Women's Decision-Making And Factors Affecting Their Choice Of ...
Women's Decision-Making And Factors Affecting Their Choice Of ... Women's Decision-Making And Factors Affecting Their Choice Of ...
discerning of women's desire for continuity of care and carer throughout pregnancy and childbirth. The government responded to the specific recommendations and conclusions of the Winterton report, and set about addressing wider issues in the organisation of maternity care. A report of the government's response was published (Department of Health 1992). A departmental task force was established, which set up a number of studies to address issues such as team midwifery (Wraight, Ball, Seccombe et al 1993) and midwifery-led and GP-led units (Department of Health 1993a). Of more relevance to the present discussion, the Expert Maternity Group was set up to review policy on NHS maternity care, particularly during childbirth, and to make recommendations. The work of the Expert Maternity Group, also known as the Cumberlege committee, will be discussed next. The Cumberlege Report (1993) The Cumberlege Report, commonly known as Changing Childbirth, (Department of Health 1993b) is a result of work done by the Expert Maternity Group that was established in October 1992 under the chairmanship of Lady Cumberlege, Parliament Under Secretary of State for Health. The members of the committee included women using NHS services, professionals providing the service such as a Midwife, General Practitioner, Obstetrician, Paediatrician, Midwifery professor as well as other members of the public such as a National Childbirth Trust representative, a journalist, and a management consultant. The report is considered a document for change, while the Winterton report (House of Commons Health Committee 1992) mapped the future of maternity services. 23
The Expert Maternity Group gathered evidence from a wide range of organisations, professional groups and individuals interested in maternity care. Women using the service gave oral evidence, while anaesthetists, general practitioners, midwives, obstetricians, paediatricians, other health professionals, and professional and other organisations gave written evidence. As an integral part of gathering evidence the group visited consultant maternity units, small maternity units, and midwifery schemes. In addition to information provided by known organisations and groups, the committee wanted the views of others not linked to such groups. They therefore commissioned a study by the Market and Opinion Research Institute (MORI) of mothers who had given birth in England since April 1989. The survey found that most women felt they were given little choice about the place of birth. The majority reported that delivery in a consultant unit was the only option fully explained to them. Ninety-eight percent of women gave birth in an obstetric hospital, and 72% would have appreciated a choice. Of those wanting an alternative, 22% would have considered a home birth and 44% a midwife-led domino delivery. A consensus conference was organised for the Department of Health by the Kings Fund Centre, a policy research group, to help explore the issues further. The conference panel produced a consensus statement, highlighting women's wishes for a safe and kind maternity service that offers continuity of care and carer, inspires confidence, responds to individual needs, and enables women to feel in control. The service must also make possible informed choice about the available options. The panel felt that professionals had no right to arbitrarily impose their views even when the women's views contradicted theirs. 24
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The Expert Maternity Group gathered evidence from a wide range of<br />
organisations, professional groups and individuals interested in maternity care.<br />
Women using the service gave oral evidence, while anaesthetists, general<br />
practitioners, midwives, obstetricians, paediatricians, other health professionals,<br />
and professional and other organisations gave written evidence. As an integral<br />
part of gathering evidence the group visited consultant maternity units, small<br />
maternity units, and midwifery schemes.<br />
In addition to information provided by known organisations and groups,<br />
the committee wanted the views of others not linked to such groups. They<br />
therefore commissioned a study by the Market and Opinion Research Institute<br />
(MORI) of mothers who had given birth in England since April 1989. The survey<br />
found that most women felt they were given little choice about the place of birth.<br />
The majority reported that delivery in a consultant unit was the only option fully<br />
explained to them. Ninety-eight percent of women gave birth in an obstetric<br />
hospital, and 72% would have appreciated a choice. <strong>Of</strong> those wanting an<br />
alternative, 22% would have considered a home birth and 44% a midwife-led<br />
domino delivery.<br />
A consensus conference was organised for the Department of Health by<br />
the Kings Fund Centre, a policy research group, to help explore the issues further.<br />
The conference panel produced a consensus statement, highlighting women's<br />
wishes for a safe and kind maternity service that offers continuity of care and<br />
carer, inspires confidence, responds to individual needs, and enables women to<br />
feel in control. The service must also make possible informed choice about the<br />
available options. The panel felt that professionals had no right to arbitrarily<br />
impose their views even when the women's views contradicted theirs.<br />
24
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