Lesley Page
King's College London and UTS and Griffith University
President the Royal College of Midwives for over 5 years till June 2017. Many publications and keynote presentations over the world. Extensive global work. Combined leadership, academic work, management and hands on practice for much of my career. Practised in obstetric Units and midwifery led care including at home births.
Support for normal birth is critical to safe high quality maternity care. Support for normal birth is also included in much of current maternity services policy and national clinical guidelines. Despite this, rates of normal birth are decreasing, and there is pervasive resistance to normal birth. It has been claimed that women and babies need protection from the dangers of normal birth ideology, and there has even been a move to control the language of normal birth. In no other field of health care would there be a responsible resistance to the evidence based reduction of unnecessary interventions, support for physiological processes, and positive experience of care.
Drawing on strong evidence of the risks of over medicalization of birth, and evidence of the importance of support for normal birth to quality of care, reasons for this resistance will be explored drawing on theories of medicalization of maternity care. These theories explain for example why support for normal birth and positive experience is treated as though it were deviant.
The humanisation of care is a response to medicalization and will provide a way of extending access to normal birth, and normality for those women with more complex care needs, in the context of human, respectful, and institutional support. Theories of medicalization and humanisation will be described.
It is not enough to increase rates of normal birth by cutting intervention rates, support and intensive education for support is critical. While intuitively we may expect humanisation of care to be valued, it is, paradoxically, very political and is often resisted. The opportunity for support for normal birth, that is critical to humanisation, is also a highly political issue.
Against a background awareness of the political nature of resistance to normal birth, the presentation will map a path to humanised and high quality care that optimises health, including the chance of normal birth, drawing on evidence, practice, organisation and effective change.
Preferred presentation: oral
