In the company of other young mothers, I mention none of these things. I prefer to stay silent. Partly out of embarrassment and partly out of fear. Embarrassment for the reasons above: I should have shouted louder, demanded more; the answers to my discomfort began and ended with me. Fear, because to criticise the NHS as a mother is tantamount to blasphemy of our national secular religion. And who wants to do that in the company of other young mothers at a playgroup or at the nursery gates? Precisely no one.
Far better to nod politely at the other, well-worn chronicle of NHS childbirth: misty-eyed gratitude, cult-like devotion to the blue logo and the lumpy beds, saccharine sentimentality towards the nation’s midwife, the now-aged NHS. Two years post-Covid, this devotion has become amplified. After the clapping, after Captain Tom, after the thank-you banners, after everything, to dare to come up with a different vision is unwelcome, confusing, maybe. And so I say nothing.
Mothers have long held a complicated relationship with the NHS, which is hardly surprising given what happens to us there. Flooded with hormones and often in extreme pain, for many pregnant women it is their first major hospital visit – and certainly the only time you leave a medical institution having doubled in number. These physiological facts are huge and go some way to explaining the extremes of emotion the NHS incites in us.
Much of this emotion is wholly justified; we are extremely fortunate to receive this care and so much of it is excellent. But we do, I think, need to acknowledge that it is underwritten with a heavy cultural sense of debt to the state for granting us the service. Like all debts of gratitude, it is hard to quantify and even harder to pay off. Our quid pro quo has become enshrined in silence, frozen in pictures posted to Instagram and captioned with heart emojis, even as we may feel secretly devastated.
The Ockenden Review will rightfully begin to challenge the omertà forced on mothers who give birth on the NHS. Led by midwife Donna Ockenden, the report will look into cases – including stillbirths, neonatal deaths, maternal deaths and babies born with brain injuries – that took place at the Shrewsbury and Telford Hospital.
Heartbreakingly, Kayleigh Griffiths and Rhiannon Davies, the bereaved mothers whose tragedies began the investigation, corresponded initially with apology: “I hope you don’t mind me contacting you, and I hope I don’t cause any upset.” Evidence, if any were needed, of the difficulty women have in communicating the messy truths of their experience. Evidence, that we stay silent to our detriment.
The report will challenge other silences of the labour ward, now long overdue. Its findings will report the targets placed upon hospitals to ensure the numbers of vaginal births were far higher than the numbers of medicalised procedures, namely Caesarean sections which are expensive and often deemed “unnecessary”. Mention this fact to a fellow mother and you may get a wry smile.
What you may not get is a true picture of the pressure placed upon women to “pop into the birthing pool”, to “just get on the bouncy ball” or the extent to which mothers are made to feel like they have failed if they have a medicalised birth or dare ask for pain relief. As someone who underwent an extremely medicalised birth, I can attest to the fact that I felt as if I had cheated, as if I had not been glued to my baby with the necessary, natural pain. Was this feeling linked to a bottom line on an NHS spreadsheet somewhere? I can’t say and the doctors and consultants who treated me with expertise certainly didn’t make me think so in the moment. And yet, as a feeling, it persists. It is there whenever I look at my surgical scar.
