Women feel coerced during maternity care in England, charity says | Midwifery
Women feel pressured to have medical procedures such as caesarean sections during their maternity care, according to a report.
The charity Birthrights compiled the experiences of 300 people in the UK who said they felt or witnessed pressure in the birth environment.
She said caregivers used authoritarian language that undermined the idea of women being able to make informed decisions about maternity care.
Experiences shared in the report include healthcare professionals telling women they had to agree to a vaginal examination or they would not be able to admit them to the birthing center, and women feeling pressured to agree to an induction without being explained why it was necessary.
One woman described feeling like she had to have a caesarean section without being explained why it was necessary. “I remember the doctor telling me: You can choose to have a C-section now, or you can wait a few hours and I’ll press the buzzer on the back of your head and you’ll still have a C-section,” the woman said.
Domestic violence practitioner Megan Rogerson, 37, from Hull, said she felt compelled to have a caesarean section. She said it was never explained why she couldn’t have a vaginal birth.
“I was fully prepared for my second birth and was approved for VBAC [vaginal birth after caesarean]Rogerson said: “But when I went to hospital with Braxton Hicks, I was told I would be scheduled for a caesarean section, without any discussion about the cause. I was told I couldn’t give birth that way.”
He added: “I felt like I had no choice, I felt like I was being talked to like a child who had done something wrong. It was a kind of belittling experience really. Instead of being explained why that was the case, I was told we couldn’t do it.”
Hazel Williams, chief executive of Birthrights, said: “This important report documents the rise in coercive practices as a systemic problem across the maternity system, with black and brown women and birthing people facing the worst attacks on their human rights, choices and bodily autonomy.
“Women and birthing people are constantly told they are ‘not allowed’ or threatened with referral to children’s services, not given all the facts and denied true informed choice. Coercion has no place in safe birth care and must stop now.”
According to guidance from the Nursing and Midwifery Council, women using maternity services should be provided with evidence-based information to make an informed choice and should be able to close out conversations about their care, regardless of their reasons for doing so.
The law requires clinicians to support pregnant women in making informed decisions about their care, and this legal standard would be violated if a person was coerced into making a particular decision.
President of the Royal College of Obstetricians and Gynecologists, Dr. Alison Wright said: “The RCOG absolutely recognizes that coercion and racial risk profiling have no place in maternity care. However, we know that the extreme pressure maternity services are under creates barriers to staff making time for education, including culturally sensitive care, informed choice and consent processes.
“Birthing staff need time and space to have conversations that help them understand what each woman wants for her pregnancy, labor and birth, and how best to deliver that safely. That’s why we must see continued investment in maternity services and better support for the workforce so that every woman and family can receive the safe, personalized and equitable care they need and deserve.”
NHS England has been approached for comment.
