‘Normal birth drive’ criticism removed from maternity report, expert claims

A review into maternity safety in England was changed just days before publication to remove criticism of a “normal birth drive”, according to a former member of the inquiry team.

The campaign, which encourages vaginal birth without any medical intervention and is backed by many midwives, has been found to have contributed to avoidable deaths and harm in other reviews.

But Dr Bill Kirkup told the BBC that similar criticism was removed from the government-commissioned review, forcing him to resign.

“I don’t think it’s right that we should push this under the covers,” he said. “This is a patient safety danger and I think it should be called out as such.”

Asked to respond to his remarks, Baroness Amos refused to comment.

The National Maternity and Neonatal Investigation report was published on Tuesday.

Examining care across England, it found that women were repeatedly not listened to by maternity services.

One of its key recommendations – that the government appoint a maternity commissioner to drive improvements – has been accepted by ministers.

Many campaigners were, however, surprised that the review concluded that a “normal” birth agenda was not a contributory factor to poor maternity outcomes.

Between 2007 and 2017, the Royal College of Midwives told its members to encourage women to have a vaginal delivery without any medical interventions, such as pharmaceutical pain relief or forceps, for instance.

It argued that such a birth was better for women and babies. But its practice – which sometimes encouraged women to stay at home when they needed medical attention or denied caesarean sections – has been criticised in several reviews as contributing to avoidable deaths and harms.

Writing last year, the former Health Secretary Sir Jeremy Hunt said that “the language, and the thinking behind it, is still alive.”

Dr Kirkup chaired maternity reviews in Morecambe Bay and East Kent, and found the practice caused harm in both areas. His inquiry into Morecambe Bay for instance found midwives were pursuing normal birth “at any cost.”

Investigators working for the Amos review, he said, had found evidence “that it was still an issue, at least in some places.”

He told the BBC that “a significant number of people” had signed off a version of the report that included criticism of normal birth but that eight days before its publication, “it disappeared.”

Given the evidence, Kirkup felt he had to resign. “We ought to acknowledge that this is a problem, and that it’s got patient safety implications for mothers and babies,” he said.

“I think it needs daylight shining on it and then we can have a proper conversation about why this sometimes happens and how we make sure that it doesn’t keep on happening.”

Kirkup said he wouldn’t discuss how the changes had occurred but that “I think she [Baroness Amos] has listened to the wrong voices on this particular issue.”