There was an interview with the new chief executive of the NHS. One of the things he mentioned was the "need" to close maternity units. Apparently, he thinks that women are best served in larger units with full-time consultant staff.
From where I sit, this is the NHS contradicting itself. Before I got pregnant, I kept hearing about choice, about flexibility, about reducing intervention in birth. Now they come out with plans that do a U-turn on all of that. (I take the stats on intervention with a grain of salt, of course, since the patient populations aren't equal, but apparently consultant-led units have a higher intervention rate even when you allow for different levels of risk.)
Then, of course, I discovered that it was all rhetoric anyway. If you're a patient like me, and I'm not even exceptionally risky, you don't have a choice. Those nice "birthing centres" keep their stats healthy by carefully screening their patients. Legally, I have a right to a home birth: a trust cannot deny them, although they can make it difficult. (Why I have a legal right to a home birth, but not to a midwife-led one, escapes me.) But I'm very sure that if I asked, they'd do everything they could to discourage me.
And then, of course, I experienced the fun of being a maternity patient at Barnet Hospital, which has certainly not endeared me to NHS maternity care. Closing more maternity units will undoubtedly mean more women experiencing the substandard care I've received. If the NHS has any intention of closing or "consolidating" units, they better be damn sure that it won't result in a decline in care--something about which I am very, very sceptical, given the debts of many trusts.
This came on the heels of the following article by Annalisa Barbieri:
http://www.guardian.co.uk/comment/story/0,,1869306,00.htmlNow, it's true that she was given FUD about the risks of VBAC: if you have a new-style low incision, VBAC is perfectly safe (assuming that the problems that led to the initial Caesarean don't recur) provided that you are not induced. The risk of complication jumps by several times if you're induced. Otherwise fine. However, she then goes into her own FUD tactics regarding the risks of a Caesarean birth. While some Caesareans are needlessly performed, many are necessary and presenting them in this light is no better than women being "browbeaten" into C-sections. And while I am firmly in favour of women making informed choices, I also know that there are limits to a layperson's knowledge. If my blood pressure stays high, I run a risk of induction and/or C-section. If I am told by a consultant that I should deliver via C-section, I will ask why, ask about the risks, and if I am satisfied with the answers--I'll agree. Accepting a doctor's advice without question may be foolish, but rejecting it when it's well thought out is at least as silly.