Worrying statement by RCM's new President

"...midwifery led care is safe and is associated with a lower intervention rate and is more cost effective than care by a team of doctors and midwives gives an impetus to developing more midwifery led care including out of hospital care. Perhaps it is time for this to be the default path for healthy women."

This is an extract from a statement by Professor Lesley Page (my bold), who is the new President of the Royal College of Midwives.
Readers of this blog will know that I am deeply concerned about the push for all women with 'low risk' pregnancies to be 'encouraged' to give birth in midwife-led birth centres, and the presentation of homebirth as being of equal risk to birth in hospital.

I support birth choices, and the RCM press office assures me that that it supports choice too (including maternal request cesareans), but it makes me very uncomfortable (as did a number of quotes from RCM members during recent obesity link articles) to read something so prescriptive as a "default path for healthy women". What about healthy women who would prefer obstetrician-led (or at least obstetrician-present-on-the-ward) care? Or women who want a cesarean? What does this statement say to them?

You may or may not share my concerns, but to help you make up your own mind, here is the link to Lesley's statement in full: "Midwives hold the future"


"Midwives hold the future of mother, baby and family at every contact with a woman and her baby and family. Midwives may make a difference between life and death for the baby and mother, to a healthy start to life and motherhood, to the woman and her family feeling strong and confident and ready to take on the long term commitment of parenting.

Midwives hold the future of the profession at a time when there are many opportunities: recent evidence that midwifery led care is safe and is associated with a lower intervention rate and is more cost effective than care by a team of doctors and midwives gives an impetus to developing more midwifery led care including out of hospital care. Perhaps it is time for this to be the default path for healthy women.

Midwives hold the future of the profession in their hands at a critical time when they take on the fight against too few midwives, poor pay and conditions of service, and find ways of developing services that support good midwifery and encourage professional growth and learning so that there is a future midwifery profession.

Midwives hold the future if they are united by organising in trades union and professional organisations to bring greater power to influence government and policy, develop knowledge and understanding,  and for protection of maternity services and midwives.

I have been elected as president of the Royal College of Midwives and will take office on April 2nd 2012.."