Denise and her blog
Is NHS Midwifery Becoming Obstetric Nursing?
There have been plenty of social media posts from midwives and doulas about the parlous state of maternity care in the westernised world. There is an increasing backlash against the catastrophic medicalisation of birth from almost entirely unnecessary and potentially harmful interventions imposed on women, especially around labour onset and progress. Induction rates in some tertiary UK units are as high as 60% (personal communications) whilst UK Caesarean rate reached an average of 42% in 2024, with some units having even higher rates. Indeed, even Elon Musk has commented that Caesareans lead to babies with “bigger brains” although what he may have meant was “bigger heads” due to avoidance of the moulding that occurs in spontaneous vaginal birth. Whether or not he feels that having a larger head is a positive or negative matter is unclear, but it is unbelievable that he should deign to comment on something about which he knows nothing. Parameters of “safe” practice are now being changed negatively, including the “safe” gestation parameters for term, resulting in earlier inductions, or the cutoff point for diagnosing diabetes in pregnancy, leading to stress in women who are told they are “diabetic” yet who would not have been diagnosed as such previously.
More importantly, midwifery practice is changing – in my opinion, not for the better. Students are not witnessing physiological birth and newly qualified midwives lack the confidence (and, I would argue, the competence) to work with women in physiologically normal labour. Midwives are frightened by the perceived “risk” of childbirth and also by the implicit threat of disciplinary action for not following local or national guidelines or by the risk of litigation if they do something “wrong”. This is not helped by the redefinition of “normal” birth that now allows students to count towards their required 40 “normal” births those in which they may not have personally managed the entire labour experience, for example, not managing placental expulsion. It seems that the main reason for this change in the regulations relates to the diminishing rates of physiological birth. Further, the NMC now permits increased hours of simulated practice rather than direct clinical contact with women and babies, presumably because of a shortage of placements for students. Whilst certain clinical skills can be learned in simulation laboratories, there is no replacement for direct clinical contact with service users, all of whom have different responses to procedures, treatments and the whole childbearing experience.
Midwives’ knowledge of anatomy and physiology is deplorable, sometimes to the point of being potentially negligent in clinical practice. This is compounded by the reduction in, and methods of teaching anatomy and physiology to students, presumably to accommodate the extra psycho-social elements of contemporary midwifery practice. This lack of knowledge means that midwives may be unable to detect changing physiopathology early enough to raise concerns, especially in labour, something that is only going to worsen as more and more women are coerced – indeed, emotionally blackmailed – into interventions, notably inductions, with the high risk of a cascade of intervention leading to Caesarean. Universities are reducing the required teaching hours of A&P and the pass marks for assignments, with to my knowledge, some students being given three, four or even five attempts to pass an exam or assignment. It is very saddening to see social media comments by student midwives agonising over the theoretical difficulties of midwifery pre-registration education, many – perhaps most – finding A&P and related subjects such as pharmacology “too hard”. This is extremely worrying – would you want a relative (or yourself) to be cared for by a doctor, midwife or nurse who only knows half of what they need to know because they deemed it “too hard” to learn? If someone wishes to become a healthcare professional – with the emphasis on the word “professional” - then potential midwives need to realise that pre-registration education IS hard and requires an absolute commitment to all elements required to carry out the role.
NHS midwives have completely lost their autonomy and now appear to work almost entirely under the direction of local and national clinical guidelines, including the debatable NICE guidelines, medical instructions and managerial financial, time and staffing constraints. Essentially, they have become obstetric nurses. Much of the work of midwives within maternity units is now more akin to surgical nursing care and administrative duties than the holistic bio-psycho-social focus of traditional midwifery care. I despair of what I see and hear about NHS midwifery (and state-run maternity services in other developed countries). Care of families going through the maternity services is not compassionate and is certainly not physiological, suggesting that it is also not safe. I have very grave concerns for when the time comes for my son and his partner to start their own family and would actively advise them not to have NHS care over which they have no control – what a sad indictment for someone who has been a committed midwife and midwifery lecturer for almost 50 years.
