The illusion of choice

This year I have been to some amazing births, I've been to some not so amazing ones, but one the whole... amazing!

I was filled with awe and a sense of wonder when I was at a totally physiological birth of twins within a West London hospital.  This wasn't an easy thing to achieve, but with some determination, good information and great communication, it was achieved to the joy of the parents, babies, medical staff and doula.

I've been privileged to be at the East London homebirth of a second child.  The first was born after a very long and difficult, medicalised hospital birth.  Homebirth was not on this couple's initial agenda, but made plenty of sense to them as they wanted to avoid many of the interventions they had experienced the first time.

I was recently at a VBAC (Vaginal Birth After Caesarean) in an East London where mum had held lots of anxieties, particularly after the birth of her first.  This VBAC left mum ecstatic as she had lost faith in her body's ability to birth a child.

I supported a couple through a long, slow labour that culminated in the birth of a gorgeous boy in water at a West London birth centre, staffed with the most incredibly loving midwives.

I could list all of the births that I was privileged to be at this year, but that would take some time and I would drift off into memory and not get this much neglected blog written.  I simply wanted to share that not all of the births that I attend are within hospitals.  

What has spurred me on to write today is the shocking news that the Homerton Homebirth Team has been reduced from six amazing midwives to four.  One has been removed from the team without her consent, the other is leaving and will not be replaced.  The midwife that has been removed, Angela Barry, was the reason one of my ladies (not mentioned above) had a wonderful VBAC in hospital.  Angela, who had visited her at home, talked with her about her homebirth and hospital options and been instrumental in bringing calm and banishing fear from her birth.  

Why is it shocking?  There has been no consultation process with the midwives in question, no consultation process with the women that they support, nothing mentioned at the MSLC (Maternity Liaison Services Committee) and, to date, no clear rationale as to why this very popular service has been reduced.  There is no lead in time for this and so women are suddenly left unsupported as planned through the remainder of their pregnancies and the subsequent births of their babies.  I dread to think what will happen during the postnatal period, a time where more and more women are being told to go into Children's Centres rather than have a midwife visit them at home.  Remember that this is a time when they should be resting and recovering from the birth process, not shlepping over to Children's Centres.  (Did that sound a little miffed?  Wow! I'm getting better at holding my disgust in).

I am advised that at a level of 4 team members it will be impossible for the Homerton to guarantee a 24 hour/7 days a week homebirth service. This will make a real difference to the choices available to women in Hackney and also is a likely indicator of a lack of investment by the Trust in providing choice and continuity of care to the women of Hackney, wherever they choose to give birth. It is particularly worrying in light of the homebirth team's recent statistics which show a 9% caesarean rate against approx. 26% in Homerton itself.

If this news concerns you, as it does me, I would like to ask you to help me by letting the powers that be at Homerton know that this is not acceptable. To this end I would like to invite you to :

1) Open the attached pro-forma letter outlining the situation and the concerns. Please personalise this as you wish and send to: Chief Executive Officer Tracey Fletcher: tracey.fletcher@homerton.nhs.uk. Divisional Operations Director Daniel Waldren: daniel.waldron@homerton.nhs.uk

2) Sign this petition: http://www.change.org/en-GB/petitions/homerton-hospital-stop-the-reduction-in-the-home-birth-team-and-maintain-home-birth-as-a-real-choice-for-women-in-hackney

3) Forward the attached letter to any contacts you have who you know would be willing to write in

4) Link to the petition via your twitter/facebook/website and encourage others to sign up

5) Send me a sentence or two, if appropriate, about what the Homerton homebirth service has meant to you and why it needs to stay as is. Let me know if you are comfortable for this to be including in any future press release to the local papers.

I would love to hear of any ideas that you might have about how we might prevent this worrying reduction of Home Birth provision in Hackney. 

We are told on one hand that every woman has the right to choose how and where she births her child.  This is not ignoring medical advice etc, this is about the human right to choose.  With postnatal services being withdrawn, Independent Midwives being forced out of work, less midwives being hired as well as home birth and birthing centre teams being deliberately understaffed... where is the choice?  Or is it just an illusion?