Every Sunday evening, an average of eight million viewers settle down to watch the hugely successful series Call the Midwife, based on an original book written by a very experienced and astute midwife, the late Jennifer Worth – who trained and practiced in the East End of London during the 1950s. It depicts a bygone age, when the majority of women gave birth at home and they knew their midwife well, right from the first antenatal appointment, up to the point of delivery and beyond.
Today, we call that same model ‘continuity of carer’, which this government aims to roll-out across England by March next year, meaning that the majority of women will have the same midwife throughout pregnancy, birth and postnatally. Of course, having the same midwife is not always possible, some hospital-based midwives travel a considerable distance to work and cannot always be there for a mother who presents with a quick delivery.
However, as the health minister with responsibility for maternity and patient safety, I am absolutely committed to push forward with this aim and objective as far as is possible.
This is not because I have some nostalgic hankering after the sound of a pushbike bell and a smiling angel in a cape, carrying a Gladstone bag, wearing a frilly cap and crepe-soled shoes – appearing just as a woman’s waters break. It’s because the evidence shows us that it is by far a safer way to deliver babies.
“Women who have the same midwife throughout pregnancy are 16% less likely to lose their baby, 19% less likely to lose their baby before twenty-four weeks and 24% less likely to experience a pre-term birth”
Building an emotional bond between mother and midwife, established over many months is a proven method of reducing the risk factor for harm. Women who have the same midwife throughout pregnancy are 16% less likely to lose their baby, 19% less likely to lose their baby before twenty-four weeks and 24% less likely to experience a pre-term birth.
It can also help tackle underlying health inequalities. Currently, black women are five times more likely to die from causes related to pregnancy and childbirth than white women – and Asian women are twice as likely to die. Continuity of carer is a crucial step in the right direction towards helping to reduce such unjust statistics.
Today, this tried and trusted method of delivering babies is provided by modern, professional teams made up of 4-6 midwives and allows for the development of a care plan that is based around the mother’s needs and those of her family. Needs which may fluctuate or change over time.
It allows a mother to decide where she wants to give birth, at home or in hospital, with unbiased and supportive information given by a midwife she knows, because we know this is the model which works best for all.
“We have made tremendous progress... but there is more to do for Britain’s parents”
I have been eager to find out more about how a modern midwife works in practice and recently I spent a morning at St Thomas’ hospital in London with our amazingly talented and knowledgeable Chief Midwife, Jacqueline Dunkley-Bent. There, continuity of carer has been well established for some considerable time, thanks to the professional dedication of the Matron for the Continuity of Carer Project at Guy’s and St Thomas’ NHS Foundation Trust, Clare Church. Clare admirably demonstrates why good leadership is an essential component in the delivery of good public services. She told me:
“Continuity of Carer not only provides better clinical outcomes for women and babies, but also enables a meaningful relationship to develop between the midwife and a family. This means that both benefit from the opportunity to journey together through pregnancy and birth. If women are vulnerable due to issues such as mental health, language barriers or social circumstances, then having someone who can help and guide them all the way through has a huge impact as to how they feel about motherhood.”
Despite the march of time, some things never change and there is no place in the world as full of love and happiness as a bedroom at home or a birthing suite in a hospital where the air is filled with the euphoria of newborns and hope. Babies bring their love with them and becoming a mum can be the most magical time of your life, regardless of how many times you have done it before.
When your newborn arrives, you won’t let the wind blow on them. You are exhausted and yet, you lie awake, staring at the miracle you have created, marvelling at every pucker of rosebud lips or the clenching and unclenching of tiny furled up fists crowned by flimsy paper thin nails. Sadly, for some parents, the story is not always one of a happy ending. That’s why we’re determined to do whatever we can to help those parents avoid tragedy. We have an ambitious Long Term Plan for the NHS which commits to halving the rates of stillbirths, maternal and neonatal deaths by 2025. We have made tremendous progress – we met our stillbirth target early, already reducing the rate by 20% in 2018 – but there is more to do for Britain’s parents.
Through constantly seeking to improve maternal patient safety and experience, we will be supporting midwives, mothers and babies in our unwavering determination to make Britain, not just one of the safest places, but the safest place in the world to give birth and our best practice will shine a beacon across the globe for others to follow.
Nadine Dorries is minister for maternity and patient safety, and Conservative MP for Mid Bedfordshire.