I support entirely those midwives who choose to work independently, however, difficult that may be in terms of fighting the system, obtaining insurance and other trials that come with being self-employed. Perhaps it is time to re-evaluate completely the way in which maternity care is provided in the UK. Increasing numbers of midwives are choosing to work outside the “system” although most no longer provide birth services but focus on enhancing pregnancy and postnatal care with services not generally provided by the NHS, such as individualised preparation for birth, complementary therapies, traditional postnatal care over the first month of the babies’ lives and more. Does this mean that the NHS will provide services in which doctors and nurses manage births, with medicalisation becoming all the more the conventional way of having a baby, leaving midwives to provide psycho-social care during pregnancy and after the birth?
Moxibustion
When a woman has a breech presentation, she’s often eager to avoid an external cephalic version (ECV) or a caesarean section if the baby doesn’t turn.
That’s where moxibustion can be a game-changer!
This simple, inexpensive therapy can be taught to parents, empowering them to do the treatment themselves.
Starting around 34 weeks of pregnancy, it involves using a stick of burning herbs (I know, it sounds unusual!) as a heat source applied to an acupuncture point on the little toe.
This gentle heat helps relax the uterus, increases baby’s movements, and has a success rate of around 68% for turning a breech baby to head-first.
Couples are encouraged to do the treatment twice a day for 5–7 days, which makes it both practical and effective.
Predicting the stages of menstruation
When I was at the University of Greenwich running a degree in Complementary Therapies, I was fortunate to conduct some fascinating research.
My favourite project focused on using reflexology points on the feet to predict stages of the menstrual cycle.
By palpating areas of the feet corresponding to the pituitary gland, ovaries, fallopian tube, and uterus, it’s possible to determine which ovary is active, where the woman is in her cycle, and estimate the onset of her next period.
I’ve taken this research into our Reflex Zone Therapy courses for midwives, teaching how these techniques can be adapted to predict the onset of labour.
While we can’t pinpoint the exact time (it won’t be “4pm Friday”!), we can estimate whether it’s a matter of days or weeks.
It’s evidence-based, incredibly practical—and yes, a little fun!
Schumann Resonance Explained
Work by the scientist, Winifred Otto Schumann in the 1950s revealed that the earth’s energy vibrates at a particular energetic frequency and that the energetic level of humans (and animals) in optimum health is exactly the same as that of the earth. This is measured as 7.83 Hz. Any compromised wellbeing alters the energy frequency measurement, leading to ill health or disease. Other sources of energy (heat) can adversely affect wellbeing, also potentially leading to ill health. Electrical equipment such as TVs, mobile ‘phones, X-rays, microwaves, medical monitors such as CTG machines and more can interfere with the optimum 7.83 Hz energy of an individual. Stress hormones act as a vibrational heat source to agitate the brain (“hot tempered”) and blood (increased risk of clumping of platelets).
Adverse energies can also arise from changes in geopathic stress – volcanoes, earthquakes and global warming – leading to issues such as sick building syndrome and adversely affecting human and animal health.
During complementary therapy, the practitioner acts as a conduit to channel positive energy to aid a return to homeostatic balance – which is why it is vital that therapists are in good health when they are treating clients. This applies whether the therapy is manual, as with massage or reflexology, psychological, for example, Hypnotherapy, or energetic such as homeopathy or reiki. Midwives providing massage or aromatherapy in labour should not be stressed, busy or tired since their increasing negative energy levels can be transmitted to the birthing person, potentially adding to any negative energies arising from equipment, stress levels, noise, movement and light. This is why a quiet, secluded birthing environment is so important for both mother and baby.
The Importance of Touch
How many of you touch women in labour with a caring, nurturing touch?
As midwives, we know how powerful our hands can be.
Did you know there’s evidence showing that massage can significantly reduce stress hormones during labour?
And when stress hormones decrease, birth hormones can do their job more effectively – a win for both mum and baby.
Let’s not forget, massage and oils have been trusted in childbirth for centuries.
This isn’t just a “nice-to-have”; it’s a practice grounded in history and science.
Previous articles
Is NHS Midwifery Becoming Obstetric Nursing?
Moxibustion
Predicting the stages of menstruation
Schumann Resonance Explained
The Importance of Touch
A joyful and Peaceful December
Self-Care For Midwives
Boundaries Of Midwifery Practice
Commitment to Learning: A Rant About Education!
International Labour and Birth Research Conference in Hong Kong
