, which we really recommend watching, and spoke about their
Universal
Rights of Childbearing Women Charter.
Childbirth is the biggest killer of women
globally but real progress is being made - over the last ten years the rates of
maternal mortality have halved. But, as Brigid McConville of the WRA said, “we
need to reach the other half.”
Respectful care can play a vital role in
reducing maternal mortality rates as fear and distrust of medical professionals
acts a huge barrier to women attending health centres. Stories of abuse, such
as women being held against their will because they were unable to pay for
their care or being forcibly shaved during labour, have, understandably, an
incredibly negative impact on women’s decision to use maternity care services.
As fear can be a more powerful deterrent than geographical and finical
obstacles, respectful care must be a priority to in the drive to reduce
maternal mortality rates globally.
Choice in birth and the C-section
question
The issue of choice in birth was central to
the Dignity in Childbirth survey. The survey found that only 68% of women were
given a choice of where to give birth, 31% of women said that they did not feel
in control of their birth experience and 15% of women were unhappy with the
availability of pain relief. The survey did find overall women that women were
satisfied with the care they received, yet there were a significant variations
and areas of concern.
Only half of the women surveyed said that
they had the birth they wanted. Whilst a greater proportion of women who had
caesarean sections reported they did not have the birth they wanted (64% of
those surveyed), it would be useful to see more research in to this which
differentiates between women’s experience of planned and emergency c-sections.
Pauline Hull, co-author of Choosing Cesarean,
A Natural Birth Plan and editor of
electivecesarean.com
, raised the importance of this distinction in questions about caesareans. In
her presentation, she suggested that dignity, respect and support are very much
absent from discussions around elective c-sections. This is a rational birth
choice that should be campaigned for by those who want to ensure dignity in
childbirth for women, Hull argued. It was positive to hear from many speakers
that choice should be at the centre of all discussions around childbirth, and
that more must be done to ensure that women are able to exercise their autonomy
at this time.
As Carrie Longton, the co-founder of
Mumsnet, said during her presentation, birth
is not the most important thing about becoming a parent, but it is a moment in
a mother’s life and in her baby’s life that they will never be able to change.
The idea that “as long as the baby is healthy that’s all that matters” is
simply not true. Women need to feel part of the decision making process, they
should have their views respected, and they should be able to make the choices
that are right for them. They deserve nothing less.
