Wednesday, October 23, 2013

The Winterton and Cumberlege Reports

During the Parliamentary Session of 1991-1992, the Health Committee of the House of Commons conducted an investigation into Maternity Services in the United Kingdom. Under the chairmanship of Nicholas Winterton, MP, the Committee heard the views of midwives, obstetricians, pediatricians, GPs, health and social services administrators, dieticians and neonatal nurses. Most importantly, the Committee also listened to many women who spoke about their own experiences of the maternity services or who represented other women who had used or would use them in the future. Representatives of The National Childbirth Trust, the Maternity Alliance, the Association for Improvements in Maternity Services, the Stillbirth and Neonatal Death Society and the Society for Support after Termination for Abnormality spoke at length to the Committee about the kind of care they felt women wanted during pregnancy, when they were in labour and in the early days and months of parenthood. A 130-page summary of the Committee's findings was published at the beginning of 1992. It stressed repeatedly that health professionals should not presume to know what is best for any individual woman, but confine themselves to the task - a very important one - of providing information to help women make their own decisions about the kind of care they want. The Health Committee stated that midwives should be the key professionals to care for the vast majority of women who have perfectly normal pregnancies and births and that obstetricians should only look after the few women who have complicated pregnancies. The Committee decided there was no evidence to suggest that home birth is unsafe for healthy women and asked health professionals to ensure that every woman knows she has the right to choose to have her baby at home.

Following the publication of what became known as the Winterton Report, the Government set up an Expert Maternity Group to consider the Report's findings. This group was chaired by Baroness Julia Cumberlege and published its own Report in 1993 entitled Changing Childbirth. It is a much shorter document than the Winterton Report and far more readable; you should be able to see a copy of it at any central library.

The essence of Changing Childbirth is captured in the three 'Cs': Choice, Control and Continuity:
CHOICE: a woman should be able to choose the type of care which she feels is best for her (for example, home birth or hospital birth; to receive maternity care from midwives or doctors).
CONTROL: she should feel in control of what is happening to her because she is able to participate in decisions about her care.
CONTINUITY: She should be able to get to know a small group of health professionals during her pregnancy who will care for her until a few weeks after her baby is born, rather than having to meet a different professional at every stage of her maternity care.

Changing Childbirth is an exciting and revolutionary document. It constitutes a Bill of Rights for childbearing women. Maternity services are now being planned in accordance with its recommendations and women should soon be able to have more say in their care than they have ever had before.

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