Women feel coerced during maternity care in England, charity says | Midwifery
Women feel pressured to undergo medical procedures such as C-sections during maternity care, a report suggests.
The charity Birthrights has collated the experiences of 300 people in England who said they felt or witnessed coercion in a maternity ward.
He said carers used authoritative language that undermined the idea that women could make informed decisions about their maternity care.
Experiences shared in the report include health professionals telling women they must agree to a vaginal exam or they will not be able to be admitted to the birth center, and women feeling pressured to agree to an induction without it being explained why this was necessary.
One woman described feeling pressured to have a cesarean section without being told why it was necessary. “I remember a doctor telling me: you can choose to have a C-section now or you can wait a few hours and I will press this buzzer behind your head and you will have one either way,” the woman said.
Megan Rogerson, a 37-year-old domestic violence specialist from Hull, said she felt forced to have a caesarean section. She said it was never explained why she couldn’t give birth vaginally.
“For my second delivery, I was ready and approved for a VBAC [vaginal birth after caesarean]” said Rogerson. “But when I went to the hospital to have Braxton Hicks, I was told I would have to have a C-section without any conversation as to why. I was just told that I couldn’t give birth that way.
She added: “I felt like I had no choice, I felt like I was being talked to like a child who’s doing something wrong. It was really kind of a demeaning experience. I was just told we couldn’t do this rather than being told why that was.”
Hazel Williams, chief executive of Birthrights, said: “This crucial report documents the rise in coercive practices as a systemic problem across the maternity system, with black and brown women and women who give birth facing the worst attacks on their human rights, choice and bodily autonomy.
“Women and people giving birth are repeatedly told that they are ‘not allowed’ or threatened with referral to children’s services, not given all the facts and denied a truly informed choice. Coercion has no place in safe maternity care and must stop now.”
According to Nursing and Midwifery Council guidelines, women using maternity services should be given evidence-based information to make an informed choice and should be able to end conversations around their care, regardless of why they are doing so.
The law requires clinicians to help pregnant women make their own informed decisions about their care, and if a person is coerced into making a particular decision, this legal standard is violated.
Dr Alison Wright, President of the Royal College of Obstetricians and Gynecologists, said: “The RCOG strongly agrees that coercion and racialized risk profiling have no place in maternity care. However, we know that the extreme pressure maternity services are under creates barriers to staff having time to train, including on the provision of culturally sensitive care, informed choices and consent processes.
“Maternity 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 provide it safely. Therefore, we need to see sustainable investment in maternity services and better support for staff, so that every woman and family can receive the safe, personalized and equitable care they need and deserve.”
NHS England has been contacted for comment.
