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The Guardian - UK
The Guardian - UK
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Zoe Williams

Maternity care in England is in a doom loop – how has it come to this?

A pregnant woman in a green shacket cradles her bare belly, standing near a kitchen window
Childbirth has changed hugely over the last few decades. Photograph: Posed by model; shurkin_son/Getty Images

The classic way to outrage someone who’s pregnant is to touch their stomach without asking. I would never do that and it never, back in the day, happened to me – but I always thought, as outrageous as it might hypothetically be, that it also stood as a vivid analogy for the generalised social intrusiveness you get while you’re visibly pregnant. Endless questions about how you’re feeling, when you’re due, what hospital you’re going to, whether it’s a boy or a girl, how much time you have off. I hated this interrogation 20 years ago, but now I do it on a reflex; some driving force of human fellowship makes me want to know. I realised mid-sentence, asking a stranger about hospitals – and replying “That’s a great hospital, my sister had her kids in there” – that it must be even more grating than it was in the 00s. My nieces are 19 and 21 now, and that great hospital, unless it’s magically unconnected to the rest of the NHS, has probably changed quite a lot.

The NHS Alliance has announced that up to 20 of the country’s 155 smaller, consultant-led maternity units, mostly in rural or coastal areas, might have to close, since their safety is in question. The problem – which will seem very pressing and obvious to anyone about to give birth, yet quite abstract and manageable to anyone who isn’t – is that those areas aren’t teeming with alternatives. There are women in Devon whose maternity hospital has been temporarily closed, whose next nearest hospital is 53 miles away. Do they even encourage people to write a birthing plan any more? Because nobody’s, surely, would start: “First, I’d like to spend 90 minutes in a car, yelling at my birthing partner.”

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