Informed decision making, Birth Statistics and the recent Ockenden Report

8 Jul

I thought my next blog post would be on informed decision making, birth statistics and the recent Ockenden Report.

In today’s current maternity system, getting a grasp on what is happening at your trust before you dive into looking at your birth options can make a huge difference to your decision making and where you choose to birth. It may also help you decide what is important to you, what you want for birth and what you can do to support yourself to put you in the best position to have a positive birthing experience where you feel safe and supported.

Having a “healthy baby” should be the only thing you take from birth. We often hear phrases after a difficult or traumatic birth are “thank god they are here safe” “at least she/he is here healthy”.

You deserve more.

You deserve to be given all the information to make an informed decision.

Postpartum depression is on the rise and this can not only affect bonding, it can affect everything, how you feel about yourself, your relationship, your physical health and so much more. Birth doesn’t just go away when your baby is born, it stays with you forever. It affects you, your baby and your family and those around you.

Why is informed decision important?

How would you feel if you made a decision without all the information and it ended in a difficult or traumatic birth and after you found out that the medical decision you made increased the chance of something happening which if you had known about you may have made a different decision?

Some examples could include but not limited:

Accepting an induction not knowing it could increase your chances of caesarean birth
Accepting an induction not knowing that it could take 3 days until your baby is here
Accepting an induction being told your placenta will age and stop working at 40 weeks and you had a long birth but your placenta was working as it should and it hadn’t stopped working.
Accepting a managed third stage of labour when you have had a physiological birth can increase your risk of a postpartum haemoridge.

If this has happened to you, I am so sorry. You deserved to have informed consent (where you were presented with all the information). You deserved to be listened to every step of the way.

You deserved to be presented with unbiased information with clear language. You deserved time and space to think things through and ask questions.

If you are not being presented with all the information you are not giving informed consent.

Birth Statistics

Your local trust may release statistics about the births in your local hospital and home birth setting.

This may include:

Number of babies born
Number of babies passed
Gender
Babies Weight
Vaginal Births
How many home births
Home birth transfers
How many sets of twins
Caesarean births (planned/unplanned)
Assisted Births
Rarely Induction (will depend on trust)
Postpartum Haemeridges (rarely I have seen this)

What is not important is the babies weight, gender, it has no real importance to what is happening in your trust. It is often designed to deflect away from the other important information and make it fluffy and pretty with lots of colours and emojis!

To truly look at what is happening, look for any reports or investigations (this is often highlighted in the media) and look on the maternity statistics dashboard for your local trust.

It compares the statistics alongside the current national statistics.

What it won’t show is the statistics for home birth, you would need to keep an eye out on your local trusts homebirth Facebook or Instagram page. If you are based in Nottingham and birthing within NUH homebirth team, our lovely team shares the statistics and information about their home births every now and again.

You don’t need a degree to read it, you just need to know what those statistics are showing and what it means for you. What do you need to know to support yourself? Could it be looking at a different trust to birth in? Could it be considered a home birth? What could you do to support yourself?

Across all trusts we are seeing a steady rise in interventions and unplanned caesarean births to around a third of births (33%) and caesarean rate around a half of births (50%) BUT what we are not seeing is better outcomes for mothers and babies and families.

Birth is not a medical emergency and yes there will arise some situations that births do require interventions and they do require babies to be born by caesarean and that is why we have these medical interventions. However we are now in a situation where they are being overused unnecessarily and in some cases causing more harm than good.

Every person will make a decision based on their own individual circumstances and that is what is important. We know that parents make better decisions when they have been supported and listened to and given all the information and that is how it should be.

As a doula, I have supported physiological births, home births, inductions, planned caesreans and unplanned caesareans. My role is always to create pockets of space and support my clients decisions with all information, feeling cared for and supported in their decision without judgement.

The Ockdenden Report

If you are Nottingham based you will know that last month the Ockenden report was released following one of the largest maternity inquiries. Over 2500 brave families came forward to share their story, their experience and their loss. They have waited such a long time for answers, acknowledgement and to be heard. I cannot imagine the pain each one of those families experienced and they deserved so much more.

There is no pressure for you to read it, especially if you are pregnant right now and understandably you may find it triggering or difficult to read. You need to protect your headspace and that is OK. Knowing that there was a report is more than enough and if you do want to read it you know you can.

Whilst I won’t go into the details of the report, as this is a safe space and you will find lots of thoughts/opinions and discussion about this report and for time to come across the media right now. What I will say as a doula working across Nottingham and in both hospitals, I am sad to say I am not shocked by the reports findings. I have been aware of the current state of the maternity system in Nottingham. There are some amazing midwives out there and consultants working under a lot of pressure right now to make things better.

What I will say is that it is very clear and has been for a long time that pregnant women are not being listened to. They were not listened to when they spoke up for support and asked for more care nor were they listened to when they advocated for themselves. I have also seen this first hand myself supporting births.

You deserve to be listened to and to help you prepare for birthing in Nottingham there are lots of things you can do to support yourself:

Build a supportive birth team and network around you
Build your pregnancy and birth knowledge
Protect your headspace
Ask questions
Ask for second options
Know your rights

Knowledge is power and the more you know the stronger and confident you or your partner will feel to advocate for yourself and ask questions and to make sure you are listened to! I know it can feel a little overwhelming and scary to suddenly find lots of things out about birth and it may not guarantee a particular outcome but it will put you in the best possible position to navigate birth, the maternity system.

There are lots of ways to help prepare such as:

Reading lots of birth books and research
Taking a good antenatal/hypnobirthing class
Writing a birth plan
Having a doula to support you throughout

Everyone’s budgets for birth support will be different so I am sharing some free resources to help you get started so you know your getting the best information: