This guest blog was written by Jo Dagustun, Greater Manchester birth activist
23rd August 2017
Following the publication of Better Births (the 2016 National Maternity Review report), each area across England is now in the process of drawing up a 5-year maternity service vision and transformation strategy. The clock is ticking: these strategies should be agreed in the Autumn, with more detailed action plans following soon afterwards.
Worryingly, however, signs are emerging that some local maternity systems are seemingly reluctant to sign up in full to the Better Births vision and recommendations. Instead, ongoing discussions in some areas suggest that the feasibility, affordability and even the desirability of the Better Births vision and its clear recommendations are up for debate.
In this context, I would like to pose the following question: is there any reason why Local Maternity Systems should not adopt the Better Births vision and all its recommendations IN FULL as a minimum to drive local strategy work?
Yes, of course we know that the HOW will be affected by the local context, and in some very specific situations it is possible that agreement might be reached that some limited modifications might be acceptable. But I would like to suggest that it would be a big mistake for local activists to confuse the need for specific local action plans with actions which undermine local commitment to the Better Births recommendations.
We need to stand firm. We have always known that the agenda for change set out in Better Births would be highly challenging for existing service providers. It is meant to be. It represents an ambitious demand for a shift in the power relations of maternity services, one which has been fully evidenced both by the best available scientific research as well by a careful exercise in which the voices of a huge number of women and families around the country were heard. But we also need to be clear about one more thing: it does not represent an agenda that is infeasible nor unaffordable, and it is important for activists to avoid being dragged (or even seduced) into debates which seek to suggest any different.
Rather, I would urge all birth activists across England to play an active role in ensuring that the Better Births vision, and its recommendations, are accepted in full in each of our local areas, as the core of local transformation strategies. In full is important, because the individual recommendations are designed to work together as a package: each is necessary for the successful delivery of the others.
Now is the time – as local areas develop 5-year maternity transformation strategies and action plans – for the united voices of birth activists in every area of the country to be heard loud and clear. Let’s make co-production more than just a buzzword in maternity services. Local activists – including service user representatives, doulas, antenatal educators, midwives, scholar-activists and indeed everyone else with a keen interest in improving maternity services – must come together and decide whether they are willing to become the ‘guardians’ of the Better Birth vision and recommendations. For without our ongoing support, they are bound to fail.
Implementing Better Births: key actions for birth activists now
- Issue The Better Births vision for maternity services should be at the core of local strategies
- How will we know if this is the case? Each of the Better Birth recommendations aimed at providers and CCGs should be replicated in local strategy documents and local action plans
- How can we help achieve this? By working together to scrutinise and give feedback on draft strategies and action plans. If you are not already in the loop on what’s happening in your local area, then looking up your local Maternity Voices Partnership (MVP) might be a good start. (Every area across England should by now have service user representatives at the decision-making table, and often this will be led by the local network of MVPs.)
Better Births recommended a transformational change in the way in which maternity services are designed and delivered. No-one seriously underestimates the challenges that will be involved in bringing about such transformation. But women, their babies and their families – in every area of England – deserve no less.
Jo Dagustun is a social geographer and has recently completed a PhD on women’s skill and knowledge about birth, especially as it develops over their childbearing careers. Mum of four and AIMS member, Jo is currently working with the Greater Manchester and East Cheshire Maternity Voices Partnership (MVP) network. Jo would be pleased to hear from doulas about how Better Births is being implemented in their local areas, either via the comments section below or by email to jdagustun@hotmail.com.
