Max Pemberton: How did we allow maternity care to become so broken that the miracle of birth is now fraught with danger and fear?
The birth of a new baby should be a time of joy and celebration and yet, increasingly, women are finding it one of lasting trauma and distress.
Talk to mothers today and you'll find that so many of them either had, or knows someone who has had, an atrocious experience giving birth on an NHS maternity ward. And I'm not just talking about those tragic cases where women haemorrhaged to death or serious complications occurred during the birth that left the baby disabled.
Far too often women on maternity wards are viewed as an irritation by the staff — something that gets in the way of the smooth running of the service, forgetting that the service is there to provide care.
At their most nervous and vulnerable, these patients are treated with contempt, their concerns dismissed, their pain ignored by rude and uninterested midwives and doctors.
A damning report published last week on maternity services means that we can no longer dismiss bad care as rare.
The UK's first parliamentary inquiry into birth trauma found there is 'shockingly poor quality' in maternity services and that good care was 'the exception, rather than the rule'
On the contrary, it appears to be endemic. The UK's first parliamentary inquiry into birth trauma found there is 'shockingly poor quality' in maternity services and that good care was 'the exception, rather than the rule'.
It heard evidence from more than 1,300 women, including new mothers who had been left to lie on blood-soaked sheets for hours and others berated by midwives for having soiled themselves.
One woman carrying twins who went into premature labour at 19 weeks was told by a consultant to stop getting upset after she lost the first baby.
The woman told the report, 'His words were 'the baby was dead a long time anyway, so you should stop stressing over it and let's try to save the other one'.' The second baby also died. I read the findings with mounting anger and despair.
My own friends have told me of the appalling care they've received while giving birth in NHS hospitals. One — a doctor — was scolded for arriving too early despite being sure she was in the latter stages of labour.
The midwife didn't examine her and physically pushed her out of the door. She went home, ran a bath and realised she could feel the baby's head. She got in a taxi and as she walked into the hospital, fell to the floor and delivered her baby in the corridor.
The same midwife then had the audacity to angrily chastise her for the mess in the corridor. Another friend — also a doctor — was told she'd need a hysterectomy or she'd die after the midwife couldn't remove the placenta and she started bleeding profusely. My friend, despite being scared and distressed, insisted someone senior attend, who then promptly removed the placenta and stopped the bleeding in a matter of minutes.
How did we allow the system to become so broken that the miracle of birth is now fraught with danger and fear?
In my role I have visited maternity wards to check patients' mental wellbeing and have spoken to many new mums who were severely traumatised by their experiences.
Being in agony for hours and denied the pain relief they begged for was the most common complaint. The emotional impact of this can be profound. A previous report by NHS watchdog the Care Quality Commission (CQC) found one in four women reported being left alone in labour while anxious, with almost half saying they weren't given enough support after the birth.
All this is happening despite the fact we know that women who are anxious or stressed are more likely to have complications giving birth, and to develop postnatal depression.
Going private is prohibitively expensive so that is not an option for most people. And besides, it is not necessarily any safer. Many private maternity units lack the resources to deal with complex emergencies, so if things do go wrong for either mother or baby, they are generally blue-lighted to the NHS anyway.
Despite the maternity care crisis I do also have a lot of sympathy for the staff working in these conditions who are stretched to breaking point and unable to give every woman the attention she needs.
It's why I often advise friends and family to employ a doula if they are giving birth in an NHS hospital — a non-medical professional who assists the pregnant woman and advocates for her before, during and after labour.
They shouldn't be necessary, of course; no mother-to-be should be forced to pay for someone to stand up for her rights and ensure she gets half-decent care.
How did we allow the system to become so broken that the miracle of birth is now fraught with danger and fear?
In the UK, 44 per cent of adults look at their phone every hour — more than the French and Americans. We often berate youngsters for being glued to a mobile, but with so many parents modelling bad behaviour, it's no wonder children copy them.
Weight loss shouldn't be judged
American singer Kelly Clarkson has finally admitted that weight-loss injections have helped with her dramatic physical transformation — after previously insisting it was simply the result of a low-carb diet and walking.
It's not just celebrities who don't come clean. I've been surprised by how many people dare not tell friends or family they are using the likes of Ozempic and Wegovy.
American singer Kelly Clarkson has finally admitted that weight-loss injections have helped with her dramatic physical transformation
They feel a sense of failure and shame in resorting to medical help, a feeling often fuelled by some doctor's attitudes. There's a sense that people have to 'suffer' to lose weight and that jabs are 'cheating'. We don't apply this logic elsewhere — no one says the same about nicotine replacement therapy for smokers.
These medicines offer real hope to those who have struggled with their weight for years. We know the devastating effects of obesity. Enough of the judgment. We should be congratulating anyone who is motivated to lose weight, regardless of how they do it.
I work near University College London and walked past the pro-Palestine camp on the main quad lawn.
A friend is a lecturer there and said how shocked she was that so many of those supporting the movement were LGBT+ and women — despite the appalling human rights record of Hamas for these groups.
My friend is a staunch feminist and while she is appalled at the horrors happening in Gaza, she understands the war is in response to the absolutely barbaric attack that took place on October 7. There is something especially bizarre about the 'Queers For Palestine' movement and I can only assume there is considerable cognitive dissonance going on — the psychological term for the process by which people reconcile inconsistencies in their logic.
How can they be vehemently pro-LGBT+ and women's rights yet also show apparent support for a regime run by gay-hating, murderous misogynists? It requires extraordinary mental gymnastics to square the circle and, as with all cognitive dissonance, part of this involves consciously ignoring or dismissing inconvenient facts in order to hold their illogical position. They deflect and rely on rhetoric and ideology and seek out information that supports, rather than contradicts, their argument.
It must surely help that they never have to deal with Hamas's hatred personally.
Dr Max prescribes... Poignant Book by psychiatrist
Lifting the lid on life as a psychiatrist, You Don't Have To Be Mad To Work Here by Benji Waterhouse manages to walk a fine line between being funny but also touching and, at times, incredibly sad. A love letter to both psychiatry and the patients we care for, the author's humanity and devotion shine through.
You Don't Have To Be Mad To Work Here by Benji Waterhouse manages to walk a fine line between being funny but also touching and, at times, incredibly sad