London anarcha feminist kolektiv has started contributing comment and articles to Freedom Newspaper. Below is our article on the closure of the Albany Midwifery Practice.
Welcome to the first of what will hopefully become a regular feature in ‘Freedom’: news and views from an anarcha-feminist perspective. We’re aware that many of the issues we spend our time and energy discussing (and taking action about) don’t make it into the anarchist mainstream, and that unless we make the effort to share this information, our struggles may remain invisible. We welcome your thoughts and feedback.
Reclaiming Birth, and the Albany Midwives
The Albany Midwifery Practice provided a free service – as part of the NHS – for women around Peckham for over twelve years. As an independent group, based in the community and sub-contracted by Kings Healthcare Trust, the Albany midwives provided individual, continuous maternity care for all kinds of women, including those who are often denied proper choices by the Health Service: working-class women, women from ethnic minorities, those with mental and physical disabilities or with medical risks.
The Albany midwives aimed to provide choice, continuity and control for women, with a philosophy that pregnancy and birth are a normal part of women’s lives, not a medical problem. They would provide information and let women make their own decisions, about their maternity care and the birth itself. They believed that women deserved continuity, so guaranteed access to the same pair of midwives throughout pregnancy, giving them a chance to develop a mutually-respectful, trusting, relationship with each woman before she gave birth.
This type of care is understandably popular with women, and has been proven to result in lower rates of infant mortality, lower rates of caesarian section (less than half the national average), and also much higher rates of home-birth and breastfeeding. 74% of the women using the Albany decided they didn’t need pain relief during labour.
This quality of care is rarely available on the NHS. Although there are some other group practices which operate in a similar way to the Albany midwives, in many areas women have to pay privately if they want this kind of maternity care, which puts it beyond the means of most.
In December 2009, Kings Healthcare Trust abruptly terminated its contract with the Albany midwives, without any consultation ( either with the midwives themselves or those who used their services) or warning (even for those women about to give birth in the next few weeks).
Kings claimed that the issue was one of patient safety, as earlier on in the year a baby had died one week after being delivered by the Albany. Kings commissioned a report from the Centre for Maternal and Child Enquiries (CMACE). They claimed that babies delivered by the Albany Practice at this time had higher rates of “Hypoxic Ischaemic Encephalopathy” ( brain damage caused by lack of oxygen), than those delivered by midwives directly employed by the Trust. These figures have been contested since the outset, with various organisations, including the National Childbirth Trust (NCT), criticising the CMACE reports. Despite requests, the full reports have still not been made public. Although Kings terminated the Albany contract on the grounds of patient safety, they then offered the same midwives jobs within the Trust’s own midwifery service. All of them declined the offer.
The closure of the Albany Midwifery Practice prompted a range of protests, including a large, very vocal, very colourful march and rally in central London on Sunday 7th March. The ‘Reclaiming Birth’ march was called by the Albany Mums Group, both to protest the closure and to push for better, more women-centred approaches to childbirth. It was supported by the NCT, the Royal College of Midwives, the Association of Radical Midwives, Independent Midwives UK, the Alliance for Improvement in Maternity Services (AIMS) and many feminist groups.
If Kings succeed in damaging the reputation of the Albany midwives, this could have serious repercussions on a wider scale. Their model of care has long been recognised as a way of improving outcomes for mothers and babies. Most women in the UK don’t get offered this level of choice, or continuity. Instead, they are only offered an obstetric-based model of care, institutionalised, with high levels of medical intervention and operative deliveries. The choice to birth at home is dependent on the availability of midwives, and unfortunately there is a shortage of midwives. Those already working in the NHS are under-paid and over-worked, and there are not enough staff to provide the quality of care women deserve, let alone set up loads of small group practices like the Albany.
Centralised, industrial-scale obstetric care may be expedient for bureaucrats, but does not allow true choice, and does not equate with a satisfying, safe and empowering birth experience. As public services suffer more cuts, our already over-stretched and under-resourced maternity services are in crisis, and ultimately this is bad news for us all.
For more information on the Albany Midwifery Practice, the CMACE report,and the ‘Reclaiming Birth’ march, visit: www.savethealbany.org.uk.
Another article worth reading: “Industrial Birth”, by Shonagh of Dublin’s Revolutionary Anarchafeminist Group (RAG). www.adbusters.org/magazine/80/industrial_childbirth.html.
Birth – Everyone’s Business
Are you alive? Then you were born.
The way in which you were born affected your immediate chances of survival, the kind of nourishment you would come to receive and your potential for intelligence, growth, health, emotional development and social adjustment. It helped set the relationships you would have with your parents, by either encouraging or preventing their ability to positively bond with you. It was monumentally important in your life – but you probably won’t remember it.
Your mother will. Her experience is likely to have had a profound effect on her. Was it good? Did she feel free, empowered and in control amongst people she loved and trusted? If she did, she was fortunate and more likely to be able to love, care for and breastfeed you thus setting you up for a lifetime of good health and well-being outcomes – providing resilience to the physical, emotional and social challenges of life.
Was your father there? Did he welcome you into the world? Did he feel involved and know his child from the outset? Did he accept you into his heart as his own to love and protect regardless of how life and relationships would progress? Were other parents, family members, friends and communities supported and supportive? Were you all as a family welcomed, provided and cared for in the world? Were you as a baby given the chance to thrive? Because it affected you for life.
Perhaps you have or want children of your own? Perhaps it will happen unexpectedly. Or maybe you hope for a different, better society, or a revolution? For the human race to continue in any form, from utopian to post-apocalyptic, babies will need to be born, parents will need to care for them and communities will need to raise them. How it’s done isn’t just important; it’s integral, and its effects are infinitely wide ranging. It matters, to you, to me, to everyone.
None of us can afford to forget about childbirth, but that’s easily done when we don’t remember it happening to us, and the event itself is hidden away in special secret places, which often provide difficult, negative and traumatic experiences. Lets stop sidelining this as a women’s issue, a health issue or identity politics. It’s huge, it’s vital and we should all be taking an interest and a responsibility for the coming generations.
London Anarcha Feminist Kolektiv