Why are we here?
The term ‘normal birth’ became the most commonly used term to describe an uncomplicated, straightforward physiological labour and birth during the 1990s in the UK. Prior to that, the most commonly used term was a ‘spontaneous vaginal or vertex delivery’. The term ‘normal’ birth is important to many midwives who see it as central to the role of the midwife, the bedrock of what we do and who we are. We also already use many other words to describe this type of birth, such as ‘physiological’, ‘straightforward’, ‘optimal’ and so on.
Many will be aware of the difficult conversations around ‘normal birth’ that have happened since the Kirkup report and more recently, in response to the first Ockenden Report from Shrewsbury and Telford at the end of last year. There has been significant political and campaign pressure to review the use of the term ‘normal birth’ – as it has been seen as divisive and has been linked with an approach to care that appears to only value a normal birth above all other possible types of birth or outcomes.
We have also been hearing from many women who struggle with the term ‘normal birth’, which leaves them feeling like they are abnormal if their births happened to not follow a prescribed path. We have heard from some of the women and families that have come through maternity services in the UK that there is some language used by professionals that feels difficult, old fashioned, judgemental. One of these is the term ‘normal birth’.
We all want care to be safer: not too little too late or too much too soon, but does being ‘passionate about normal birth or normality’ exclude? Does it feed disunity in the profession and between professions?
We don’t yet know the answer to these questions, but we want to find out. Re:birth is a collaborative project between midwives, obstetricians, other birth workers and families, facilitated by the RCM.
This project aims to bring all of the key stakeholders on this issue together – what we are calling the ‘maternity community’ – that is, women and families, birth workers and maternity professionals – to seek consensus on acceptable terminology to describe different types of birth – and also to positively express the aims of maternity care.
The RCM is funding the project and is overseeing it, but this is not a midwifery project. This is a collaborative, open process and we do not wish to preempt what the outcome will be.
We want to hear different opinions and perspectives, we want maternity professionals and service users to hear each others’ opinions and perspectives. We then want to see if we can come to a shared position on terminology.
The Project process
It aims to listen to all stakeholders and work with them to come to an agreement about how we should collectively talk about different kinds of birth. We want to use these conversations to provide guidance and resources that will help practitioners, as well as the RCM, navigate describing birth, how we talk to women and families about the benefits and risks of different types of birth in an individualised, but evidence based, way and how we express to those we care for what we hope for them from their birth.
What are our values as a project oversight group?
Collaboration – we want to work with everyone involved with or who cares about birth
Inclusivity – we would rather include more voices than exclude
Openness – we are open to any outcome
Listening – we prioritise listening
Evidence-based – we will ensure the process is rigorous and evidence-based
What is the structure of the project?
The structure of the project is being developed alongside the methods. We want to make sure the project is as collaborative as possible and so we are interested in the possibility of forming a project coproduction group to take on the development and delivery of the project to work in partnership with Dr Juliet Rayment (the project research fellow) and Dr Mary Ross-Davie (the RCM Director for Professional midwifery and RCM lead for the project), supported by the Project Oversight Group: