If I were to explain that within six months you would no longer be able to choose a midwife who you and you family could build up a relationship with over 9 months, have a home birth without uniforms and bizzare multi-presence protocol and not be pressured into sonograms you don't need and a birth plan that has your wishes at the centre, you may wonder: "Did I ever have this choice in the first place?" ...
Yes, it is actually possible to birth outside of the NHS and no they didn't invent it! There has always been this choice in the UK, independent midwives (IMs) have worked before, during and after the NHS and state manipulation of midwifery and have provided individual woman centred care for ..well I could say centuries, but to be more exact since time began! Women have always had the option to opt-out of the system and hire (its not as expensive as you would think and therefore not just the reserve of the middle classes as is it is often viewed) a woman to support them during the pregnancy, birth and post natal period. IMs have lovingly dealt with all aspects of fear, trauma, post-natal depression etc. and do so by providing as much time as you need, not a 5 minute slot in an over-run surgery.
Until now that is, independent midwifery (IM) in the UK has been serious threat for around 5 years or so. I won't go into the legislative attack on IMs in this post, much better detail can be found by clicking in this link and also a brief search on the net. But lets say in short that by 2013, unless they work for a supporting company who can provide funding for exorbitant insurance fees rising over the price that any individual could afford (around £80,000 and rising) then its bye bye birthing practice. Their only choice (ahem!) is to join the ranks of the uniformed NHS and do it their way. Nice strategy government body people to populate a dwindling NHS profession - force IMs into your service!! Without that IMs can work as doulas, a noble art and invaluable role to all women and families - but invaluable as support to woman and midwife. It's basically saying "look we know you're qualified, have many years of experience and are more caring than any nameless institutional drone will ever be BUT you just have to watch and you don't get to say when!" Strangely enough a bit like NHS midwives when an obstetrician enters the labour room!
Now before I get too carried away, I wanted to write this post not so much from my usual activist and anthropologist view (although they'll get in there somewhere!), but from a woman and mother's point of view. I write a lot about the problems in Chiapas and Mexico and feel strongly about the treatment of women there, however, I also take great pride in having lived there, married there and started my family there - with the subjective freedom to search out and identify the support and services that I needed. I gave birth to my second child in the UK and although there are just as many stories to the contrary as to support mine - I NEVER WOULD AGAIN if left to the mercy of a public system that has no respect for the divine wisdom and magic of original midwifery. No matter where I am in the world as a woman I know my own body and I know its limits. As a mother I trust in myself and my baby to find our way through together and to listen to what we are thinking/feeling/doing. Whether in a challenged, post-colonial economy or a fucked up British one I feel it should the right of any woman to seek her own education about reproduction, birth, abortion and make her own decisions about what happens with her own body. It should be the right of any woman to birth the next generation in a safe environment with those she loves and respects close by and no stranger touching her who doesn't even bother to ask her, her name.
The current system in the UK is striving to offer women more choice (ahem!) birthing centres next to hospitals, elective caesarean, perhaps a home birth if you, your baby, your home meet the criteria. Whilst activists for reproductive rights are fighting for the right to choose (ahem!) interventions and surgery on the basis that no-one should suffer in modern day (without considering that if most pregnancies and births are taken out of a pathological model and medical birthing environment the 'suffering' would not so much be an issue).
So reading between the political spin and woeful lack of media coverage (as expected on women's health issues) you can shortly feel free to elect for surgical interventions that can lead to long term complications, problems with breast feeding, institutional challenges to follow-up vaginal birth, drugs in yours and your baby's system a big fat scar and an obstetrician who doesn't know your name but may charge you a small fortune when they eventually kill off maternity services from the NHS. BUT YOU CAN NOT FEEL FREE TO choose whom you wish to attend you based on whether you like their personality and approach to pregnancy, get to know your midwife and they you and your family over 9 months, decide where you really want to bring your baby into the world and receive support that enables you to feel empowered and in control of your reproductive destiny so that suffering is not a concept (managing pain yes, suffering no). On rare occasions you may fall into an NHS postcode that supports this type of midwifery practice in the system, but that's not a choice (ahem!) its the luck of the draw - lucky you!
Midwives are amazing and many in the system are just as amazing as those outside it, but here in my country of origin I don't get to decide any more which one I want to allow into the most personal, naked, precious moment of my life and I am no longer able to say please don't put your fingers inside my vagina stranger person as I do not wish to have an internal examination if you show me I can do it myself......quite frankly that sucks!