Fear in the service: British mothers threatened by social services for refusing maternity care | Childbirth
Pregnant women and new mothers are being referred to social services by midwives for refusing to take their advice, patient advocacy groups have warned.
Prospective parents who have refused treatment, in particular by refusing examinations, refusing inductions or not showing up for prenatal appointments, are among those who have been threatened by health professionals amounting to coercion, according to the Association for the Improvement of Maternity Services (Aims).
“Since the pandemic, our helpline has seen an increase in the number of people threatened or referred to social services for refusing some form of medical care during their pregnancy, even if the withdrawal of inductions, tests or analyzes are perfectly legal and valid choices, ”said Maddie McMahon, a helpline volunteer.
While the problem is long-standing, calls to Aims have multiplied since the Covid-19 crisis, with 5% of requests between April 2020 and March 2021 regarding concerns about a dismissal, real or threatened. Aims coordinator Nadia Higson said: “Often times, the threat of dismissal is used to coerce someone into accepting unwanted care.”
She added that since the start of the pandemic, there had been an increase in the number of cases where threats had been made against those who opted for free childbirth – giving birth without medical staff present by choice – after services were withdrawn. home in some areas – rather than accepting what they saw as the riskiest option of having their baby in a Covid-infected hospital.
The birthrights charity says it has also seen the number of reports on referrals to social services more than double in the past fiscal year.
Rachel Ree of Manchester gave birth at home on December 23 without complications. But on Christmas Day she got a call saying blood samples taken from the umbilical cord for routine checks had been mislabelled and destroyed, meaning she would have to take her baby to the hospital that day. there for a blood test.
“I told them I would not be taking my newborn to hospital during a pandemic for something that was of no use to him – but they said if I refused they would ‘involve another agency’ “she said. “They even said the police would come and take the baby to the hospital.”
Heather Spain wrote an open letter to the midwives, claiming she was “held captive” in a postnatal ward in Wales after her son was born in February. She had been told to stay in the hospital for a new blood test instead of bringing her baby home and coming back later for the test. The 34-year-old said: “Waiting for the test would have meant another night in the hot and noisy ward, where I was completely exhausted and struggling to sleep and take care of my baby without the support of. my partner, who was unable to visit due to Covid-19 restrictions.
Yet when she tried to leave, staff refused to unlock the doors, called security and threatened to call the police, she alleged. She wrote: “There isn’t a day that I don’t wonder …[why] you held me captive with my then four day old newborn baby in the maternity ward, when you initiated the child abduction protocol, which resulted in three male security guards physically blocking my path.
After negotiating with the manager, she was finally able to leave but was warned that staff would be required to report her to social services. “If I hadn’t been alone I don’t think I would have been treated that way,” Spain said. “I think women became more and more vulnerable to such threats during the pandemic because they didn’t have their birth partners to support them.
“I knew they had no legal right to keep me there, but I was shocked to feel so helpless.”
Spain, who is a diplomat and has read a lot on the subject of childbirth after learning she was pregnant, said she felt haunted by the idea of women less able to defend themselves.
Shivalee Patel, from west London, gave birth freely after feeling that trust had broken between her and the midwives in the community. She was reported to Children’s Social Services at 36 weeks pregnant because those assigned to her home birth did not agree with how she intended to handle her labor. “I ended up doing it on my own with my partner, a friend and a birth coach,” she said. “I would also have preferred the support of a midwife, but I didn’t feel safe around her because she wasn’t listening to me.
Maria Booker, Director of Programs at Birthrights, said: “References to social services relate to concerns about how a baby will be cared for after birth. They are not a tool to force women and birth attendants to make different birth choices. “
Leah Hazard, Scotland-based midwife and author of Hard Pushed: The story of a midwife, said it was important not to vilify midwives. She said: “It is never okay to threaten women in social services for a difference of opinion. But I think part of the problem is a broader culture of defensive practice, and perhaps, for some people, it might push them to make decisions that are not in line with their professional obligations.
The Royal College of Midwives (RCM) highlighted the role of the midwife in empowering women to make informed choices during pregnancy and childbirth. He said the ability of midwives to communicate the implications of a particular choice was based on building confidence. But he added: “Serious midwifery shortages are impacting this capacity, with little or no time to develop these important relationships. This is a big concern for the MRC… The reality is that pressures on time and resources mean that communication is sometimes not as clear as it should be and unfortunately some women feel that their wishes were ignored.
RCM has published advice for midwives, including how to support those who opt for an unassisted birth. NHS England said it was up to individual trusts to adopt their own safeguard protocols.