UK Health Secretary promises broader childbirth choice

On the 8th June 2010, the Rt Hon Andrew Lansley CBE MP, Secretary of State for Health, set out his ambition for "patient-centred care".

I really don't wish to speak too soon, but I can't help feeling very excited about the tone and content of the Health Secretary's comments on maternity care, and in particular, choice for women.

For too long, maternity groups in the UK have been obsessed with focusing on choice in terms of where a woman gives birth - at home, in hospital, in a midwifery-led unit - and women like me have been crying out to have our voices heard too.

HOW (e.g. vaginal or cesarean delivery) we give birth and WITH WHOM (e.g. midwife or obstetrician) are equally valid choices. See what you think when you read the extract from Lansley's speech below, and rest assured that I will be following this up and continuing my campaign to ensure that a woman's legitimate decision to have a planned cesarean at +39 weeks' gestation is one day supported throughout all NHS hospitals.

"And what about the relationship of information to choice? The expectation of choice has been a feature of maternity services going back to Julia Cumberlege’s 1993 report, “Changing Childbirth”. But choosing between a home delivery, a midwife-led service and an obstetric delivery is a limiting concept of choice.

Mothers-to-be should have information about the different aspects of maternity care including choices of location, but also issues like pain-relief, choice of providers as well as risk assessments – because not all choices will be appropriate or safe for all women. They should have the ability not only to compare key aspects of care, like continuity of midwifery support and one-to-one midwifery support in labour; but they should also be able to see what other mothers’ experiences have been and to hear their views of the safety and quality of care.

Mothers must have this information not only to exercise choice when originally booking their maternity care, but to be able to be in control of their childbirth, exercising safe choices at each stage.

Because, like that process of choice, listening to patients is at the heart of what we should be doing.

And listening to patients – asking, reporting, and learning from patient experience – will be of great importance in designing and improving services, including achieving greater efficiency. Just look at the high levels of patient-reported satisfaction in productive wards."

He concludes:

"Reform has stalled. Targets have trumped quality. On too many key areas our health outcomes lag behind our European neighbours.

We need change. We need to set the service free to deliver high-quality care, based on evidence of what works. Accountable for results. Answerable to informed and engaged patients. Focussed on what matters most to those patients – safe, reliable, effective care. The best care for each patient and the best outcomes for all patients.

That is my ambition, and I have been delighted today to be able to share it with you.

Thank you."