Commenting on the cumulative global impact of the recent Lancet editorial and other international studies and reports criticising homebirth and midwife-led care in America, Australia, the Netherlands and elsewhere, Cathy Warwick, general secretary of the Royal College of Midwives, said: “We are extremely concerned that there appears to be a worldwide anti-homebirth, anti-midwife and anti- normal birth movement. We feel under attack and that there is a concerted and calculated global attack and backlash against homebirth and midwife-led care.”
“Homebirth is being unfairly pilloried by some sectors of the global medical maternity establishment. There is a danger that risk during childbirth is presented in a way, which is leading women to believe that hospital birth equals a safe birth – it does not; there is no hard and fast guarantee that a woman will have a safer birth in a hospital than at home.
“I feel saddened and disappointed that homebirth is being wrongly linked to high perinatal mortality rates. What particularly concerns me is that the relativity of risk during pregnancy is not being fully discussed in these reports. Meanwhile, research on positive outcomes for women about homebirth in the Netherlands has been under attack for a year.”
Speaking about the Wax research published in America, which was cited in The Lancet editorial, she said: “The publication of evidence with flaws is being used globally to deter women from choosing midwifery-led options, such as homebirth, and to pathologise and demonise normal childbirth.”
“What shocked us about The Lancet editorial about homebirth was its language and tone and how it pumped the hype about the dangers of homebirth, and made sweeping and misogynistic statements, such as “Women do not have the right to put their baby at risk.”
She added: “No mother would ever put her baby at risk and there is no evidence base to suggest that having a homebirth deliberately puts a baby at risk. Politicians, too, do not have the right to put babies at risk by failing to address health inequalities, not tacking obesity and inappropriately reorganising maternity services.”
“I believe that the homebirth issue dovetails with other trends that we are seeing with maternity care. The NICE guidance on weight management before, during and after pregnancy rightly points out that whilst there is a risk from being overweight and obese while pregnant. However, that risk is still relatively small and commentary in the guidance does not highlight that with positive supportive care from midwives, such women can still have a completely normal birth without medical interventions like a caesarean section or an epidural.”
She added: “Risk during childbirth is a very relative concept and its exaggeration highlights the way that women can be persuaded and frightened into making choices they don’t want or need.”
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Notes to editors
The Royal College of Midwives (RCM) aims to promote and advance the profession of the midwife. The RCM represents the vast majority of the UK's midwives and is one of the world's oldest and largest midwifery organisations, and celebrated its 125th anniversary in 2006. It is also a trade union. For more information visit the RCM website at www.rcm.org.uk.
